Alright guys. Two weeks ago, we began unpacking a loaded subject. And that is: what to do if your dog eats something he shouldn’t. For simplicity sake we broke things down into a toxic like substance vs something that could act as a potential foreign body or obstruction. This is lumped under the general term “dietary indiscretion.” Which is essentially a fancy way for saying your dog "got into something." We also touched on awareness and knowing your dog, and how this can help you determine if your dog is partaking in “dietary indiscretion.”
If you haven’t already, be sure to go check out our initial blog post on this topic so things kinda start fitting together and making better sense.
So today we are addressing first aid treatment for different episodes of dietary indiscretion. We have all heard that using hydrogen peroxide to induce vomiting can be a useful technique for this particular situation.
However, it’s not always cut and dry- and using 3% hydrogen peroxide isn’t always the answer. That is what we are going to address here to start.
Contraindications (ie when vomiting isn’t the answer):
First off, let’s talk about scenarios where you shouldn’t use 3% hydrogen peroxide to induce vomiting.
- If you are assuming your pup ate something caustic, for example something corrosive, acidic, basic, or irritating to his esophageal or stomach tissues it might not be the best idea to induce vomiting. The major principle here is that if it's caustic going down- it will also be caustic coming back up. When in doubt call the animal poison control center at (888) 426-4435 to find out if it is safe to induce vomiting.
- If your dog has a history of seizures, severe heart disease, or is really sick- inducing vomiting with hydrogen peroxide might not be the best solution. In these situations, seriously consider contacting a veterinarian prior to administering hydrogen peroxide.
- If your dog ate a foreign object that is potentially sharp, or large enough that it could cause an obstruction coming back up it might not be the best solution to induce vomiting. Sharp objects can do more damage coming back up or could potentially get lodged in the esophagus. In theory with foreign objects- if they were able to swallow it, they should be able to bring it back up without choking or without it getting lodged, but this is not always a hard and fast rule and it unfortunately doesn’t always work out that way. I encourage you to use extreme caution and your best judgement. If possible call a veterinarian prior to induction of vomiting for foreign bodies, as this will vary greatly on a case by case basis.
- The next thing to consider is the amount of time between the ingestion of the object and the point at which you get him or her to vomit- let’s say your dog ate something that is toxic, and it is presumably safe to induce vomiting for this particular toxic agent. Well if it’s been greater than 2-3 hours understand that it might be too late. Some substances will already be going systemic and causing internal damage. So just understand that the sooner you can get them to vomit the better.
- If you have a dog who consumed something toxic and he has been showing some side effects from the toxin- especially side effects like seizures or neurological issues, understand that it might not be safe to induce vomiting at this point. If a patient is neurologically unstable and we induce vomiting, we might predispose him to aspiration pneumonia – where they aspirate their stomach contacts once vomiting is induced.
First Aid and Treatment options:
Okay let’s talk treatment options.
- Stating the obvious here, and since we already touched on it- one option to induce vomiting (if deemed safe to do so) is hydrogen peroxide. Most of you probably have this in the house… but do you hike with it? Or at least have it back at the truck?
In the previous blog post we talked about knowing your dog. I do not hike with hydrogen peroxide. However, I know Walter well and he is not one to consume things he shouldn’t. Every now and again he will pick up a piece of a dried deer skeleton in the woods, but he mostly will walk around with it for a while and then drop it. I do watch him closely in these situations. I let him have his moments of glory with his new-found prize, but I also watch him like a hawk until he drops it or hides it and we continue to hike on.
I am sure you have all googled the hydrogen peroxide dose, but we include it here to be complete.
If you have deemed it safe to induce vomiting after dietary indiscretion (when in doubt call a vet or ASPCA) the dose for 3% hydrogen peroxide is 1 teaspoon per 5lbs. Ensure that it is the 3% concentration and not greater.
This equates to 1mL per pound if that is easier for you to remember. Regardless of your dog’s size do not go over 3 tablespoons or 45mL of hydrogen peroxide. If you administer the first dose and your dog does not vomit you may repeat the dose ONCE after 10 minutes.
If you are having a hard time getting the peroxide in- one quick pro tip- if you have bread on hand soak the bread with the recommended dose of hydrogen peroxide and feed it to your dog. Sometimes feeding a small meal prior to giving the hydrogen peroxide can also help. Also consider taking them for a short and quiet walk to help get them to vomit. Hydrogen peroxide tends to be effective at inducing vomiting in 90 percent of dogs, and will usually eliminate 40-60 percent of the stomach contents. A small meal before induction of vomiting can help to ensure they get most everything back up.
Another side note about this technique is that sometimes antihistamines (such as Benadryl) can make hydrogen peroxide less effective to induce vomiting.
Do not be surprised if your dog still feels nauseated for about 45 minutes to an hour after a successful attempt with hydrogen peroxide.
- In situations where you are unable to get your dog to vomit, or you are concerned about the window of time since the ingestion (ie it has been greater than 2-3 hours post ingestion), or your dog did vomit but you are concerned that there might be some toxic substance left in the stomach, you may consider a medication called activated charcoal.
The product we use in the clinic is called Toxiban. The principle behind activated charcoal is that it will bind to the toxic substance so that it can be eliminated. Hopefully with this medication we will reduce side effects and the bound toxin will not cause systemic effects.
Activated charcoal is not the end all be all and will not be effective towards caustic agents- and generally is not recommended for these substances (see next bullet point). Great care should be given in administering this medication to avoid aspiration.
The dose for activated charcoal is .5-1 gm/lb. This dosage may need to be repeated every 4-8 hours at ½ the INITIAL dose depending on the toxicity.
In the ideal world you would call the poison hotline and check with their recommendations or with a veterinarian prior to administering activated charcoal. However, if you are in back country, and hours or days away from care or cell reception and you just need to do something- this is a viable option if you have it on hand.
- For situations where your dog ate a substance that is caustic you may attempt to dilute the substance with water or milk.
As previously stated, in these situations we do not want to induce vomiting. If you have milk on hand and elect to use it ensure that you only give about 1-2mL/lb so you do not cause stomach upset from the milk itself. If your dog ends up vomiting the milk because he is not used to it... well then we risk the toxic agent coming back up again which defeats the purpose. If you are concerned about your dog vomiting the milk you may also attempt to dilute the substance with small frequent doses of plain water.
Remember it is ALWAYS best to seek professional veterinary advice either from the hotline or a clinic prior to treatment of any toxicity.
For our purposes these pieces of advice without professional consult are only warranted in the event that you are far from a vet, and you need to do something until you can get to definitive veterinary care. In the perfect world- if our dogs eat something they shouldn’t have- we will be at home, with a medicine cabinet full of hydrogen peroxide, and a vet who is 5 minutes down the road. We are discussing this today because that isn’t always the case in real life. Sometimes these things happen when we are without cell reception and we are very far away from care. And sometimes we just have to do our best in these situations and make use of what we have on us...
That is why it is so important to just know and master this information. Commit it to memory. Because worst case scenario we might not have internet or cell reception to google what to do or how much hydrogen peroxide is acceptable for the size of our dogs. We might not be able to call the Animal Poison Control Center. We might be 100 percent reliant on our most valuable asset, which is our previously gained knowledge and the tool between our ears. Never forget that an educated guess with a solid knowledge base can save your dog’s life. In these situations, all you can do is prepare, be aware, be proactive, and be your dog’s hero.
Until next time, get out and explore more with your pup!
Libbie Fort, DVM