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Aspirin

Giving OTC Pain Medication to a Shih Tzu

Aspirin, Tylenol, Advil, Aleve

Shih Tzu puppy female
Bunny, 3 months old
Photo courtesy of Bonnie Olivier 
Overview

There may be times that you want to know if it is safe to give your Shih Tzu aspirin, Tylenol or another over the counter pain medication. This is most common if there is a minor injury or ache that occurs on the weekend or late in the evening when a veterinarian appointment needs to wait for the next day. In other cases, a Shih Tzu may be running a low fever or is perhaps at the tail end of recovery from an injury and seems to need a bit of pain relief.

It is important to know which pain medications are safe to give to toy sized breed and the appropriate dose for the ones that are safe.  

This section will discuss:
  • Is it safe to give Aspirin, Tylenol (acetaminophen) , Advil (ibuprofen) or Aleve (naproxen) to a Shih Tzu
  • The correct dosing instructions for the medication that can safely be given
  • Possible side effects
  • Signs of overdose and what to do if your Shih Tzu accidentally ingests one of these medications
  • Illness and injury that can usually be treated at home
  • Signs and symptoms that a Shih Tzu needs professional veterinary care
Advil (ibuprofen) and Aleve (naproxen) - Both of these are over the counter pain medications that are used to relieve mild to moderate discomfort, fever and swelling with humans. These medicines fall under the category of NAIDS (nonsteroidal anti-inflammatories). Because these have anti-inflammatory properties, they do much more in the body than fight pain. 

When there is swelling, fever and pain, there is a release of active lipid compounds called prostaglandins. Naproxen and Ibuprofen both work to slow the release of an enzyme called cyclooxygenase which regulates the production of prostaglandins. The prostaglandins are also responsible for maintaining proper blood flow to the kidneys, protect the gastrointestinal tract from stomach acid via a layer of mucus and aids in normal blood clotting. 

Because these pain medications affect the kidneys, gastrointestinal tract and even the way in which blood clots in the body, it can be dangerous to give these to a Shih Tzu.  

Even at low doses Ibuprofen and Naproxen can cause stomach upset, vomiting, diarrhea, unusual stools, skin lesions, appetite changes, bleeding disorders and liver or kidney dysfunction. In high doses including accidental ingestion, liver and/or kidney failure may develop and this can be fatal. Both of these medications are considered toxic to canines.  

The bottom line is that it is not safe to give either Advil or Aleve to a Shih Tzu of any age. 

Aspirin - This is a slightly different story; however it cannot be arbitrarily given to a Shih Tzu. It is also a NSAID that works in the same way that Advil and Aleve works. The difference is that this can be found in coated form (buffered), which somewhat protects the stomach lining and intestinal tract from the harmful effects of NSAIDs and also it can be found in very low doses (baby Aspirin). This makes it somewhat safer to give to a Shih Tzu. 

In some cases of a low grade fever or mild acute pain, a veterinarian will prescribe low dose, coated Bayer baby Aspirin to dogs, however there are many other canine NSAIDs which are safer. When given, it is only for very short term use (usually no more than one week) and it is given with food. For a Shih Tzu under 10 pounds (4.53 kg) the dose is very small, just 1/2 of a baby Aspirin. 

Side effects - There are some possible side effects to be aware of. This includes stomach upset, vomiting and/or diarrhea. If any of these occur with your Shih Tzu you should stop giving your dog the Aspirin and contact the veterinarian. If this were to be given long term, it can cause stomach ulcers, kidney damage and blood thinning. 

The bottom line is that the buffered (coated) tablets are safer than some of the other at-home human products and at a low dose & under vet supervision, this can be given for short term use. 

Tylenol (acetaminophen) - Unlike Aspirin, Advil and Aleve this is not a NSAID. Other medications that contain acetaminophen are Excedrin and Midol. It does not have an effect on the cyclooxygenase enzyme and therefore is safer in some ways. Since it does not have any anti-inflammatory properties, it is only used to treat pain and to reduce fever.

In high doses, this can cause irreversible liver damage and can even be fatal. 

This should only be given to a Shih Tzu with the approval of a veterinarian. In most cases, the vet will recommend a pain medication including NSAIDs that are approved for canine use as opposed to those manufactured for people. However, if a dog has a slight fever or other issue that calls for pain relief or a fever reducer, he/she may approve a low dose. 

For pill form, the typical does for a Shih Tzu is 5 mg per each pound of body weight. Therefore, a 5 pound Shih Tzu would be given 25 mg and a 10 pound Shih Tzu would be given 50 mg. This is given once every 12 hours. 

If you were to give liquid Tylenol to a Shih Tzu, keep the following in mind: 1 ml of fluid in the dropper equals a whopping 80 mg of medicine. Since a dog is normally given 5 mg per each pound, a ten pound dog needing 50 mg would only need just a tad more than 1/2 of 1 milliliter. A 5 lb. Shih Tzu puppy would only need a tad over 1/4 milliliters of liquid Tylenol (1/4 ml is the equivalent of 20 mg).

If a dog were to ingest 50 mg or more per pound of body weight, this is considered a toxic level of Tylenol; although anything over 5 mg per pound is considered risky and can lead to liver problems rather quickly. 

Symptoms of toxicity include brown or gray colored gums, trouble breathing, swelling of the face, neck or limbs, low body temperature, a yellowing of the eyes and/or vomiting. This can lead to coma and even death if not immediately treated. 

The bottom line is that it is safe to give Tylenol to a Shih Tzu if the dose is very low, for very short term use and under the approval of your puppy or dog's veterinarian. 
Accidental Overdose of Aspirin, Tylenol, Advil and other OTC Pain Meds

Whether in tablet, gel cap or liquid form all of these medications are toxic in anything other than very low levels. If your Shih Tzu has ate a bottle of any of these, it will be important to take action immediately even if your puppy or dog is not showing any signs of poisoning. 

The most common signs of poisoning include vomiting, diarrhea, weakness, depression, pale gums, breathing issues (breathing heavy or having trouble breathing), swelling (this can be on any part of the body however is usually apparent on the face and/or paws), dry eyes, dark urine. If not treated this can lead to permanent liver and/or kidney damage, coma and eventual death. It can take a while for these symptoms to start, so you'll want to respond quickly.

What to do: Generally, only if a dog is asymptomatic (not showing any signs yet of poisoning), has no pre-existing health issues, has swallowed the pills within the last 50 minutes and if you are sure that the substance ingested is not a corrosive chemical or something that could affect the lungs, it is often best to induce vomiting. When done, the dog must still be taken to the vet right away. When in doubt about inducing vomiting, call your vet. 

For canines, one of the most effective methods is to give hydrogen peroxide, however it is crucial to give the right amount since too much will cause violent vomiting and can lead to even more problems. Typically .5 ml (1/10 of a teaspoon) is given for each pound of body weight. Therefore, this is 1/2 teaspoon for a 5 lb. puppy or dog and 1 teaspoon for a 10 lb. dog.

Even if you are not sure exactly how many pills your Shih Tzu swallowed and even if your dog seems to be okay, it is imperative to bring him/her to the veterinarian or closest animal hospital ASAP. If possible, bring the bottle that held the pills your Shih Tzu ingested. You should also bring towels; it is common for the symptom of vomiting to begin during the car ride or if you gave your dog hydrogen peroxide, the effects of that may begin in the car. It can be helpful for a second person to catch this in the towel so that it can be examined by the vet for pills that may have been thrown up undigested. 

Treatment for OTC pain medication overdose - There are several steps that a veterinarian can take to try and counteract the toxicity of Tylenol and other medications. This includes giving some or all of the following:
  • n-acetyl-cysteine (Mucomyst and Acetadote) - This helps protect a dog's from damage by oxidation and is almost always used as part of the treatment in Tylenol overdose cases with canines. 
  • Vitamin C - This increases the oxygen carrying capacity of the red blood cells.
  • s-adenosyl-methionine - To aide in the protecting the liver
  • milk thistle - To reduce liver damage
The vet will also take baseline blood work, monitor liver values and give IV fluids. Depending on the severity of the damage done to the body, a dog may also receive oxygen therapy and may even need blood transfusions. 

If caught early enough, prognosis is good. 

Weighing At Home Treatment VS a Vet Visit

If your Shih Tzu is not feeling well, your first instinct may be to want to give him/her something for their discomfort. However, in just about any case of a fever or signs of pain, a Shih Tzu should be brought to the veterinarian to determine the underlying cause. There is a vast array of disease and health issues that can cause fever, pain or both. Simply trying to treat these at home with OTC meds manufactured for humans is risky. These medications do not cure illness and will only cover symptoms while not addressing the cause.  

Fever is often the first symptom of a range of health conditions; if a fever is treated with Tylenol at home this may bring a dog's body temperature back to normal but will mask the initial condition that caused the fever. For this reason, any temperature higher than 102.5 F should be reported to the vet.
Minor pain such as that which may occur after a single bee sting (without any signs of allergic reaction) or other trivial issue can be treated at home with the vet's 'okay' however be extremely diligent regarding dosing amount and frequency. 

Any signs of pain that appear to be moderate or severe or that last for more than a day or are accompanied by any other symptoms is reason to not attempt to treat your Shih Tzu at home and bring him/her for professional veterinary care. 

With your vet's approval, baby Aspirin or low dose Tylenol may be given for low grade fevers or acute pain due to a minor injury. In cases of moderate to severe pain or for chronic pain such as a senior Shih Tzu suffering from arthritis, there are much better choices for pain management.

Better Alternatives

For chronic issues such as hip dysplasia, luxating patella and joint issues, carprofen which is an FDA approved NSAIDs for canines is often given. This is marketed as Vetprofen, Rimadyl, Novox and Rovera.

For post-operative pain management, deracoxib (marketed as Deramaxx and Novartis) is often given.  Tramadol (Ultram) is another option for canines and is often given if a dog does not respond well to NSAID; this is a very strong pain reliever that works by blocking the brain's perception of pain. It is given after surgery and in some cases, for chronic issues. 

Other FDA approved options for canines include etodolac (Etogesic), firocoxib (Previcox) and meloxicam (Metacam ). Tepoxalin (Zubrin) used to be given but was taken off of the market in 2014. If you have unused pills of Zubrin, please do not give any to your Shih Tzu and disposed of them by flushing them down the toilet. 

Do keep in mind that just like Aspirin, Advil, Tylenol and other human drugs, long-term use or high doses of canine NSAIDs can cause liver issues and other adverse effects. Common side effects include decreased appetite, weakness and dryness of the eyes. More serious side effects may include yellowing of the eyes, pale gums, stomach distress, vomiting, diarrhea, excessive thirst and/or disorientation. If any of these are noticed, you should stop giving the medication to your Shih Tzu and alert the vet. 

Shih Tzu should be regularly monitored for these issues. In some cases, a change of diet along with supplements (Omega 3 for example for joint pain) can ease discomfort without having to give a dog prescribed medication. 
In Summary

You can give very low doses of some OTC pain medications FDA approved for humans to a Shih Tzu. Advil and other brands that contain Ibuprofen and Aleve and other brands that contain Naproxen should not be given. 

We strongly encourage owners to receive approval from the veterinarian before giving low-dose Tylenol or buffered low-dose Aspirin. If your Shih Tzu has a fever or is having pain that lasts more than a day or is more than minor, this should not be treated at home; it is important to have the underlying cause diagnosed.

If your Shih Tzu has a chronic issue such as arthritis, there are much better long-term alternatives including NSAIDs that are FDA approved for canines and supplements for joint health. 

Please keep your Shih Tzu safe by keeping all medications safely put away out of reach. These should be placed in high cabinets and if you keep medicine in your pocketbook, always be careful where you place that. 
Cute Shih Tzu with short hair
Gizmo, 7 years old
Photo courtesy of Shauna
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