Managing Veterinary Medication Administration Errors

On occasion patients are administered medications and other products via the wrong route. Sometimes drugs that are meant to be given intravenously are given subcutaneously, or something that is meant to go in the ear is applied to the eye instead. Here are suggestions from the ASPCA’s Animal Poison Control Center (APCC) on what to do when this happens.

Ocular

In general, if a product is given in the eye when it is meant to be given elsewhere, it can lead to conjunctivitis and potentially corneal ulceration. APCC recommends flushing and  staining the eye, and treating if an ulcer is present.

Intravenously

Most of the time, if a product is given intravenously when it should have been given by an alternate route, anaphylaxis is the main side effect to be concerned about. Typically, this will happen shortly after the injection is administered and treatment for anaphylaxis is symptomatic and supportive. 

Subcutaneously

If a product is erroneously given subcutaneously, the most common side effects are pain at the injection site, cellulitis, and abscess formation. The injection site can be infused with sterile saline to dilute out the original product. If painful, the patient can be given an anti-inflammatory unless contraindicated. The site can be monitored for swelling, heat, and redness, and if an abscess develops, it can be treated symptomatically and supportively.

One of the most common mix-ups occurs with the Bordetella vaccine.  The vaccine is meant to be administered intranasally and is sometimes accidentally given subcutaneously.  When this occurs, the main concerns are for cellulitis and an abscess—however, on rare occasions, hepatotoxicity can occur.  In these instances, the injection site can be infused with gentamicin diluted in saline, an oral antibiotic can be started, and liver values should be monitored.  The injection site should be monitored for signs of an abscess and liver values should be rechecked if any signs of vomiting, anorexia, or lethargy are seen at home.

If a patient was administered a product via an incorrect route, contact the ASPCA Animal Poison Control Center at 888-426-4435 for assistance.