Ibuprofen and Diclofenac
Ibuprofen and diclofenac belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs), which are frequently used as pain medications in human medicine. These substances have anti-inflammatory (antiphlogistic), analgesic, and antipyretic effects. While they are relatively safe for humans at correct dosages, they can cause serious poisoning in dogs and cats even at low doses.
The most important facts at a glance
Ibuprofen and diclofenac poisoning represents a serious threat to dogs and cats. These human pain medications can cause serious poisoning even at low doses. The toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. effect is mainly based on the inhibition of prostaglandin synthesisProstaglandin synthesis is the biochemical process by which prostaglandins are produced from fatty acids. Inhibiting prostaglandin synthesis with an NSAID (non-steroidal anti-inflammatory drug) is used to treat Pain and Inflammatory conditions in dogs and cats., which leads to damage to the gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. mucosaMucosa, also called mucous membrane, refers to the moist lining of body cavities that are connected to the outside world, such as the mouth, nose, lungs, and gastrointestinal tract. It serves to protect and facilitate the absorption of nutrients., kidneys, and in severe cases to metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. derangements and neurological symptoms.
Symptoms typically develop within a few hours and range from vomiting and diarrheaDiarrhea refers to the condition of frequent, watery bowel movements, which can be a sign of infections, digestive disorders, or other health problems. to renal dysfunctionDysfunction refers to an impaired or abnormal function of an organ or system in the body. This can be due to diseases, disorders, or damage and can affect the quality of life. to seizures and comaA coma is a deep state of unconsciousness where an individual cannot be awakened and does not respond to stimuli. In dogs and cats, it can be caused by severe illnesses, poisoning, or neurological problems.. DiagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is based on medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits., clinical examination, and laboratory diagnostic parameters.
TherapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. includes decontaminationDecontamination refers to the removal of toxic substances or pathogens from a living being, object, or environment to prevent or treat poisoning or infection., gastric protectionProtection refers to safeguarding against diseases or harm. In veterinary medicine, this can include protecting animals through vaccinations, the use of parasite control products, or providing a safe environment., fluid therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., and symptomatic measures. With early treatment, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is good; with already existing organ damage, it is guarded to poor.
For preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring., safe storage of medications and education of pet owners about the dangers of human pain medications is crucial. Pet owners should never independently administer human NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. to their pets and should seek immediate veterinary help if poisoning is suspected.
Causes, development and progression
Ibuprofen and diclofenac belong to the non-steroidalNon-steroidal refers to medications or substances that are not steroids and often have anti-inflammatory, analgesic, or antipyretic effects. They are used in dogs and cats to treat Pain and Inflammatory conditions. (not based on glucocorticoid action) anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain..
Non-steroidalNon-steroidal refers to medications or substances that are not steroids and often have anti-inflammatory, analgesic, or antipyretic effects. They are used in dogs and cats to treat Pain and Inflammatory conditions. anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. are abbreviated as NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. (Non-SteroidalNon-steroidal refers to medications or substances that are not steroids and often have anti-inflammatory, analgesic, or antipyretic effects. They are used in dogs and cats to treat Pain and Inflammatory conditions. Anti-Inflammatory DrugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain.).
NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. inhibit the synthesis of prostaglandins, which are essential for inflammatory processes in the body.
Prostaglandins also influence pain transmission and pain perception.
In this way, they have anti-inflammatory (antiphlogistic), analgesicAn analgesic is a medication used to relieve Pain without affecting the patient's level of consciousness., and antipyreticAntipyretic drugs are medications used to reduce Fever. They work by acting on the heat-regulating center in the brain, thus regulating body temperature. These medications can be used in dogs and cats to reduce Fever, which is often a symptom of an infection or inflammation. effects.
The most common cause of ibuprofen or diclofenac poisoning in pets is improper administration by the pet owner. Human pain medications are often given with the assumption that they are as safe for animals as they are for humans. This self-medication can have fatal consequences.
Further causes include:
- AccidentalAccidental means random or unintentional and refers to events or exposures that are not deliberate, such as the accidental swallowing of foreign objects or toxins by dogs and cats. ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. of unsupervised medications left lying around
- Access to unsecured medicine cabinets
- Lack of awareness about the risks of human pain medications in animals
- Confusion with veterinary-approved NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine.
The toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. dose for dogs is already 8 mg/kg body weight per day for ibuprofen, which for a 10 kg dog corresponds to only a quarter of a typical 400 mg tablet for humans. In cats, a single dose of 50 mg/kg body weight already leads to poisoning symptoms. In pre-existing conditions, particularly renal insufficiencyInsufficiency refers to the inadequate function or performance of an organ or system. This can include, for example, heart failure, kidney failure, or venous insufficiency., the toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. threshold may be even lower.
Diclofenac has a similar toxicityToxicity is the measure of a substance's harmfulness or poisonousness. Toxicity can vary depending on the dose, route of exposure, and individual sensitivity. profile and can cause serious damage even at low doses. Young animals, older animals, and animals with pre-existing kidney or liver diseases are particularly at risk.
Mechanism of action
The main mechanism of action of these substances is based on the inhibition of cyclooxygenase (COX), an enzyme responsible for the formation of prostaglandins. Prostaglandins play an important role in inflammatory processes, but also in protecting the gastric mucosaMucosa, also called mucous membrane, refers to the moist lining of body cavities that are connected to the outside world, such as the mouth, nose, lungs, and gastrointestinal tract. It serves to protect and facilitate the absorption of nutrients. and maintaining kidney function. The inhibition of prostaglandin synthesisProstaglandin synthesis is the biochemical process by which prostaglandins are produced from fatty acids. Inhibiting prostaglandin synthesis with an NSAID (non-steroidal anti-inflammatory drug) is used to treat Pain and Inflammatory conditions in dogs and cats. explains both the therapeutic and toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. effects of these medications.
In dogs and cats, the metabolism of these substances is significantly slower than in humans, leading to a longer residence time in the body and thus increased toxicityToxicity is the measure of a substance's harmfulness or poisonousness. Toxicity can vary depending on the dose, route of exposure, and individual sensitivity.. Additionally, the organ systems of dogs and especially cats react more sensitively to the effects of these medications.
The mechanism of action in detail is based primarily locally and systemically (affecting the entire body) on the decrease in prostaglandin synthesisProstaglandin synthesis is the biochemical process by which prostaglandins are produced from fatty acids. Inhibiting prostaglandin synthesis with an NSAID (non-steroidal anti-inflammatory drug) is used to treat Pain and Inflammatory conditions in dogs and cats..
It is characterized by:
- Irritation of the mucous membranes in the gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract
- Loss of protective effect on the gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract (increased acid production and reduced mucus formation when prostaglandins decrease)
- GI tract bleeding as a result of direct damage and inhibition of blood coagulationBlood coagulation is a process that helps stop Bleeding when a blood vessel is damaged. Platelets and certain proteins in the plasma form a blood clot that seals the wound.
- Development of metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders.
- Kidney damage due to decreased blood flow
Pharmacological Background – COX Inhibition
COX-1 and COX-2
Cyclooxygenase (COX) exists in two main forms:
- COX-1: constitutively expressed, responsible for “housekeeping” prostaglandins, e.g., mucosal protectionProtection refers to safeguarding against diseases or harm. In veterinary medicine, this can include protecting animals through vaccinations, the use of parasite control products, or providing a safe environment., renal perfusionPerfusion is the process of blood supply to a tissue or organ. Adequate perfusion is crucial for oxygen and nutrient supply, as well as for the removal of metabolic products., platelet aggregationPlatelet aggregation is the process by which platelets clump together to form a blood clot. This process is crucial for stopping bleeding after injuries.
- COX-2: inducible during inflammation → mediates pain, fever, inflammatory reactions
NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. such as ibuprofen and diclofenac inhibit both isoforms, especially in overdose. The adverse effects in animals result primarily from the inhibition of COX-1 and thus from the absence of protective prostaglandins in the stomach, kidney, and CNSCNS stands for the central nervous system, which consists of the brain and the spinal cord. It is responsible for processing information and controls many functions of the body..
Mechanism of Action of Ibuprofen in Dogs and Cats
Gastrointestinal Tract
- Prostaglandins protect the gastric mucosaMucosa, also called mucous membrane, refers to the moist lining of body cavities that are connected to the outside world, such as the mouth, nose, lungs, and gastrointestinal tract. It serves to protect and facilitate the absorption of nutrients. by stimulating mucus and bicarbonate secretion and regulating blood flow.
- COX inhibition creates an imbalanceImbalance refers to an imbalance or disruption of normal function or composition in the body, which can lead to health problems.: increased gastric acid, reduced mucus protectionProtection refers to safeguarding against diseases or harm. In veterinary medicine, this can include protecting animals through vaccinations, the use of parasite control products, or providing a safe environment. → gastritis, ulcers, bleeding.
- Cats are particularly sensitive because they lack important glucuronidationGlucuronidation is a metabolic process in which glucuronic acid is bound to substances such as drugs, toxins, or hormones to make them more water-soluble and easier to excrete. This process is important for detoxification in the body of dogs and cats. mechanisms → delayed metabolism.
Kidneys
- Prostaglandins regulate renal blood flow, primarily under stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. (e.g., dehydrationDehydration occurs when the body loses more fluid than it takes in. This can lead to a number of problems, including headaches, Dizziness, and in extreme cases, renal failure or Cardiovascular collapse.).
- COX inhibition leads to renal vasoconstriction, reducing renal blood flow and glomerular filtration rate (GFR) → acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. renal failure, especially in predisposed animals (older, dehydrated animals, cardiac patients).
Central Nervous System
- At high doses, ibuprofen can directly affect the CNSCNS stands for the central nervous system, which consists of the brain and the spinal cord. It is responsible for processing information and controls many functions of the body.: seizures, ataxia, lethargy.
- Possible cause: disruption of neurotransmitterNeurotransmitters are chemical messengers that transmit signals from one neuron to the next across the synaptic cleft. They are essential for numerous functions of the nervous system, including mood, sleep, and motor skills. balance or secondary effects from metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders..
Mechanism of Action of Diclofenac in Dogs and Cats
Diclofenac is similarly toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. but even more potent in its COX inhibition and leads to severe symptoms even at low doses.
Gastrointestinal Damage
- Very aggressive ulcerationAn ulceration is an open wound or sore, typically on the skin or mucous membranes, characterized by the loss of surface tissue. Ulcerations in dogs and cats can be caused by infections, chronic inflammatory conditions, or cancer. due to strong inhibition of protective prostaglandins.
- HemorrhagicHemorrhagic refers to anything related to Bleeding. In medicine, it describes conditions or events that are caused by or characterized by Bleeding, such as hemorrhagic Fever. gastroenteritis is typical: bloody vomiting, tarry stools, abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. pain.
Nephrotoxicity
- Pronounced renal dysfunctionDysfunction refers to an impaired or abnormal function of an organ or system in the body. This can be due to diseases, disorders, or damage and can affect the quality of life. due to decreased GFR → increase in ureaUrea, also known as carbamide, is a waste product of protein metabolism in the body. It's formed in the liver and excreted by the kidneys in urine. The urea level in the blood indicates kidney function., creatinineCreatinine is a waste product that results from the breakdown of creatine, a chemical compound that provides energy in the muscles. The concentration of creatinine in the blood and urine is an important indicator of kidney function., electrolyte disturbances (especially hyperkalemiaHyperkalemia refers to a potassium level in the blood that is too high. Potassium is essential for normal cell function, but an excess can lead to cardiac arrhythmia and other health problems.), acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders..
- Even single doses can triggerA trigger is a stimulus that elicits a specific reaction or state. In veterinary medicine, this can refer to emotional responses, such as fear or aggression, or medical conditions, such as seizures in dogs and cats. acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. renal failure in animals with reduced renal reserve (older animals, pre-existing conditions).
CNS effects
- High diclofenac levels can lead to altered consciousness, seizures, and loss of coordination.
- In combination with metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. derangements (acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders., electrolyte disturbances), this can quickly become life-threatening.
Species-specific Characteristics
Dog:
- ToxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. dose for Ibuprofen: from approx. 25 mg/kg → first symptoms, from 100 mg/kg → potentially fatal.
- Diclofenac is already critical at 5–10 mg/kg.
- Common symptoms: vomiting, loss of appetite, lethargy, diarrheaDiarrhea refers to the condition of frequent, watery bowel movements, which can be a sign of infections, digestive disorders, or other health problems., possibly CNSCNS stands for the central nervous system, which consists of the brain and the spinal cord. It is responsible for processing information and controls many functions of the body. disturbances and circulatory problems.
Cat:
- Very low tolerance, as cats can hardly detoxify NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. (lacking UDP-glucuronosyltransferase).
- ToxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. dose for Ibuprofen: already possible from 5–10 mg/kg!
- Diclofenac in any amount is potentially fatal.
- Symptoms often appear delayed but then severe: hypersalivation, inappetence, vomiting, hematemesisHematemesis is the Vomiting of blood, indicating Bleeding in the upper gastrointestinal tract. In dogs and cats, this can be caused by ulcers, foreign bodies, poisoning, or Tumors and requires immediate veterinary attention., apathyApathy refers to a state of indifference and reduced interest or lack of emotional involvement in activities or events that would normally arouse interest., renal failure.
Summary of Mechanisms of Action
| Organ System | Mechanism of Action by Ibuprofen/Diclofenac | Consequences |
| GastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract | COX-1 inhibition → ↓ mucus, ↑ acid secretion → mucosal damage | Ulcers, hemorrhageA hemorrhage is severe Bleeding caused by the rupture of blood vessels. It can be internal or external and often requires medical intervention., perforationA perforation is a rupture or hole in the wall of a hollow organ, such as the gastrointestinal tract or bladder, which can lead to the release of contents into the body and severe infection. Perforations are Emergencies that require rapid veterinary intervention in dogs and cats., pain |
| Kidney | COX inhibition → ↓ prostaglandins → vasoconstriction of renal vessels | AcuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. renal failure, oliguria, azotemia |
| Central nervous systemThe CNS (central nervous system) consists of the brain and spinal cord. It is responsible for processing information and controls most functions of the body and behavior. | indirect metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. effects, with overdose also direct influence | Seizures, ataxia, comaA coma is a deep state of unconsciousness where an individual cannot be awakened and does not respond to stimuli. In dogs and cats, it can be caused by severe illnesses, poisoning, or neurological problems. |
| Blood count | At very high doses: potentially hemolytic anemia or thrombocytopeniaThrombocytopenia is a condition in which the number of platelets in the blood is lower than normal, increasing the risk of mild to severe Bleeding. | Pale mucous membranes, petechiaePetechiae are small, pinpoint skin hemorrhages caused by blood leaking from the capillaries. They can indicate a variety of conditions, including infections, allergic reactions, and blood clotting disorders., weakness |
Ibuprofen and diclofenac are among the most common household poisons for dogs and cats. They lead to suppression of vital prostaglandins through non-selective inhibition of cyclooxygenase. The result is multi-system poisoning with focus on the gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract, kidney, and CNSCNS stands for the central nervous system, which consists of the brain and the spinal cord. It is responsible for processing information and controls many functions of the body.. Cats are extremely sensitive because they can hardly metabolize these substances. Any ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. is considered potentially toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. and requires immediate veterinary treatment.
Symptoms of intoxication
For dogs and cats, ibuprofen and diclofenac are toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. even at low doses.
They must not be used in dogs and cats!
In dogs, as little as 8 mg/kg/day and in cats a single dose of 50 mg/kg body weight leads to poisoning symptoms.
The symptoms of poisoning with Ibuprofen or Diclofenac typically develop within 2–6 hours after ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. and can be divided into different phases.
In the early phase, general symptoms first appear:
- ApathyApathy refers to a state of indifference and reduced interest or lack of emotional involvement in activities or events that would normally arouse interest. and lethargy
- Impaired consciousness
- Restlessness or drowsiness
- Loss of appetite
As poisoning progresses, symptoms of the gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract dominate:
- Excessive salivation
- AbdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. pain (recognizable by a tense abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. wall or pain response on palpationPalpation is an examination method in which the condition of body tissues is assessed by feeling them with the hands. It is used to identify swelling, pain, or other abnormalities.)
- Vomiting, which can become bloody as poisoning progresses
- DiarrheaDiarrhea refers to the condition of frequent, watery bowel movements, which can be a sign of infections, digestive disorders, or other health problems., which can also become bloody
- Dark, tarry stool (melena) as a sign of bleeding in the upper gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. tract
In severe cases or with advanced poisoning, the following symptoms may occur:
- Shallow, rapid breathing
- Increasing apathyApathy refers to a state of indifference and reduced interest or lack of emotional involvement in activities or events that would normally arouse interest. up to lying on side
- Elevated body temperature (hyperthermiaHyperthermia refers to an elevated body temperature beyond the normal range. In dogs and cats, this can be caused by overheating, Fever, or certain diseases, and often requires urgent medical attention.)
- MetabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders.
- Convulsions
- ComaA coma is a deep state of unconsciousness where an individual cannot be awakened and does not respond to stimuli. In dogs and cats, it can be caused by severe illnesses, poisoning, or neurological problems.
Additionally, signs of kidney damage may occur:
- Increased or decreased urination
- Dark or bloody urine
- DehydrationDehydration occurs when the body loses more fluid than it takes in. This can lead to a number of problems, including headaches, Dizziness, and in extreme cases, renal failure or Cardiovascular collapse.
In cats, symptoms can be particularly severe because they metabolize NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. even more poorly than dogs.
Diagnosis
The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of ibuprofen or diclofenac poisoning is based on several pillars:
Medical history: A thorough medical history is crucial. Pet owners should be asked whether:
- there was access to pain relievers
- self-medication occurred
- empty medication packaging was found
- the time of possible ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. is known
- the approximate amount of the ingested substance can be estimated
Clinical examination: During the clinical examination, the above-mentioned symptoms are recorded and evaluated. Particular attention is paid to:
- Vital parameters (heart rate, respiratoryRespiratory refers to breathing or the process of breathing. Respiratory diseases affect the respiratory tract and can impair the ability to breathe effectively. rate, body temperature)
- Mucous membrane color and capillary refill time
- Hydration status
- Neurological status
- PalpationPalpation is an examination method in which the condition of body tissues is assessed by feeling them with the hands. It is used to identify swelling, pain, or other abnormalities. of the AbdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen.
Laboratory diagnostics: To confirm the diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and assess the severity, the following laboratory tests are performed:
- Blood count to detect anemia from blood loss
- Blood chemistry with renal and hepatic parameters
- ElectrolytesElectrolytes are minerals in the body that carry an electric charge and perform vital functions such as regulating fluid balance, acid-base balance, and nerve and muscle activity. The main electrolytes include sodium, potassium, chloride, and magnesium. and acid-base status
- CoagulationCoagulation is the process of blood coagulation, in which liquid blood is transformed into a solid clot. This process is crucial for stopping Bleeding and promoting wound healing. parameters
- Urinalysis to detect blood or proteinProteins are large molecules made up of amino acids and play an essential role in almost all biological processes. They are necessary for building body tissue, the function of the immune system, and as enzymes for metabolic reactions. in urine
Imaging procedures: UltrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. examinations can help identify changes in the stomach, intestines, kidneys, and liver. X-rays can provide clues about stomach contents or free fluid in the abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity.
Toxicological Detection: In specialized laboratories, direct detection of Ibuprofen or Diclofenac in blood or stomach contents is possible, but is rarely performed due to time constraints.
If NSAIDNSAID stands for "Non-Steroidal Anti-Inflammatory Drugs." These medications are used to reduce inflammatory conditions, pain, and fever. In dogs and cats, NSAIDs must be used with caution, as they can have side effects, especially on the gastrointestinal tract and kidneys. poisoning is suspected, therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. should be initiated immediately, even if not all diagnostic results are available yet.
Therapeutic principles
TherapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. should be initiated in dogs after a single ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. of 10 mg/kg body weight.
If pre-existing renal insufficiencyInsufficiency refers to the inadequate function or performance of an organ or system. This can include, for example, heart failure, kidney failure, or venous insufficiency. is known, therapy should be started after a single ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. of 5 mg/kg body weight.
Prostaglandins promote renal blood flow. When prostaglandin synthesisProstaglandin synthesis is the biochemical process by which prostaglandins are produced from fatty acids. Inhibiting prostaglandin synthesis with an NSAID (non-steroidal anti-inflammatory drug) is used to treat Pain and Inflammatory conditions in dogs and cats. decreases and renal blood flow is reduced, pre-existing renal insufficiencyInsufficiency refers to the inadequate function or performance of an organ or system. This can include, for example, heart failure, kidney failure, or venous insufficiency. can worsen.
DecontaminationDecontamination refers to the removal of toxic substances or pathogens from a living being, object, or environment to prevent or treat poisoning or infection.. With sustained-release preparations, decontaminationDecontamination refers to the removal of toxic substances or pathogens from a living being, object, or environment to prevent or treat poisoning or infection. through vomiting, gastric lavageLavage is a rinsing procedure that uses a liquid to clean a body cavity, organ, or wound. In veterinary medicine, lavage can be used, for example, for gastric lavage or to clean an infected wound., and bowel irrigation can still be helpful more than 5 hours after ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems.. Activated charcoalActivated charcoal is a fine-pored, highly adsorbing material commonly used in veterinary medicine to treat poisoning. It binds toxins in the gastrointestinal tract to prevent their absorption into the body. should be administered multipleMultiple means manifold or repeated and is used to describe conditions or events that occur in multiple instances or at different locations. In veterinary medicine, this may indicate multiple lesions, tumors, or other pathological changes. times.
Misoprostol, a synthetically produced prostaglandinProstaglandins are a group of physiologically active lipid compounds found in almost all tissues and organs. They play an important role in Inflammatory conditions, pain transmission, and the regulation of blood flow and platelet function., is used as an antidoteAn antidote is a substance used to neutralize or reverse the harmful effects of poisoning or a drug overdose. Antidotes can be specific to certain poisons or have more general detoxifying effects. in dogs. Misoprostol reduces gastric acid production.
In cats, there is little experience with the use of misoprostol, so its use cannot be recommended.
Symptomatic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. serves to stabilize vital functionsVital functions are essential bodily functions necessary to sustain life. These include breathing, heart rate, blood pressure, body temperature, and level of consciousness. and treat symptoms such as pain, vomiting, and seizures.
Continuous intravenous infusion serves not only to replace fluid losses but also to optimize electrolyte concentrations and acid-base balanceThe acid-base balance refers to the equilibrium between acids and bases in the body, which is important for maintaining the physiological pH in the blood and other bodily fluids. Imbalances can lead to serious health problems. in the blood. The acid-base balanceThe acid-base balance refers to the equilibrium between acids and bases in the body, which is important for maintaining the physiological pH in the blood and other bodily fluids. Imbalances can lead to serious health problems. is severely disturbed. In the advanced stage of intoxication, acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders. (metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders.) dominates.
Fluid replacement simultaneously supports cardiovascular and kidney function.
TherapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. for ibuprofen or diclofenac poisoning should begin as early as possible and includes several approaches:
DecontaminationDecontamination refers to the removal of toxic substances or pathogens from a living being, object, or environment to prevent or treat poisoning or infection.: If ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. occurred less than 2–3 hours ago, decontaminationDecontamination refers to the removal of toxic substances or pathogens from a living being, object, or environment to prevent or treat poisoning or infection. may be useful:
- Inducing vomiting (only in alert animals and early presentation)
- Gastric lavageLavage is a rinsing procedure that uses a liquid to clean a body cavity, organ, or wound. In veterinary medicine, lavage can be used, for example, for gastric lavage or to clean an infected wound. under anesthesia for larger amounts
- Administration of activated charcoalActivated charcoal is a fine-pored, highly adsorbing material commonly used in veterinary medicine to treat poisoning. It binds toxins in the gastrointestinal tract to prevent their absorption into the body. to bind substances not yet absorbed (initially 1–4 g/kg body weight)
- Repeated administration of activated charcoalActivated charcoal is a fine-pored, highly adsorbing material commonly used in veterinary medicine to treat poisoning. It binds toxins in the gastrointestinal tract to prevent their absorption into the body. every 4–6 hours, as NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. undergo enterohepatic circulation
- With sustained-release preparations, decontaminationDecontamination refers to the removal of toxic substances or pathogens from a living being, object, or environment to prevent or treat poisoning or infection. can still be useful even after more than 5 hours
AntidoteAn antidote is a substance used to neutralize or reverse the harmful effects of poisoning or a drug overdose. Antidotes can be specific to certain poisons or have more general detoxifying effects.: In dogs, misoprostol, a synthetic prostaglandinProstaglandins are a group of physiologically active lipid compounds found in almost all tissues and organs. They play an important role in Inflammatory conditions, pain transmission, and the regulation of blood flow and platelet function. E1 analog, can be used as a partial antidoteAn antidote is a substance used to neutralize or reverse the harmful effects of poisoning or a drug overdose. Antidotes can be specific to certain poisons or have more general detoxifying effects.. It protects the gastric mucosaMucosa, also called mucous membrane, refers to the moist lining of body cavities that are connected to the outside world, such as the mouth, nose, lungs, and gastrointestinal tract. It serves to protect and facilitate the absorption of nutrients. and can prevent ulcerationAn ulceration is an open wound or sore, typically on the skin or mucous membranes, characterized by the loss of surface tissue. Ulcerations in dogs and cats can be caused by infections, chronic inflammatory conditions, or cancer.. The usual dosage is 2–5 μg/kg every 6–8 hours. In cats, there is little experience, so its use is not generally recommended.
Gastric protectionProtection refers to safeguarding against diseases or harm. In veterinary medicine, this can include protecting animals through vaccinations, the use of parasite control products, or providing a safe environment.: For preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring. and treatment of gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. ulcerationAn ulceration is an open wound or sore, typically on the skin or mucous membranes, characterized by the loss of surface tissue. Ulcerations in dogs and cats can be caused by infections, chronic inflammatory conditions, or cancer., the following are used:
- Proton pump inhibitors such as omeprazole (0.5-1.0 mg/kg once daily)
- H2 receptor antagonists such as famotidine (0.5-1.0 mg/kg 1-2 times daily)
- Sucralfate as mucosal protectionProtection refers to safeguarding against diseases or harm. In veterinary medicine, this can include protecting animals through vaccinations, the use of parasite control products, or providing a safe environment. (0.5-1.0 g per animal 3-4 times daily)
Fluid therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.: Aggressive fluid therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. is crucial for:
- Maintaining renal function by promoting diuresisDiuresis is the increase in urine excretion by the kidneys. It is a natural process for removing excess water and waste products from the body.
- Replacing fluid losses from vomiting and diarrheaDiarrhea refers to the condition of frequent, watery bowel movements, which can be a sign of infections, digestive disorders, or other health problems.
- Correcting electrolyte imbalances
- Correcting metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. acidosisAcidosis is a condition in which the pH value in the body is too acidic, either due to an increase in acid or a loss of bases. In dogs and cats, acidosis can occur due to renal failure, diabetes, or other metabolic disorders.
Symptomatic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.:
- AntiemeticsAntiemetics are medications used to prevent or treat Nausea and Vomiting. In dogs and cats, they are used in various situations, including after surgery, for motion sickness, or for certain conditions that cause Nausea. for persistentPersistent means lasting or continuing for an extended period. In veterinary medicine, it can refer to chronic diseases or symptoms that do not subside. vomiting (e.g., maropitant)
- AnticonvulsantAn anticonvulsant is a medication used to prevent or control seizures and other types of neurological disorders associated with abnormal electrical activity in the brain. medications for seizures
- Oxygen administration for respiratoryRespiratory refers to breathing or the process of breathing. Respiratory diseases affect the respiratory tract and can impair the ability to breathe effectively. distress
- Pain management with opioids (no NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine.!)
- Blood transfusion may be necessary in case of severe blood loss
Treatment of complications:
- In renal failure, dialysisDialysis is a medical procedure that mimics the function of the kidneys by removing waste and excess water from the blood when the kidneys are no longer able to perform this task adequately. may be considered
- In cerebral edemaAn edema is a buildup of fluid in the body's tissues, leading to Swelling. Edema can be localized or generalized and is often a sign of an underlying condition.: head elevation, osmotherapyOsmotherapy is a treatment method that aims to change the osmotic pressure in the body to reduce edema or brain swelling, for example. It can be used in animals to reduce pressure inside the skull., glucocorticoidsGlucocorticoids are a class of steroid hormones produced in the adrenal cortex that play an important role in regulating metabolism, immune response, and stress response. They are also used therapeutically as anti-inflammatory and immunosuppressive drugs.
- For liver failure: liver protective therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.
Monitoring of vital parameters, renal function, and acid-base balanceThe acid-base balance refers to the equilibrium between acids and bases in the body, which is important for maintaining the physiological pH in the blood and other bodily fluids. Imbalances can lead to serious health problems. should be performed closely. TherapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. often must be continued for several days, even if clinical symptoms are already subsiding.
Blood transfusion can be life-saving in case of severe blood loss.
The development of cerebral edemaAn edema is a buildup of fluid in the body's tissues, leading to Swelling. Edema can be localized or generalized and is often a sign of an underlying condition. represents a serious complication and is potentially life-threatening. Treatment options are limited and include body elevation, osmotherapyOsmotherapy is a treatment method that aims to change the osmotic pressure in the body to reduce edema or brain swelling, for example. It can be used in animals to reduce pressure inside the skull., maximum stimulation of urine output, administration of specific glucocorticoidsGlucocorticoids are a class of steroid hormones produced in the adrenal cortex that play an important role in regulating metabolism, immune response, and stress response. They are also used therapeutically as anti-inflammatory and immunosuppressive drugs., and sedativesSedatives are medications used to reduce Nervousness, anxiety, or Agitation and to achieve a calming effect. They are used in dogs and cats for various medical procedures or to calm them in stressful situations..
Prognosis & follow-up care
The prognosis is very good with timely therapy. In advanced intoxications with already existing renal damage, it should be considered guarded.
The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. of ibuprofen or diclofenac poisoning depends on several factors:
- Timing of therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. initiation after ingestion
- Amount ingested
- General condition and pre-existing illnesses of the animal
- Severity of existing organ damage
With early therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. within the first 2–4 hours after ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems. and at low doses, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is generally good. With already existing renal damage, severe gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. bleeding, or neurological symptoms, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is guarded to poor.
Follow-up care after surviving acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. poisoning includes:
Short-term aftercare:
- Regular monitoring of kidney and liver values (initially after 24–48 hours, then after 5–7 days)
- Continuation of gastric protectionProtection refers to safeguarding against diseases or harm. In veterinary medicine, this can include protecting animals through vaccinations, the use of parasite control products, or providing a safe environment. for 1–2 weeks
- Easily digestible, gentle diet
Long-term aftercare:
- In case of kidney damage: regular monitoring of kidney values over several months
- Dietary adjustment in chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. renal insufficiency
- Avoidance of nephrotoxic medications in the future
Preventive measures:
- Education of pet owners about the dangers of human NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine.
- Secure storage of medications out of reach of pets
- Use of child-resistant medicine cabinets
- Information about veterinary-approved alternatives for pain therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.
Complete recovery can take weeks to months depending on the severity of poisoning. Some animals may retain permanent damage, especially to the kidneys.
Research outlook
Research in the field of NSAIDNSAID stands for "Non-Steroidal Anti-Inflammatory Drugs." These medications are used to reduce inflammatory conditions, pain, and fever. In dogs and cats, NSAIDs must be used with caution, as they can have side effects, especially on the gastrointestinal tract and kidneys. poisoning in small animals currently focuses on several promising approaches:
Improved antidotes: Researchers are working on developing more specific antidotes for NSAID poisoning. Substances are being investigated that can selectively neutralize toxicToxic means "poisonous" and refers to substances that can have harmful effects on the body, including damage to organs, cells, or disruption of metabolic processes. effects without affecting the underlying condition.
Biomarkers for early diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients.: New biomarkers in blood and urine could enable earlier detection of organ damage. Particularly promising are markers for acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. kidney injury such as NGAL (Neutrophil Gelatinase-Associated Lipocalin) and KIM-1 (Kidney Injury Molecule-1), which can detect kidney damage before conventional parameters such as creatinineCreatinine is a waste product that results from the breakdown of creatine, a chemical compound that provides energy in the muscles. The concentration of creatinine in the blood and urine is an important indicator of kidney function. rise.
Innovative dialysisDialysis is a medical procedure that mimics the function of the kidneys by removing waste and excess water from the blood when the kidneys are no longer able to perform this task adequately. procedures: For severe poisoning cases, improved extracorporeal eliminationElimination refers to the process by which waste products and toxins are removed from the body. This includes excretion via the kidneys (urine), intestines (stool), lungs (breath), and skin. procedures are being developed that can filter toxic substances from the blood more effectively than conventional dialysisDialysis is a medical procedure that mimics the function of the kidneys by removing waste and excess water from the blood when the kidneys are no longer able to perform this task adequately. methods.
Regenerative therapies: Stem cell therapies and other regenerative approaches are being researched to regenerate damaged organs after NSAID poisoning. InitialInitial means beginning or at the start. In medicine, it can refer to the first symptoms of a disease or the first phase of a treatment process. studies show promising results in the regeneration of kidney and liver tissue.
Improved risk assessment: Genetic factors that influence susceptibility to NSAIDNSAID stands for "Non-Steroidal Anti-Inflammatory Drugs." These medications are used to reduce inflammatory conditions, pain, and fever. In dogs and cats, NSAIDs must be used with caution, as they can have side effects, especially on the gastrointestinal tract and kidneys. toxicityToxicity is the measure of a substance's harmfulness or poisonousness. Toxicity can vary depending on the dose, route of exposure, and individual sensitivity. are being investigated. In the future, genetic tests could help identify particularly vulnerable animals.
Development of safer alternatives: Research on veterinary pain medications with improved safety profiles is advancing. New drug classes with more selective mechanisms of action could reduce the risk of adverse effects.
These research approaches promise improved diagnostic and treatment options for NSAID poisoning in the future, which could ultimately lead to a better prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. for affected animals.
Frequently asked questions (FAQs)
- Can I give my dog or cat ibuprofen or diclofenac for pain?
No, absolutely not. These medications are highly toxic to dogs and cats and can cause life-threatening poisoning even at low doses. Always consult a veterinarian who can prescribe appropriate, veterinary-approved pain medications. - How quickly do poisoning symptoms appear after ingestion of Ibuprofen or Diclofenac?
InitialInitial means beginning or at the start. In medicine, it can refer to the first symptoms of a disease or the first phase of a treatment process. symptoms can appear as early as 2–6 hours after ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems.. The severity of symptoms typically increases over the following 12–24 hours. - What should I do if my pet has accidentally ingested Ibuprofen or Diclofenac?
Seek veterinary care immediately, even if no symptoms are visible yet. Bring the medication packaging and inform the veterinarian about the possible amount and time of ingestionIngestion refers to the intake of substances through the mouth and their delivery to the digestive tract. In dogs and cats, the ingestion of toxic substances, foreign objects, or incompatible foods can lead to health problems.. - Can Ibuprofen or Diclofenac poisoning be fatal?
Yes, untreated, poisoning by these substances can lead to death, particularly from renal failure or gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. bleeding. - Which pain relievers are safe for dogs and cats?
There are specific, veterinary-approved NSAIDs such as carprofen, meloxicam, or robenacoxib that can be safely used under veterinary supervision. Opioids can also be used for pain therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.. - How can I protect my pet from accidentalAccidental means random or unintentional and refers to events or exposures that are not deliberate, such as the accidental swallowing of foreign objects or toxins by dogs and cats. poisoning?
Store all medications in locked cabinets that are inaccessible to animals. Do not leave tablets lying around and inform all household members about the dangers. - Are there long-term consequences after surviving poisoning?
Yes, primarily the kidneys can be permanently damaged, which can lead to chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. renal insufficiencyInsufficiency refers to the inadequate function or performance of an organ or system. This can include, for example, heart failure, kidney failure, or venous insufficiency.. ChronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. problems can also occur as a consequence. - How long does the treatment for poisoning last?
AcuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. treatment typically lasts 2–5 days, depending on the severity of poisoning. Follow-up care can extend over weeks to months. - Are certain dog or cat breeds more susceptible to NSAIDNSAID stands for "Non-Steroidal Anti-Inflammatory Drugs." These medications are used to reduce inflammatory conditions, pain, and fever. In dogs and cats, NSAIDs must be used with caution, as they can have side effects, especially on the gastrointestinal tract and kidneys. poisoning?
Basically, all breeds are at risk. However, animals with pre-existing kidney or liver diseases, very young or very old animals, and small breeds (due to lower body weight with the same amount of active ingredient) may carry a higher risk. - How can I tell if my pet is in pain and needs veterinary help?
Signs of pain can include: altered posture, lameness, reduced activity, loss of appetite, vocalizations when touched, aggressive behavior, or withdrawal. If you suspect pain, always consult a veterinarian.
Literature
- Dunayer, E., 2004. Ibuprofen toxicityToxicity is the measure of a substance's harmfulness or poisonousness. Toxicity can vary depending on the dose, route of exposure, and individual sensitivity. in dogs, cats, and ferrets. Veterinary Medicine – Bonner Springs, later Edwardsville, 99, pages 580–586.
- Gwaltney-Brant, S. M. and Meadows, I., 2018. Nonsteroidal anti-inflammatory drugAnti-inflammatory drugs are medications or substances that help reduce or prevent inflammatory responses in the body. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and steroidal anti-inflammatory drugs (e.g., corticosteroids). toxicosis. Veterinary Clinics of North America: Small Animal Practice, 48(6), pages 1033–1044. Available at: https://doi.org/10.1016/j.cvsm.2018.06.003.
- Khan, S. A. and McLean, M. K., 2021. Toxicology of frequently encountered nonsteroidal anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. in dogs and cats. Veterinary Clinics of North America: Small Animal Practice, 51(6), pages 1133–1147. Available at: https://doi.org/10.1016/j.cvsm.2021.05.004.
- Lomas, A. L. and Grauer, G. F., 2015. The renal effects of NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine. in dogs. Journal of the American Animal Hospital Association, 51(3), pages 197–203. Available at: https://doi.org/10.5326/JAAHA-MS-6239.
- Löwe, G. and Löwe, O., 2021. Poisoning in dogs and cats – A veterinary Guides. 2nd Edition. Kreuztal: Kynos-Verlag. 208 pages.
- Marks, S. L., Kook, P. H., Papich, M. G., Tolbert, M. K., and Willard, M. D., 2018. ACVIM consensus statement: Support for rational administration of gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. protectants to dogs and cats. Journal of Veterinary Internal MedicineInternal medicine is a medical specialty that deals with the prevention, diagnosis, and treatment of diseases of the internal organs. Internists treat a wide range of diseases that primarily affect adults., 32(6), pages 1823–1840. Available at: https://doi.org/10.1111/jvim.15337.
- Martínez-Subiela, S., Cerón, J. J., Strauss-Ayali, D., Garcia-Martinez, J. D., Tecles, F., and Tvarijonaviciute, A., 2020. Urinary biomarkers for early detection of acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. kidney injury in dogs and cats: A review. Journal of Veterinary Internal MedicineInternal medicine is a medical specialty that deals with the prevention, diagnosis, and treatment of diseases of the internal organs. Internists treat a wide range of diseases that primarily affect adults., 34(6), pages 2293–2308. Available at: https://doi.org/10.1111/jvim.15891