Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs

Abstract

Background: Therapeutic plasma exchange (TPE) is gaining popularity for the management of nonsteroidal anti-inflammatory drug (NSAID) overdose in dogs.Hypothesis/Objectives: Describe a population of dogs treated with TPE for NSAID overdose.Animals: Sixty-two dogs with NSAID overdose treated with TPE.Methods: Multicenter retrospective study of dogs treated with TPE for ibuprofen, carprofen, or naproxen overdose. Results:The median dose of ibuprofen, carprofen or naproxen ingested was 533 mg/kg (range, 36-4857 mg/kg), 217 mg/kg (range, 88-625 mg/kg) and 138 mg/ kg (range, 26-3000 mg/kg), respectively. Based on previously established toxic ranges for each NSAID, 2 (3.2%), 14 (22.6%), and 46 (74.2%) dogs ingested a gastrointestinal, renal, and neurological toxic dose, respectively. The median time between ingestion and presentation was 4 hours (range, 1-20 hours). The median number of plasma volumes processed was 1.6 (range, 0.4-2.2). The median TPE session duration was 2 hours (range, 1-4.5 hours). Circuit clotting developed during 8 (12.9%) sessions. Patient adverse events reported during 21 (33.8%) sessions consisted of urticaria (12.9%), asymptomatic hypocalcemia (9.6%), and hypotension (9.6%). The median duration of hospitalization was 2.25 days (range, 1-11 days).Sixty-one (98.4%) dogs survived to discharge, and none were rehospitalized. Thirtyone (91.1%) of the 34 dogs with at least 1 follow-up visit were not azotemic at the time of reevaluation.

Nephrology in Veterinary Medicine

“…[22][23][24][25][26] Extracorporeal toxin removal (ECTR) has become central to the management of acute intoxications in dogs and cats. [27][28][29] Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly treated intoxication. Ibuprofen and naproxen have serious adverse effects in dogs and cats and are not used in veterinary medicine.…”