What to Do in the First 60 Minutes of a Drug Reaction

The Hour That Decides Everything

I replay the night Cooper died more often than I should. The drooling, the glassy eyes, the frantic phone call to the vet clinic. What I remember most is the paralysis. I didn’t know what I was looking at. I didn’t know what to do. I wasted hours that could have been minutes.

If you’re reading this page right now because your dog is showing symptoms, skip to the emergency checklist below. Read the rest later. Right now, act.

If you’re reading this proactively - before anything has gone wrong - then good. This is the kind of preparation that saves lives. Print this page. Put it on your refrigerator. Keep it in your car. Know it by heart before you need it.

Recognizing a Drug Reaction

Drug toxicity in MDR1-affected dogs doesn’t always look dramatic at first. Sometimes the early signs are subtle enough that you second-guess yourself. You think maybe your dog is just tired, or a little stressed from the vet visit, or having an off day.

Trust your instincts. If your dog received any medication in the past 24 hours and something feels wrong, it probably is.

Early Warning Signs (0-6 hours after medication)

• Excessive drooling or salivation
• Loss of appetite or refusal to eat
• Unusual quietness or lethargy
• Dilated pupils
• Mild disorientation - your dog seems “spacey” or doesn’t respond normally to their name
• Slight trembling, especially in the hindquarters

Progressing Signs (6-24 hours)

• Stumbling or difficulty walking
• Vomiting
• Diarrhea
• Increased drooling
• Apparent blindness - bumping into furniture, not tracking movement
• Hypersensitivity to touch or sound

Severe Signs - ACT IMMEDIATELY

• Seizures or convulsions
• Inability to stand
• Loss of consciousness
• Extremely slow or irregular heartbeat
• Difficulty breathing
• Complete unresponsiveness

If you see any severe sign, don’t finish reading this page. Call your emergency vet now. Then come back.

The First 60 Minutes: Step by Step

Minute 0-5: Assess and Call

Minute 5-15: Prepare for Transport

While you’re on the phone or waiting for a callback:

• Gather the medication container. Bring the bottle, the box, the label - whatever you have. The vet needs to know exactly what drug and what dose your dog received.
• Bring your dog’s MDR1 test results if you have them.
• Clear a path to your car. If your dog can’t walk, you may need to carry them. Get blankets ready.
• Do NOT induce vomiting unless specifically instructed by a veterinarian. Some drugs cause more damage on the way back up.
• Do NOT give any other medications. No Benadryl, no activated charcoal, no home remedies unless a vet tells you to.

Minute 15-30: Transport

• Keep your dog warm. Drug toxicity can cause temperature dysregulation. Wrap them in a blanket.
• Keep them on their side if they’re unconscious or seizing. This helps prevent aspiration if they vomit.
• Drive to the vet. Have someone else drive if possible so you can stay with your dog.
• If your dog is seizing, do not try to hold their mouth open or put anything in it. Just keep them from hitting their head on hard surfaces.
• Time the seizures. The vet will want to know how long they lasted and how frequently they’re occurring.

Minute 30-60: At the Emergency Clinic

What the Emergency Vet Will Do

There is no antidote for most MDR1-related drug toxicities. Treatment is supportive, which means the goal is to keep your dog alive while their body processes and eliminates the drug. For dogs with the MDR1 mutation, this takes much longer than normal because the protein that’s supposed to pump the drug out of the brain isn’t working properly.

Typical emergency treatment may include:

• IV fluids to support hydration and help flush the drug from the system
• Activated charcoal (if the drug was given orally and recently enough) to reduce further absorption
• Anti-seizure medication if your dog is convulsing
• Respiratory support including supplemental oxygen or, in severe cases, mechanical ventilation
• Temperature regulation - heating or cooling as needed
• Monitoring of heart rate, blood pressure, and neurological status

Important: Make sure the emergency vet knows about the MDR1 status before they administer any additional drugs. Some medications used in emergency treatment are themselves on the danger list. The last thing your dog needs is a second problematic drug on top of the first.

The Hardest Part: Waiting

I’m not going to sugarcoat this. Once your dog is in the hands of the emergency team, the hardest part begins. Waiting. Not knowing. Hoping.

Some drug reactions resolve within hours. Others take days. Some dogs recover fully. Some don’t.

The severity depends on many factors:

• Which drug was involved (some are more dangerous than others)
• What dose was given
• Your dog’s MDR1 genotype - mutant/mutant dogs are affected much more severely than normal/mutant dogs
• How quickly treatment began - this is why the first 60 minutes matter so much
• Your dog’s overall health - younger, healthier dogs generally cope better

What Our Community Has Learned

Over the years, families in our community have shared their emergency experiences. Their collective wisdom has shaped this guide, and their stories appear on our community stories page. Here’s what they want you to know:

“The emergency vet had never heard of MDR1. I had to explain it while my dog was dying. Please, please print out the information and keep it with you. You shouldn’t have to be the educator in your worst moment.” - Sarah T., Austin, TX

“Time saved my boy. I recognized the drooling within two hours of the medication and got him to the ER immediately. He spent four days in the ICU but he came home. Four days feels like forever, but he came home.” - Richard B., Boston, MA

“I called the ASPCA Poison Control hotline and they were incredibly helpful. They knew about MDR1 and were able to advise the emergency vet directly. That number is worth memorizing: 888-426-4435.” - Carol N., San Francisco, CA

After the Emergency

Whether your dog survives or not, the aftermath of a drug reaction is overwhelming. You’ll need support. Don’t try to process this alone.

If your dog survived:

• Follow up with your regular vet within 48 hours
• Monitor for delayed symptoms for at least two weeks
• Get your dog MDR1-tested if you haven’t already
• Update their veterinary records immediately
• Consider keeping a daily symptom log during recovery

If your dog didn’t survive:

• You did everything you could. Read that sentence again.
• Grief is natural and there’s no timeline for it
• Our support resources page has grief hotlines and communities that understand
• When you’re ready, consider sharing your story to help others

Prevention Is Everything

The best emergency response is the one you never have to use. For a comprehensive overview of drug sensitivities in herding breeds and how the MDR1 mutation works at a genetic level, Ivermectin Sensitivity provides detailed, science-based information that every herding breed owner should read.

Prevention comes down to three things:

1. Test your dog. A simple cheek swab tells you their MDR1 status for life. Our MDR1 testing guide walks you through every testing option, from ordering a home kit to interpreting your results.
2. Inform every vet. Every clinic, every visit, every time. No exceptions.
3. Know the danger drugs. Keep the list accessible. Question every prescription. And learn the safer alternatives so you can suggest them when a dangerous drug is proposed.

I wrote this guide because I didn’t have it when I needed it. Cooper might still be alive if I had. That thought keeps me up at night, but it also keeps me writing. It keeps me sharing. It keeps me hoping that one day, no family will need this page because every vet will already know, and every dog will already be tested.

Until that day, print this out. Keep it close. And if you ever need it, know that our community is here for you on the other side.

This emergency guide was developed with input from veterinary professionals and families who’ve experienced drug reactions firsthand. It is not medical advice. Always follow the instructions of your veterinarian. If you have suggestions for improving this guide, please contact us.