\u00a0<\/span><\/p>\nObviously, something was upsetting him \u2013 but what?\u00a0<\/span>\u00a0<\/span><\/p>\n![\"Fur-Tunately:](\"\/blog\/wp-content\/uploads\/2023\/02\/6-2.png\")
<\/p>\n
The Search<\/span><\/b>\u00a0<\/span><\/h4>\nHis humans searched the house to see if Leo might have gotten into anything, but all appeared to be normal. The kitchen cupboards were closed, the houseplants were untouched, and the wastebasket was undisturbed.\u00a0<\/span>\u00a0<\/span><\/p>\nThere was one clue, however, in the bathroom. There, on the floor, was an albuterol inhaler that belongs to one of Leo’s humans who has asthma. A casual examination of the inhaler revealed nothing out of the ordinary\u2026but wait – what was that?<\/span>\u00a0<\/span><\/p>\nTwo small holes in the inhaler.\u00a0<\/span>\u00a0<\/span><\/p>\nHad Leo bitten it? But would that cause these severe symptoms? After all, he hadn\u2019t eaten the inhaler; it was all there. There was even still contents inside. Leo\u2019s humans didn\u2019t think biting an inhaler could make him so sick.<\/span>\u00a0<\/span><\/p>\n![\"Fur-Tunately:](\"\/blog\/wp-content\/uploads\/2023\/02\/9.png\")
<\/p>\n
The ER Visit<\/span><\/b>\u00a0<\/span><\/p>\nLeo\u2019s humans were baffled, but regardless of the cause of Leo\u2019s sickness, they decided to bring Leo to our ER for evaluation.\u00a0<\/span>\u00a0<\/span><\/p>\nUpon arrival, our team noticed Leo was restless, agitated, and pacing. Fortunately, his temperature was normal, but his heart was racing. Normally, Leo\u2019s heart rate should be 70-120 beats per minute. Leo\u2019s was 190! His pupils were still dilated, and he was clearly stimulated and distressed. Bloodwork was normal except for one thing \u2013 a severely low blood potassium level.<\/span>\u00a0<\/span><\/p>\nSo, What Was Causing Leo\u2019s Symptoms?<\/span><\/b>\u00a0<\/span><\/p>\nIt was a good thing Leo\u2019s parents did a quick sweep of the house for possible causes. With their findings, our team pieced together that Leo was suffering from a classic case of albuterol toxicity. This means he was most likely attracted by the interesting smell of the medication and did indeed bite the inhaler!<\/span>\u00a0<\/span><\/p>\nAlbuterol belongs to a class of drugs called bronchodilators, which work to relax and open airways during asthma attacks. More specifically, the medication is a beta2-adrenergic agonist, which works on smooth muscle in the lung to dilate and open airways. In an overdose, the medication can also cause dilation of blood vessels, changes in blood pressure, and stimulation of the heart – leading to racing heartbeat and agitation\/anxiety. Albuterol exposure also causes shifts in the body\u2019s potassium stores, driving potassium into the cells and decreasing the circulating potassium in the blood.\u00a0<\/span>\u00a0<\/span><\/p>\n![\"Fur-Tunately:](\"\/blog\/wp-content\/uploads\/2023\/02\/8.png\")
<\/p>\n
But why were Leo\u2019s signs so severe from just a small bite?<\/span><\/b>\u00a0<\/span><\/p>\nAlbuterol liquid in inhalers is pressurized so that it can be nebulized. When Leo\u2019s sharp canine tooth pierced the inhaler, the pressurized liquid inside the inhaler shot out into his mouth and was quickly absorbed into the tissues inside his mouth.\u00a0<\/span>\u00a0<\/span><\/p>\nInhalers contain enough liquid for many doses of medication, so although he didn\u2019t eat or potentially even swallow the medication, he received a significant overdose, rapidly delivered. The signs of agitation, panting, and restlessness soon made themselves known.\u00a0<\/span>\u00a0<\/span><\/p>\nLeo\u2019s condition was severe enough that hospitalization was recommended. There is no antidote for albuterol toxicity. Treatment entails supportive care until all the medication is metabolized and out of the system. So, it’s fortunate that Leo\u2019s family brought him in when they did!<\/span>\u00a0<\/span><\/p>\nLeo stayed in the hospital overnight and received IV fluids, potassium supplementation, and beta-blockers to control his racing heartbeat. Despite the beta-blockers, Leo\u2019s heart rate did not decrease overnight. He ate well, however, and the rest of his vital signs were normal.\u00a0<\/span>\u00a0<\/span><\/p>\n![\"Fur-Tunately:](\"\/blog\/wp-content\/uploads\/2023\/02\/7-1.png\")
<\/p>\n
Feeling Much Better<\/span><\/b>\u00a0<\/span><\/p>\nBy the next morning, Leo\u2019s heart rate was slowing down, and as the albuterol left his system, he improved steadily. His potassium levels returned to normal, and the potassium supplementation was discontinued. By mid-afternoon, his heart rate was finally normal!<\/span>\u00a0<\/span><\/p>\nLeo was cleared to go home, and his family came to get him, with a vow to keep better track of their albuterol inhalers!<\/span>\u00a0<\/span><\/p>\nLeo\u2019s story serves as an important reminder to always keep medications out of pets\u2019 reach, including inhalers. Don\u2019t leave medications where pets can easily access them – on the counter, table, or nightstand, or in a backpack or purse on the floor. In fact, if the asthmatic individual can easily open baby-proofed cupboards and drawers, these provide an extra layer of security.\u00a0<\/span>\u00a0<\/span><\/p>\nOur \u201cFur-tunately: Stories of Animal Survival\u201d series features real pets treated by our team at Animal Emergency & Referral Center of Minnesota. All images and information have been shared with the owner\u2019s permission.\u202f<\/span><\/i>\u202f\u202f<\/span>\u00a0<\/span><\/p>\nCase content provided by Kathy Rausch, DVM.\u202f<\/span><\/i>\u202f\u202f<\/span>\u00a0<\/span><\/p>\n![\"Animal](\"\/blog\/wp-content\/uploads\/2022\/08\/Fast-Track-Triage-for-Clients-Facebook-Post-7.png\")
<\/p>\n
<\/a>
\n
![\"Fur-Tunately,](\"\/blog\/wp-content\/uploads\/2021\/10\/Copy-of-Copy-of-stories-of-animal-survival-11.png\")
<\/p>\n