By Carol McCarthy
How’s this for a scary statistic? Every day, 91 Americans die of an opioid overdose. Also alarming, most pet parents may not know that the widespread availability of these morphine-like painkillers, whether by prescription or illegal purchase, can put animals at risk.
Peter Thibault of Andover, Massachusetts, made this frightening discovery while taking his family’s yellow Lab puppy, Zoey, on her morning walk in September 2017. Zoey spotted an empty cigarette pack on the sidewalk close to where Thibault’s children catch their school bus and picked it up with her mouth. Thibault, who was accustomed to the curious pup trying to eat all manner of items, quickly pulled the cigarette pack away from her. Within 100 steps of that corner, Zoey collapsed, unconscious. “It was horrifying,” he recalls. “I didn’t know what was wrong.”
Thibault rushed Zoey to nearby Bulger Veterinary Hospital, where a veterinarian asked him to describe exactly what happened. Suspecting that Zoey had inhaled or ingested residue of fentanyl, a potent, short-acting opioid, from the cigarette pack, the veterinarian quickly injected the dog with naloxone. Widely known as Narcan, the drug acts as an opioid antagonist and can reverse an overdose. Within minutes, Zoey was alert and behaving as if nothing had happened, Thibault says. But he was shaken.
“I was in complete disbelief,” he says. “Even on the ride home, I didn’t believe it. I was beside myself.”
While accidental exposure to opioids in the community is uncommon, this case illustrates that accidental exposure can harm anyone, anywhere, says Dr. Kiko Bracker of the emergency and critical care unit at Angell Animal Medical Center in Boston.
“It was a big wakeup call,” says Thibault, who never expected to encounter opioids in his quiet community.
What is fentanyl? Is it different from heroin?
The veterinarian who treated Zoey suspected fentanyl because the dog collapsed so quickly after probable exposure. Fentanyl is a fast-acting prescription opioid used for pain control in humans and animals that is considered 100 times more potent than morphine, says Charlotte Flint, senior consulting veterinarian, clinical toxicology, for Pet Poison Helpline & Safety Call International.
Heroin, on the other hand, is an opioid not used medically but sold as a street drug. It is considered two to four times more potent than morphine, Flint says. Fentanyl, and other chemicals, can be “cut” into heroin to increase its potency and, in turn, its lethality, Flint notes. This poses risks to working dogs, including K-9 officers and drug-sniffing canines.
How is fentanyl used?
Physicians and veterinarians prescribe fentanyl to treat pain after surgery, trauma, or such painful diseases as cancer and is considered safe for short-term use. Fentanyl comes in several forms, including an injectable liquid, typically used only in hospital settings; patches that release the drug through the skin over a period of days; and tablets, films, and lozenges taken orally, Flint says. A veterinary-only product for dogs, called Recuvyra, is applied to the skin in the hospital for short-term, post-surgery pain relief, she says.
How much exposure can cause a pet to overdose?
Because fentanyl comes in different concentrations, and an animal’s size is a factor, it is impossible for veterinarians to define a potentially fatal dose, but suspected exposure requires immediate medical attention, our experts agree. “Any exposure should prompt concern, but certainly not every exposure is lethal,” Bracker says.
What are the signs of opioid overdose in pets?
Because they might not see their animal ingest a substance, pet parents need to recognize signs of possible overdose. Dr. Paula A. Johnson, clinical assistant professor of small animal emergency and critical care at Purdue University College of Veterinary Medicine, says signs and symptoms include changes in behavior—from decreased responsiveness to agitation—walking like a drunk, respiratory depression, dribbling urine, vomiting, and collapse.
Cats often experience dilated pupils and more commonly get agitated and disoriented, rather than sleepy, and might also drool and vomit, Flint says. However, it’s important to keep in mind that none of these symptoms are seen only with opioid overdose or exposure, Bracker notes.
Do vets typically stock naloxone?
Pet parents unfamiliar with prescription use of opioids for animals might assume Thibault was lucky that the veterinarian had naloxone in stock. However, Johnson says the drug is found in most veterinarians’ medicine cabinets. “Any vet using opioids in their practice should have naloxone on hand as a safety measure,” she says.
Are there guidelines regarding opioid overdose in animals?
With increased awareness about risks of accidental overdose in animals, organizations such as the American Veterinary Medical Association are taking a closer look at the issue. During the summer of 2017, the organization made a training video to help veterinarians treat police and drug-sniffing dogs who are exposed to opioid drugs in the line of duty, Flint notes.
In general, though, guidelines on opioids and naloxone will differ by state and by region, Bracker says.
How do I protect my pet from overdose?
Most cases of opioid poisoning occur when a pet gets into a family member’s improperly stored prescriptions or a neighbor’s discarded drugs, Flint says, so proper use and disposal can be key to prevention. “Sometimes pets eat a dropped pill or chew into a bottle of pills. We also have many cases where someone has thrown a used fentanyl patch in the garbage, and the pet licks or chews the patch,” she says. “It still has quite a bit of the drug in it, so they can be poisoned even if they don’t ingest the whole patch.”
When in public spaces, exercise caution. “You have to be very careful and attentive to what [pets] are sniffing and putting in their mouths,” Johnson advises.
“It definitely makes me more aware,” Thibault says of his experience with his dog. “At first, we were really nervous to take her on that path again.”
These days, he keeps Zoey on a short leash when walking her and is vigilant about anything she tries to put in her mouth, which, as a Lab puppy, is pretty much everything.