It’s a common horror-movie trope: unsuspecting schmuck closes the medicine cabinet door only to reveal the monster/vengeful ghost/poltergeist in the mirror behind him. Horror-movie shenanigans ensue. I would maintain, however, that the real monster is not in the mirror but in the medicine cabinet itself.

Thousands of pets are poisoned every year by ingesting their owner’s medications – either prescription, or over-the-counter (OTC). With more and more people taking increasing quantities of medications, the risk of collateral damage to our pets is on the rise, and sometimes with deadly results.

Pet poisonings usually come in three flavors:

• Pets ingesting an actual poison – antifreeze, rat poison, grapes, etc.
• Pets being given something by their owners in a misguided attempt at home care; cats and acetaminophen (Tylenol) is the classic.
• Pets getting into a dropped pill or a pill vial of their owners’ medication

The first two have been around for a while, but the last one is really gaining speed. The Pet Poison Helpline (a veterinary-specific poison control center) estimates that half of their 100,000 cases are now related to pets ingesting human medications. (The ASCPCA also runs a poison control hotline.)

How many times have you fumbled for an Advil or Tylenol, spilling a few on the floor? And they always roll under the most inaccessible place – behind the commode, under the bed, lost in the deep pile of the burnt orange shag rug (at my house, anyway). Our naturally inquisitive pets are masters at seeking out those lost pills, playing with them for a bit, and then swallowing them. Ever seen a cat play with a bug? They bat it around for a while, and then down the hatch it goes. Same thing with an Extra Strength Tylenol, and then it’s buh-bye liver. One 500 mg acetaminophen can not only kill your headache, it can easily kill a cat as well.

As the average population of the world gets older, a few new and dangerous phenomena emerge: more medications are prescribed to treat the ills of an aging population, and elderly people, who may have cognitive impairment and diminished motor skills, are more likely to drop a pill and forget the fact that they dropped it. If their pet becomes ill, those treating the poisoned pet have to sort through 10 or 15 medications that could be possible culprits. We often have to play detective (with the help of poison control) and try and match the patient’s symptoms to the list of medications that the owner takes every day.

As an example, I recall a little white dog who came into the ER in the middle of the night nearly comatose. The only time she roused from her stupor was to have a brief, violent seizure, and then she would settle back into her coma like a shark sinking back into the sea after an attack. The owner was a wheelchair-bound elderly lady with Parkinson’s disease, and she was on a mini-pharmacopeia of drugs: anti-depressants, calcium channel blockers, antacids, muscle relaxers, plus a handful of others. She frequently spilled pills due to her Parkinson’s and thought that her dog could have gotten into any one (or several) of her dozen-or-so prescriptions.

We puzzled ‘til our puzzlers were sore. Without knowing what the dog had gotten into we were left with only supportive care; if we knew the poison, we at least had some hope that there might be an antidote, or some form of specific treatment.

After a bit of investigation, and an assist from the specialists at poison control, we found out what did it. By matching the dog’s symptoms to those that might be caused by the ones on her list of drugs, we came up with baclofen, a potent muscle relaxer used to treat the painful cramps and spasms that accompany Parkinson’s disease. After some fast medical moves, a stint on a ventilator in ICU and a bout of ventilator-associated pneumonia, the little dog did well and was sent home.

Having a pet is like having a permanent toddler. We need to work to protect them from the threats that are around them nearly all the time. Some steps to consider in order to reduce the risk of pet poisoning due to human medications include:

• Secure containers to prevent pets from opening and ingesting meds (kids, too).
• Help, especially for the elderly or those with cognitive or physical impairment, for sorting, dispensing and securing drugs.
• Discussing with human healthcare providers if every drug in the medicine cabinet is needed
• Keeping medications out of reach of children and pets.
• Get rid of expired and unused drugs; most pharmacies have a means of safe disposal (don’t flush them – wee sea creatures don’t need them any more than your pet does).
• Picking up and making sure all pills are accounted for after a spill.

Make sure your pet doesn’t need one of those 50,000 annual calls to poison control. Protect them from the monster in the medicine cabinet.