Tagged: “medicine”

Drugstore Care for Those After-Hour Emergencies

by Zeke Zekoff, DVM

The purpose of this paper is to introduce people who are associated with animal welfare organizations to some common first-aid techniques that can be administered to animals at times when you can’t get veterinary aid for whatever reason.  These techniques are unique in that you will be using commonly available items from the drugstore.  It seems that everywhere you turn now a days, drugstores have replaced gas stations on every major corner.  As they prepare for the baby boomers falling apart, they also stay open longer hours than a vast majority of veterinary clinics. This makes them the most likely source of pet first-aid medical supplies when you are not able to get to a veterinarian.

Many of these notes come from a presentation made to canine corps officers several years ago.  These 4-legged police officers and their two-legged partners were more often than not in harms way at night. With many cities not having veterinary emergency clinics, it seemed logical to teach the 2-legged officers how to take care of their 4-legged partners in times of medical crisis: such as hit-by-car, poisonings, lacerations and cuts, and even bullet wounds. Over the years, vets called at home have developed a knack for dissecting an owner’s health history of their pet’s ‘emergency’, and have realized that many calls were not ‘true emergencies’. With a modicum of care using supplies readily available in most people’s medicine cabinets or a nearby drugstore, most ‘emergencies’ could be handled till the next day. With this in mind, a list of commonly available drugstore first-aid items will be presented and how they can be used for your home ‘animal first-aid kit.’

Gauze sponges.  Gauze sponges are used to help dress wounds.  They can be used with water (or better yet, saline solutions) to help clean out a wound. The texture of the sponges helps to clean out debris from the wound that would normally contaminate it and introduce bacteria. After cleaning out a wound with the sponges and a liberal application of a flush solution, clean sponges can than be used to make a wound dressing. Liberal application of a triple antibiotic ointment (such as Neosporin, Polysporin, or Triple Antibiotic Ointment) to the sponge, along with making it damp with a sterile saline eye wash solution, will make an excellent dressing until it can be properly taken cared of.  By making the sponge slightly damp, this allows the dressing to not get dried out and stick to the wound.  3 x 3” or 4 x 4” -sized sponges are usually the most versatile to keep around. Use the bandage materials described later to keep the dressings on.

Triple Antibiotic/Neosporin/Polysporin Ointment. These are commonly available antibiotic ointments that can be used on most skin infections and for the treatment of most wounds. You should be cautious using it around the eyes as it may inadvertently get into the eye by the animal rubbing its face.  After cleaning out a wound (as previously described), the ointment can be applied.  Ideally you should use a clean applicator device, such as a tongue depressor, or the back of a clean spoon.  By attacking the bacterial load in the ‘golden period’ of wound infection (the first 2-4 hours after a wound occurs), you can significantly decrease the chance of infection in the wound area.

Rubbing Alcohol.  Rubbing alcohol (70% isopropyl alcohol) is an excellent disinfectant and can be used to kill bacteria on most things you would want to use.  Caution should be used with rubbing alcohol when getting anywhere near an open wound on a dog or cat.  Just as it ‘burns you’ when you get it in an open cut, sore, etc., it will do the same thing to an animal.  They will not just respond with yelling, but rather they may turn and try to bite the person who applied such an offending agent. If by accident you get any in the eye, flush the eye thoroughly with liberal amounts of an eyewash, or just water, if eyewash is not available.

Rubber bulb ear syringes.  These remnants from the days of our youth when we had impacted wax flushed out of our ears, have many uses. They can be used with water to flush out debris from a wound; aspirate or suction out fluids from the nostrils and mouth of your pet prior to performing CPR; in the proper situation, water and hydrogen peroxide can be mixed together to make a more efficient wound cleansing agent; they can be used to collect liquid samples of vomitus, etc. if needed to analyze a poison, etc.; and, they can also be used to flush out ear canals when necessary.

Ace bandages.  These readily available bandages have many uses. By properly applying an ace bandage to a lower appendage, they can act as a support bandage for injured toes, feet, carpal (wrist), and hock (ankle) areas of pets.  Do not apply it too tight, or it may act as a tourniquet. Ace bandages can be used to hold a temporary splint on a fractured or injured limb.  The splint can be made with a number of different objects…including rolled-up newspapers, board, etc. It can be used for holding the wound dressing on the body previously described. By applying pressure to the abdominal area in case of suspected abdominal bleeding, a properly applied large Ace bandage could help slow down blood loss and the onset of shock.  These bandages are washable and reusable.  It is recommended that you should have at least 2 Ace bandage rolls each of  the 2” and 4” sizes.

Petroleum jelly/Vaseline®.  This ‘wonder goo’ has many uses besides treating diaper rash.  One use is to lubricate a rectal thermometer before taking an animal’s temperature. After a wound area is flushed out, it can be applied in a liberal amount, mixed in with a triple antibiotic ointment, to keep a wound area from ‘drying out’ and sticking to any bandage materials.  This is especially useful when you have a thermal burn wound as fluid loss can be critical from this type of wound. Degloving injuries and ‘road burns’ that occur during hit-by-cars (HBC) are also another area where petroleum jelly applied to your dressing can be a tremendous help. Do not use petroleum jelly dressings on chemical burns as their moisture-retention ability may also keep the chemical irritant trapped on the body. Petroleum jelly can also serve as a laxative, as it is the basis for most hairball laxatives.  Most cats would be given ½ to 1 teaspoon applied on their paws, face, or in their mouth.

Eye wash.   It is important to always have a good eye flush solution readily available. Most drugstores sell saline eyewash that can be gotten for less than $2.00 for a 12 oz. Bottle. Having more than one on hand would be better. Contaminants that can get into the eye include dust, chemicals, smoke, insects (when those dogs that are determined to replay the Titanic scene by sticking their head out of the window of a car), grass awns, and even dirty water from contaminated ponds and streams. A good, liberal flow into the affected eye is important. Have the animal look at the ceiling or sky and keep flushing for 1 –2 minutes. Many people will think to try a Visine® or such substance in the eye. It is much better to use water than this.  For eye care, it is important to not put anything into an animal’s eye that you wouldn’t put in your own, but Visine and contact solutions are exceptions to this.  If your pet is squinting badly, light-sensitive and constantly rubbing its eye, this may indicate that it has scratched its cornea.  This is a painful injury, and seeking veterinary care should be a priority.

Non-stick Wound Pads.  These wound-dressing pads, which come in sterile wrappers, are usually 3 x 3” or 4 x 4”.  They make great wound dressings that you can use with your triple antibiotic ointment and Vaseline/ petroleum jelly.  They are better for final wound dressings than gauze sponges.

Stretch gauze bandages.  These one-time use bandages are great for helping to keep wound dressings on.  The stretch-feature will help to accommodate any swelling that normally accompanies most trauma wounds. It reduces the chance that the bandage will become a tourniquet when applied.  Having said that, it is important that these bandages are NOT applied too tight. The looser, the better.

Cloth tape.  This type of tape is important to help keep wound dressings where they are supposed to be.  It is important to involve the animal’s hair into the tape as it is applied.  This will assure you that the dressing won’t end up on the floor of your car.

Blankets.   These are not readily available at most drugstores, but do have many uses. In cases of trauma where shock may set in, they can be used to keep the animal warm. Rolled up, it can be used as a support bandage for neck wounds, fractured limbs, and pressure support around the abdomen to help ward off shock.  They also make great stretchers, and help to contain an injured cat that may be aggressive due to pain.

Tweezers.   These are important to help pull debris out of wound, objects out or mouths without getting your fingers involved, and such items as insect stingers and spine needles from cacti.

Splints.   Splints can be bought custom-made, but they can also be made out of a number of materials.  These include newspapers, branches, boards, and any other straight and hard object.  With a roll of roll-cotton, a splint, and an Ace bandage or Vet wrap, you can make a very stabilizing bandage called a Robert Jones bandage. These are great for stabilizing lower leg fractures of animals until veterinary attention can be sought.

Rectal Thermometers.   Thermometers serve a purpose when you are worried about hypothermia (low body temperature) and hyperthermia (high body temperature such as may occur in a heat stroke).  The important thing to remember is that the normal canine and feline body temperature ranges between 101.0 degrees F. and 102.5 degrees F.  Do not use a ‘warm nose’ as your determinant of a fever in an animal.  Also remember to lubricate the thermometer, have someone holding the animal’s head when inserting the thermometer, insert it in at least 1 ½ inches, and read after one minute.

VetRap® bandage material.  This is a bandage material that can be acquired in feed stores, Western stores (used a lot in horses), and your favorite veterinary clinic.  This ‘self-stick’ bandage has a lot of uses in cases of emergencies.  You must be careful to apply it without too much stretching of the bandage, as stretching it too tight may make it a tourniquet. By not overstretching it when applying it, it can be removed and used several times.  Have 2” and 4” rolls available.

Ziplock bags.  Many uses for this kitchen favorite.  Among them are storage containers for samples of body fluids, contaminants, etc.; temporary ice bags; helping to keep your first-aid supplies dry till you need them, and water-proof bags to keep feet injuries dry.  One quart and one gallon ziplock bags are good sizes to have.

Muzzle.   This overlooked item can be very useful if you are confronted with an injured and painful dog.  No matter how well any dog is trained, pain from trauma might induce a dog to turn on you no matter how close you and the dog are.  You can get soft, nylon quick-release muzzles through your veterinarian’s distributors; use a doubled-up gauze bandage roll from the drugstore in looping fashion; or use a belt you may have on. Be sure to have your veterinarian or one of the staff members of the clinic show you how to properly apply a muzzle the next time you are in. the clinic.  Be prepared in advance for this one.  You cannot help if you are treating a bite wound on yourself.

  • Pepto Bismol® tablets (bismuth subsulfate).   (NOT TO BE GIVEN TO CATS)

These are good for non-complicated cases of vomiting in the dog.  The ingredients in this tablet have proven anti-inflammatory properties in the GI tract and also help to apply a protectant lining to the stomach.  Tablets are usually easier to administer vs. liquids. The approximate dose is one adult tablet/ 15 – 25# of dog’s body weight every 8 – 12 hours.  Two precautions.  This tablet will make the dog’s bowel movement appear very dark for several days.  The second is that if your veterinarian has to take a radiograph of your dog’s abdomen soon after administering the tablet, the tablet will appear to be a metallic-density foreign object in your dog’s abdomen and may lead to an in-correct diagnosis of a foreign body that is causing all the problems.  Be sure to let your veterinarian know what medications you have administered.

  • Kaopectate® tablets.   (NOT TO BE GIVEN TO CATS)  The kaolin and pectin in these tablets are especially useful in helping to the line the intestinal tract of a dog with diarrhea. The usual dose is 1 tablet (less messy than liquid) for every 25 – 30 lbs. of dog’s body weight, given every 8 – 12 hours.

  • Benadryl® (diphenhydramine).   This antihistamine can be very useful for very pruritic (itchy) dogs, motion sickness, and for allergic reactions such as from a bee sting.  Adult Benadryl® is available in 25mg capsules or tablets, or 25mg/5ml (teaspoon). Children’s Benadryl® is available in 12.5mg chewable tablets or 12.5mg/5 ml (teaspoon).  The approximate dose is 0.5 to  1mg/lb of body weight every 8 – 12 hours.  For example, a 25# dog would get one half to one adult tablet every 8 – 12 hours. Drowsiness and a dry mouth will be the main side effects you may see.  In cases of allergic insect sting reactions where the face and muzzle swells up suddenly, giving this antihistamine soon after seeing the symptoms can help alleviate the discomfort.  The same doses can also be used to help alleviate intense itching from skin problems, as well as decrease the side effects of motion sickness. This medication is also available in a 1% and 2% ointment that can be used on the skin to help treat ‘hot spots’ or acute moist dermatitis of the skin.
  • 1% Hydrocortisone cream.  This popular over-the-counter steroid itchy-skin remedy can also be used in dogs and cats.  If your dog has a ‘hot spot’ (which is the laymen’s term for acute moist dermatitis), it can drive your dog to further inflict damage to itself.  These can literally come up ‘over night’.  Most are painful as they are deep-seated infections that involve the superficial pain nerve endings in the skin.  Until you get professional help for your pet, the best thing that you can do is to begin treatment by gently washing the inflamed area with a mixture of 1 part 3% hydrogen peroxide to 2 parts of water. Be sure to have someone restrain the head of your dog.  After washing the area, dry the area by pat drying with a soft towel. You can begin treatment by mixing a 50:50 mix of 1% hydrocortisone cream and triple antibiotic ointment (Neosporin or polysporin also works) and applying a thin layer to the affected skin. Take your dog for a walk afterwards to give the treatment time to work and take its mind off from wanting to lick the area.
  • Aspirin.   (NOT TO BE GIVEN TO CATS)  Used correctly, aspirin is a very effective analgesic (pain reliever), anti-inflammatory, and fever reducer in dogs.  It is considered in a class of drugs called NonSteroidal Anti-Inflammatory Drugs (NSAID). This class of drugs can be very irritating to the stomach and can cause everything from vomiting/nausea to bleeding gastric ulcers. It needs to be used at the proper dosage and frequency.  At any signs of nausea or vomiting, you should not continue the drug.  Giving it with a little bit of food in the stomach may help prevent these side effects. The usual dose is 1 – 5grain (325mg) adult aspirin/ 60 lbs. of dog’s body weight every 12 hours.  A ‘baby aspirin’ or low-dose adult aspirin contains 1 ¼ grain (or approximately 81mg) and would be appropriate for a 15 lb. dog every 12 hours.
  • 3% Hydrogen Peroxide.   This inexpensive solution is a part of many drug cabinets, and has many uses.  The first use is to help wash out wounds and clean the debris, blood and dirt out of a wound.  The foaming action helps to break up the dirt and clear out bacterial contaminants.  It can also be damaging to tissues, so diluting it with water will make it safer.  DO NOT pour peroxide into any puncture wounds as the sudden foaming action will cause gas production and stretch the skin and subcutaneous with resultant sharp pain and discomfort. This would be a situation where the animal could turn around and bite due to the pain.

    3% hydrogen peroxide is also an effective emetic (causing vomiting)…DO NOT USE THE 20% SOLUTION USED TO BLEACH HAIR!  If your pet has swallowed something such as chocolate, pills on your bed stand, etc., it has occurred in the last 15 – 20 minutes, and if you are advised to make your pet vomit, you can administer 3% hydrogen peroxide with a tablespoon to get it to vomit the substance up.  Do not use it if you have seen your pet swallow a sharp object or a caustic substance.  This is a true emergency, and the pet must be seen soon.  The effective dose, in those situations when you can use it, is 5 –25 ml (1-5 tsp.)/ 10 lb. of body weight to the back of the throat.  You can repeat it every 5 – 10 minutes for 2 – 3x. The vomitus that comes up will be white and very foamy and hopefully have the offending agent in it.  After the vomiting episode, your dog or cat will feel very sheepish.  You may try giving your dog a slice or two of water-soaked white bread to settle its stomach.  This usually works faster and better than syrup of ipecac.  If you have some of it (ipecac), the dose is 1- 2ml/kg in dogs and 3 – 6ml/kg in cats, but sometimes in can take up to 20 – 40 minutes to induce vomiting.  In cats it works best if diluted 50:50 with water and given 6ml/kg of body weight. The viscosity of syrup of ipecac is similar to motor oil.

Common Sense Numbers That You Can Use

1 kilogram (kg) = 2.2 pounds

…..if you want to rough it, make a kilogram equal to 2 pounds, i.e. a 20 pound dog = 10 kg. (rather than 9.09 kg.)…it will do in a pinch.

1 Milliliter (ml) approx = 1 cubic centimeter (cc).  These terms are used interchangeably.

  •  5 ml = 1 teaspoon
  •  3 teaspoons = 1 tablespoon
  •  15 ml = 1 tablespoon
  •  2 tablespoons = 1 ounce (oz.)
  •  30 ml = 1 oz.
  •  Therefore, 1 oz. = 6 teaspoons
    1 cup = 8 ounces
  •  240 ml = 8 oz.
  •  2 cups = 1 pint (pt)
  •  2 pints = 1 quart (qt)
  •  1 quart is approximately = to 1 liter or 1000 ml.

1 grain = 65 mg., therefore a normal 5 grain aspirin tablet is equal to 325 mg.

A baby aspirin or low-dose adult aspirin is 1 ¼ grain or approx. 81mg; it takes 4 baby aspirins to equal 1 adult aspirin.

A dog and cat’s normal rectal body temperature (with rectal thermometer staying in for 1 minute) ranges from 101.0 degrees Fahrenheit – 102.5 degrees Fahrenheit.  This normal range may vary depending on the dog or cat’s activities and the environmental temperature (there are many ‘normal and healthy’ dogs who have a 103.0 +/- degree Fahrenheit temperature due to excitement and hot days). ALL DOGS HAVE A TEMPERATURE, NOT ALL DOGS HAVE A FEVER!

Respiratory rate of healthy, resting dog: (young) 20 – 22 breaths/minute and for old dogs 14 –16 breaths/minute.

Heart rate of healthy, resting dog: Young dog:  110-120 beats/minute; Dog of large breed, adult:  60 – 80 beats/minute; Dog of small breed, adult: 80 – 120 beats/minute.