Iboprofen poisoning in 6 month old puppy

Re: Iboprofen poisoning in 6 month old puppy

Bob Russell — Sat, 05 Feb 2011 11:47:43 GMT

Just though it was time for an update. The little bugger is fine! Spent most of the week worrying about the sod and she is back eating and being treated with Antepsin only now!! Owner is now going to insure her!

Thanks for all the advice!

Re: Iboprofen poisoning in 6 month old puppy

Kate Richardson — Sat, 05 Feb 2011 11:42:13 GMT

I swa a 6kg dog yesterday that had eaten one 200mg ibuprofen tablet 48hrs earlier. Vomited a couple of times over the following 24hrs and then developed diarhoea, faeces described as darker than normal. Dog was bright and well and eating and drinking normally now the vomiting had stopped, and hydration was normal. Gave it sucralfate for a few days and am sure it will be fine, but this is much lower than the reported toxic dose of 100-200mg/kg, so I work on the fact that any ibuprofen can be toxic to one degree or another!

Re: Iboprofen poisoning in 6 month old puppy

Michelle Tapp — Thu, 03 Feb 2011 10:55:38 GMT

I phoned the VPIS on Monday night about Ibuprofen and they said renal issues are not reported to be a factor below doses of 200mg/kg! GI disturbance and gastric ulceration however can occur at any dose and they recommend gastric protectants for 14days. I suppose as in humans, the severity of symptoms depends on the individual dogs sensitivity.

Re: Iboprofen poisoning in 6 month old puppy

Joyce Whitehead — Thu, 03 Feb 2011 10:14:50 GMT

I had one many years ago that had eaten (IIRC) about 6 Ibuprofen - it was a pharoah hound, around 30kg. He was not presented until the next morning, and unfortunately despite very aggressive fluid therapy and anti ulcer/antiemetics etc, he died about 3 days later of renal failure. It was actually his second ingestion of them, but the first time he only ate a couple and survived with medication. Hope this is not the case with the pup - good luck.

Re: Iboprofen poisoning in 6 month old puppy

Richard Carter — Thu, 03 Feb 2011 10:04:48 GMT

From the feline liver webinar Hepatosyl cures everything - give it a try. In South Africa where babesia is common and dogs present with kidneys and livers clogged up with broken rbc and haemoglobin we had a rather nice drug called essentiale which was glucuronic acid marketed for the hang over post party crowd. Could reduce jaundice in a day! Would also think about an anabolic to try stimulate any enzymatic cascades that have stalled.

Re: Iboprofen poisoning in 6 month old puppy

Bob Russell — Thu, 03 Feb 2011 09:49:26 GMT

Went home bright as a button and eating but apparently back to square one this morning. Will see this morning.

Re: Iboprofen poisoning in 6 month old puppy

Mark Hedberg — Wed, 02 Feb 2011 22:09:44 GMT

aside comment to Mr Atkinson...sole charge wore me out after 3 years. (no ooh provider so it was all me, all the time.) Good luck to puppy! :)

Re: Iboprofen poisoning in 6 month old puppy

Christopher Saul — Wed, 02 Feb 2011 21:56:49 GMT

Are you monitoring electrolytes?

Re: Iboprofen poisoning in 6 month old puppy

Julian Earl — Wed, 02 Feb 2011 18:59:22 GMT

[quote user="Martin Atkinson"]

If only they could talk!!

[/quote]

Sonds like a good title for a book to me.

Re: Iboprofen poisoning in 6 month old puppy

Martin Atkinson — Wed, 02 Feb 2011 18:37:21 GMT

When I have suffered from orthorpaedic injuries requiring surgery I tell the anaesthetist not to give me any morphine as it makes me feel horribly nauseous and I'd rather put up with the pain. I can tolerate volateral and indomethacin was wonderful. I now tend to take meloxicam in tablet form if I really have to but I'd rather have nothing. i wonder how many of our patients given the option and being able to understand the rational of pain relief and potential side effects would feel the same. If only they could talk!!

Re: Iboprofen poisoning in 6 month old puppy

Martin Jones — Wed, 02 Feb 2011 18:01:10 GMT

[quote user="Martin Atkinson"]

I am surprised that doctors still recommend ibuprofen, I wouldn't recommend it for my patients let alone take it myself. It gave me abdominal pains and my wife a duodenal ulcer - why do medics still recommend it when the safety margin is so narrow and there are so many much safer drugs? It probably wouldn't get a licence now if someone had just invented it!

[/quote]

Personally, never had an issue with it, having taken it for several years after nasty ankle fractures at doses routinely double the recommended levels (young man immortality syndrome). Even today, I can take fistful in the certain knowledge that I won't react. Voltarol, on the other hand, sends me loopy and a couple of years ago, one tramadol laid me prostrate for 24 hours (although last year, en France, I was mainlining them for whiplash and not a problem at all).

But I have seen a couple of dogs with nasty outcomes - neither fatal, thankfully. I do also remember a case a few years ago where a miniature chihuahua's owner had given it half an aspirin - as the smallest convenient dose - and it was sh1tting blood like nobody's business. Apparently, it couldn't have been the aspirin because 'everyone knows it's good for you'. When we worked out that it had had a 15x dose, he was somewhat more chastened. But that pulled through OK.

Omeprazole, for sure - best ulcer tx going

Re: Iboprofen poisoning in 6 month old puppy

Kate Richardson — Wed, 02 Feb 2011 17:49:41 GMT

I treated a dog last year with severe GIT haemorrhage secondary to ibuprofen- approx 15kg cocker from memory, had 1 tablet. Had such severe melaena it nearly died.

Re: Iboprofen poisoning in 6 month old puppy

Martin Atkinson — Wed, 02 Feb 2011 16:06:12 GMT

[quote user="Julian Earl"]

"Back in the day", I was in contact with Boots who manufactured ibuprofen at that time and their data indicated that 50mg/kg was a fatal dose for dogs. There had been a recommendation in an In Practice magazine to use 20-30mg/kg as a therapeutic dose, but the safety margin is not all that great if someone used the wrong size of Brufen. As a result, yours truly placed a letter in the Vet Record about the potential risk.

It did work very well as an arthritis treatment though.

[/quote]

Notwithstanding my misunderstanding of the total dose the puppy received, I am surprised that doctors still recommend ibuprofen, I wouldn't recommend it for my patients let alone take it myself. It gave me abdominal pains and my wife a duodenal ulcer - why do medics still recommend it when the safety margin is so narrow and there are so many much safer drugs? It probably wouldn't get a licence now if someone had just invented it!

Re: Iboprofen poisoning in 6 month old puppy

Bob Russell — Wed, 02 Feb 2011 15:58:41 GMT

I do have some sympathy for Martins comment as well!

I have referred a dog with a history of insulinoma, suspected pancreatitis (although I have been unable to prove it!) and is now diabetic!!!

I had suggested to the owner that she is a good candidate for continuous blood glucose monitoring and it seems the specialist has now come to the same conclusion. It is nice when they eventually agree with what you have been saying!

Re: Iboprofen poisoning in 6 month old puppy

Julian Earl — Wed, 02 Feb 2011 15:41:13 GMT

[quote user="Michael Woodhouse"]

[quote user="Martin Atkinson"]400mg doesn't sound much Ibuprofen to me to cause that much of a problem.[/quote]

4kg dog = 100mg/kg!

According to studies of acute ingestion of ibuprofen in dogs, vomiting, diarrhea, nausea, anorexia, gastric ulceration, and abdominal pain can be seen with doses of 50-125mg/kg

http://www.aspcapro.org/mydocuments/c-veccs_july00.pdf [/quote]

It did work very well as an arthritis treatment though.

Re: Iboprofen poisoning in 6 month old puppy

Martin Atkinson — Wed, 02 Feb 2011 15:22:19 GMT

[quote user="Bob Russell"]

One of the things I really hate about single vet practice is not being able to mull over cases with a colleague or two over coffee!

[/quote]

One of things I most love about sole charge is no-one else interfering with my cases. Not wishing to sound arrogant (but clearly am!) - the only time I got things wrong was when I listened to someone else.

Re: Iboprofen poisoning in 6 month old puppy

Bob Russell — Wed, 02 Feb 2011 15:02:57 GMT

X-ray unremarkable but puppy is much brighter, has not vomited and even took a tiny amount of food offered. I suspect she would eat more if I offered it! Thanks for the advice. It either gives me confidence that I am doing things right or gives food for thought about other ways of tackling a case.

One of the things I really hate about single vet practice is not being able to mull over cases with a colleague or two over coffee!

Re: Iboprofen poisoning in 6 month old puppy

Martin Atkinson — Wed, 02 Feb 2011 14:49:51 GMT

[quote user="Michael Woodhouse"]

4kg dog = 100mg/kg!

According to studies of acute ingestion of ibuprofen in dogs, vomiting, diarrhea, nausea, anorexia, gastric ulceration, and abdominal pain can be seen with doses of 50-125mg/kg

http://www.aspcapro.org/mydocuments/c-veccs_july00.pdf

[/quote]

Sorry didn't spot the weight just saw the age and imagined a 20kg Labrador.

Re: Iboprofen poisoning in 6 month old puppy

Bob Russell — Wed, 02 Feb 2011 13:09:22 GMT

[quote user="Michael Woodhouse"]

[quote user="Martin Atkinson"]400mg doesn't sound much Ibuprofen to me to cause that much of a problem.[/quote]

4kg dog = 100mg/kg!

According to studies of acute ingestion of ibuprofen in dogs, vomiting, diarrhea, nausea, anorexia, gastric ulceration, and abdominal pain can be seen with doses of 50-125mg/kg

http://www.aspcapro.org/mydocuments/c-veccs_july00.pdf

[/quote]

Thanks - I already have this on my desktop - a useful summary. Thanks

Re: Iboprofen poisoning in 6 month old puppy

Bob Russell — Wed, 02 Feb 2011 13:07:56 GMT

I see I cannot even spell ibuprofen but never mind!

400ng in a 4Kg dog seems q a high dose to me - it is the full adult dose. I will check on the packaging but the owners stated that she had opened a third compartment but the table was still inside so I suspect the packaging was not ingested. It is a very good point though I will check!

I decided to use Cerenia as metoclopramide seems to be contra-indicated if there is perforation. There is no evidence of perforation as yet but I decided to hold fire with it. There has been no vomiting this morning!

Re: Iboprofen poisoning in 6 month old puppy

Michael Woodhouse — Wed, 02 Feb 2011 12:58:57 GMT

[quote user="Martin Atkinson"]400mg doesn't sound much Ibuprofen to me to cause that much of a problem.[/quote]

4kg dog = 100mg/kg!

According to studies of acute ingestion of ibuprofen in dogs, vomiting, diarrhea, nausea, anorexia, gastric ulceration, and abdominal pain can be seen with doses of 50-125mg/kg

http://www.aspcapro.org/mydocuments/c-veccs_july00.pdf

Re: Iboprofen poisoning in 6 month old puppy

Martin Atkinson — Wed, 02 Feb 2011 12:48:02 GMT

[quote user="Emma Middleton"]

Was it just the tablets or packaging as well?

[/quote]

Good point. Or if its a scavenger what else has it eaten that may be a foreign body? Take an X-ray at least for peace of mind if nothing else. 400mg doesn't sound much Ibuprofen to me to cause that much of a problem.

Re: Iboprofen poisoning in 6 month old puppy

Aurelijus vet — Wed, 02 Feb 2011 12:39:19 GMT

I would agree with ranitidine, human Smecta and Finidiar.

Re: Iboprofen poisoning in 6 month old puppy

Theo Jordaan — Wed, 02 Feb 2011 12:28:28 GMT

I would agree with the omeprazole in place of the Zantac, maybe add ondansetron as an antemetic?

Re: Iboprofen poisoning in 6 month old puppy

Emma Middleton — Wed, 02 Feb 2011 12:00:38 GMT

Hi Bob,

Was it just the tablets or packaging as well?

Have you thought about starting her on Omeprazole just in case of GI ulceration? I know there's no melena or coffee grounds in the vomit, but it might be worth thinking about.

Also, how is the metoclopramide being administered? I heard somewhere that it is more effective given as a constant rate infusion.