(Mucomyst?)：乙酰半胱氨酸可以保护肝脏免受对乙酰氨基酚的毒性作用。该药物不能使已经发生损伤的肝脏得到恢复，但是可以减少损伤进一步发生
·维生素C：加快对乙酰氨基酚的清除
·西米替丁(Tagamet?):保护肝脏免受损伤
·在严重的病例中，输血和鼻饲管是很有必要的。
犬对乙酰氨基份中毒一般需要观察2-4天。预后存活根据犬服用对乙酰氨基酚后接受治疗的快速情况。严重的肝损伤常常发生，即使进行了治疗，最后可能导致死亡。
家庭护理和预防:
对乙酰氨基酚中毒无需家庭护理。如果怀疑您的爱犬服用了一定对乙酰氨基酚毒量（一丸或是更多），立即联系你的家庭兽医，或是当地兽医紧急救助机构。对乙酰氨基酚中毒存活后，可能发生持久的肝脏损伤。需要特殊的饮食和长期的药物来抵御肝脏的损伤。最好的预防性护理是在兽医的指导下给予犬药物。对人安全的药，可能对于犬确是致命的。也需要确保所有的药物置于好奇的犬够不着的地方。安全保存可以避免悲剧的发生。
Acetaminophen (Tylenol) Toxicity in Dogs By: Dr. Anne Marie Mannin
Acetaminophen is a medication commonly used to
alleviate fever and pain. Common brands include Tylenol?,
Percoset?, aspirin free Excedrin? and various sinus, cold and flu
medications. Dogs most commonly receive toxic amounts of
acetaminophen because owners medicate them without consulting a
veterinarian. They also consume tablets that are dropped on the
floor or left lying around.
Dogs are less sensitive to acetaminophen than
cats. For example,
a 50 pound dog would need to ingest over seven 500 mg tablets in
order to suffer toxic effects. In the cat, one 250 mg acetaminophen
tablet could be fatal.
In addition to severe
liver failure, acetaminophen causes
damage to red blood cells. These include:
Hemolysis, which is the destruction of red blood cells Formation of
Heinz bodies, which are defects in red cells that cause them to be
removed from circulation sooner than normal Formation of
methemoglobin, a non-functional type of hemoglobin. Hemoglobin
allows red blood cells to carry oxygen. When methemoglobin is
formed, red blood cells cannot carry oxygen and the cat has
difficulty breathing. What to Watch For
The symptoms of acetaminophen toxicity develop in stages. Symptoms
may occur more quickly or slowly depending on the amount
ingested.
Stage 1 (0-12 hours). Symptoms include
vomiting, dullness,
difficulty breathing, development of brown-colored
gums (instead of a normal pink color) and drooling. Stage 2 (12-24
hours). Symptoms include swelling of the face, lips and limbs,
uncoordinated movements, [[AWT\140|convulsions]], coma and
potential death. Stage 3 (more than 24 hours). Symptoms are
associated with liver failure and include a painful belly,
jaundice (yellow tinge to gums, eyes and skin) and an
inappropriate mental state. Diagnosis
Prompt veterinary care is crucial to surviving the toxic effects of
acetaminophen. If the dog is treated soon after ingestion there is
a greater chance of survival, regardless of the amount
ingested.
The diagnosis of acetaminophen toxicity is generally based on
physical exam findings and a history of access or exposure to
acetaminophen.
Blood levels of acetaminophen can be analyzed, but the results may
not be accessible for hours to days. Determination of blood
methemoglobin levels can help determine how long treatment will be
necessary as well as determine prognosis. Not all veterinary
clinics have the ability to measure the methemoglobin level.
Treatment
Treatment is typically started as soon as the diagnosis is
suspected, often in the absence of specific diagnostic test
results. Blood work may be evaluated in order to assess the current
function of the liver and the level of red blood cells and
hemoglobin.
Hospitalization with continuous intravenous fluid therapy Oxygen
support
Activated charcoal to reduce the amount of
acetaminophen absorbed by the stomach, if ingestion of the
substance occurred within a few hours of admission to the hospital
Administration of
acetylcysteine (Mucomyst?) to protect the
liver from the toxic effects of acetaminophen. The medication
cannot reverse liver damage that has already occurred but can help
reduce further damage
Vitamin C to hasten elimination of the
acetaminophen
Cimetidine (Tagamet?) to protect the
liver from ongoing damage In severe cases, blood transfusions and
feeding tubes may be necessary
Dogs intoxicated with acetaminophen are generally hospitalized for
2-4 days. Prognosis for survival is based on how quickly the dog
receives treatment following ingestion of a toxic amount of
acetaminophen. Severe liver damage is often seen and may result in
death despite therapy. Home Care and Prevention
There is no home care for acetaminophen toxicity. If you suspect
that your dog has ingested a toxic amount of acetaminophen, (one
pill or more), contact your family veterinarian or local veterinary
emergency facility immediately.
After surviving acetaminophen toxicity, permanent liver damage may
have occurred. Special diets and lifetime medications may be needed
to counteract the liver damage.
The best preventative care is to give your dog medications only as
directed by your veterinarian. Medications that may be safe for
people can be fatal to dogs. Also, make sure that all medications
are kept out of the reach of inquisitive dogs. Keeping medicine
safely stored away can prevent many tragedies.
