For many of the 22 million people in the United States with asthma a simple device known as an inhaler can offer almost immediate relief during an attack.
Inhalers are composed of a small pressurized canister that contains a solution of asthma medicine fitted into a plastic actuator that releases a fixed dose of the solution in an aerosol or inhalant form. An Inhaler can either be used in emergencies to manage acute symptoms or on a daily basis to control chronic symptoms. The majority of rescue inhalers contain albuterol, a drug used to stimulate the bronchial muscles in the lungs to relax and allow the air passages to open. When used properly, an inhaler is the safest, quickest, and most effective way to manage an asthma attack.
Unfortunately, to dogs the colorful plastic, small size and odd smell is something they won’t just pass by if they find it lying around. When his sharp teeth puncture the pressurized canister, the entire contents are released instantly. In a 60-lb dog, a full inhaler contains approximately 10 times the therapeutic dose of albuterol. In an overdose, these drugs affect both the bronchial muscles as well as the cardiac muscles. The results are immediate, severe, and include the following:
- Increased heart rate (up to 200 beats a minute!)
- Abnormal heart rhythms (arrhythmias)
- Increased respiratory rate or panting
- Abnormal behavior (Tremors, shaking, restlessness, hiding, agitation, lethargy, weakness)
- Low or high blood pressure
- Electrolyte abnormalities, most commonly low potassium
- Nausea and/or vomiting
If you see your pet bite into or ingest an inhaler, or if your pet is experiencing symptoms of albuterol toxicity, take him to your nearest emergency clinic for immediate care. Bring the inhaler, and if available, the original packaging as well as any medications that your pet is currently taking. Do NOT induce vomiting at home or give your pet any over-the-counter medication.
Lucky will typically need to be hospitalized on IV fluids for 12 to 48 hours while his body metabolizes or gets rid of the albuterol. An electrocardiogram or ECG machine will provide continuous visualization of his heart rate and rhythm, and his blood pressure will be regularly monitored. Blood tests will be used to check his electrolytes and regular doses of a beta antagonist (aka beta blocker) may be used to counteract the effects of the albuterol, an agonist. Other drugs may be given for muscle tremors, seizures, arrhythmias, vomiting, or diarrhea.
If treated promptly albuterol toxicity is rarely fatal, though pre-existing heart conditions or pets on other medications are at greater risk for complications. The best thing you can do for your pet is to keep those inhalers out of their reach. Avoid disposing of used canisters in trash cans that are accessible to pets as even used inhalers can be dangerous. Central Veterinary Emergency Services is available night, weekends, and holidays so that, if Lucky does take a bite out of your inhaler, you can breathe easier knowing that he’s in the best of hands and hearts.