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GI Decontamination

UF College of Veterinary Medicine

Created on March 19, 2026

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GI Decontamination

Indication: Administer if the dog is asymptomatic and ingestion occurred within the past 2 hours. Induction of emesis: Apomorphine (dogs) or hydrogen peroxide (3%) if apomorphine unavailable. Do NOT induce emesis if the animal is already symptomatic (seizure risk). Activated charcoal: 1–4 g/kg orally. Use a cathartic (sorbitol) with the FIRST dose only. REPEAT EVERY 3 HOURS: theobromine undergoes enterohepatic recirculation and will be reabsorbed without repeated charcoal.

WHY REPEAT ACTIVATED CHARCOAL EVERY 3 HOURS? Theobromine undergoes enterohepatic recirculation: it is conjugated in the liver, secreted in bile into the small intestine, and then reabsorbed. Each dose of activated charcoal binds the theobromine in the intestinal lumen before it can be reabsorbed — breaking this cycle. Skipping repeat doses significantly reduces efficacy and prolongs the toxicity window.