Vetdrugs 2.0Hydrogen peroxide is an oxidizing compound with a restricted veterinary role as a gastric-irritant emetic. Dilute 3% preparations have been used for selected recent toxicant ingestions in dogs. Its emetic effect arises locally in the gastrointestinal tract, making this application pharmacologically different from centrally acting prescription emetics.
Group
Oxidizing agent; gastric irritant emetic
Mechanism of Action
Hydrogen peroxide undergoes rapid decomposition in contact with tissue enzymes, releasing oxygen and producing local oxidative effects. Irritation of the gastric mucosa activates afferent pathways that trigger the vomiting reflex. Expulsion of gastric contents may reduce the amount of some recently ingested toxicants available for absorption; effectiveness depends on the exposure and timing.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Induction of emesis | Reference only | PO | Once | Do not use in: Caustic ingestion, Hydrocarbon ingestion, Impaired consciousness, Aspiration risk; Use only the 3% oral solution when emesis is indicated and other suitable options are unavailable: 1–2 mL/kg, maximum 45 mL. Do not use stronger preparations. Reassessment is required before any repeat. |
Indications
- Induction of emesis for selected recent toxicant ingestion in dogs when veterinarian-directed gastrointestinal decontamination is appropriate and a suitable prescription emetic is unavailable.
Contraindications
- Cats for emesis
- Caustic or hydrocarbon ingestion
- Impaired consciousness, seizures or unprotected airway
- High aspiration risk
- Use for wound lavage
- Already vomiting
- Megaesophagus
- Recent abdominal surgery
- Ingestion of sharp objects or bagged drugs
Interactions
- Oral acetylcysteine may be oxidized by peroxide in the gut; another emetic is preferred for acetaminophen exposure.
- Antiemetics may prevent the expected emesis.
Adverse effects
- Hemorrhagic gastritis or esophagitis
- Aspiration pneumonia
- Persistent vomiting
Toxicity
Concentrates are corrosive and can release large volumes of gas. Treat mucosal injury and aspiration; do not induce vomiting after corrosive exposure.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Hydrogen peroxide solution 3% w/v 30 mg/mL in this w/v presentation. Emesis is volume- and concentration-specific, not a generic systemic mg/kg treatment. Do not use for wound lavage. | Other | 30 mg / mL | PO, TOPICAL |
Monitoring and Administration
Canine emesis protocols describe 3% solution at 1–2 mL/kg PO, maximum 45 mL. An alternative published amount is 2.2 mL/kg; neither concentration nor maximum can be omitted when interpreting the volume.
Use only after assessing the ingested substance, elapsed time and aspiration risk. Do not repeatedly administer after failed emesis without reassessment.
Do not pour into an open wound; saline is preferable for lavage.
Observe heart rate and breathing during and after emesis. Bradycardia and aspiration can occur; prevent re-ingestion of vomitus. Successful vomiting does not prove complete toxin removal.
An older canine alternative used 1–5 mL/kg of 3% solution, maximum 50 mL, with one repeat after 10 minutes. This differs from the preferred 45 mL-limited course and is not combined with it.
Store in an airtight light-protective container at room temperature; degraded or expired peroxide may fail to induce vomiting. Historical feline use is not adopted because of the current warning against feline emesis with peroxide. Pot-bellied pig and ferret use is mentioned without a distinct species-specific schedule.