NSAID and Ibuprofen Toxicosis in Veterinary Medicine

Flashcards covering the clinical signs, diagnosis, treatment, and pathophysiology of ibuprofen and NSAID toxicity in dogs, cats, and ferrets.

COX enzymes

Enzymes blocked by NSAIDS to inhibit prostaglandins, which are necessary for normal kidney blood flow and generating GI mucosal barriers.

Species most sensitive to Ibuprofen

Cats and ferrets, which are highly toxic at lower doses than those seen in dogs.

Low-dose Ibuprofen signs ($6$-$12\,h$)

Vomiting and GI upset.

Low-dose Ibuprofen signs ($12$-$24\,h$)

Hematemesis and melena due to GI ulcers.

Higher-dose Ibuprofen signs

Renal failure (following GI signs in $1$-$2\,d$) and PU/PD.

Very high-dose Ibuprofen signs

CNS effects including depression, seizure, and coma.

Ibuprofen toxicity labwork findings

Anemia and low protein (from GI ulcers).

Urinalysis monitoring for NSAID toxicity

Baseline and daily monitoring for tubular casts and proteinuria.

Kidney value monitoring protocol

Baseline kidney values and recheck $q24h \times 3d$.

Ibuprofen decontamination (first $24\,h$)

Emesis within $4\,h$ and Activated Charcoal ($AC$) with repeated dosing in the first $24\,h$.

GI protectant duration

Antacids (H2 and/or proton pump inhibitors) and sucralfate for $14\,d$; prostaglandin analogs for $2$-$3\,d$.

IV fluid diuresis protocol

IV fluid diuresis for $48\,h$ with normal renal values, or longer with azotemia.

Symptomatic neuro support for NSAIDs

The use of Diazepam for seizures.

Surgery for NSAID toxicity

Indicated for GI perforation.

Ibuprofen use in dogs

Do not use ibuprofen in dogs even though there are published doses.

Ibuprofen toxicosis prognosis

Good with prompt Tx; worsening with delayed care or large doses; may lead to chronic kidney Dz.