Warning: Cerenia Can Cause Death in Dogs
Whether Cerenia can cause death in dogs is something dog owners may be concerned about.
Whether your dog is enduring Cerenia side effects or you have been made aware of the hazards of death linked with this drug (as death is among the unfavorable effects mentioned in the drug's information brochure), you might be pondering what are the odds of this drug causing mortality in canines.
Side effects of drugs can be scary, especially when death is listed.
Following is some in-depth information about Cerenia for dogs, how this drug works and whether it's true that Cerenia can cause death in dogs.
Maropitant, Cerenia for Dogs
Cerenia for dogs, also known by its generic name, maropitant citrate, is a medication made for veterinary use and therefore requires a prescription by a licensed veterinarian.
The medication is indicated for dogs suffering from acute vomiting, but also to prevent the onset of motion sickness in dogs.
Cerenia for dog vomiting may be dosed differently based on the dog's age.
For dogs between 2 and 7 months, Cerenia may be given at a minimum dose of 0.9 mg for pound (2mg/kg) for up to 5 days in a row.
In dogs over 7 months, Cerenia is given at a minimum dose of 0.9 mg for pound (2mg/kg) until the acute vomiting resolves. .
According to DVM360, the latter instructions were updated recently from giving this drug for just a few days to giving it until the vomiting resolves.
According to Clinicianc's Brief higher dosages prescribed for motion sickness are approved only for puppies 16 weeks or older due to risks for bone marrow hypoplasia.
Consult with your vet for appropriate dosages based on your dog's age and weight.
While Cerenia may work to help dogs suffering from acute vomiting, Cerenia appears to be most effective in preventing vomiting by giving it prior to the onset of car sickness or for chemotherapy in cancer-stricken dogs.
In cases of copious vomiting, where the dog is unable to hold food or water down, the vet may decide to use an injection of Cerenia.
Can Cerenia Cause Death in Dogs?
Yes, Cerenia can kill dogs, but this can happen indirectly.
It's often forgotten that vomiting, albeit annoying, plays a very important role which is ridding the body from harmful substances such as toxins, viruses and bacteria.
Now, Cerenia has been proven to offer superior efficacy in preventing and reducing vomiting in dogs.
Indeed, in a couple of studies, even when dogs were administered products known to effectively cause vomiting in dogs such as apomorphine or syrup of ipecac, Cerenia was effective to such an extent as to being capable of inhibiting vomiting.
It's important to therefore understand that, when an effective product such as Cerenia is used to address vomiting in dogs, this drug does not treat the underlying cause of vomiting, but rather masks the symptoms.
This may cause dog owners to delay diagnostics and the institution of the most appropriate treatment.
It is best to therefore use Cerenia only after running standard tests and when some underlying important medical causes for a dog's vomiting have been ruled out.
Cerenia may therefore mostly prove beneficial in cases of self-limiting vomiting when it's known why the dog is vomiting in the first place (result of chemo, car sicknesses, dietary indiscretion) and more serious underlying causes have been ruled out.
Failure to address certain underlying causes of vomiting in a timely manner may result in serious complications and even death.
For instance, let's imagine a small dog who is vomiting due to an obstruction from ingesting pieces of plastic or a puppy that is vomiting from ingesting a toxic substance.
Giving Cerenia to these dogs may temporarily stop the vomiting, while the plastic may puncture the intestinal wall and lead to a case of peritonitis or the poison may get more and more absorbed.
Both these scenarios may likely result in death.
" Maropitant and other antiemetics should not be used in patients suspected of toxin ingestion, as this may mask progression and allow more time for toxin absorption.
In addition, the use of these antiemetics should be delayed until a clinical examination and abdominal radiographs have ruled out GI obstruction." ~Clinician's Brief
The side effects of Cerenia for dogs may be several.
Cerenia Can Cause Death from Adverse Effects
Many dog owners are concerned about whether Cerenia can cause side effects or death in dogs, but not from underlying disease processes.
These concerns are not unfounded, considering that the drug information leaflet lists several potential side effects some of which can be quite scary. However, it's also true that any medication can cause side effects!
Namely, side effects of Cerenia for dogs include hypersalivation, drowsiness, diarrhea, bloody stools, and lack of appetite as the most common.
Other Cerenia side effects in dogs include inflammation of the ear (3 dogs out of 206, 1.5 percent), endotoxic shock (2 dogs out of 206, 1 percent), blood in urine (2 dogs out of 206, 1 percent) excoriation, presence of erosion or ulceration caused by scratching, biting or rubbing (2 dogs out of 206, 1 percent).
Whether your dog develops side effects from Cerenia may vary based on several factors. For example, allergies to the drug is always a possibility.
This drug should be used with caution in dogs with impaired liver function. Cerenia has not been evaluated whether it is safe to use in pregnant or nursing animals.
The risks for Cerenia side effects in dogs are increased when Cerenia is combined with other drugs such as phenobarbital (a medication to control seizures); chloramphenicol (an antibiotic); ketoconazole along with some other antifungal drugs, certain types of thyroid hormone supplements, behavioral medications and some cardiac drugs, and non-steroidal anti-inflammatory drugs.
Make sure your vet knows whether your dog is on other medications while taking Cerenia.
The leaflet contained in the Cerenia package also mentions death as a side effect which can be concerning.
The drug information leaflet however fails going into more specific details as to the exact cause of death which may be insightful for concerned puppy and dog owners.
Did you know? Using Cerenia every day eventually risks depleting a dog's reserves of dopamine in their central nervous system leading to tremors (think Parkinson’s disease).
According to veterinarian Dr. Jennifer Coates, giving Cerenia on a schedule of five days on–two days off, or every other day, helps prevent this side effect.
Study Reports Dogs Dying After Cerenia
The drug information leaflet for Cerenia lists death as an adverse reaction in a US field study evaluating dogs administered Cerenia.
The leaflet mentions 10 dogs dying out of 206 receiving Cerenia, which is 4.9 percent.
This can be a scary statistic for concerned dog owners. The leaflet also lists 2 dogs being euthanized during the study, but there is no information as to why.
Interestingly though, the study also mentions 4 dogs dying during the study out of 69 (which is 5.8 percent) when given a placebo.
This leads to us pondering whether dogs may just die during studies. Perhaps they are old, frail or overly stressed making them more vulnerable.
Update 2022: The Zoetis website has been updated with some reassuring details: "The deaths were believed to be due to the underlying disease or condition that caused the dog to vomit and not due to Cerenia™.
At this time, there is no direct evidence that links these deaths with the use of Cerenia. "
Anecdotal Reports of Dogs Dying From Cerenia
Online, by simply googling "Cerenia killed my dog" it's easy to stumble upon several reports from dog owners witnessing death in their beloved dogs after being given Cerenia.
As scary as these reports are, it is unclear what really causes these deaths.
There are good chances that the dog ate something toxic or was suffering from a severe underlying disorder. Here are a few reports with some veterinarian observations.
Did Cerenia Cause My Puppy to Bleed to Death?
One owner reports her 10-week-old puppy dying from intestinal bleeding after being given Cerenia along with famotidine.
Her research led to reports of both these drugs potentially triggering diarrhea and causing her to suspect Cerenia as a cause for her puppy's death.
Veterinarian Dr. Scott Perry mentions that although the two medications can have potential side effects, intestinal bleeding is not one of them.
He explains how intestinal bleeding is likely to occur as a result of an ulcer, or as a result of catastrophic events when health is failing as a result of chronic inflammation or sepsis.
In this case, he suspects that the puppy's death may have more likely occurred as a result of a canine parvovirus infection. Other possibilities include intestinal parasites, poisoning, ingestion of a foreign body, or an infection.
Did a Cerenia Injection Cause My Dog to Die From a Heart Attack?
Another dog owner is concerned about her 13-year-old dog with a heart murmur dying as a result of Cerenia.
This dog also had a thyroid condition so was on the drug Synthroid and was taking Tramadol for pain.
The dog had a history of displaying seizure-like symptoms, causing him to faint and get stiff for about a minute.
After having bloodwork done, the vet prescribed Cerenia and an hour later the dog died.
Veterinarian Dr. Brazzell comments on the happening and remarks that the heart condition and potential pulmonary hypertension should have been the main focus and dealt with as top priority. He also mentions how the heart would may have given out eventually.
No answer was clearly provided whether Cerenia could have been a culprit.
Did The Cerenia Shot Cause My Dog to Die?
This report comes from a complaint allegation sent to a law firm. A dog was taken to the vet for developing diarrhea, leading to stopping eating and drinking.
Blood tests revealed an enlarged liver possibly due to ingesting something toxic. Metronidazole was dispensed to treat diarrhea and an IV was used to treat dehydration along with an antibiotic injection.
The dog owner was unaware of the dog being given a Cerenia shot. Instructions were given to give medications at home, including Cerenia tablets.
Owner reported the dog developed black stools (melena), at which point the vet suggested to stop the Cerenia.
The dog at some point could no longer walk and died.
Owner at this point did research on Cerenia and read that it's not supposed to be given to dogs with liver issues, small dogs or dogs who ingested anything toxic.
The veterinarian reported that the owner sought veterinary care ten days after having diarrhea. The owner tried to treat it at home by feeding a bland diet, but the diarrhea got worse and the dog refused to eat, and was drinking and peeing more.
The owner reported that her apartment complex was treated for bugs in her absence.
Owner then reported that the dog vomited blood a few minutes after being given a Cerenia pill.
The vet explained to her that it was impossible for the pill to be absorbed that quickly and cause gastric bleeding, but called a pharmacy to dispense some sucralfate to coat any possible bleeding ulcer.
The owner then announced the dog had died and requested medical records. Since no necropsy was performed, the cause of death remains unknown.
Can a Single Cerenia Shot Cause My Cat to Die From Anaphylactic Shock?
There are also some reports of cats dying from Cerenia.
To suffer from anaphylactic shock, your cat would have to have been exposed to Cerenia at least once before.
In order for anaphylactic shock to take place, you first need to make antibodies to it, and then the second, third, or tenth, you are exposed to it, then you would go on to develop the reaction.
Humans who develop anaphylaxis as a result of being exposed to peanuts do not have a reaction to them the first time they are exposed.
Therefore, unless your cat was given Cerenia in the past, it would be unlikely for him to develop anaphylaxis, explains veterinarian Dr. Rebecca.
On a More Positive Note
Despite several reports online of dogs mysteriously dying after receiving a Cerenia pill or Cerenia injection, many vets report that Cerenia is very safe.
Veterinarian Dr. Edwards, for instance, states "Cerenia - Maropitant is actually very safe. ..I have never seen any side effects in using this drug for more than 4 years now."
Countless dog owners also attest that Cerenia in their experience has been a god-send and it has literally saved their dog's lives.
In general when Cerenia is given correctly as prescribed, it is considered safe for dogs.
However, all dogs are different and therefore they may react to drugs differently. Any difference in your dog’s normal disposition should be promptly reported to your vet.
Whether Cerenia can cause death in dogs is under debate
What To Do If Cerenia Killed Your Dog?
In the unfortunate case of death following administration of Cerenia, a necropsy may be helpful to ascertain whether your dog truly died as a result of this drug.
The dog necropsy may reveal whether the drug may have been a culprit or whether there may have been underlying disease processes or toxic exposures at play.
If the dog had lab work prior to the administration of Cerenia which ruled out potential underlying disease processes or toxicities, then there are chances that the drug company may pay for the necropsy to determine whether an adverse reaction was possible.
If your dog has died as a result of Cerenia, you may wish to call the drug company to report the adverse outcome.
You can contact Zoetis Inc at 1-888-963-8471. Get a copy of your dog's medical records and recall all the events that led to the death.
You will be asked for information pertaining to your dog and the mishap. You can find the company's contact information usually on the drug's labels.
Upon receiving your complaint, the drug company will have to submit a report of adverse drug experience to the FDA.
Adverse reactions can also be filed directly with the FDA using their form. Information on how to report an adverse reaction can be found here: Reporting Animal Drugs.
This article on Cerenia deaths in dogs was originally published on Apr 29, 2018 at 4:56 AM
References:
- Sedlacek, HS, Ramsey, DS, Boucher, JF et al. Comparative efficacy of maropitant and selected drugs in preventing emesis induced by centrally or peripherally acting emetogens in dogs. J Vet Pharmacol Ther. 2008; 31: 533–537
- Efficacy of maropitant in preventing vomiting in dogs premedicated with hydromorphone, Bonnie L. Hay Krau, January 2013 Volume 40, Issue 1, Pages 28–34 Veterinary Anesthesia and Analgesia
- PetMD: Off Label Use of Drugs in Veterinary Medicine, Dr. Jennifer Coates
Disclaimer: this article is not meant to be used as a substitute for professional veterinary advice or behavioral advice. If your dog is acting sick or aggressive please consult with a qualified professional for proper diagnosis and treatment.
