Canine Liver Disease And Tylenol Overdose Retrobulbar Hematoma Risks

PDF Acetaminophen Toxicity

ABOUT THE DISEASE Acetaminophen is a pain reliever and fever reducing medication. Acetaminophen is highly toxic to both canine and feline patients. Ingestion of acetaminophen can ultimately lead to severely low red blood cell count and liver failure. Feline patients are more sensitive than dogs and will show signs of toxicity with lower doses.

Dogs with liver or kidney disease are also at a higher risk , as their bodies are less efficient at eliminating toxins. Additionally, concurrent use of other medications can interact with acetaminophen, increasing its toxicity.

Drug-induced liver injury (DILI) is an underrecognized cause of hepatic disease in dogs and cats. Successful identification of cases requires an initial suspicion by the practitioner, a thorough drug exposure history, and knowledge of the toxic potential for common veterinary drugs.

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In dogs, acetaminophen poisoning can cause elevated liver enzymes and progress to liver failure, while in cats, it causes an abnormal ability for red blood cells (RBCs) to carry oxygen (due to methemoglobinemia), resulting in life-threatening low oxygen levels.

Acetaminophen Toxicity in Dogs

Dogs exposed to acetaminophen are likely to develop liver damage at lower doses and red blood cell changes at higher doses. Small breed dogs may also be at risk for decreased tear production (dry eye) secondary to acetaminophen poisoning. Dogs can develop liver damage within several days after ingestion of small doses of acetaminophen.

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Hemorrhage was observed in multiple organs and was considered consistent with coagulopathy secondary to liver failure. Acetaminophen toxicity is dose-dependent, and suspicion of intoxication is based on the presence of methemoglobinemia, hemolytic anemia and acute hepatic failure.

Acetaminophen Poisoning Alert for Dogs and Cats

What are the signs of acetaminophen poisoning in dogs and cats? Dogs and cats may develop liver damage and changes to red blood cells, depending on the dose. Cats are more likely to develop red blood cell changes that interfere with the blood's ability to provide oxygen to cells and tissues, followed by delayed liver damage.

High doses of acetaminophen result in glutathione depletion in the liver and red blood cells, which raises concentrations of N-acetyl-p-benzoquinoneimine. N-acetyl-p-benzoquinoneimine binds covalently with amino acid residues of cellular macromolecules and proteins, and results in cell death and tissue necrosis.