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Effectiveness and adverse effects of the use of apomorphine and 3% hydrogen peroxide solution to induce emesis in dogs

Safdar A. KhanAmerican Society for the Prevention of Cruelty to Animals Animal Poison Control Center, 1717 S Philo Rd, Ste 36, Urbana, IL 61802.

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Mary Kay McleanAmerican Society for the Prevention of Cruelty to Animals Animal Poison Control Center, 1717 S Philo Rd, Ste 36, Urbana, IL 61802.

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Margaret SlaterAmerican Society for the Prevention of Cruelty to Animals Animal Poison Control Center, 1717 S Philo Rd, Ste 36, Urbana, IL 61802.

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Steven HansenAmerican Society for the Prevention of Cruelty to Animals Animal Poison Control Center, 1717 S Philo Rd, Ste 36, Urbana, IL 61802.

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Stephen ZawistowskiAmerican Society for the Prevention of Cruelty to Animals Animal Poison Control Center, 1717 S Philo Rd, Ste 36, Urbana, IL 61802.

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Abstract

Objective—To determine the effectiveness and adverse effects of apomorphine and 3% hydrogen peroxide solution used for emesis in dogs.

Design—Prospective observational study.

Animals—147 dogs that received apomorphine (IV or placed in the conjunctival sac) or 3% hydrogen peroxide solution (PO) to induce emesis after exposure to toxic agents.

Procedures—Data regarding signalment; agent information; type, dose, route, and number of emetic administrations; whether emesis was successful; number of times emesis occurred; percentage of ingested agent recovered; and adverse effects were collected via telephone during American Society for the Prevention of Cruelty to Animals Animal Poison Control Center operations and stored in a database for analysis. Mann-Whitney and Fisher exact tests were used to evaluate emetic success rates.

Results—Apomorphine and 3% hydrogen peroxide solution successfully induced emesis in 59 of 63 (94%) and 76 of 84 (90%) of dogs, respectively. Mean time to onset of emesis after the first dose of emetic was 14.5 and 18.6 minutes when hydrogen peroxide (n = 37) and apomorphine (31) were used, respectively, with mean durations of 42 and 27 minutes, respectively. Mean estimates for recovery of ingested agents were 48% for hydrogen peroxide and 52% for apomorphine. Adverse effects were reported in 16 of 112 (14%) dogs for which information was available.

Conclusions and Clinical Relevance—3% hydrogen peroxide solution and apomorphine effectively induced emesis in dogs when used as directed. Emesis occurred within minutes after administration and helped recover substantial amounts of ingested agents. Adverse effects of both emetics were considered mild and self-limiting.

Abstract

Objective—To determine the effectiveness and adverse effects of apomorphine and 3% hydrogen peroxide solution used for emesis in dogs.

Design—Prospective observational study.

Animals—147 dogs that received apomorphine (IV or placed in the conjunctival sac) or 3% hydrogen peroxide solution (PO) to induce emesis after exposure to toxic agents.

Procedures—Data regarding signalment; agent information; type, dose, route, and number of emetic administrations; whether emesis was successful; number of times emesis occurred; percentage of ingested agent recovered; and adverse effects were collected via telephone during American Society for the Prevention of Cruelty to Animals Animal Poison Control Center operations and stored in a database for analysis. Mann-Whitney and Fisher exact tests were used to evaluate emetic success rates.

Results—Apomorphine and 3% hydrogen peroxide solution successfully induced emesis in 59 of 63 (94%) and 76 of 84 (90%) of dogs, respectively. Mean time to onset of emesis after the first dose of emetic was 14.5 and 18.6 minutes when hydrogen peroxide (n = 37) and apomorphine (31) were used, respectively, with mean durations of 42 and 27 minutes, respectively. Mean estimates for recovery of ingested agents were 48% for hydrogen peroxide and 52% for apomorphine. Adverse effects were reported in 16 of 112 (14%) dogs for which information was available.

Conclusions and Clinical Relevance—3% hydrogen peroxide solution and apomorphine effectively induced emesis in dogs when used as directed. Emesis occurred within minutes after administration and helped recover substantial amounts of ingested agents. Adverse effects of both emetics were considered mild and self-limiting.

Contributor Notes

Dr. Zawistowski's present address is 520 Eighth Ave, New York, NY 10018.

Presented in abstract form at the 7th Annual World Congress on Alternatives and Animal Use in the Life Sciences Research Meeting, Rome, August–September 2009.

Address correspondence to Dr. Khan (safdar.khan@aspca.org).