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My large dog may have eaten a Excedrin tablet. 3 years old,

Customer Question
My large dog may...

My large dog may have eaten a Excedrin tablet.

Veterinarian's Assistant: I'll do all I can to help. The Expert will know if the dog will be able to digest that. What is the dog's name and age?

3 years old, Charlie he is a mix bull dog and pit. Weighs about 50 pounds.

Veterinarian's Assistant: What is the dog's name?

Charlie

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Charlie?

He seems okay. I just found a wet tablet in the floor..and am not sure there was another one.

Submitted: 7 months ago.Category: Dog Veterinary
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Answered in 4 minutes by:
12/18/2017
Dog Veterinarian: Dr. Kara, Veterinarian replied 7 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,818
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

I'm sorry to hear that Charlie may have ingested an Excedrin tablet.

  1. Do the Excedrin tablets you have contain 250mg of acetaminophen, 250mg of aspirin, and 65mg of caffeine?
  2. How long ago did this occur?
  3. Do you have fresh (unexpired) 3% hydrogen peroxide?
  4. Is Charlie taking any other medications?
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Customer reply replied 7 months ago
about 30 minutes and yes I have the unexpired 3 hydrogen peroxide\
Customer reply replied 7 months ago
I don't want to call please. We can just chat here on line
Dog Veterinarian: Dr. Kara, Veterinarian replied 7 months ago

Given the multiple drugs in these tablets I encourage you to induce vomiting by giving him 3 tablespoons of fresh (unexpired) 3% hydrogen peroxide orally or mixed with a little ice cream or bread chunks, then take him out and run him around to get the peroxide fizzing.

Do not give more than 3 tablespoons in a single dose.

If no vomiting in 10 minutes repeat the peroxide dose once more.

If he doesn't vomit I recommend that you get him to a veterinarian immediately to induce vomiting, and possibly and get him on fluids and oral gastroprotectant medications. Both acetaminophen and aspirin can cause gastrointestinal ulcers and organ damage and if enough is given acetaminophen can cause red blood cell damage. Caffeine is very poorly tolerated by dogs as well and can lead to a very fast, irregular heart beat, damage to the heart and seizures.

After 2-3 hours it may be too late to induce vomiting, the pills may be out of his stomach, they may only be able to give activated charcoal to try to bind the toxins and treat him symptomatically for the damages that may occur.

So time is of the essence.

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Customer reply replied 7 months ago
Thank you for your information.
Dog Veterinarian: Dr. Kara, Veterinarian replied 7 months ago

We see toxicity symptoms in dogs at a dose of acetaminophen higher then 75 mg per kilogram (2.2 pounds per kilogram) of body weight.

At 50 pounds he is 22.72 kilograms, so he would need to eat 1704mgs of acetaminophen. (22.72kg X 75mg/kg = 1704mg)

He ingested 250mgs, so he did not eat a toxic amount of acetaminophen alone.

Signs to watch for with acetaminophen toxicity would be brown or gray colored gums, difficulty breathing, edema or swelling of the face, neck, legs or feet, vomiting, yellow color to the skin and in very severe cases coma.

Aspirin can be given to dogs, but the dose is 5mg to 10mg per pound of body weight. For a 50 pound dog that is 250mgs to 500mgs. He ingested 250mgs, which is within what we consider a normal dose. But because he ate acetaminophen too we may see gastrointestinal side effects. Possible symptoms of toxicity include vomiting and diarrhea, possibly bloody, gastric ulcers, possibly perforating (ulcerating all the way through the stomach wall) and secondary peritonitis and increased bleeding as well as possible organ failure.

When two nonsteroidal drugs are given at the same time the odds of side effects increase by several times the normal risk, they potentiate each other's side effects.

Caffeine can damage the heart, lungs, kidney and central nervous system. A lethal dose is considered to be around 70 mg per 1 lb body weight or 3500mgs for a 50 pound dog. She ingested 65mgs, so not a lethal dose, but it may be enough to cause an irregular, fast heart rate and rhythm and further stress his other organs.
He has not eaten a highly toxic dose of any of the ingredients alone, but I am concerned about all of them together leading to a problem for him, most notably gastrointestinal upset. So if he were my fellow I would induce vomiting.

If he vomits and seems to clear his stomach and be done I would check to see if the pill pieces are present.
Once he clears his stomach to try and settle his stomach today you can try either:
1) Pepcid-ac (famotidine) at a dose of one 10mg tablet per 20 to 40 pounds of body weight every 12 hours.
OR
2) Prilosec (omeprazole) at a dose of one 20mg tablet per 40 to 80 pounds of body weight every 24 hours.
Either of these will reduce stomach acid and should help settle his stomach. I would use one of these for the next 10 -14 days or so to try and help his stomach heal
Then feed a homemade diet of 1/3 boiled, lean hamburger or boiled, white, skinless chicken, all fats and juices drained off the meat and 2/3 boiled, white rice.
If you don't have peroxide you can get him to an emergency clinic to induce vomiting.
If it has been more than 2 hours, or he doesn't vomit the pills, then you can take a watch and see approach or have him admitted to a veterinary clinic to be given oral activated charcoal to absorb the drug and decrease its absorption into his body, placed on fluids, and given injectable drugs and oral drugs to reduce nausea and protect against ulcer formation.
Even if you do get him to vomit the pill at home watch him closely for abdominal pain, vomiting blood, loss of appetite, passing dark tarry stools or extreme lethargy, or a very fast heart rate and an inability to settle and have him seen by a veterinarian if those occur.
Please let me know if you have any further questions.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 6 months ago

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

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