Objective: To compare the use of dexmedetomidine hydrochloride, xylazine hydrochloride, and hydrogen peroxide for emesis induction in cats.
Design: Retrospective case series.
Animals: 43 client-owned cats for which emesis induction was attempted because of known or suspected toxicant ingestion or recent ingestion of a string foreign body.
Procedures: Data collected from the cats' medical records included type, dose, and route of administration of emetic agent; outcome of attempted emesis induction; time until emesis or postemesis administration of a reversal agent (to counter sedative effects of the emetic agent); and adverse events.
Results: Emesis induction was attempted by oral administration of hydrogen peroxide (n = 3) or IM or IV administration of xylazine (25 [including 1 cat that had already received hydrogen peroxide]) or dexmedetomidine (16). No cat that received hydrogen peroxide vomited. Emesis was induced in 11 of 25 xylazine-treated cats and in 13 of 16 dexmedetomidine-treated cats. Dexmedetomidine was more likely to cause vomiting than xylazine (OR, 5.5; 95% confidence interval, 1.1 to 36). The median dose of dexmedetomidine that caused emesis was 7.0 μg/kg (3.2 μg/lb; range, 0.96 to 10.0 μg/kg [0.44 to 4.55 μg/lb]). The elapsed time until emesis or postemesis reversal agent administration was recorded for 5 xylazine-treated cats (median interval, 10 minutes [range, 5 to 175 minutes]) and 10 dexmedetomidine-treated cats (median interval, 5 minutes [range, 1 to 12 minutes]). Sedation was the only adverse effect, occurring in 2 xylazine-treated cats and 1 dexmedetomidine-treated cat.
Conclusions and clinical relevance: Results indicated that dexmedetomidine can be used successfully to induce emesis in cats.
Emetics can play a key role in the prevention of clinical signs in dogs and cats who have had oral exposures to toxins. These tips will help you know what emetics may work best for you. (And be sure to read this companion article on when NOT to induce emesis!)
Dogs
Typically, apomorphine and hydrogen peroxide are the emetics of choice with dogs. Published data shows that about 94% of dogs vomit after apomorphine administration and about 90% of dogs vomit after hydrogen peroxide administration. Percentage of the toxin recovered and time to onset of emesis were very similar with both emetics.
Apomorphine
Pros: Pet does not need to be exercised; easy to administer.
Cons: Has to be done at a vet hospital and if the owner is far away the delay can be too long for emesis to be effective; can significantly worsen CNS depression, if the agent is likely to cause those signs. (Note: Naloxone will reverse the depressive effects of the apomorphine without reversing the emetic effects, so it can be safely given if depression is seen.)
Hydrogen Peroxide
Pros: Can have owners do at home quickly; readily available (not likely to be back-ordered).
Cons: Can cause gastritis; can potentially cause GI ulceration or air embolus, if overdosed; pet needs to be walked for the peroxide to have maximum effectiveness.
Cats
Xylazine
Generally see vomiting within five minutes that tends not to be prolonged. Xylazine can cause CNS or respiratory depression, but this can be reversed with Antisedan.
Dexmedetomidine
Like xylazine, emesis with dexmedetomidine tends to occur within quickly and is not prolonged. It may be more effective than xylazine. CNS or respiratory depression are still a concern but they can be reversed with atipamizole (AntisedanTM) or yohimbine.
Midazolam/Hydromorphone
A combination of midazolam and hydromorphone may be good choice, particularly in feline patients who are elderly or having underlying cardiovascular disease. Not only are they easier on the cardiovascular system than xylazine and dexmedetomadine, they are both reversible if needed.
Apomorphine
Typically not recommended as it is not likely to be effective, due to species differences between dogs and cats. The dog's chemoreceptor trigger zone (CRTZ) is controlled largely by dopamine receptors, so apomorphine typically induces emesis. However, the CRTZ in the cat has alpha 2 receptors, so xylazine or dexmedetomadine typically produces a better response.
Hydrogen Peroxide
Like apomorphine, hydrogen peroxide is generally not advised in feline patients because it is not highly effective at making them vomit in a timely manner and cats are more prone to develop gastritis or even hemorrhagic gastritis from hydrogen peroxide than dogs are.
Read about when NOT to induce emesis in dogs and cats.
The ASPCA's Animal Poison Control Center has a host of publications to help you in treating animals, as well as a monthly newsletter with the latest research, helpful hints, and training opportunities.
Three percent hydrogen peroxide is quite popular and effective in making cats and dogs vomit. You must be sure to use three percent peroxide and not hair coloring strength peroxide. Despite the label indicating that hydrogen peroxide is toxic, it is safe to give to cats. It is considered toxic since it induces vomiting and therefore does not stay in the body.
The appropriate dose of hydrogen peroxide is one teaspoon per 10 pounds of body weight. If you have an oral syringe, one teaspoon equals 5 cc or 5 ml. Once given, walk your cat around or gently shake the stomach area to mix the peroxide with the stomach contents. Vomiting should occur within 15 to 20 minutes. If no vomiting occurs, you can safely repeat the three percent hydrogen peroxide once. If it is still not effective, your cat may need to be seen by a veterinarian for stronger vomiting medication.
Once the hydrogen peroxide is given, it is important to watch your pet so that he does not re-ingest the substance. If there is concern about toxicity, collect and take a sample of the vomitus to your veterinarian.
This medication is frequently used to induce vomiting in children. Unfortunately, it can be dangerous and even toxic to cats so it should not be used unless specifically advised by your veterinarian.
These are other alternatives that have been used to induce vomiting but have not been proven to be very effective. Therefore, it is not recommended to give salt water or mustard seed water for any reason to cats unless specifically recommended by your veterinarian.
If your pet ingests something potentially toxic, usually one of the quickest ways to help them is to induce vomiting. Many pet parents will take matters into their own hands here, and after searching the internet for resources, will attempt to induce vomit at home. When we suspect that our furry friends are in danger, it makes sense to want to act quickly, but, the ASPCA Animal Poison Control Center (APCC) warns pet parents that trying to induce vomiting in your pet at home can be dangerous. There are many myths and a large amount of misinformation available to pet parents on the internet, and APCC wants to make sure you have the facts you need.
Dangerous At-Home Remedies
There are various household items and methods that APCC has seen pet parents try, but many of these should not be used and can potentially cause our furry friends more harm than good.
- Salt is a common ingredient people may turn to when attempting to induce vomit. However, ingestion of large amounts of salt can lead to dangerously high salt levels in your pet’s blood. This can cause your pet to walk unsteadily, develop tremors, seizures or even go into a coma. If these signs go untreated, excessive salt consumption can be life-threatening to pets.
- Gagging pets, or sticking a finger or an object down their throats will not make them vomit because pets don’t have the same gag reflex as humans do. This method could actually cause trauma to the pet’s throat or could lead to the pet biting someone out of discomfort or fear.
- Olive oil is also problematic for pets. If olive oil is given to pets, it can lead to greasy stools and pancreatitis. Even if they do end up vomiting after consuming the oil, it can lead to further complications (such as pneumonia) because the oil can be inhaled back into your pet’s lungs.
- It’s true that Ipecac can make pets vomit, however it is very unsafe and can lead to much more serious problems. Symptoms following Ipecac ingestion can include drooling, difficulty breathing, a drop in heart rate, abnormal heart rhythm and a potentially deadly heart condition.
Other common kitchen items and ingredients that are commonly thought to effectively induce vomit in pets include mustard, toast, water and milk. Although your pet might enjoy eating some of these, they unfortunately do not work when attempting to make your pet vomit.
So What’s the Safest Method?
The best thing you can do after a toxin ingestion concerning your pet is to immediately contact your veterinarian or APCC at (888) 426-4435. The only method that can be used to safely get a dog to vomit at home is by using hydrogen peroxide. But even when using peroxide, it needs to be done under the guidance of a veterinary professional because too much peroxide can be problematic. Contacting your local vet or APCC and explaining the type of toxin, the amount ingested and any other relatable information should always be your first step. That way, they can then advise you on whether or not you should bring your pet in, or if they think you can/should induce vomiting at home. Additionally, hydrogen peroxide should not be given to cats. It is too irritating to felines and can cause problems with their stomachs and esophagus. Unfortunately, there is nothing that can be given at home to safely get a cat to vomit.
If you believe your pet has ingested something potentially toxic or seems to be having an adverse reaction to something, please contact your veterinarian or the ASPCA Animal Poison Control Center immediately at (888) 426-4435 for assistance.