Ibuprofen toxicity

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Sections available in full article Introduction, Presenting signs, Special risks (e.g. anesthetic), Pathogenesis, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Prevention, Prophylaxis, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Lisa Moore DVM DipACVIM

Introduction

  • Cause : ingestion of non-steroidal anti-inflammatory agent (NSAID).
  • Signs : vomiting, melena.
  • Diagnosis : history, clinical signs.
  • Treatment : symptomatic.
  • Prognosis : good.
  • No adverse clinical signs or abnormal laboratory parameters if serum ibuprofen concentrations <31 ug/ml.

Diagnosis

Clinical signs

  • Ataxia.
  • Abdominal pain.
  • Respiratory stimulation (metabolic acidosis).
  • Respiratory depression.
  • Coma.
  • Death.

Diagnosis

Differential diagnosis

  • Other poisonings:
    • Naproxen Naproxen poisoning or other NSAIDs.
    • Ethylene glycol Ethylene glycol poisoning.
  • Ketoacidosis.
  • Addisonian crisis.

Sequelae

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.
  • Rising PCV.
  • Resolution of azotemia.

Reasons for treatment failure

  • Organ failure due to massive overdose.
  • Inadequate supportive care.

Sources

Publications

Refereed papers

  • Cote E (1998) Over the counter human medications in small animals. Comp Cont Ed Prac Vet 20 , 791-805.
  • Villar D, Buck W B & Gonzalez G M (1998) Ibuprofen, aspirin and acetaminophen toxicosis and treatment in dogs and cats. Vet Hum Toxicol 40 , 156-162.
  • Kore A M (1997) Over the counter analgesic drug toxicoses in small animals. Vet Med 92 , 158-165.
  • Godshalu C P, Roush J K, Fingland R B et al(1992) Gastric perforation associated with administration of ibuprofen in a dog. JAVMA 201 , 1734-1736.
  • Spyridakis L K, Bacia J J, Barsanti J A & Brown S A (1986) Ibuprofen toxicosis in a dog. JAVMA 189 (8), 918-9.

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