Acetaminophen toxicosis in dogs and cats: reports at the Dutch Poisons Information Center (2010 – 2019)

Background. Pain management in dogs is an important and challenging task in veterinary medicine. Various types of analgesics are available to a veterinarian to fulfil this task, for example glucocorticosteroids, nonsteroidal anti-inflammatory drugs and opioids. However, these drugs are not applicable in every situation and every canine patient, among others, because of their side effects. In compromised patients, acetaminophen appears to be a solution to induce analgesia in some cases. Besides, acetaminophen is also used in addition to other analgesics. As a consequence, there are signs that acetaminophen has been used more often by veterinarians in recent years. However, the use of acetaminophen in animals is not without risks. The therapeutic window is not wide in dogs, and its use in cats is even contraindicated. In addition, acetaminophen, along with ibuprofen, has been at the top of the list of exposures to human medications in dogs and cats for years, according to data from the Dutch Poisons Information Center. When veterinarians are using acetaminophen in dogs more often, this may lead to an increase in self-medication with acetaminophen by pet owners, putting both dogs and cats at risk for toxicosis. Aim. The aim of this study was to analyse the number of dogs and cats supposedly exposed to acetaminophen about which the Dutch Poisons Information Center was consulted and to evaluate the circumstances of those exposures, with special regard to whether the medication was stolen by the animal or administered by a person. Method. A dataset concerning acetaminophen exposures of dogs and cats, provided by the Dutch Poisons Information Center, was analysed. A dataset with regard to ibuprofen exposures was also analysed, in order to make a comparison with another over-the-counter available analgesic. The cases studied were reports of veterinarians of supposed exposures by ingestion during the period 2010 – 2019. The analysis was based on worst case scenarios, as actu