Another what would you do question

RE: Another what would you do question

Glen McIntosh — Wed, 22 Apr 2026 15:08:00 GMT

[quote userid="8991" url="~/f/clinical-questions/31348/another-what-would-you-do-question/248738#248738"]If you've seen the cat and assessed it as normal then you lay out the options for the owner and give your advice based on what's most likely - that it would be very unuusal for a cat to eat a paracetamol tablet but if you want to be absolutely certain and do everything then they go to OOH for prophylactic treatment that is probably not needed but may give the owner reassurance [/quote]

This is how I would approach this case, even as the vet in the OOH clinic.

A bit of n-acetyl cysteine won’t hurt the cat, but the OOH treatment might cause a stabbing pain in the owners wallet.

RE: Another what would you do question

Clive Ansell — Wed, 22 Apr 2026 14:52:02 GMT

[quote userid="8991" url="~/f/clinical-questions/31348/another-what-would-you-do-question/248738#248738"]Not enough to recommend treatment for me, just because something is possible doesn't mean it is likely. A big part of our job is to contextualise information / evidence for the individual case and advise the owner. However if an owner does want to do everything even if you don't think its required then I'd say I don't think its required but if you want to treat for possible exposure, it will need to go somewhere else (in this situation). [/quote]

Exactly that; discuss the options, give what you consider best advice, they can decide.

I agree with others, very unlikely cat would have ingested it, although of course cannot be 100% sure if it did or not.

Cases I have seen (4 that I remember) of known paracetamol toxicity, where owners had dosed them (Lemsip I kid you not, and Calpol) , they became ill very quickly. Despite being seen quickly and treated aggressively with IVFT and acetyl-cysteine, all succumbed to hepatic failure and died or where PTS.

So, even if this cat was sent OOH for treatment, the end result would likely be unchanged.

In most of the practices I work for, costs of OOH care would be the overriding limiting factor. We sent an end stage renal failure dog (owners insistence despite being advised PTS) to the local OOH centre last weekend, already on fluids and blood work done, estimate was £3000 for initial bloods and blood gases, and ongoing weekend care, which really would have been just monitoring and repeat bloods, over less than 48 hours.

RE: Another what would you do question

Lesley Strong — Wed, 22 Apr 2026 14:20:40 GMT

A cat wont eat a "palatable" tablet never mind a hideously bitter enormous patacetamol. I vote with Micheal and not even need seeing and if you have seen it and given the owner options then you have acted reasonably and its up to them if they decide to waste their time and money at OOH

RE: Another what would you do question

David Mills — Wed, 22 Apr 2026 09:24:35 GMT

[quote userid="3169" url="~/f/clinical-questions/31348/another-what-would-you-do-question/248730#248730"]There is not a hope in hell the cat has eaten the pill, I'm staying home with the kids. You're not even getting seen by me. I take it you've tried to pill a cat at some point?![/quote]

This.

Lost count of the number of times someone thinks their animal has ingested medication and they find it when they get home. I'm not sure how a cat would even eat a tablet that size, and they don't taste great anyway.

I don't think I've ever seen a case of a cat willingly and independently eating medication. Lillies, anti-freeze, sure, but human tablet medication? No. Maybe others have?

[quote userid="9440" url="~/f/clinical-questions/31348/another-what-would-you-do-question"]if you phone the VPIS are you then obliged to follow recommendations that may be based on worst case scenario/ defensive medication or would you feel confident enough to take all the advice on board but make your own judgement with regards the clinical case you are monitoring?[/quote]

Of course your'e not obliged, just the same you're not obliged to send every cruicate for a TPLO. Now the VPIS is a useful service but the quality of their evidence is low, mainly conisting of a collection of anecdotal case reports. And as is natural they do err on the defensive side with their advice. So they are a source of information but the advice is not obligatory.

It's a bit like chocolate toxicity where the online calculators are skewed towards "the animal should be seen". And don't get me started on grapes.

If you've seen the cat and assessed it as normal then you lay out the options for the owner and give your advice based on what's most likely - that it would be very unuusal for a cat to eat a paracetamol tablet but if you want to be absolutely certain and do everything then they go to OOH for prophylactic treatment that is probably not needed but may give the owner reassurance (and stop them calling every hour updating you that their cat has just got up and stretched out or is twitching in their sleep and should I be worried). I don't see the point in admitting if you haven't got the treatment, as the latter is far more effective before the paracetamol destroys their liver.

[quote userid="9440" url="~/f/clinical-questions/31348/another-what-would-you-do-question/248735#248735"]That would have been my inclination, especially as no clinical signs , but what if it had and then deteriorated rapidly after you sent it home [/quote]

Anything can, and sometimes will, deteriorate after you've seen it. Competence is generally taking reasonable steps with the information you have at the time (and negligence the opposite). What information do you have?

- A missing tablet that a cat is highly unlikely to have eaten in the last 11 hours

- A healthy cat on examination

- VPIS general guidance on treating paracetamol toxicity in cats

- a neurotic owner

Not enough to recommend treatment for me, just because something is possible doesn't mean it is likely. A big part of our job is to contextualise information / evidence for the individual case and advise the owner. However if an owner does want to do everything even if you don't think its required then I'd say I don't think its required but if you want to treat for possible exposure, it will need to go somewhere else (in this situation).

RE: Another what would you do question

janine redman — Wed, 22 Apr 2026 08:00:35 GMT

Ps client is very intense

RE: Another what would you do question

janine redman — Wed, 22 Apr 2026 08:00:11 GMT

That would have been my inclination, especially as no clinical signs , but what if it had and then deteriorated rapidly after you sent it home ?

RE: Another what would you do question

Michael Woodhouse — Wed, 22 Apr 2026 00:12:11 GMT

There is not a hope in hell the cat has eaten the pill, I'm staying home with the kids. You're not even getting seen by me. I take it you've tried to pill a cat at some point?!