NSAIDs in the face of vomiting

RE: NSAIDs in the face of vomiting

Andrew Kent — Sun, 17 Jan 2021 09:35:46 GMT

Thanks for the update Emily - glad things seem to be settling!

Andy

RE: NSAIDs in the face of vomiting

Emily Ross — Fri, 15 Jan 2021 15:59:08 GMT

Hi Andy, thank you very much for your reply, I have read through the consensus statement, it seems we have to accept for the time being a serious lack of evidence supporting their use. I feel more familiar with where they may be useful however, and also with their side effects- I agree with you they appear to be over used, I have a number of colleagues who use one or several of them for nearly every vomiting animal. The cat in question is doing much better on meloxicam and the vomiting is a little less so so far so good

Thanks again

RE: NSAIDs in the face of vomiting

Andrew Kent — Thu, 07 Jan 2021 10:33:40 GMT

Hi Emily,

This is always a difficult discussion as lots of opinions and not a huge amount of evidence. In terms of gastroprotectants - the relatively recent consensus statement is a good place to start - https://onlinelibrary.wiley.com/doi/10.1111/jvim.15337

In terms of the NSAID - I suppose I am always a bit cautious in using these in dogs/cats with active GI disease but ultimately it comes down to benefit vs risk and we have relatively few alternative options in cats. So if its working and seemingly well tolerated you may be ok.

My take on GI protectants is that they are not benign drugs and likely over used in many situations so use should be considered carefully. NSAID prophylaxis is one of the indications in people so worth considering and I have tried this occasionally in patients who are poorly tolerant of these drugs when I feel they are necessary.

Like everything for me this comes down to weighing up the pros and cons and a frank discussion with the owner so they can make an informed decision.

Andy