Written by Justine Lee, DVM, DACVECC, DABT
Have you ever tried to successfully pill a cat before? Knowing how hard it is to pill cats, it seems ironic that our feline friends will electively eat some human medications on their own! So, what common over-the-counter (OTC) or prescription medications are toxic to cats? Keep reading to find out why you should be cautious when it comes to leaving medications lying around the house.
Which OTC & prescription medications most commonly poison cats?
The ASPCA Animal Poison Control Center (APCC), the only non-profit poison control center in the world, receives over 250,000 calls a year. Recently, they released their top 10 poisons affecting dogs and cats. While 90% of their calls involve dogs (as cats often have discriminating palates and don't “woof” things down the way dogs do!), 10% comprise poisoning calls about cats.
While poisonings in cats is less common, keep in mind that feline poisonings can be more severe! That’s because cats have an altered liver metabolism (e.g., glucuronidation) and can’t break down chemicals, drugs, and medications as well as dogs can. That means that things that aren’t poisonous to dogs may be poisonous—or even deadly—to cats.
As an emergency critical care veterinary specialist and toxicologist, the top 10 OTC and prescription medications that I commonly see poisoning cats in the veterinary ER are:
- Antidepressants (e.g., Effexor™)
- Amphetamines (e.g., ADD/ADHD medications like Adderall™)
- Ibuprofen (e.g., Advil™, Motrin™)
- Naproxen (e.g., Aleve™)
- Acetaminophen (e.g., Tylenol™)
- Triple antibiotic ointment (e.g., Neosporin™)
- Topical creams (e.g., estrogen creams, diaper rash creams, etc.)
- Bismuth subsalicylate (e.g., Pepto-Bismol™)
- Chewable veterinary NSAIDs (e.g., Rimadyl™, Deramaxx™)
Surprisingly, one of the top prescription medications munched on by cats are human antidepressant medications. Antidepressants, commonly called SSRIs or selective-serotonin reuptake inhibitors, affect the serotonin levels in the body. For some unusual reason, cats seem to be drawn to the smell or flavor of SSRIs—particularly Effexor. Other common antidepressants include brands such as Prozac™, Zoloft™, and Cymbalta™, all which can be quite poisonous to cats. Unfortunately, antidepressants can be quite dangerous when ingested, and result in signs of lethargy, vomiting, tremors, seizures, hyperthermia, and diarrhea. With treatment, the prognosis is excellent.
Note: Fluoxetine (e.g., Prozac) may be prescribed by veterinarians to treat behavioral disorders in cats or dogs. However, the dose is typically minimal compared to human dosage of this medication—so, please, never give your pet Prozac without talking to your vet!
ADD or ADHD medications like Adderall typically contain amphetamines which stimulate the body systems. These can result in similar poisoning signs of SSRI antidepressants. When cats accidentally ingest even one pill of an amphetamine, it can cause agitation, dilated pupils, hyperactivity, a racing heart rate, hypertension, and even tremors or seizures with high doses. Treatment for amphetamine poisoning is similar to antidepressant poisoning, and typically includes decontamination, IV fluids, sedation, blood pressure and heart rate monitoring, muscle relaxants, and anti-seizure medication. Thankfully, the prognosis is excellent with treatment if your cat accidentally got into this commonly prescribed human medication, but it does typically require 12-24 hours of hospitalization for treatment.
OTC pain medications
Can you give cats ibuprofen? No. Common household pain medications such as ibuprofen, naproxen, and aspirin all belong to a class of drugs called non-steroidal anti-inflammatories (NSAIDs). When in doubt, never give pain medication to your cat without consulting a veterinarian or the ASPCA APCC. That’s because these pain medications—while very safe for humans to take—can potentially be fatal to a cat. Even 1/2 a tablet of ibuprofen can result in severe acute kidney failure and stomach ulcers. If your cat got into an NSAID, treatment typically includes decontamination, hospitalization for 48 hours for IV fluid therapy, anti-vomiting medication, daily blood work, antacids, and supportive care. Thankfully, with prompt treatment, the prognosis is good as long as your cat does not develop kidney injury from it.
Can you give a cat Tylenol? Again, no! Acetaminophen—which is called paracetamol in other countries—is a common OTC and prescription human medication. But it should never be used in cats: 1 pill (typically containing 325 mg of acetaminophen) can kill a cat. Acetaminophen causes a chemical change to your cat’s hemoglobin (which is what helps carry oxygen inside your cat’s red blood cells). Signs of acetaminophen poisoning in cats include atypical swelling of the face and paws, difficulty breathing, a chocolate to blueish color to the gums of the mouth, lethargy, vomiting, and death. Thankfully, acetaminophen poisoning has a prescription-strength antidote called n-acetylcysteine, but it requires prompt treatment to work. Other treatment includes IV fluids, oxygen, anti-vomiting medication, blood work monitoring, and supportive care. Thankfully, the prognosis is good with 48 hours of hospitalization.
Triple antibiotic ointment
Before you reach for triple antibiotic ointment like Neosporin to put on your cat’s skin wound, think again. While rare, cats can develop a severe, life-threatening anaphylactic reaction to the ingredients within triple antibiotic ointment. This is one of the reasons why veterinary professionals rarely prescribe it—even for ophthalmic use! When in doubt, NEVER use your own medication—or another pet’s medication—on your cat without consulting your veterinarian or the ASPCA Animal Poison Control Center.
Other topical creams also pose potential poisoning risks to pets when ingested. As some cats love to groom and lick their owners, chronic poisoning can accidentally occur. This can, for example, result in rare cases of estrogen poisoning (from menopausal hormone creams). With other topical creams such as diaper rash creams, profuse gastrointestinal signs can be seen. Less common topical creams (such as the topical chemotherapeutic, 5-FU) can be deadly with just a few licks. When in doubt, keep these OTC and prescription tubes out of reach, and don’t let your cat lick where you apply medication onto yourself!
One of the ingredients in OTC Pepto-Bismol or Kaopectate can be poisonous to your cat—especially when used chronically. This aspirin-like compound can cause gastric ulcers and even kidney failure, and as little as half a tablespoon can be poisonous to cats.
Chewable veterinary NSAIDs
As a veterinarian, I may prescribe certain medications (like Rimadyl or Deramaxx) for your dog or cat that are safe at the correct dosage. However, if your cat gets into your large dog’s medication, it can be dangerous. When do I see cats getting into these medications? When you put your dog’s pill in a Pill Pocket™ and leave it on the counter or throw a chewable pill in your dog’s kibble (only to have your cat walk by and eat it). So, keep veterinary medications out of reach just as you would human medications. As with human NSAIDs, treatment for your cat typically includes decontamination, hospitalization for 48 hours for IV fluid therapy, anti-vomiting medication, daily blood work, antacids, and supportive care. With prompt treatment, the prognosis is good as long as your cat does not develop kidney injury.
So many commonly used human medications in the house pose a poisoning risk to your cat. If you think your cat was poisoned, call your veterinarian or the ASPCA Animal Poison Control Center (888-426-4435) immediately for life-saving advice! Keep in mind that you can’t induce vomiting in cats at home safely. So, most of the time, an emergency visit is a must! When in doubt, you want to make sure your household is appropriately pet-proofed so we can protect our feline family members.