Podcasts

Prospective study on the use of hydrogen peroxide as an emetic agent in dogs | Dr. Alicia Niedzwecki | VETgirl Veterinary Continuing Education Podcasts

In this VETgirl online veterinary continuing education podcast, we interview Dr. Alicia Niedzwecki, DACVECC, on a recent study that she performed entitled Effect of oral 3% hydrogen peroxide used as an emetic on the gastroduodenal mucosa of healthy dogs. In this study, Dr. Niedzwecki performed a prospective study aimed to investigate the effects of 3% hydrogen peroxide on the gastrointestinal mucosa in healthy dogs when ingested in amounts we routinely use for emesis induction. What’d they find? Maybe we shouldn’t be using hydrogen peroxide in our veterinary poisoned canine patients after all, as evidence of esophagitis, gastritis and gastric ulceration can be seen. This study supports that hydrogen peroxide is not as benign as perhaps we once thought. While the authors’ take away from this study was that the use of hydrogen peroxide shouldn’t be recommended for at-home use in pet owners unless the benefits outweigh the risks, the toxicologist in me is going to take a little bit of a different take on it. VETgirl will likely still use it as an emetic agent (again, only in dogs), but now I’m going to add on gastric protectants and antacids for 1-2 weeks post-administration of hydrogen peroxide.

Keep in mind that if a poisoned dog cannot be presented in a timely fashion to a veterinary clinic that can administer apomorphine, and if the substance ingested is too dangerous to treat supportively, then the recommendation for hydrogen peroxide administration can be made, but the pet owner should be warned of the gastrointestinal consequences that can arise. Special consideration should be made for patients with known preexisting gastrointestinal disease before recommending emesis induction with hydrogen peroxide. When in doubt, contact the ASPCA Animal Poison Control Center for life-saving advice!

References:
1. Schildt JC, Jutkowitz LA. Approach to poisoning and drug overdose. In: Silverstein DC, Hopper K. eds. Small Animal Critical Care Medicine. 1st ed. St. Louis: Saunders Elsevier; 2009, pp.326-329.
2. Caraccio TR, Comer GM, Hnery MC, et al. Hydrogen peroxide 3% exposures. J Toxicol Clin Toxicol 1996; 34(3):323-327.
3. Moon JM, Chun BJ, Min YI. Hemorrhagic gastroenteritis and gas emboli after ingesting 3% hydrogen peroxide. J Emerg Med 2006; 30(4):403-406.
4. Pritchett A, Green D, Rossos P. Accidental ingestion of 35% hydrogen peroxide. Can J Gastroenterol 2007;21(7):665-667.
5. Schindler AE, Schneider JA, Obstein KL. Foaming at the mouth: ingestion of 35% hydrogen peroxide solution (with video). Clin Gastroenterol Hepatol 2012;10:e13-e14.
6. Niedzwecki AH, Book BP, Lewis KM, et al. Effect of oral 3% hydrogen peroxide used as an emetic on the gastroduodenal mucosa of healthy dogs. JVECC 2017;27(2):178-184.

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