Keracunan Parasetamol Pada Kucing Dan Anjing: Gejala Klinis dan Terapi
Paracetamol Poisoning in Cats and Dogs: Clinical Symptoms and Therapy
DOI:
https://doi.org/10.46549/jipvet.v10i1.86Keywords:
paracetamol, toxicity, methaemoglobinaemia, acetylcysteineAbstract
Acetaminophen, commonly known as paracetamol, is a non-steroidal anti-inflammatory drug commonly used in human medicine for its antipyretic and analgesic action. As paracetamol became readily available in many over-the-counter and no-prescription products, reports of paracetamol poisoning in dogs and cats became more common. The toxicity of paracetamol is more pronounced in cats when compared to dogs. Clinical signs of paracetamol toxicity include depression, weakness, tachypnea, dyspnea, vomiting, hypothermia, facial or paw edema, hepatic necrosis, and death. The characteristics of severe paracetamol poisoning are methemoglobinemia, cyanosis, anemia, and jaundice. Although there are no specific antidotes, acetylcysteine is the drug of choice for paracetamol poisoning treatment. Symptomatic and supportive therapies play a more definitive role in the management of paracetamol poisoning. This paper aims to briefly review the clinical symptoms, diagnosis, and treatment of paracetamol poisoning in dogs and cats.
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References
AHFS Drug Information. 2000. Acetaminophen. American Society of Health-System Pharmacists. Edited by McEvoy, GK.
Allen AL. 2003. The diagnosis of acetaminophen toxicosis in a cat. Can Vet J. 44(6), 509–510.
Aronoff DM, Oates JA and Boutaud O. 2006. New insights into mechanism of action of acetaminophen: Its clinical pharmacologic characteristics reflect its inhibition of the two prostaglandin H2 synthases. Clin. Pharmacol. Ther. 79(1): 9-19.
Aronson LR and Drobatz K. 1996. Acetaminophen Toxicosis in 17 Cats. Journal of Veterinary Emergency and Critical Care. 6(2): 65-69.
Bales JR, Nicholson JK and Sadler PJ. 1985. Two-dimensional proton nuclear magnetic resonance "maps" of acetaminophen metabolites in human urine. Clinical Chemistry. 31(5): 757-762.
Bates N. 2016. Paracetamol poisoning. Companion Animal. 21(10): 576-580.
Botting RM. 2000. Mechanism of action acetaminophen: Is there a cyclooxygenase 3? Clinical Infectious Disease. 31(S2): 02-210.
Court MH. 2013. Feline drug metabolism and disposition: pharmacokinetic evidence for species differences and molecular mechanisms. Vet Clin North Am Small Anim Pract. 43(5): 1039-1054.
Court, MH and Greenblatt DJ. 2000. Molecular genetic basis for deficient acetaminophen glucuronidation by cats: UGT1A6 is a pseudogene, and evidence for reduced diversity of expressed hepatic UGT1A isoforms. Pharmacogenetics. 10: 355–369.
Denzoin-Vulcano LA, Confalonieri O, Franci R, Tapia M.O and Soraci AL. 2013. Efficacy of free glutathione and niosomal glutathione in the treatment of acetaminophen-induced hepatotoxicity in cats. Open Veterinary Journal. 3(1): 56-63.
Dewandaru RA, Indarjulianto S, Yanuartono, Nururrozi A, Purnamaningsih H and Hayati R. 2019. Diare disebabkan Infeksi Escherichia coli pada Anjing. Jurnal Ilmu Peternakan dan Veteriner Tropis (Journal of Tropical Animal and Veterinary Science). 9(2): 38-43
Donova JW. 1998. Nonsteroidal anti-inflammatory drugs and cochicine. In: Clinical Management of Poisoning and Drug Overdose, 3rd Ed. Ed by LM Haddad. Philadelphia, W.B. Saunders Company. pp. 687-699.
Finco DR, Duncan JR, Schall W.D and Prasse KW. 1975. Acetaminophen toxicosis in the cat. J Am Vet Med Assoc. 166(5): 469-472.
Gunnell D, Murray V and Hawton K. 2000. Use of paracetamol (acetaminophen) for suicide and nonfatal poisoning: worldwide patterns of use and misuse. Suicide Life Threat Behav. 30(4): 313-326.
Gwaltney-Brant S, Albretsen JC and Khan SA. 2000. 5-Hydroxytryptophan toxicosis in dogs: 21 cases (1989-1999). Journal of the American Veterinary Medical Association. 216(12): 1937-1940.
Haschek WM. 1998. Hepatobiliary System. In Fundamentals of Toxicologic Pathology. Academic Press, San Diego. pp 127-151.
Hendricks J and Gates K. 2019. Transient methemoglobinemia suspected secondary to ingestion of Brassica species in a dog. Vet Med (Auckl). 10: 37-42.
Hjelle JJ and Grauer GF. 1986. Acetaminophen-induced toxicosis in dogs and cats. J Am Vet Med Assoc. 188(7): 742–746.
Holtzworth J. 1987. Diseases of the Cat. In Medicine and Surgery. W. B. Saunders Company, Philadelphia, PA. p.742.
Horowitz RS. 2000. Acetaminophen B acute single ingestion. In: Dart RC, ed. The 5 Minute Toxicology Consultant. New York: Lippincott Williams & Wilkins. pp.164–167.
Ibrahim T, Agnihotri S and Agnihotri AK. 2002. Paracetamol Toxicity- An Overview. Emergency Med. 3(6): 1-3.
Ilkiw JE and Ratcliffe RC. 1987. Paracetamol toxicity in a cat. Aust Vet J. 64(8): 245–247.
Jaeschke H, Gores GJ, Cederbaum AI, Hinson JA, Pessayre D and Lemasters JJ. 2002. Mechanisms of Hepatotoxicity. Toxicol. Sci. 65(2): 166–176.
Jahr JS and Lee VK. 2010. Intravenous acetaminophen. Anesthesiol Clin. 28(4): 619–645.
Jenkins EL, De Souza NJ, Beatty JA and Barrs VRD. 2019. Suspected adverse drug interaction between spinosad and milbemycin oxime in a cat. Journal of Feline Medicine and Surgery Open Reports. 5(1):1-5.
Jerzsele A. 2012. Comparative veterinary pharmacokinetics.http://cdn.intechopen.com/pdfs-wm/35674.pdf.
Jóźwiak-Bebenista M and Nowak JZ. 2014. Paracetamol, mechanism of action, applications and safety concern. Acta Pol. Pharm. 71(1): 11-23.
Judge PR. 2018. Protocol for Management of Paracetamol/Acetaminophen Toxicity in Dogs and Cats. https://veteducation.com.au › wp-content › uploads › 2018/05 › Paracetam.
Kalsi SS, Wood DM, Waring WS and Dargan PI. 2011. Does cytochrome P450 liver isoenzyme induction increase the risk of liver toxicity after paracetamol overdose? Open Access Emerg Med. 3: 69–76.
Kelly WR. 1984. Examination of abdomen in small animals. Vet. Clin. Diagnosis. 3 Ed. pp.26-46.
Khan A, Kathryn Flavin K and Tsang J. 2014. Weight a minute - iatrogenic paracetamol toxicity is preventable by utilisation of well-designed drug charts. BMJ Qual Improv Rep. 3(1): 1-3.
Klainbart S, Merbl Y, Kelmer E, Cuneah O, Edery N and Shimshoni JA. 2014. Tremor-Salivation Syndrome in Canine following Pyrethroid/Permethrin Intoxication. Pharmaceutica Analytica Acta. 5(9): 1-3.
Larsen FS and Wendon J. 2014. Understanding paracetamolinduced liver failure. Intensive Care Med. 40(6): 888–890.
Lee JA. 2013. Emergency Management and Treatment of the Poisoned Small Animal Patient. Vet Clin Small Anim. 43 (2013): 757–771.
MacNaughton SM. 2003. Acetaminophen toxicosis in a Dalmatian. Can Vet J. 44(2): 142–144.
Mariani CL and Fulton Jr RB. 2001. Atypical Reaction to Acetaminophen Intoxication in a Dog. Journal Of Veterinary Emergency And Critical Care. 11(2): 123-126.
McConkey SE, Grant DM and Cribb AE. 2009. The role of para-aminophenol in acetaminophen-induced methemoglobinemia in dogs and cats. J Vet Pharmacol Ther. 32(6): 585-595.
Merol VM and Eubig PA. 2012. Toxicology of avermectins and milbemycins (macrocylic lactones) and the role of P-glycoprotein in dogs and cats. Vet Clin North Am Small Anim Pract.42(2): 313–333.
Mitchelle JR, Jollow DJ, Potter WZ, Davis DC, Gillette JR and Brodie BB. 1973. Acetaminophen-induced hepatic necrosis-I Role of drug metabolism. J Pharmacol Exp Ther. 187(1): 185-194.
Nash SL and Oehme FW. 1984. A review of acetaminophen's effect on methemoglobin, glutathione, and some related enzymes. Vet Hum Toxicol. 26(2): 123-132.
Osweiler G. 1997. Household Drugs. The Handbook of Small Animal Practice, 3rd Edition, Churchill Livingstone, New York: pp 1279-1283;
Oros NA, Farcal RL, Marculescu A, Cernea M and Bale GA. 2007. Clinical, paraclinical and therapeutic evaluations of acetaminophen toxicosis in dogs. Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. 62(1-2): 514–520.
Perry H. 1998. Acetaminophen. Clinical Management of Poisoning and Overdoses. Clinical Management of Poisoning and Drug Overdose. 3rd ed. W.B. Saunders Company, Philadelphia. pp.88-198.
Plumb DC. 1999. Veterinary Drug Handbook, 3rd ed. Ames, Iowa State University Press.
Pothiappan P, Muthuramalingam T, Sureshkumar R, Selvakumar G, Thangapandiyan M and Rao GD. 2014. Paracetamol Poisoning In A Cat And Its Treatment. Ind. J. Vet. & Anim. Sci. Res. 43(5): 388-389.
Rajesh J, Mahendran K, Bhanuprakash A, Lekshmanan A, Choudhary S and Dixit S. 2017. Paracetamol toxicity in a cat. International Journal of Livestock Research. 7(2): 212-214.
Richardson JA. 2000. Management of acetaminophen and ibuprofen toxicoses in dogs and cats. Journal of Veterinary Emergency and Critical Care. 10(4): 285-291.
Rossoff IS. 1994. Handbook of Veterinary Drugs and Chemicals, Pharmatox Publishing Company, Taylorville, Illinois, USA.
Salgado BS, Monteiro LN and Rocha NS. 2011. Allium species poisoning in dogs and cats. J Venom Anim Toxins incl Trop Dis. 17(1): 4-11.
Savides MC, Oehme FW, Nash SL and Leipold HW. 1984. The toxicity and biotransformation of single doses of acetaminophen in dogs and cats. Toxicol Appl Pharmacol. 74(1): 26–34.
Scherkl R, Hashem A and Frey HH. 1990. Apomorphine-induced emesis in the dog--routes of administration, efficacy and synergism by naloxone. J Vet Pharmacol Ther. 13(2): 154-158.
Schlesinger DP. 1995.Methemoglobinemia and anemia in a dog with acetaminophon toxicity. Can Vet J. 36(8): 515-517.
Sehitoglu MH, Yayla M, Kiraz A, Oztopuz RO, Bayir Y, Karaca T, Khalid S and Akpinar E. 2017. The effects of apomorphine on paracetamol-induced hepatotoxicity in rats. Cell Mol Biol. 63(12): 41-45.
Sellon RK. 2001. Acetaminophen. In: Peterson ME, Talcott PA, eds. Small Animal Toxicology. Toronto: WB Saunders. pp.388-395.
Sheen CL, Dillon JF, Bateman DN, Simpson KJ and Macdonald TM. 2002. Paracetamol toxicity: epidemiology, prevention and costs to the health-care system. QJM 95(9): 609-619.
Skold A, Cosco DL and Klein R. 2011. Methemoglobinemia: pathogenesis, diagnosis, and management. South Med J. 104(11): 757-761.
Srabovic M, Huremovic M, Catovic B, Kulic S and Taletovic A. 2017. Design synthesis and crystallization of acetaminophen. J Chem Bio Phy Sci. 7(1): 218-230.
Steenbergen V. 2003. Acetaminophen and cats – a dangerous combination. Vet Technician. 24(1): 43-45.
Stidworthy MF, Bleakley JS, Cheeseman MT and Kelly DF. 1997. Chocolate poisoning in dogs. Vet Rec. 141(1): 28.
Taylor NS and Dhupa N. 2000. Acetaminophen toxicity in cats and dogs. Comp Cont Ed Pract Vet. 22:160-171.
Thompson A. 2012. Canine toxicology in the home environment. Vet Nursing J. 27(10): 380-382.
Villar D and Buck WB. 1998. Ibuprofen, aspirin and acetaminophen toxicosis and treatment in dogs and cats. Vet Hum Toxicol. 40(3):156–162.
Wang X, Wu Q, Liu A, Anadon A, Rodriguez JL, martinez-larrañaga R, Yuan Z and MarÃa-Aránzazu M. 2017. Paracetamol: overdose-induced oxidative stress toxicity, metabolism, and protective effects of various compounds in vivo and in vitro. Drug Met Rev. 49(4):81-83.
Wilson H and Humm, K. 2013. In vitro study of the effect of dog food on the adsorptive capacity of activated charcoal. J Vet Emerg Crit Care. 23(3): 263-267
Allen AL. 2003. The diagnosis of acetaminophen toxicosis in a cat. Can Vet J. 44(6), 509–510.
Aronoff DM, Oates JA and Boutaud O. 2006. New insights into mechanism of action of acetaminophen: Its clinical pharmacologic characteristics reflect its inhibition of the two prostaglandin H2 synthases. Clin. Pharmacol. Ther. 79(1): 9-19.
Aronson LR and Drobatz K. 1996. Acetaminophen Toxicosis in 17 Cats. Journal of Veterinary Emergency and Critical Care. 6(2): 65-69.
Bales JR, Nicholson JK and Sadler PJ. 1985. Two-dimensional proton nuclear magnetic resonance "maps" of acetaminophen metabolites in human urine. Clinical Chemistry. 31(5): 757-762.
Bates N. 2016. Paracetamol poisoning. Companion Animal. 21(10): 576-580.
Botting RM. 2000. Mechanism of action acetaminophen: Is there a cyclooxygenase 3? Clinical Infectious Disease. 31(S2): 02-210.
Court MH. 2013. Feline drug metabolism and disposition: pharmacokinetic evidence for species differences and molecular mechanisms. Vet Clin North Am Small Anim Pract. 43(5): 1039-1054.
Court, MH and Greenblatt DJ. 2000. Molecular genetic basis for deficient acetaminophen glucuronidation by cats: UGT1A6 is a pseudogene, and evidence for reduced diversity of expressed hepatic UGT1A isoforms. Pharmacogenetics. 10: 355–369.
Denzoin-Vulcano LA, Confalonieri O, Franci R, Tapia M.O and Soraci AL. 2013. Efficacy of free glutathione and niosomal glutathione in the treatment of acetaminophen-induced hepatotoxicity in cats. Open Veterinary Journal. 3(1): 56-63.
Dewandaru RA, Indarjulianto S, Yanuartono, Nururrozi A, Purnamaningsih H and Hayati R. 2019. Diare disebabkan Infeksi Escherichia coli pada Anjing. Jurnal Ilmu Peternakan dan Veteriner Tropis (Journal of Tropical Animal and Veterinary Science). 9(2): 38-43
Donova JW. 1998. Nonsteroidal anti-inflammatory drugs and cochicine. In: Clinical Management of Poisoning and Drug Overdose, 3rd Ed. Ed by LM Haddad. Philadelphia, W.B. Saunders Company. pp. 687-699.
Finco DR, Duncan JR, Schall W.D and Prasse KW. 1975. Acetaminophen toxicosis in the cat. J Am Vet Med Assoc. 166(5): 469-472.
Gunnell D, Murray V and Hawton K. 2000. Use of paracetamol (acetaminophen) for suicide and nonfatal poisoning: worldwide patterns of use and misuse. Suicide Life Threat Behav. 30(4): 313-326.
Gwaltney-Brant S, Albretsen JC and Khan SA. 2000. 5-Hydroxytryptophan toxicosis in dogs: 21 cases (1989-1999). Journal of the American Veterinary Medical Association. 216(12): 1937-1940.
Haschek WM. 1998. Hepatobiliary System. In Fundamentals of Toxicologic Pathology. Academic Press, San Diego. pp 127-151.
Hendricks J and Gates K. 2019. Transient methemoglobinemia suspected secondary to ingestion of Brassica species in a dog. Vet Med (Auckl). 10: 37-42.
Hjelle JJ and Grauer GF. 1986. Acetaminophen-induced toxicosis in dogs and cats. J Am Vet Med Assoc. 188(7): 742–746.
Holtzworth J. 1987. Diseases of the Cat. In Medicine and Surgery. W. B. Saunders Company, Philadelphia, PA. p.742.
Horowitz RS. 2000. Acetaminophen B acute single ingestion. In: Dart RC, ed. The 5 Minute Toxicology Consultant. New York: Lippincott Williams & Wilkins. pp.164–167.
Ibrahim T, Agnihotri S and Agnihotri AK. 2002. Paracetamol Toxicity- An Overview. Emergency Med. 3(6): 1-3.
Ilkiw JE and Ratcliffe RC. 1987. Paracetamol toxicity in a cat. Aust Vet J. 64(8): 245–247.
Jaeschke H, Gores GJ, Cederbaum AI, Hinson JA, Pessayre D and Lemasters JJ. 2002. Mechanisms of Hepatotoxicity. Toxicol. Sci. 65(2): 166–176.
Jahr JS and Lee VK. 2010. Intravenous acetaminophen. Anesthesiol Clin. 28(4): 619–645.
Jenkins EL, De Souza NJ, Beatty JA and Barrs VRD. 2019. Suspected adverse drug interaction between spinosad and milbemycin oxime in a cat. Journal of Feline Medicine and Surgery Open Reports. 5(1):1-5.
Jerzsele A. 2012. Comparative veterinary pharmacokinetics.http://cdn.intechopen.com/pdfs-wm/35674.pdf.
Jóźwiak-Bebenista M and Nowak JZ. 2014. Paracetamol, mechanism of action, applications and safety concern. Acta Pol. Pharm. 71(1): 11-23.
Judge PR. 2018. Protocol for Management of Paracetamol/Acetaminophen Toxicity in Dogs and Cats. https://veteducation.com.au › wp-content › uploads › 2018/05 › Paracetam.
Kalsi SS, Wood DM, Waring WS and Dargan PI. 2011. Does cytochrome P450 liver isoenzyme induction increase the risk of liver toxicity after paracetamol overdose? Open Access Emerg Med. 3: 69–76.
Kelly WR. 1984. Examination of abdomen in small animals. Vet. Clin. Diagnosis. 3 Ed. pp.26-46.
Khan A, Kathryn Flavin K and Tsang J. 2014. Weight a minute - iatrogenic paracetamol toxicity is preventable by utilisation of well-designed drug charts. BMJ Qual Improv Rep. 3(1): 1-3.
Klainbart S, Merbl Y, Kelmer E, Cuneah O, Edery N and Shimshoni JA. 2014. Tremor-Salivation Syndrome in Canine following Pyrethroid/Permethrin Intoxication. Pharmaceutica Analytica Acta. 5(9): 1-3.
Larsen FS and Wendon J. 2014. Understanding paracetamolinduced liver failure. Intensive Care Med. 40(6): 888–890.
Lee JA. 2013. Emergency Management and Treatment of the Poisoned Small Animal Patient. Vet Clin Small Anim. 43 (2013): 757–771.
MacNaughton SM. 2003. Acetaminophen toxicosis in a Dalmatian. Can Vet J. 44(2): 142–144.
Mariani CL and Fulton Jr RB. 2001. Atypical Reaction to Acetaminophen Intoxication in a Dog. Journal Of Veterinary Emergency And Critical Care. 11(2): 123-126.
McConkey SE, Grant DM and Cribb AE. 2009. The role of para-aminophenol in acetaminophen-induced methemoglobinemia in dogs and cats. J Vet Pharmacol Ther. 32(6): 585-595.
Merol VM and Eubig PA. 2012. Toxicology of avermectins and milbemycins (macrocylic lactones) and the role of P-glycoprotein in dogs and cats. Vet Clin North Am Small Anim Pract.42(2): 313–333.
Mitchelle JR, Jollow DJ, Potter WZ, Davis DC, Gillette JR and Brodie BB. 1973. Acetaminophen-induced hepatic necrosis-I Role of drug metabolism. J Pharmacol Exp Ther. 187(1): 185-194.
Nash SL and Oehme FW. 1984. A review of acetaminophen's effect on methemoglobin, glutathione, and some related enzymes. Vet Hum Toxicol. 26(2): 123-132.
Osweiler G. 1997. Household Drugs. The Handbook of Small Animal Practice, 3rd Edition, Churchill Livingstone, New York: pp 1279-1283;
Oros NA, Farcal RL, Marculescu A, Cernea M and Bale GA. 2007. Clinical, paraclinical and therapeutic evaluations of acetaminophen toxicosis in dogs. Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. 62(1-2): 514–520.
Perry H. 1998. Acetaminophen. Clinical Management of Poisoning and Overdoses. Clinical Management of Poisoning and Drug Overdose. 3rd ed. W.B. Saunders Company, Philadelphia. pp.88-198.
Plumb DC. 1999. Veterinary Drug Handbook, 3rd ed. Ames, Iowa State University Press.
Pothiappan P, Muthuramalingam T, Sureshkumar R, Selvakumar G, Thangapandiyan M and Rao GD. 2014. Paracetamol Poisoning In A Cat And Its Treatment. Ind. J. Vet. & Anim. Sci. Res. 43(5): 388-389.
Rajesh J, Mahendran K, Bhanuprakash A, Lekshmanan A, Choudhary S and Dixit S. 2017. Paracetamol toxicity in a cat. International Journal of Livestock Research. 7(2): 212-214.
Richardson JA. 2000. Management of acetaminophen and ibuprofen toxicoses in dogs and cats. Journal of Veterinary Emergency and Critical Care. 10(4): 285-291.
Rossoff IS. 1994. Handbook of Veterinary Drugs and Chemicals, Pharmatox Publishing Company, Taylorville, Illinois, USA.
Salgado BS, Monteiro LN and Rocha NS. 2011. Allium species poisoning in dogs and cats. J Venom Anim Toxins incl Trop Dis. 17(1): 4-11.
Savides MC, Oehme FW, Nash SL and Leipold HW. 1984. The toxicity and biotransformation of single doses of acetaminophen in dogs and cats. Toxicol Appl Pharmacol. 74(1): 26–34.
Scherkl R, Hashem A and Frey HH. 1990. Apomorphine-induced emesis in the dog--routes of administration, efficacy and synergism by naloxone. J Vet Pharmacol Ther. 13(2): 154-158.
Schlesinger DP. 1995.Methemoglobinemia and anemia in a dog with acetaminophon toxicity. Can Vet J. 36(8): 515-517.
Sehitoglu MH, Yayla M, Kiraz A, Oztopuz RO, Bayir Y, Karaca T, Khalid S and Akpinar E. 2017. The effects of apomorphine on paracetamol-induced hepatotoxicity in rats. Cell Mol Biol. 63(12): 41-45.
Sellon RK. 2001. Acetaminophen. In: Peterson ME, Talcott PA, eds. Small Animal Toxicology. Toronto: WB Saunders. pp.388-395.
Sheen CL, Dillon JF, Bateman DN, Simpson KJ and Macdonald TM. 2002. Paracetamol toxicity: epidemiology, prevention and costs to the health-care system. QJM 95(9): 609-619.
Skold A, Cosco DL and Klein R. 2011. Methemoglobinemia: pathogenesis, diagnosis, and management. South Med J. 104(11): 757-761.
Srabovic M, Huremovic M, Catovic B, Kulic S and Taletovic A. 2017. Design synthesis and crystallization of acetaminophen. J Chem Bio Phy Sci. 7(1): 218-230.
Steenbergen V. 2003. Acetaminophen and cats – a dangerous combination. Vet Technician. 24(1): 43-45.
Stidworthy MF, Bleakley JS, Cheeseman MT and Kelly DF. 1997. Chocolate poisoning in dogs. Vet Rec. 141(1): 28.
Taylor NS and Dhupa N. 2000. Acetaminophen toxicity in cats and dogs. Comp Cont Ed Pract Vet. 22:160-171.
Thompson A. 2012. Canine toxicology in the home environment. Vet Nursing J. 27(10): 380-382.
Villar D and Buck WB. 1998. Ibuprofen, aspirin and acetaminophen toxicosis and treatment in dogs and cats. Vet Hum Toxicol. 40(3):156–162.
Wang X, Wu Q, Liu A, Anadon A, Rodriguez JL, martinez-larrañaga R, Yuan Z and MarÃa-Aránzazu M. 2017. Paracetamol: overdose-induced oxidative stress toxicity, metabolism, and protective effects of various compounds in vivo and in vitro. Drug Met Rev. 49(4):81-83.
Wilson H and Humm, K. 2013. In vitro study of the effect of dog food on the adsorptive capacity of activated charcoal. J Vet Emerg Crit Care. 23(3): 263-267
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2020-05-05
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Yanuartono, Y., Nururrozi, A., Indarjulianto, S., Raharjo, S., Purnamaningsih, H., & Haribowo, N. (2020). Keracunan Parasetamol Pada Kucing Dan Anjing: Gejala Klinis dan Terapi: Paracetamol Poisoning in Cats and Dogs: Clinical Symptoms and Therapy. Jurnal Ilmu Peternakan Dan Veteriner Tropis (Journal of Tropical Animal and Veterinary Science), 10(1), 55–62. https://doi.org/10.46549/jipvet.v10i1.86
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