PARACETAMOL TOXICITY IN CATS, Paracetamol, also known as acetaminophen, is a medication commonly used by humans to treat pain and fever.

However, it is highly toxic to cats and can even be fatal if ingested.

Why is paracetamol toxic to cats?

Unlike humans, cats lack the necessary enzymes to properly metabolize and eliminate paracetamol from their bodies.

Acetaminophen is primarily elimi- nated by two major pathways:

Glucuronidation and Sulfation. 

When these pathways are saturated or deficient, an alternative pathway breaks down the acetaminophen to a toxic metabolite called NAPQIa a free radical that damages hemoglobin, red bloodcells(RBCs), and, occasionally, kidney cells. 

Cats are deficient in glucuronidation and sulfation abilities and, therefore, more susceptible to acetaminophen toxicosis than dogs.

NAPQI can bind to the hepatic cell membrane and damage the lipid layer, causing hepatocyte injury and death. 

The oxi-dant damage to heme molecules results in methemoglobin

Oxidation of hemoglobin may also cause Heinz body formation. 

Damaged RBCs maybe subsequently removed from circulation, causing anemia.

Symptoms of paracetamol toxicity in cats:

Early signs (within 1-4 hours of ingestion):



Loss of appetite

Pale gums

Rapid breathing

Later signs (within 24-72 hours of ingestion):

Difficulty breathing

Blue or chocolate-brown colored gums (methemoglobinemia)

Facial swelling

Dark urine

Jaundice (yellowing of the skin and eyes)

Liver failure


The diagnosis of acetaminophen toxicity is most often made by the exposure history and development of assciated clinical signs. 

A rapid bench-top test that may be helpful entails placing a drop of the patient's blood next to a drop of normal blood on white filter paper. 

Blood containing excess methemoglobin appears chocolate brown in contrast to normal blood.


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Treatment for paracetamol toxicity in cats:

The treatment for paracetamol toxicity in cats will depend on the severity of the poisoning and the specific symptoms present. 

It may include-

Intravenous fluids to support hydration and electrolyte balance.

N-acetylcysteine, an antidote that helps to reduce the levels of toxic metabolites.

Oxygen therapy to improve oxygen delivery to the tissues

Blood transfusions in severe cases

Liver protectants


Research has shown a higher incidence of acetaminophen-induced methemoglobinemia in cats fed a diet high in propylene glycol than in those fed diets low in propylene glycol. 

Wet cat food contains 7% to 13% propylene glycol, which may induce methemoglobinemia or Heinz body formation in cats. 

The preexistence of RBC injury due to propylene glycol consumption may contribute to increased sensitivity of RBCs to oxidative stress caused by acetaminophen ingestion.

Credits: ASPCA, Illinois

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