Xanax Toxicity in Dogs

Xanax is a product used in human and veterinary medicine.  While the margin of safety is very high in our pets, accidental overdose can occur.  Your dog may receive the incorrect dosage upon administration or he may accidentally get a hold of the bottle himself.  Symptoms of a mild toxicity may include severe sedation, incoordination, nausea, and agitation.  A more severe toxicity may include symptoms of vomiting, hypothermia or hyperthermia, respiratory depression and cardiac depression.  

You should seek veterinary treatment as soon as possible for your dog if he has ingested more Xanax than he should have or is experiencing any of these symptoms.  Your veterinarian will be able to confirm your dog’s toxicity with blood work and a urinalysis.  Depending on the severity of your dog’s toxicity, your dog may just need supportive treatment at home, or he may need to be hospitalized if his case is more severe.  His prognosis of recovery will depend on the severity of his toxicity as well as how quickly you seek medical treatment for him. 

Xanax toxicity can range from mild to severe.  In the most severe cases it can lead to respiratory and/or cardiac distress for your dog.  This is considered a medical emergency and you need to get your dog to your veterinarian as soon as possible.

Symptoms of Xanax toxicity may include:

• Severe sedation
• Depression 
• Agitation
• Aggression
• Incoordination
• Hypothermia  or hyperthermia 
• Nausea
• Vomiting
• Respiratory depression
• Cardiovascular depression

Types

Xanax is a classification of medication known as a benzodiazepine.  This drug is used in humans as well as pets; primarily those with anxiety. These medications can also be prescribed for use as a muscle relaxant, sleep aid and anti-convulsant medication.  Related medication include alprazolam, zolazepam, prazepam, pinazepam, oxazepam, nitrazepam, midazolam, diazepam, lorazepam, clonazepam, Klonopin, Versed and Valium.

Benzodiazepines such as Xanax work by increasing the release of neurotransmitter gamma-aminobutyric acid (GABA) within the body.  If taken in a safe amount, your dog should be calm and relaxed with a duration ranging hours to days depending on your dog. For most, the effect lasts 6-10 hours. Typically this medication has a wide margin of safety and is difficult to overdose on.  However, if taken in excess symptoms of toxicity will appear.

Your veterinarian will begin by performing a full physical exam on your dog.  She will take his vitals, check him all over for signs of sensitivity anywhere in his body and check his responses.  Her assessment will give her an idea of what diagnostic testing she should proceed with in order to properly diagnose what is causing your dog’s symptoms.  

She will also want to collect a verbal history from you.  She will want to know when your dog’s symptoms started, how they have progressed, and if you know of anything he may have ingested by accident.  If you find he was chewing on a bottle of medication before his symptoms began, be sure to bring in the medication with you.  This will allow your veterinarian to know exactly what your pet ingested and therefore begin her treatment plan as soon as possible.

In cases where you did not find evidence as to what is causing your dog’s symptoms, your veterinarian will need to perform testing to try and diagnose the cause.  She will begin with general blood work to see how your dog’s organs and blood production within the body are functioning.  A complete blood count (CBC) and chemistry panel will provide your veterinarian with this information.  She may also want to collect a urine sample in order to run a urinalysis.  This will also give information on the health of your dog’s kidneys and bladder.  Other diagnostic procedures, such as radiographic imaging, will be unhelpful.

Benzodiazepines can be detected in the blood and urine; when your veterinarian gets your dog’s blood work results, she will have her answer to the cause of your dog’s symptoms.  With the cause properly diagnosed, your veterinarian will be able to begin treatment.  If you get your dog to his veterinarian quickly after ingestion, your veterinarian will be able to induce vomiting in order to get him to expel his stomach contents.  She may also choose to administer an absorbent such as activated charcoal to prevent the body from absorbing the medication.  If this is unsuccessful, she will proceed with other treatments.

If your dog is suffering only a mild overdose, your dog should be able to be treated with outpatient care.  If your dog is simply lethargic and ataxic, you should confine your dog at home to prevent him from accidentally hurting himself.  You should also try to keep him in a dark, quiet room to avoid stimulation while waiting for the effects of the medication to wear off.  

If your dog is experiencing more severe symptoms of toxicity, your veterinarian may want to keep him in the hospital for treatment and observation.  There are a variety of treatments your veterinarian may want to do for your dog depending on his needs.  She will start by placing an intravenous catheter in order to administer intravenous fluids.  This will keep your dog hydrated and flush the toxin from his system quicker.  His body temperature will also need to be constantly monitored to ensure he is not experiencing hyperthermia or hypothermia.  If his body temperature is off, cooling or warming methods will be put into place to return his body temperature to normal.   

If your dog is recumbent and unable to get himself up, the veterinarian will be sure to turn your dog frequently and ensure he has good bedding.  This will prevent any type of bed sores from forming and make sure your dog does not get stiff by lying in one position.  She will want to keep him in a calm, quiet place in order to minimize stimulation, especially if he is sensitive to the stimulation and it causes him to be agitated.  

Medications will be administered to help your dog’s nausea and vomiting.  If your dog is experiencing respiratory distress, he may be administered medications as well as placed on supplemental oxygen therapy.  If he is experiencing cardiac distress, this is considered an emergency.  Your veterinarian will want to perform an EKG as well as an ultrasound of the heart to check where the abnormality is occurring. Depending on what is wrong with the heart, different medications and therapies will be administered.

Additional treatments will be supportive in response to your dog’s symptoms. 

Your dog’s prognosis of recovery will be tied directly to the severity of the toxicity.  In mild cases, your dog’s prognosis is good with supportive treatment.  If his toxicity is more severe and includes cardiac and/or respiratory distress, his prognosis of recovery declines.  The sooner you seek medical assistance for your dog, the better his chances at recovery.  If toxicity is addressed early by a veterinary professional, your dog will have the best chance of recovery possible for his condition.