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Dr. Altman
Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 12085
Experience:  Practicing small animal veterinarian for 17 years.
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Dog just got into a bottle of prednisone prescribed for his

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Dog just got into a bottle of prednisone prescribed for his Addison's disease. They are 1mg pills, but he may have eaten up to 40mg or so. I am not sure because I found some on the floor and couldn't find all of it. But that is the most I am guessing it could have been considering how much was initially in the bottle. He weighs 16 lbs and is a yorkie-poodle mix. Has Addison's disease and is on DOCP every 25 days as well as 2.5mg prednisone daily. What should I do? Can I induce vomiting with hydrogen peroxide?

Dr. Altman :

Welcome! I am Dr. Altman, a licensed veterinarian and happy to answer your questions today.

Dr. Altman :

If it has been less than an hour yes I would induce vomiting with 3% hydrogen peroxide 1 & 1/2 teaspoons and walk him around to mix the peroxide in his stomach to agitate the lining

Dr. Altman :

If no vomiting in 10 minutes please repeat

Dr. Altman :

The dose of steroids he could have ingested can cause some issues with the stomach and cause ulceration and even perforation so we want to get this out asap

Dr. Altman :

If no vomiting within 20 minutes I would strongly advise going to a veterinary er where they can give stronger medication such as apomorphine to induce vomiting and give oral activated charcoal to minimize the absorption of the steroids

Dr. Altman :

I will monitor for your entry to the chat and will wait while you administer the peroxide

Dr. Altman :

You can use a turkey baster to get the peroxide in more readily or a syringe if you have one

Customer: Ok going to go try it now. Thank you!
Dr. Altman :

You are welcome

Dr. Altman :

Please keep me updated...

Dr. Altman :

Positive thoughts for Charlie

Customer: Ok just had 4 successful "vomits". It had some undigested kibble. No sign of plastic from bottle. No solid pills but I'm guessing they would have been dissolved?
Dr. Altman :

Yes you would expect to see white goo in there. Is there any signs of that?

Customer: Oh and the last time he ate was about an hour ago (probably right before he got into the pred)
Customer: Yes lots of white goo
Dr. Altman :

OK good

Dr. Altman :

Well there are two options now

Dr. Altman :

One is to not give another dose tonight and give an antacid in about 30 minutes to try to protect the stomach

Dr. Altman :

Or go to the er to give activated charcoal as a precaution in case there are still enough to cause ulceration of the stomach that has already passed

Customer: He's still having a few vomits, and it's all white and gooey. What should I do next? What should I watch for?
Dr. Altman :

If he ingested 16 mg or 16 pills were digested that would be the maximum for his size

Dr. Altman :

If you think he likely brought up more than that and less than 10 pills remain then you would be alright

Dr. Altman :

I would not feed for a few hours

Dr. Altman :

Do you have pepcid or prilosec at home?

Dr. Altman :

Go ahead and give him 1/2 tablet pepcid (10 mg) in about an hour or prilosec (20 mg) 1/2 tablet if this is what you have

Dr. Altman :

This will hopefully help protect his stomach a bit to minimize the gi upset

Customer: Ok. I'm doubting he ate that many as there was a lot on the floor.y problem was that I couldn't have any way of knowing how much was originally in the bottle.
Dr. Altman :

I would also give him a meal in a few hours with white rice and half his normal dinner

Dr. Altman :

Is there a date and quantity on the bottle?

Dr. Altman :

And you give #2.5 tablets daily ? So we can estimate how many were in the bottle

Customer: It was 9/24 for 90 pills. He had been getting 3 a day, because we were tapering down to a lower dose, but that's what he was getting. And I found probably 20 pills on the floor
Dr. Altman :

When did you taper from the three/ day?

Customer: I just stared the 2.5 mg yesterday from the taper
Dr. Altman :

OK give me one moment to look at a calendar to see if I can give an approximation of how many was left

Dr. Altman :

So approximately 37.5 were given

Dr. Altman :

Meaning that 52.5 were in the bottle

Customer: We also have 2 other dogs who may have been involved which is the other complication :(
Customer: But they are much bigger
Dr. Altman :

Unfortunately that could be a good thing for Charlie

Dr. Altman :

Removing the 20 you found on the floor that estimates about 32.5 tablets

Dr. Altman :

If he brought up half of that you should be alright...

Dr. Altman :

A maximum daily dose is 16 mg/ day

Dr. Altman :

Does this make sense?

Customer: Ok so do you think he's safe for tonight as far as having a reaction or anything? Also should I skip his dose tomorrow morning?
Dr. Altman :

But I would be giving the antacid and white rice tonight as a precaution

Dr. Altman :

Yes, I would miss tomorrow morning's dose

Dr. Altman :

Do you give it once daily?

Customer: Yes, once daily
Dr. Altman :

I would give tomorrow morning's dose tomorrow night

Dr. Altman :

We definitely don't want to take a chance of the steroids going too low with the addison's

Dr. Altman :

24 hours should be ok

Dr. Altman :

You can definitely confirm with your vet tomorrow morning that this is what they recommend

Customer: I have sucralfate 1/2 gram from when he went to the animal hospital in addisonian crisis (how we found out) from a month ago. Can I give that? The vet was giving it for nausea. Or is Pepcid better?
Dr. Altman :

You can actually give both

Dr. Altman :

Sucralfate is to coat the stomach against ulcerations

Dr. Altman :

Pepcid is to reduce acid buildup and nausea

Customer: Ok, I'll go get Pepcid and give the other now.
Dr. Altman :

10 mg 1/2 tablet every 12 hours for a few days as a precaution

Dr. Altman :

Can I assist with any additional questions or clarify anything today?

Dr. Altman :

Are you still there?

Customer: Ok great thank you! I think that's everything. I really appreciate it! You are awesome!
Dr. Altman :

So glad I could assist you both, it sounds like Charlie is in good hands :)

Customer: Sorry I was putting him in his kennel for a little rest now
Customer: Thank you!
Dr. Altman :

No worries, just wanted to make sure I didn't miss you

Dr. Altman :

Good luck to you both, truly!

Dr. Altman :

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Customer: Thank you! It is much appreciated!
Dr. Altman :

You are very welcome

Dr. Altman and other Dog Veterinary Specialists are ready to help you
How is Charlie feeling? Were there any issues with the prednisone ingestion?

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