Toxicoses From Household Cleaners and Personal Care Products in Animals

Detergents, soaps, and shampoos that can pose a risk for toxicosis in animals include shampoos intended for humans or pets, liquid hand-dishwashing soaps, bar bath soaps, common laundry detergents, and many all-purpose household cleaners. Some homemade soaps contain lye (see Toxicoses From Corrosive Agents).

Mild detergents, soaps, and shampoos typically contain anionic and nonionic ingredients. Most products are of moderate pH, but some, such as electric-dishwasher detergents, are alkaline (pH > 11) and thus are corrosives. Although the pH of traditional laundry detergents and concentrated laundry detergent pods is similar, animals that ingest or chew pods can develop more serious clinical signs.

Anionic and nonionic detergents are mild irritants; many are pH adjusted so that they cause minimal dermal irritation; however, ocular and mucosal irritation is possible. There is no appreciable systemic absorption of these agents, and toxic effects are limited to ocular, oral, or GI irritation, which is usually mild and self-limiting.

Cats exposed via inhalation (eg, during self-grooming) to undiluted shampoos or other products containing sodium lauryl sulfate can develop substantial respiratory compromise, including dyspnea, increased bronchial secretions, and mild pulmonary edema. Although the exact mechanism of this syndrome is not known, it might relate to interference by the detergent with normal pulmonary surfactants.

Nausea, vomiting, and diarrhea are the most common clinical signs of toxicoses from detergents, soaps, or shampoos. Secondary dehydration and electrolyte imbalance can develop in rare instances as a result of protracted vomiting or diarrhea.

Mild ocular irritation is possible, with lacrimation and blepharospasm. Usually, no substantial lesions beyond mild local irritation develop. Cats grooming themselves after application of sodium lauryl sulfate–containing products can develop moist respiratory sounds, cyanosis, and dyspnea within 1–3 hours of exposure.

Vomiting is the most common sign in dogs that ingest detergent pods. Of those patients, some develop more severe signs of dyspnea, weakness, collapse, and shock.

• Oral fluid intake

• Antiemetics

• Supportive care

In cases of detergent, soap, or shampoo ingestion in animals, vomiting should be prevented, if possible.

Gastric irritation caused by ingested agents can be diminished by oral administration of dilute milk or broth, or water. Dilution of the ingested agent can also decrease the severity of spontaneous vomiting and resultant esophageal damage or aspiration.

Spontaneous vomiting is usually self-limiting but should be avoided, if possible. In cases of ingestion of caustic irritants—eg, exposure to laundry detergent pods—treatment can include antiemetics (eg, maropitant citrate, 1 mg/kg, SC or IV slowly, every 24 hours as needed) to prevent further tissue damage caused by emesis.

Patients with respiratory signs indicative of potential detergent aspiration might need supplemental oxygen, nebulization, and supportive care. In most cases, signs resolve within 24–72 hours.

For patients with eye exposure, copious irrigation with tepid water or physiological saline solution (0.9% NaCl) for 5 minutes is usually effective.

Chlorine bleaches are used primarily as household cleaners and pool sanitizers. Household bleaches tend to contain sodium hypochlorite at 3–10%, and the pH of these products can range from 9 (mildly irritating) to > 11 (corrosive). Pool treatments can contain lithium, calcium, or sodium hypochlorites at concentrations up to 70–80%, with a pH that can range from acidic to alkaline.

Pets can be exposed to chlorine beach by chewing on containers of undiluted product, drinking from buckets containing product diluted in water, or swimming in recently treated pools.

The relative hazard of a particular chlorine bleach product depends on the concentration of hypochlorite, pH, and dilution of the product. In general, hypochlorite tends to be a mild irritant at concentrations < 10%; if the product has a pH of > 11 or < 3.5, however, alkaline or acidic corrosive injury can occur.

Dilution of bleaches with water per label directions often decreases the corrosive potential of these products and makes them little more than mild GI or ocular irritants.

Mixing of hypochlorite and ammonia produces highly toxic chloramine gas that can result in acute respiratory distress or delayed onset of pulmonary edema within 12–24 hours of exposure.

Nonchlorine (oxidizing) bleaches that contain oxidants such as hydrogen peroxide, sodium percarbonate, and sodium perborate give rise to reactive oxygen species that produce their bleaching action. Generally, the oxidant effects of nonchlorine bleaches are relatively weak, resulting in lower risk of tissue injury compared with the risk with concentrated chlorine bleaches.

Ingestion of household chlorine bleach or nonchlorine bleach products that are dilute or have a moderate pH rarely causes more than mild vomiting, hypersalivation, lethargy, anorexia, or diarrhea.

Exposure to concentrated (> 10%) chlorine bleach products or products with pH > 11 can lead to significant corrosive injury to the GI tract. Ingestion or inhalation of substantial amounts of chlorine bleach occasionally results in hypernatremia, hyperchloremia, or metabolic acidosis.

Acute inhalation of chlorine can result in immediate coughing, gagging, sneezing, or retching. In addition to the immediate respiratory signs, patients exposed to concentrated chlorine fumes can develop pulmonary edema 12–24 hours after exposure. Respiratory lesions can include tracheitis, bronchitis, alveolitis, and pulmonary edema.

Ocular exposures can result in epiphora, blepharospasm, eyelid edema, or corneal ulceration.

Dermal exposure can result in mild dermal irritation and bleaching of the coat.

Oral, dermal, and ocular irritation or ulceration are possible.

• For ingestion, dilution with water or milk

• For topical exposure, flushing or bathing

• Management of GI signs

• Supportive care

• For appreciable respiratory exposure, supportive care and monitoring for late-onset pulmonary edema

For oral exposures to bleach, induction of emesis and administration of activated charcoal are contraindicated; instead, dilution with milk or water is recommended.

Spontaneous vomiting should be managed, and patients should be monitored for the development of GI irritation or ulceration (see Toxicoses From Corrosive Agents). When protracted vomiting results in electrolyte or hydration abnormalities, fluid therapy can be beneficial.

For respiratory exposures, the patient should be moved to an area with fresh air and monitored for dyspnea. Severely dyspneic patients must be stabilized; pulmonary edema should be treated as needed.

For dermal exposures, bathing with mild shampoo and thorough rinsing are recommended.

Ocular exposures should be treated with 10–20 minutes of ocular irrigation with saline (0.9% NaCl) solution, followed by fluorescein staining of the cornea to detect corneal injury.

Also see Principles of Therapy of Toxicosis in Animals.