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April 24, 2015

FDA Says Human Pain-Relief Creams Are Deadly to Cats

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The FDA has issued a warning to alert pet owners and veterinarians that pets, especially cats, can become ill or even die when exposed to topical pain medications containing flurbiprofen, an anti-inflammatory agent.

This statement issued by the FDA came after reports surfaced of two cats who had to receive emergency veterinary care for kidney failure (and thankfully survived.) In a second household, three cats experienced symptoms of lethargy, anorexia (reluctance to eat) vomiting and had black, bloody stools. Sadly, these three cats perished. All of the cats were exposed to creams their owners had applied to themselves, not from direct application to the cats. 

These are all symptoms known to be associated with exposure to non-steroidal anti-inflammatories (NSAIDs) in animals.

According to the FDA, "The pet owners involved in the cases had applied the cream or lotion to their own neck or feet, and not directly do the pet, and it is not known exactly how the cats became exposed to the medication." 

My guess is that the owners pet their cats after applying the cream. It's also possible that the cats became exposed to the cream if they were rubbing up against their pet parent's legs. Once the cats got the cream on their coats, they probably groomed themselves and became exposed to the toxins orally. As these products are designed to be absorbed through the skin, eventually the product would work its way through a cat's skin. 

Regardless, it is apparent that even very small amounts of the pain-killing creams cause significant damage. 

Most NSAIDs are dangerous to pets

Veterinarians have warned pet parents against the use of human pain medications on their animals. Non-steroidal anti-inflammatories (NSAIDs) can cause physical damage in an animal's intestines and kidneys. NSAIDs include drugs such as ibuprofen and naproxen. Name brand ibuprofen products include Advil and Motrin. Aleve is the name brand of naproxen.

Dogs are usually the ones to ingest NSAID pills that have candy coatings. Cats are less likely to eat the pills, but it makes sense that affectionate cats would rub against their owners who have applied an anti-inflammatory cream and would, therefore, expose themselves to danger.

The creams implicated contained the NSAID flurbiprofen and the muscle relaxer cyclobenzaprine. This family of pain relieving creams may also include ingredients such as baclofen, gabapentin, lidocaine, or prilocaine. Flurbiprofen creams are available only by prescription are are used to treat conditions such as rheumatoid arthritis or osteoarthritis, as well as soft tissue injuries, such as tendonitis and bursitis. Many of these creams are manufactured through compound pharmacies.

The FDA recommends that people who use topical medications containing flurbiprofen take care to prevent their pets from being exposed to them, even in ways that may seem unlikely to cause problems. Health care providers who prescribe topical pain medications containing flurbiprofen, and pharmacists who fill these prescriptions, should advise patients with pets to take care to prevent exposure of the pet to the medication.

Additionally, it is recommended that:

  • Patients store all medications safely out of the reach of pets.

  • Patients safely discard or clean any cloth or applicator that may retain medication and avoid leaving any residues of the medication on clothing, carpeting, or furniture.

  • Patients consult their healthcare provider on whether it is appropriate to cover the treated area to protect pets from exposure.

  • If the patient is using topical medications containing flurbiprofen and a pet becomes exposed, the patient should bathe or clean the pet as thoroughly as possible and consult a veterinarian. Even a small amount is deadly.

  • If the patient's pet shows signs such as lethargy, lack of appetite, vomiting, or other illness, the patient should seek veterinary care immediately and be sure to provide the details of the exposure.

Although the FDA has not received reports of dogs or other pets becoming sick in relation to the use of topical pain medications containing flurbiprofen, these animals may also be vulnerable to NSAID toxicity after being exposed to these medications.

Flurbiprofen isn't the only dangerous topical pain killer

Even though the official statement from the FDA concerns is for prescription creams containing flurbiprofen, there are several over-the-counter pain creams are also toxic to cats - but perhaps not to the degree that the flurbiprofen creams are. 

Common ingredients in over-the-counter pain creams that are toxic to cats are:

  • Camphor - This ingredient is mildly to moderately toxic to cats and dogs. It is found in Bengay, Carmex, Tiger Balm, Vicks VapoRub, Campho-Phenique and other arthritis pain creams.
  • Salicylates - Most pain-relief creams contain salicylates, which is basically aspirin. Both dogs and cats are moderately to severely sensitive to this substance, but it is particularly dangerous to cats. This is the active ingredient in Aspercreme, Bengay, HEET, Icy Hot, etc. The oil of wintergreen also has a high concentration of salicylates.

Other pain cream ingredients

  • Menthol - This ingredient is not toxic to cats per se, however, many cats are attracted to the smell of menthol that is in most topical pain creams, which could entice them to ingest them and expose them to the other dangerous ingredients.
  • Capsaicin - Capsaicin is the active ingredient in Capzasin-HP Arthritis Cream. Capsaicin is what makes chili peppers hot and, interestingly, blocks pain receptors (tell that to my mouth!) Although capsaicin isn't toxic, some cat repellent sprays contain chili pepper extract in order to keep cats from biting things like your garden plants. For this reason, this ingredient may act as a deterrent for ingestion.

If you are uncertain if your pet has been exposed to topical pain creams, it's better to call your vet rather than have a "wait and see" attitude. Even a small exposure can quickly be fatal. For instance, one of the cats that died from the flurbiprofen was exposed when a drop of it got on the cat's tail. The owner washed it immediately to no avail. 

If you suspect your pet has been exposed to any kind of drug, poisonous ingredient or plant, visit the Pet Poison Helpline or the ASPCA. There are quick reference guides on these sites. If you're concerned enough to get live help, both sites have an advice line that charges a fee ($49 or $65.)

To report drug or pesticide incidents with your pet, please visit the FDA.

Photo: Shutterstock

Anthony c smith on May 20 at 2:43 PM said:

These people that charge 49 dollars before they will talk to you are not right they always have s speach ready if you dot have the money oh well the animal will have to suffer or even god forbid die how many dont even have credit cards this not good
Amy on April 25 at 10:45 PM said:

Really, you want to complain about veterinarians charging for an office visit? When was the last time you saw a doctor without paying for an office visit? You do realize that veterinarians need to make money to keep their doors open, right? Rent to pay, electric, staff, keeping their shelves stocked with medications, maintenence of equipment, replacing equipment when it breaks, on top of paying for the 30 years of debt they're in for going to college for 8 years, with thousands of dollars in tuition to pay. Do you think that's all free? If you can't afford to spend $40-$50 for your pet to see a doctor, that's your problem not theirs. I'm so tired of people expecting to go through life for free. Don't get a damn pet if you can't afford its care. Or if you do, don't expect for somebody to pay the thousands of dollars it can cost to fix them when they're ill.
mercedes on July 12 at 5:55 PM said:

Dear Amy, we took in an abandoned cat that we took care of for 2 years. No one in the neighborhood knew who he belonged to and he liked the outdoors and indoors. His parents never came back or looked for him. Because he had been used to the outdoors he liked to be outside for 2 days and would come back for a week. He had been neutered.Unfortunately on one of his last trips here he was circling. (very sad) we took him to emergency. They said if they ran several tests it would have been in the thousands? no antibiotics or anything they said they could euthanize him, after they ran one such test and not one for rabies or poisoning. 3 hrs later the cat was dead at there emergency care and we had a bill over $1000. thousand dollars? You sounded off at that person in such a way I wouldnt want my animals around you. Anthony, take your pet to the humane society the usually accept payments and are not high way robbers and provide reasonable vet care. I will never fall for those BS emergency cares again and that was not even our cat. I hope these places are heavily monitored by the fda and their drugs inventoried with proof from the owners whose pets received them!
Pet Lover, Groomer, Vet Tech on October 4 at 1:31 PM said:

I just wanted to say, Amy's comment is right on! I have worked with animals for 40 years, and have seen it all! Just because we work in the Pet Care field, doesn't mean we don't deserve to get paid for our time, expertise, education, supplies, overhead etc. Many people call or come in with pets, that "they found or "rescued", and expect free treatment, grooming, Vax etc. Who do You think should be responsible for your "rescue"?? If You rescue it, then You are the one responsible! We have pets that we also rescue and rehome ourselves, and those expenses come out of our pocket. Do You have any idea how many people try to "rescue" without responsibility?? Hundreds, and thousands. If You are feeding it, You become the responsible party. Vets and Groomers have bills to pay, just like You do. And I assure You , have given many people discounts, You are not aware of. If You can't afford the care, please don't get a pet, and expect someone else to pay your expenses. It's a commitment, and it's Your choice. Do the responsible thing!
SuePaul on August 28 at 7:12 AM said:

Some cats are attracted to the menthol in these creams & I'll tell you how they ingested it....they lick their owners. Yes, some may rub up against them, get it on their fur them lick it off themselves but for the most part, the cats are licking it directly off their owners and or off the covers on the bed. I had one out of four cats that when I would rub menthol type muscle rub on my back or knees, she would smell it from the other end of the house & hunt me down to try & lick me. This was before Google, internet, etc... so I called the number on the tube & was told they hadn't heard of a cat being attracted to it but there was no harmful ingredients so like if a human ingested it, it may cause a stomach ache but it wasn't poisonous. I would cover up so my cat would not have easy access to lick it off me but she would like the covers, my clothes, the bed sheets & after I fell asleep I would be woke up to her licking my hands even though I washed them, she still got some of the menthol from them. It made her eyes dilate, look like she had solid black eyes & make up "high" like is what I thought it did, like catnip did. I didn't think it was harmful to her but I did try to keep her from it as much as I could. She never got sick from it. She lived to be 16yrs.old. I now have one out of two cats that is crazy for it & I do the same for her. I try my best to keep her from licking it directly off of me but sometimes she does get a few licks in before I can cover up. The article said they didn't know how the cats ingested it...well that's how. The owners just didn't want to admit they let their cats lick them, which most all cat owners do ??

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This entry was posted by Mary Parker.

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