Alcohol
Alcohol (ethanol) is one of the most common substances in human households. Whether in beverages like beer, wine, or spirits, in disinfectants, or fermented foods – alcohol is ubiquitous. While humans can usually tolerate alcohol in limited quantities, even a small amount of ethanol poses a significant poisoning risk for dogs and cats. Pet owners often underestimate the toxicity of alcohol for their pets, as even very small amounts can cause severe health consequences and even be life-threatening.
The most important facts at a glance
Alcohol poisoning in dogs and cats represents a medical emergency that requires rapid action. Ethanol is significantly more toxic to our pets than to humans, as they lack the enzymatic capacities for efficient metabolism. Even small amounts can lead to severe signs of poisoning, with cats being even more sensitive than dogs due to their specific metabolic situation.
Sources of ingestion are diverse, ranging from alcoholic beverages and alcohol-containing foods to fermented fruits and household items with alcohol content. Symptoms develop rapidly and include gastrointestinal discomfort, neurological abnormalities, hypothermia, hypoglycemia, and metabolic acidosis. In severe cases, unconsciousness, coma, and death are imminent.
Diagnosis is based on anamnesis, clinical examination, and targeted laboratory diagnostic tests, particularly the determination of blood alcohol levels and monitoring of blood sugar and acid-base balance. Therapy is symptomatic and includes decontamination measures, fluid therapy, glucose administration, thermal management, and, if necessary, the treatment of seizures and respiratory depression.
With early treatment, the prognosis is good, while delayed therapy or severe poisoning is associated with an increased risk of permanent organ damage. Aftercare focuses on monitoring liver function and preventing re-exposure.
However, the most important measure remains prevention: pet owners should always store alcohol-containing substances safely and protect their animals from access to alcoholic beverages and food. Special caution is advised during celebrations and social gatherings when alcohol is more accessible and pet owners’ attention may wane.
Causes, development and progression
Alcohol (ethanol, ethyl alcohol) easily diffuses through cell membranes. Alcohol is absorbed by ingesting alcohol-containing substances (drinks, confectionery, bread dough) or through the skin (alcohol-based disinfectants).
After oral ingestion, a large part of the absorption already takes place in the stomach and upper small intestine.
The cause of alcohol poisoning in dogs and cats is usually the accidental ingestion of alcoholic beverages or food. Examples include unsupervised licking of spilled drinks, ingestion of alcohol-containing foods (such as cakes, dough, or fermented fruits), or accidental drinking of alcohol-based cleaning products.
Alcohol is mostly absorbed orally and quickly leads to a toxic effect, as dogs and cats can hardly metabolize alcohol enzymatically. Even small amounts are sufficient to trigger severe symptoms. The course of poisoning is rapid, with initial symptoms predominantly appearing within 30 to 60 minutes after ingestion. Due to their specific metabolism, cats are even more sensitive to alcohol than dogs, which is why even the smallest amounts can quickly become life-threatening for them.
Mechanism of action
Alcohol is obligately hepato- (liver) and neurotoxic (nerve cells).
Alcohol inhibits the central nervous system by enhancing the inhibitory effect of various neurotransmitters, such as GABA, dopamine, and serotonin.
The primary detoxification occurs in the liver, 95% in humans. The resulting metabolic products can, in turn, lead to further damage and functional disorders, such as affecting heart function, developing metabolic acidosis, hypoglycemia, and disturbing thermoregulation.
The remaining alcohol is excreted through breath, urine, and feces.
Dogs and cats are considered more sensitive to alcohol compared to humans.
As little as 3–8 g/kg body weight can be fatal for dogs.
For cats, 6 g/kg body weight is stated as a lethal dose.
Symptoms of intoxication
Alcohol (ethanol) causes similar poisoning symptoms in dogs and cats as in humans. The main symptoms are gastrointestinal irritation, vomiting, and impaired brain function. Severe poisoning leads to impaired consciousness, coma, and impending respiratory arrest.
- Drooling
- Vomiting
- Diarrhea
- Gastric bloat
- Behavioral change
- Lethargy
- Ataxia (loss of balance up to lateral recumbency)
- Tremor
- Loss of protective reflexes
- Depression leading to coma
- Hypothermia (36.5 °C)
- Respiratory distress (dyspnea)
- Urinary incontinence
- Metabolic acidosis
- Hypoglycemia (low blood sugar)
- Decreased heart rate (bradycardia)
- Seizures
- Coma
- Cardiac Arrest
Supplement
Symptoms in dogs:
- Staggering, coordination disorders, disorientation
- Vomiting, often accompanied by diarrhea
- Drooling (hypersalivation)
- Lethargy, progressive impairment of consciousness leading to unconsciousness
- Slowed breathing leading to respiratory depression
- Slowed heart rate (bradycardia) and drop in blood pressure
- Severe hypoglycemia (low blood sugar) with seizures
- Severe hypothermia
- Coma and death due to respiratory and circulatory arrest
Symptoms in cats:
- Severe staggering, movement disorders, and trembling
- Excessive drooling
- Severe vomiting
- Breathing problems, shallow breathing
- Rapid deterioration of consciousness, coma
- Severe hypoglycemia, rapidly occurring seizures
- Severe hypothermia
- Cardiac arrhythmias, cardiovascular collapse, and death possible within a few hours without treatment
Diagnosis
In addition to the anamnesis and clinical symptoms, the following examinations should be performed to confirm the diagnosis and rule out other diseases:
Blood test:
- Blood glucose measurement (rapid detection of hypoglycemia)
- Blood gas analysis to detect metabolic acidosis
- Electrolyte status (especially potassium, sodium)
- Kidney and liver values to assess possible organ damage
Determination of ethanol level:
- Blood sample for direct determination of alcohol level (ethanol) in serum or plasma.
- This test is specific and confirms alcohol poisoning, but it is not immediately available in every veterinary practice.
Urinalysis:
- Urine sample for the detection of ethanol or metabolites in urine (rarely directly measurable, rather unspecific, but useful as a supplement).
Diagnostic imaging:
- X-ray examination of the abdominal cavity to clarify possible ingestion of larger amounts of fermenting material (e.g., yeast dough), which continues to produce alcohol in the stomach.
Other possible causes for neurological symptoms and metabolic imbalances should be differentiated, for example:
- Poisoning with other toxic substances (chocolate, antidepressants, plant toxins)
- Hypoglycemia due to other causes (e.g., insulinoma)
- Metabolic diseases (e.g., liver diseases)
- Trauma or neurological diseases (e.g., traumatic brain injury, epilepsy)
The combination of anamnesis, clinical symptoms, and targeted examinations generally reliably confirms the diagnosis of alcohol poisoning.
Therapeutic principles
The possibilities for decontamination are limited. Inducing vomiting is usually only possible in the initial phase due to the later loss of the swallowing reflex and the risk of aspiration (vomit entering the lungs).
Otherwise, gastric lavage is indicated.
Activated charcoal binds alcohol poorly.
Since a large portion of the alcohol is already absorbed in the stomach and upper small intestine, accelerating intestinal passage with Glauber’s salt is unlikely to be very successful.
There is no antidote.
Acute alcohol intoxication necessitates continuous monitoring of vital signs.
The loss of protective reflexes, metabolic imbalances (acidosis, electrolyte disturbances), and impaired respiratory and cardiac function pose an acute life threat.
Symptomatic therapy primarily involves:
- Regulation of fluid balance
- Correction of deficiencies
- in water
- electrolytes and
- glucose
- Correction of metabolic acidosis
- Provision of warmth
Prognosis & follow-up care
The prognosis is generally good.
The prognosis for alcohol intoxication heavily depends on the ingested amount, the time until treatment begins, and the animal’s condition upon admission to the clinic. If poisoning is recognized early and treated immediately, the prognosis is good. Delays increase the risk of severe complications such as permanent neurological damage or a fatal outcome. Cats generally have a more guarded prognosis than dogs, as they metabolize alcohol significantly less effectively and severe complications occur more quickly.
Research outlook
Research in the field of alcohol poisoning in pets is continuously evolving, with several promising approaches being pursued. One focus is on improving diagnostic capabilities, particularly the development of rapid point-of-care tests for determining blood alcohol levels in veterinary practice. These could accelerate diagnosis and thus enable earlier initiation of therapy.
In the area of therapy, new treatment strategies are being researched that go beyond purely symptomatic therapy. These include specific liver-protective therapies aimed at minimizing the hepatotoxic effects of alcohol. Substances such as N-acetylcysteine, silymarin, and certain phospholipids are being investigated for their protective effects in alcohol-induced liver damage.
For severe poisoning cases, extracorporeal elimination procedures such as hemodialysis or hemoperfusion are being evaluated. These could enable faster removal of alcohol from the bloodstream in critical patients, thereby shortening the duration of poisoning.
Another research focus is on better understanding species-specific differences in alcohol metabolism. The exact mechanisms of why cats are particularly sensitive to alcohol are being investigated in more detail to develop more targeted treatment strategies.
There is also a need for research in the area of long-term consequences after surviving alcohol poisoning. Studies on possible chronic neurological or hepatic damage could help optimize aftercare protocols and detect late-onset complications early.
Prevention research focuses on developing effective educational strategies for pet owners. Digital media and apps are increasingly being used to raise awareness of the dangers of alcohol for pets and to convey practical prevention measures.
Interdisciplinary research approaches that transfer knowledge from human medicine to veterinary medicine could lead to new therapeutic options in the future. Collaboration between toxicologists, neurologists, and intensive care specialists promises innovative treatment concepts for pets poisoned by alcohol.
Frequently asked questions (FAQs)
- How much alcohol is dangerous for my dog or cat?
Even very small amounts can be dangerous. As a rule of thumb: the smaller the animal, the more dangerous even a small sip. For a 5 kg dog, as little as 15–20 ml of wine or 5–10 ml of spirits can lead to signs of poisoning. - Is beer less dangerous than spirits for my pet?
Although beer has a lower alcohol content, it is by no means harmless. In addition to alcohol, beer and other fermented beverages contain hops, which can also be toxic to dogs and worsen the poisoning symptoms. - What should I do if my pet has ingested alcohol?
Contact your veterinarian or a veterinary emergency clinic immediately. Do not attempt to induce vomiting yourself, as this can be dangerous if consciousness is already impaired. Note down what type and approximate amount of alcohol was ingested and when it happened. - Can I help my pet at home after alcohol ingestion?
The most important measure is immediate transport to the veterinarian. Until then, keep your pet warm, calm, and in a safe position to prevent injuries. Do not give water or food, as this can lead to aspiration if protective reflexes are impaired. - How long does it take for alcohol poisoning symptoms to subside?
In cases of mild poisoning and prompt treatment, symptoms may subside within 12–24 hours. In more severe cases, recovery can take several days, and there is a risk of permanent damage. - Can a single instance of alcohol poisoning lead to permanent damage?
Yes, especially with severe poisoning or delayed treatment, permanent liver or brain damage can occur. Cats are particularly susceptible to this due to their limited ability to metabolize alcohol. - Are certain dog or cat breeds more sensitive to alcohol?
Sensitivity depends less on the breed and more on body size, age, and general health status. Small breeds, young animals, and animals with pre-existing liver or kidney diseases are more sensitive. - What hidden sources of alcohol are there in the household?
Besides obvious sources like alcoholic beverages, perfumes, mouthwash, disinfectants, baking extracts, rum balls, liqueur chocolates, and fermenting foods like yeast dough or overripe fruit can contain alcohol. - Can my pet become addicted to alcohol?
There is no scientific evidence of alcohol dependence in pets in the sense of addiction. Acute toxicity is the primary concern and generally prevents repeated exposure. - How can I protect my pet from alcohol poisoning?
Store alcoholic beverages and food out of reach of your pets. Be especially vigilant during parties and inform guests about the dangers. Dispose of leftover alcoholic beverages immediately and safely. In the garden, watch out for fermenting fallen fruit and remove it regularly.
Literature
- Handl, S., & Iben, C. Food toxic for small animals – a literature review. Vet. Med. Austria / Wien. Tierärztl. Mschr. 95 (2008), 235 – 242
- Prankel, S., & Schöbel, A. (2006). Acute alcohol poisoning in dogs. Tierärztliche Praxis Ausgabe K: Kleintiere/Heimtiere, 34(03), 168-171.
- Kovalkovičová N, Šutiaková I, Pistl J, Šutiak V. Some food toxic for pets. Interdisciplinary Toxicology. 2019; 12(1): 30-37.
- Lee JA. Emergency management and treatment of the poisoned small animal patient. Veterinary Clinics of North America: Small Animal Practice. 2021; 51(6): 1361-1381.
- Gupta RC, editor. Veterinary Toxicology: Basic and Clinical Principles. 3rd ed. Academic Press; 2018.
- Brutlag AG, Hovda LR. Toxicology of alcohols. In: Peterson ME, Talcott PA, editors. Small Animal Toxicology. 4th ed. Elsevier; 2022. p. 707-714.
- Löwe G, Löwe O. Poisoning in Dogs and Cats – A Veterinary Guide. 2nd edition. Kreuztal: Kynos-Verlag. 2021; 208 p.