Clinical Cases :

Acetaminophen Toxicosis : A disease occurs when a cat administrated by Acetaminophen. The drug  is administrated for a variety of reasons ( Example : as a pain reliever )

What is the fatal dose of Acetaminophen in cats ?

As as little as 10 mg/kg

Clinical Signs :

• Anorexia
• Vomiting
• Ptyalism
• Brown – colored mucous membranes ( Cyanotic )
• Edema of the face and paws
• After some days the mucous membranes become pale or icteric

Diagnosis :

• Take the history of the case ( a history of acetaminophen administration)
• Clinical Signs ( As mentioned before )
• Complete Blood Count (CBC): Show anemia and the appearance of Heinz bodies on the red cell membrane
• Urinalysis: Show Chocolate – or red – colored urine due to methemoglobinuria or hematuria.

Treatment :

• Removal of the toxin: Emesis should be induced only if drug ingestion has occurred within the previous 1 to 2 hours Because Acetaminophen is rapidly absorbed from the gastrointestinal tract.
• Acetylcysteine (Mucomyst ® ): Play a role as a specific Antidote and should be diluted to a 5% solution with 5% dextrose. An initial oral or intravenous dose of 130 to 140 mg/kg should be followed by 70 mg/kg q6h PO, IV for five to seven treatments.
• Cimetidine: with N – acetylcysteine have the Ability to to inhibit the cytochrome P450 oxidase system and thus limit formation of toxic metabolites and limit hepatotoxicity.The dose is 5 mg/kg q6 to 8 h IV for 48 hours.
• Ascorbic acid (vitamin C): Play a role as antioxidant. The dose 30 mg/kg q6h IV until methemoglobinemia resolves.
• S – Adenosylmethionine (SAMe) ( Denosyl ® , Denamarin ® )
• To treatment of severe hemolytic Anemia We use whole blood or Oxyglobin ® (5 – 15 ml/kg IV)