Potent fentanyl, fentanyl analogues threaten drug detection dogs
January 18, 2018
Sgt. Scott Kivet thinks about overdose risks to his drug detection dog, Quori, every time they search a vehicle.
"I'm very careful about my dog because I primarily deal with heroin," he said.
Kivet, a detective in Robbinsville Township, New Jersey, and Quori, a 2-year-old Labrador Retriever, work along a section of Interstate 195 east of Trenton. They are part of a drug interdiction team that is involved in more than 100 heroin-related arrests each year.
Quori, like other detection dogs, takes rapid, deep breaths when he finds drug odors, Kivet said. Heroin powder is light like baby powder and can puff into clouds.
As demand for heroin has increased, so has demand for fentanyl and carfentanil to supplement heroin, Kivet said.
Minuscule amounts of synthetic opioids, including fentanyl and fentanyl analogues such as carfentanil, can cause overdoses in the same police dogs that were safe while sniffing for heroin. University veterinarians, police departments, and nonprofit organizations are giving police and emergency medical technicians opioid antidote kits intended for emergency use in dogs and training them how to administer the antidote.
Sporadic reports indicate police dogs and some pet dogs have been victims of overdoses or suspected overdoses. Those include three police dogs that showed clinical signs but survived after fentanyl exposure in a Florida home.
We’ve already dealt with one incident where a dog got cross-contaminated by a person who ingested heroin. The person overdosed, and the dog overdosed.
Sgt. Scott Kivet, a detective in Robbinsville Township, New Jersey
No agencies are known to be collecting data on overdoses among scent detection dogs. But Drug Enforcement Administration officials issued warnings in 2016 and 2017 that noted the risk of fentanyl to police dogs.
"Canine units are particularly at risk of immediate death from inhaling fentanyl," agency officials wrote in June 2016.
Rick Ashabranner, president of the North American Police Work Dog Association, said the danger of opioids to law enforcement dogs is a grave concern. He has seen reports of dogs exposed to opioids and some saved by the opioid antagonist naloxone, but he also thinks he would have heard if overdoses had become an epidemic among police dogs.
Some overdoses may have occurred without gaining national attention, Ashabranner said. But he also suspects police officers are taking precautions that protect the dogs and themselves.
An article in the Centers for Disease Control and Prevention’s Nov. 3, 2017, Morbidity and Mortality Weekly Report indicates more than 60,000 people died in the U.S. of drug overdose deaths in 2016. About 20,000 overdosed on synthetic opioids—including fentanyl and fentanyl analogues—up from about 3,000 in 2013.
Fentanyl is 50 to 100 times more potent than morphine, according to the CDC. Carfentanil, which is used to tranquilize large animals, is estimated to be 10,000 times more potent than morphine.
Dr. Ashley Mitek, a teaching assistant professor in the University of Illinois College of Veterinary Medicine, said humans and nonhuman primates are sensitive to the respiratory depressant effect of opioids. Dogs can endure more substantial doses of opioids than humans can, which may be why few dogs have shown clinical signs of overdose in decades of sniffing for heroin. It also explains why overdoses could become more frequent with abuse of fentanyl and carfentanil.
Dr. Mitek and Dr. Maureen McMichael, also of the University of Illinois, created a video in March 2017 that describes how veterinarians can administer naloxone—sometimes in serial doses—to reverse opioid overdoses in scent detection dogs. It also provides advice on teaching dog handlers how to administer naloxone and stabilize and monitor their dogs on the way to a veterinary hospital. The veterinarians also have been training police and ambulance crews in central Illinois.
In an interview, Dr. McMichael, professor and director of emergency and critical care in the U of I CVM, said reversing an overdose within 3-5 minutes of the onset of clinical effects can save a dog. Emergency medical technicians and paramedics need to have not only opioid antidotes available but also training on handling disoriented dogs that could attack while emerging from an opioid coma.
Canine units are particularly at risk of immediate death from inhaling fentanyl.
Drug Enforcement Administration warning from June 2016
Dr. Mitek said naloxone is the typical drug of choice for reversing overdoses in animals and humans. Other opioid antagonists, including longer-lasting naltrexone, are available but most often used in zoos. Naltrexone, for example, is approved for administration to elk and moose as an antagonist to carfentanil citrate immobiliization.
Police and EMTs tend to carry naloxone autoinjectors for intramuscular use or, more often, atomizers for intranasal use, Dr. Mitek said. Atomizers are not only unapproved in dogs, but no data are available on their effectiveness in dogs.
But, if only intranasal spray were available, it still could save a dog’s life, Dr. Mitek said.
Thomas Duddy, a spokesman for Adapt Pharma, which makes Narcan nasal spray, also said his company has no data on the use of Narcan in dogs.
Finn and Primus, two of the Broward County Sheriff’s
Office dogs that showed clinical signs of overdose after
exposure to fentanyl (Courtesy of the Broward County
Dr. Cynthia M. Otto, executive director of the Penn Vet Working Dog Center and an associate professor of critical care at the University of Pennsylvania School of Veterinary Medicine, said at press time that, in January, she would conduct a study comparing the pharmacokinetics of intranasal and intramuscular administration of naloxone in 10 dogs from the working dog program. Her research team hopes to learn the effects of administration route on drug effectiveness, drug duration, and scent detection ability after treatment.
The team also will examine the risk of scent detection dogs becoming contaminated with fentanyl and spreading it to their handlers. The study is funded through a grant from the Department of Homeland Security and is a collaboration with the U.S. Army Medical Research Institute of Chemical Defense.
Dr. Otto said sedating a dog with fentanyl requires a dose about 20 times that used to sedate a human, by body weight. She said the dogs likely are at low risk of opioid overdoses, but preparation—such as stocking naloxone—is important.
Dr. Mitek wants to collect reports from law enforcement agencies and veterinarians on overdoses in scent detection dogs, with case descriptions, treatments, and outcomes.
"In the long run, we would love to have an online reporting system," she said.
Dr. McMichael said she and Dr. Mitek hope to collect overdose data this summer during a conference of police working dog handlers.
In Florida, the Broward County Sheriff’s Office added naloxone to its medical supplies for drug detection dogs after three dogs had opioid overdoses during a home search in October 2016. Andy Weiman, a detective with the Sheriff’s Office, attributed the overdoses to contact with trace amounts of fentanyl.
Weiman said officers noticed changes in the dogs’ behavior after they searched a house in Lauderhill, where they found only a small amount of marijuana. Information from the Sheriff’s Office indicates deputies and Lauderhill police were searching a home used by someone suspected of selling heroin and heroin laced with fentanyl.
The fentanyl supplier had been arrested weeks earlier. Officers had thought the home was unlikely to still contain fentanyl.
The dogs became drowsy, had difficulty standing, and stopped reacting to their handlers, Sheriff’s Office information states. Weiman said the handlers noticed the change during an observation period intended to identify opioid exposure.
Dr. Christopher McLaughlin, a veterinarian at Coral Springs Animal Hospital, saw the three dogs about 20 minutes later. Two had minor clinical signs and recovered without treatment.
The third dog began hyperventilating and could not be wakened, he said. It revived 20-30 minutes after receiving one dose of naloxone, at 0.04 mg/kg, and recovered the same day.
Dr. McLaughlin since has helped police departments develop naloxone-containing emergency kits for dogs and helped train officers how to administer intramuscular or subcutaneous injections to dogs.
Kivet, the detective from Robbinsville, carries injectable naloxone for Quori. It was donated by The Overdose Prevention Agency Corp., a nonprofit in New Jersey that works primarily to prevent overdose deaths in humans.
Paul A. Ressler founded TOPAC after the July 2010 death of his son, Corey, from an overdose. At press time, his organization planned a campaign, Corey's K-9s, to offer free training and naloxone kits for use in all police dogs in New Jersey.
Ressler plans to continue supporting police dogs and their handlers. He recommends that veterinarians who work with police dogs talk with the handlers about the potential for overdose.
Kivet estimates he has administered naloxone to upward of 20 people after overdoses and none so far to animals. Naloxone has become more often needed than a defibrillator for people who have passed out behind the wheel, he said.
"We've already dealt with one incident where a dog got cross-contaminated by a person who ingested heroin," he said. "The person overdosed, and the dog overdosed."
Kivet estimates that the pit bull–type puppy was about 10 weeks old. The overdose occurred before Kivet had injectable naloxone for Quori, and he would have administered it, were it available.
Kivet hopes he will never need to use naloxone on his dog or another. But he is glad the tool is available in his squad car.
"It's a contingency, and I know I could save an animal's life—just like I could save a human's life with the nasal" naloxone spray, he said.
Dr. Ashley Mitek at the University of Illinois is collecting reports from veterinarians and police on opioid overdoses in scent detection dogs at amitek2illinois [dot] edu.