How to use ToxBuddy
STEP 1: Find acetaminophen in ToxBuddy’s database and use the toxin calculator
The first thing you need to know is if the dog has ingested a potentially toxic amount. With ToxBuddy, you can get this crucial information easily in an instant:
- Start typing the name of the substance and choose the right one from the available options
- Enter the estimated ingested amount
- Enter the patient’s weight
In this case, the owner says that the dog, who found and toppled a poorly-closed acetaminophen pill bottle, managed to eat probably four pills of 500 mg. This gives an estimated total amount of 2000 mg. The owner also reports that the dog weighs 18 kg.
STEP 2: See the patient-specific risk assessment
ToxBuddy calculates the exposure level and gives an instant risk assessment based on the entered data. In this case, the dose is high enough to cause hepatotoxicosis and the patient needs to be examined and treated.
STEP 3: Read forward
It is not often known exactly how much of the potential toxin the dog has eaten. Even if the toxicity level is estimated to be low, it is always good to be prepared for surprises. ToxBuddy provides all the additional information you need for complete case management. The information in the following sections is not patient-specific, i.e. it is always presented in its entirety regardless of the severity of poisoning in your patient.
General Information on the Substance
A short general information entry gives you a quick overview of the substance. Although ToxBuddy currently helps you to manage poisonings exclusively in dogs, in this section you may see some specific information related to cats if they differ greatly from dogs in their sensitivity for that given substance. Here you can also see when the page was first created and when it was last reviewed.
Clinical Signs
ToxBuddy lists all potential clinical signs related to a particular substance. If the information is available, typical onset times for these signs (counted as hours or days from the moment of ingestion) are also given. Clinical signs may also be grouped into different categories. In the case of acetaminophen, the main grouping is based on whether the signs are related to hepatotoxicity or methemoglobinemia.
Decontamination
ToxBuddy presents all the relevant decontamination procedures. It is for you to review the options carefully and to choose the best course of action for your patient. Red exclamation marks highlight crucial points not to be ignored; in the case of acetaminophen, it is essential to first check the information on the antidote before administering activated charcoal.
Diagnostics
ToxBuddy gives you general guidelines to confirm your diagnosis and presents information on typical changes in laboratory samples (blood, urine) or other diagnostics (imaging). With acetaminophen, you can get a lot information from a blood sample. Changes you might see include hypokalemia and hypophosphatemia, which typically develop 12 hours after the ingestion.
Symptomatic Treatment
ToxBuddy provides you a list of options on how to treat different toxic symptoms. In this section, you can also find the information on the antidote, if there is one. Here the exclamation marks highlight particularly important details, which in the case of acetaminophen are related to diluting NAC and exercising caution when using maropitant.
Monitoring
After the patient has been evaluated and/or the potential acute clinical signs have been addressed, the next step is to keep an eye on the situation. ToxBuddy shows you which clinical and laboratory parameters to monitor during the following days or weeks.
Prognosis
It is important to be able to inform the owner who wants to know what the chances are for a full recovery. ToxBuddy provides general guidelines on how different prognostic factors might affect the outcome. With acetaminophen – as with many other toxic substances – the prognosis depends mainly on the absorbed amount and how fast the treatment was initiated.
References
ToxBuddy is based on current veterinary literature. At the end of each page, you have a reference list showing where the information was compiled from. It is our number one priority to offer trustworthy information on all occasions!
With our monthly subscription, you can use ToxBuddy as much as you want. Look up different substances and just test the calculator to see how a given toxin would affect a dog of a certain weight. We appreciate your feedback and you can send us your thoughts about the service itself or to report a missing substance. Our aim is to improve ToxBuddy on a regular basis, based on the opinions of the people who matter the most – you, the users.
Why not try ToxBuddy today?