Ibuprofen poisoning in Cats (Felis) | Vetlexicon
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Ibuprofen poisoning

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Introduction

  • Non-steroidal anti-inflammatory agent (NSAID).
  • Ingestion accidental or through treatment by owner.
  • Signs: vomiting, melena.
  • Treatment: symptomatic.
  • Prognosis: variable.
  • No adverse clinical signs or abnormal laboratory parameters if serum ibuprofen concentrations <31 ug/ml.
    Print off the owner factsheetIbuprofen and Naproxen toxicosis  Ibuprofen and Naproxen toxicosis to give to your client.

Presenting signs

  • Hemorrhagic gastroenteritis.
  • Depression.

Special risks

  • Care with gastric lavage Gastric lavage if evidence of GI inflammation or ulceration.

Pathogenesis

Pathophysiology

  • Cause a prostaglandin deficiency by inhibition of cyclo-oxygenases (COX).
  • Low safety margin as excreted slowly.
  • Low doses cause GI signs.
  • Higher doses also result in organ damage, particularly renal damage.
  • Readily absorbed from gastrointestinal tract, and highly bound by plasma proteins.
  • Interferes with prostaglandin synthesis.
  • Locally irritant to the gastrointestinal tract.
  • Reduces prostaglandin-mediated defense mechanisms in the stomach.
  • Suppresses protective prostaglandin-mediated vasodilation in the kidneys.
  • Toxic dose for dogs, 50 mg/kg with renal failure and death at 300 mg/kg. Corresponding doses for cats approximately half those for dogs.

Timecourse

  • Signs develop within 4-6 hours of acute intoxication.
  • Chronic therapy may also cause signs.
  • Renal failure may develop within 12 hours of massive dose.
  • Can be delayed up to 3-5 days at lower dose.

Diagnosis

Client history

  • History of exposure to poison and appropriate clinical signs.

Clinical signs

  • Vomiting/diarrhea.
  • Depression.
  • Anorexia.
  • Ataxia.
  • Abdominal pain.
  • Hematemesis/melena.
  • Respiratory stimulation (metabolic acidosis).
  • Respiratory depression.
  • Seizures.
  • Coma.
  • Death.

Confirmation of diagnosis

Discriminatory diagnostic features

Definitive diagnostic features

  • Serum ibuprofen concentrations.

Gross autopsy findings

  • GI congestion, hemorrhage, ulceration.

Histopathology findings

  • Renal tubular or papillary necrosis; interstitial nephritis.

Treatment

Initial symptomatic treatment

Monitoring

  • Monitor for GI ulceration/perforation.
  • Monitor hepatic and renal function.

Prevention

Prophylaxis

  • Do not administer to animals with a history of renal or gastro-intestinal disease.

Outcomes

Prognosis

  • Prognosis is good with treatment.
  • Poor prognosis with perforating GI ulcers or organ failure.

Expected response to treatment

  • Cessation of vomiting.
  • Resolution of melena.
  • Satisfactory renal function.

Reasons for treatment failure

  • Organ failure due to large dose.
  • Inadequate supportive care.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Spyridakis L K, Bacia J J, Barsanti J A et al (1986) Ibuprofen toxicosis in a dog. JAVMA 189 (8), 918-919.

Other sources of information

  • Mikiciuk M (2001) Nonsteroidal Anti-Inflammatories In: Small Animal Toxicology. Eds: M E Peterson and P A Talcott. Philadelphia: W B Saunders. ISBN: 0 7216 7826 2.
  • Osweiler G D (1995) Toxicology. Philadelphia: Williams and Wilkins. ISBN: 0 6830 6664 1.

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