If you or a loved one suffers from asthma, you surely are familiar with albuterol. The medication is used in asthma “puffers” for short-term relief of acute asthma attacks, in which air passages in the lungs constrict.
People I know who have used albuterol report that they get a brief “rush” from the medication. In addition to opening up airways, the medication affects the heart and nervous system.
But few people know that dogs are often attracted to albuterol. I do not know why canine companions are so frequently drawn to a product that is completely chemical in nature. I do know, however, that when dogs get ahold of albuterol inhalers, they can get into big trouble.
Albuterol containers hold hundreds of doses. A dog that chews on and perforates one can suffer significant exposure. The consequences can be serious — albuterol overdoses can lead to heart arrhythmias and heart muscle injury, electrolyte imbalances, and agitation or more serious neurological dysfunction.
A dog I saw recently exemplified most of the things that can go wrong. The four-year-old Labrador Retriever had sniffed out a nearly full albuterol inhaler in a schoolchild’s backpack. He chewed it open and almost immediately became restless and distressed. The owners brought him to my clinic immediately when they realized what had happened.
When I first met the dog, he was agitated. He panted continuously. His gums were bright red, and when I pressed on them they flashed white but then instantly turned red again. (A dog’s gums normally should be pink, and they should return to that color about one second after they are pressed.) His heart was racing at 250 beats per minute, more than twice the normal rate. Most ominously, it was sometimes beating without moving blood. This syndrome is manifested by “pulse deficits”: I was able to feel a pulse only about half of the time that the heart beat. Blood drawn for immediate laboratory tests showed deficits of potassium and phosphorus.
Everything about the case was classic for albuterol overdose. If something wasn’t done quickly, he risked serious heart injury and possibly death from arrhythmias.
Fortunately, there is a medication, propanolol, which reverses the most serious effects of albuterol — but most veterinary clinics don’t stock it. Since I work at an emergency clinic, I am fortunate to have the drug at my disposal. It took several doses (all given slowly, while monitoring with an ECG) and an overnight stay in the ICU, but the dog made a full recovery. The potassium and phosphorus normalized as the albuterol cleared from the dog’s system. If the incident had occurred in an area where no vet had propranolol, things might not have turned out so well.
People with asthma, and especially parents of children with asthma, need to be aware that albuterol inhalers pose a significant risk to dogs. Although treatment is possible, it is far better to avoid exposure in the first place.