Ferrets that ingest ibuprofen are at high risk for CNS depression and coma, with or without GI upset. Cats are about twice as sensitive to ibuprofen's toxic effects as dogs. Dosages of > 400 mg/kg in the dog may result in CNS signs (seizure, ataxia, coma, shock).
ASPIRIN POISONING ANTIDOTE PLUS
In dogs, an acute exposure of 50-125 mg/kg can result in gastrointestinal signs (vomiting, diarrhea, nausea, abdominal pain, and anorexia), > 175 mg/kg can result in more severe GI signs (hematemesis, melena) plus renal damage (pu/pd, oliguria, uremia). Even at the therapeutic dog dosage of 5 mg/kg, ibuprofen may cause gastric ulcers and perforations with chronic use. Plasma half-life in the dog has been reported to be 2-2.5 hours, but the elimination half-life is considerably longer. Unlike salicylates, serious hepatotoxicosis does not appear to be a common problem with acute ibuprofen overdosages.Ībsorption of ibuprofen is rapid (0.1 to 1.5 h). Ibuprofen may also affect platelet aggregation and possibly hepatic function. Ibuprofen inhibits renal blood flow, glomerular filtration rate, tubular ion transport, renin release and water homeostasis. Ibuprofen decreases secretion of the protective mucous layer in the stomach and small intestine and causes vasoconstriction in gastric mucosa. Ibuprofen inhibits prostaglandin synthesis by blocking the conversion of arachidonic acid to various prostaglandins. Ibuprofen (Motrin®, Advil®, Midol®, etc.) is a nonsteroidal anti-inflammatory agent.
Prognosis is good if the animal is treated promptly and appropriately. Hyperpyrexia should be treated conservatively as aggressive cooling (ice baths or cold water enemas) may result in hypothermia. Acid base imbalances should be corrected. Fluids, whole blood, and electrolytes should be given to control hypotension and hemorrhage, manage acute bleeding ulcers, and correct electrolyte abnormalities. Seizures should be treated with diazepam. Assisted ventilation and supplemental oxygen may be required if the animal is comatose. Bismuth subsalicylate antacid formulations and corticosteroids are contraindicated. Metoclopramide can be used to control vomiting. In the asymptomatic patient, gastric protectants should be continued for 5 - 7 days. Maintain hydration and start GI protectants (sucralfate, H2 blockers, ± misoprostol, ± omeprazole) to help manage and/or prevent gastric ulcers. Liver values, glucose, acid base status and electrolytes should be monitored. Peritoneal dialysis can be effective in removing salicylates. Decontamination of asymptomatic patients would include induction of emesis and administration of activated charcoal (repeat dosages with large exposures) and cathartic. The primary goal of treatment is to prevent or treat gastric ulceration, acidosis, hepatopathy, and coagulopathy. Renal insufficiency is uncommon with salicylate toxicoses but could develop secondary to rhabdomyolysis (from seizuring) or hypotension. Fever and seizures may be seen due to the uncoupling of oxidative phosphorylation. Signs may include vomiting (± blood), hyperpnea, respiratory alkalosis, metabolic acidosis, gastric hemorrhage, centrilobular liver necrosis, and bleeding diathesis. Dosages of 325 mg twice a day were lethal to cats. In dogs, toxicosis has occurred at dosages of 100 - 300 mg/kg/day PO for 1 - 4 weeks. Elimination is also slower in neonates and geriatric animals. Feline dosages of 5-12 mg/kg have a half-life of 22 - 27 hours, while dosages of 25 mg/kg have a half-life of approximately 44 hours. Cats are deficient in glucuronyl transferase and have prolonged excretion of aspirin due to decreased metabolism. In dogs, the half-life at the therapeutic dosage is 8.6 hours. The elimination half-life increases with the dosage. Aspirin is metabolized in the liver and excreted through the urine. Salicylates also impair platelet aggregation.Īspirin is rapidly absorbed from the stomach and proximal small intestines in monogastric animals. At very high dosages, aspirin and other salicylates uncouple oxidative phosphorylation, leading to decreased ATP production. Aspirin reduces pain and inflammation by reducing prostaglandin and thromboxane synthesis through inhibition of cyclooxygenase. Aspirin (acetylsalicylic acid, ASA) is available as tablets, capsules, powders, effervescent tablets and oral liquid preparations.
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