Acetaminophen toxicosis in a cat

Area of Science:

• Veterinary Medicine
• Toxicology
• Small Animal Internal Medicine

Background:

• Acetaminophen (N-acetyl-p-aminophenol) is a common over-the-counter analgesic and antipyretic agent that is highly toxic to cats.
• Feline acetaminophen toxicosis can rapidly lead to severe clinical signs including methemoglobinemia, hepatic necrosis, and death.
• Delayed treatment initiation significantly impacts the prognosis for acetaminophen-poisoned cats.

Purpose of the Study:

• To report a case of severe acetaminophen toxicosis in a domestic shorthaired cat.
• To review the pathophysiology and current treatment recommendations for feline acetaminophen poisoning.
• To emphasize the critical importance of early intervention in managing acetaminophen toxicosis in cats.

Main Methods:

• A seven-month-old male domestic shorthaired cat with a history of acetaminophen ingestion was presented.
• Clinical assessment included evaluation for icterus, depression, hypothermia, tachypnea, and edema.
• Treatment involved supportive care, including oral acetylcysteine, ascorbic acid, and intravenous fluids.

Main Results:

• The cat presented with severe clinical signs: icterus, depression, hypothermia, tachypnea, and significant head and neck edema.
• Despite treatment, the cat's condition deteriorated, and postmortem examination revealed icterus, subcutaneous and pulmonary edema, and evidence of hemolysis.
• The delay in initiating treatment was deemed insufficient to reverse the toxic effects.

Conclusions:

• This case underscores the rapid progression and potentially fatal outcome of acetaminophen toxicosis in cats, even with supportive care.
• Prompt recognition and aggressive treatment, including N-acetylcysteine (NAC) administration, are crucial for improving survival rates.
• Veterinary professionals should be vigilant in diagnosing and managing acetaminophen ingestion in felines, emphasizing the time-sensitive nature of effective treatment.