Necroulcerative hemorrhagic gastritis in a cat secondary to the administration of 3% hydrogen peroxide as an emetic agent.

OBJECTIVE To describe a case of necroulcerative gastritis in a cat secondary to administration of 3% hydrogen peroxide as an emetic agent. CASE SUMMARY A 10-year-old neutered male domestic shorthair was evaluated for hematemesis less than 24 hours following ingestion of a piece of foam. The pet owner had administered 2 doses of 0.5-1.0 tablespoons (7.5-15 mL) of 3% hydrogen peroxide in an attempt to induce emesis at home; emesis was achieved and produced the foam foreign body. Due to the presence of protracted vomiting and hematemesis, the patient was then presented to an emergency facility for further diagnostics and treatment. Initial blood work was normal on presentation, and advanced imaging of the abdomen was performed. An exploratory laparotomy revealed no foreign material in the gastrointestinal tract; however, severe ulceration of approximately 60% of the gastric mucosa was observed around the cardia and extended from the fundus down through the body of the stomach to the lesser curvature. Due to the severity of ulceration and presumed poor prognosis, the patient was euthanized intraoperatively. Histopathology of the stomach wall was consistent with severe confluent necroulcerative and hemorrhagic pleocellular gastritis, presumed to be secondary to administration of 3% hydrogen peroxide, which was used as the primary emetic agent in this case. NEW OR UNIQUE INFORMATION PROVIDED The oral administration of 3% hydrogen peroxide solution in cats can result in necroulcerative gastritis as a possible sequel. While hydrogen peroxide is considered a safe emetic agent in dogs, its use in cats is not recommended. As a result, the use of emetic agents in cats should be limited to veterinary administration, using alternative, safer emetic agents such as alpha-adrenergic agonists.

[1]  Alicia Mastrocco,et al.  Evaluation of oral maropitant as an antiemetic in cats receiving morphine and dexmedetomidine , 2016, Journal of feline medicine and surgery.

[2]  H. Yoshiyama,et al.  Dysbiotic infection in the stomach. , 2015, World journal of gastroenterology.

[3]  K. Moriello,et al.  Efficacy of disinfectants containing accelerated hydrogen peroxide against conidial arthrospores and isolated infective spores of Microsporum canis and Trichophyton sp. , 2014, Veterinary dermatology.

[4]  T. Kusaka,et al.  Hydrogen peroxide ingestion: a rare case of portal venous gas. , 2014, Gastrointestinal endoscopy.

[5]  N. Lu,et al.  Helicobacter pylori infection and diabetes: is it a myth or fact? , 2014, World journal of gastroenterology.

[6]  S. Zawistowski,et al.  Effectiveness and adverse effects of the use of apomorphine and 3% hydrogen peroxide solution to induce emesis in dogs. , 2012, Journal of the American Veterinary Medical Association.

[7]  S. Kolahian,et al.  Antiemetic efficacy of promethazine on xylazine-induced emesis in cats. , 2012, The Canadian veterinary journal = La revue veterinaire canadienne.

[8]  B. Horowitz,et al.  Hydrogen peroxide ingestion associated with portal venousgas and treatment with hyperbaric oxygen: a case seriesand review of the literature , 2010, Clinical toxicology.

[9]  S. Faverzani,et al.  Imaging diagnosis--portal venous gas in a dog. , 2009, Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association.

[10]  B. McKusick,et al.  Evaluation of the clinical efficacy and safety of dexmedetomidine or medetomidine in cats and their reversal with atipamezole. , 2006, Veterinary anaesthesia and analgesia.

[11]  S. Sattar,et al.  Broad-spectrum microbicidal activity, toxicologic assessment, and materials compatibility of a new generation of accelerated hydrogen peroxide-based environmental surface disinfectant , 2006, American Journal of Infection Control.

[12]  J. Moon,et al.  Hemorrhagic gastritis and gas emboli after ingesting 3% hydrogen peroxide. , 2006, The Journal of emergency medicine.

[13]  J. Sansone,et al.  Unintentional Ingestion of 60% Hydrogen Peroxide by a Six‐Year‐Old Child , 2004, Journal of toxicology. Clinical toxicology.

[14]  M. Mullins,et al.  Acute cerebral gas embolism from hydrogen peroxide ingestion successfully treated with hyperbaric oxygen. , 1998, Journal of toxicology. Clinical toxicology.

[15]  P. Enck,et al.  Pathophysiology of Diabetic Gastroparesis , 1997, Diabetes.

[16]  A. Singer,et al.  Hydrogen peroxide 3% exposures. , 1996, Journal of toxicology. Clinical toxicology.

[17]  W. Rackoff,et al.  Gas embolism after ingestion of hydrogen peroxide. , 1990, Pediatrics.