Village Veterinary Clinic of Hamburg’s Pet of the Week!
Crete is a fun loving 7 month old Rottweiler that came in on emergency last week after he decided to snag four 800 mg ibuprofen right off the kitchen counter! When Crete arrived at the Village Veterinary Clinic of Hamburg, he was bright and alert. He had not begun to have any gastrointestinal signs or symptoms of kidney damage.
We did a physical exam, his heart and lungs sounded normal. Eyes and ears checked our good and he was non-painful in his abdomen. Since there is no safe dose of ibuprofen in dogs, therapy was necessary for Crete. Four-800mg (3,200 mg) was in the category of gastrointestinal toxicity and borderline kidney toxicity based on Crete’s weight and the amount he ingested.
Ibuprofen is a non-steroidal anti-inflammatory medication commonly used in humans as a pain reliever and to reduce fever. It is available in many over-the-counter formulations (Advil, Motrin, Midol) as well as in prescription strength medications. Though relatively safe for people, ibuprofen is toxic to dogs and cats. Unlike humans, dogs do not possess the same enzymes to break down human NSAIDs, which can lead to the toxicity. No human NSAID is safe for dogs or cats.
Symptoms of ibuprofen toxicity includes vomiting, diarrhea, bloody stool (usually black-tarry), blood in vomit, nausea, weakness, pale gums (anemia), abdominal pain, lethargic, not eating, weight loss, stomach ulcers and perforations, increased thirst, increased urinations, decreased or lack or urine, seizures, incoordination, coma and death.
Humans, dogs and cats all have a lining to our stomachs. It helps protect itself during the digestion of foods and administration of medications. Ibuprofen inhibits an enzyme (COX) which normally has a protective effect on the lining of the stomach and gastrointestinal tract. It also helps keep blood flowing normally to the kidneys, and helps regulate platelet function. When COX enzymes are inhibited, the lining of the stomach and gastrointestinal tract becomes damaged, causing gastric ulcers to form. Reduced blood flow to the kidneys results in kidney damage. Reduced platelets leads to an increased tendency to bleed abnormally.
Once swallowed, ibuprofen is rapidly absorbed from the stomach and intestines. Depending on the amount of drug ingested, toxic effects can occur within an hour, but some signs can take a few days to appear. The most common side effect is stomach irritation. In mild cases, this may cause vomiting. In severe cases, it can cause the pet to vomit blood; the irritation can also be severe enough to cause stomach ulcers and stomach perforations (punctures in the stomach wall that allow stomach acid to leak into the abdomen). If stomach bleeding is severe, blood transfusions may be necessary to save the patient. Ibuprofen toxicity can also inhibit blood flow to the kidneys, which can cause kidney failure. Extremely high toxic doses of these drugs can also affect the brain, causing altered mental status, seizures, and coma.
There is no specific antidote for ibuprofen toxicity. Treatment may include intravenous fluid therapy, blood transfusions, medications to help heal stomach damage, and other medications to help support and stabilize the patient. Hospitalization may be required so that blood values, urine output, and vital signs can be monitored. Ibuprofen toxicity can be fatal. However, pets can survive if the condition is recognized, diagnosed, and treated quickly. The amount of drug involved also has a direct effect on recovery and long-term outcome.
In Crete’s case, he was hospitalized on IV fluids to keep him hydrated and to help maintain his kidneys, electrolytes and acids and bases. He did have some had minor elevations in some of kidney values (as time went on in the hospital the values did end up going down when we rechecked the bloodwork). We also administered activated charcoal, which helps bind any toxic substance in the body. It also helps it from re-circulating around in the body, which can further affect the liver and kidneys. He was put on medications to help protect the lining of his stomach along with medications that will help control any nausea and vomiting.
Crete did end up with some gastrointestinal issues, he was having severe diarrhea for a few days while in hospital. He also did have a fever that needed to be treated with antibiotics. He was closely monitored 24/7 by one of our licensed veterinary technicians.
Through all this he remained a happy boy! Crete was able to go home after a few days. He did not experience any more residual symptoms from his ingestion either!
Village Veterinary Clinic of Hamburg! We are open 7 days a week, 365 days a year (Doctors available daily until midnight. Veterinary technicians available daily 24/7 for phone support and patient monitoring)! 716-646-4023!