Ibuprofen - VG

Question 1

Chronic use of ibuprofen at __ dose can cause GI ulcers/perforations

Answer 1

5

Question 2

How much is too much for Dogs?

Answer 2

50-125 mg/kg → GI
175-200 mg/kg → GI + Renal
400-600 mg/kg → GI + Renal + CNS
>600 mg/kg → lethal dose

Question 3

How much is too much in Cats?

Answer 3

We divide dog dose by 2

Cats are 2X sensitive

Question 4

_____ mg/kg dose will cause GI signs

Answer 4

50-125

Question 5

____ mg/kg dose will cause GI + renal signs

Answer 5

175-200

Question 6

_____ mg/kg dose will cause GI + renal + CNS signs

Answer 6

400-600

Question 7

_____ mg/kg is lethal dose

Answer 7

> 600

Question 8

Time frame of CS in Ibuprofen toxicity?

Answer 8

• 2-6 hr = GI signs
• 12 h to 4 d = GI ulcers/ hemorrhage
• Renal failure usually within 12 hrs but can be delayed upto 3-5 d post exposure

Question 9

Onset of GI symptoms in how much time?

Answer 9

2-6 hr

Ulcers/hemorrhage in 12 h to 4 d

Question 10

Onset of renal failure in how much time?

Answer 10

Usually 12 hr

Can be delayed until 3-5 d

Question 11

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Answer 11

• emesis & activated charcoal depending on time frame
• GI protectants for 7+ days
• IV fluids 2X maintenance for 48 hr atleast

Question 12

General fluid rate for Rx?

Answer 12

2x maintenance for atleast 48 hr

Adjust as needed
** if BUN, Creatinine normal at 48 hr then we can take off fluids

Question 13

When to monitor renal values?

Answer 13

Baseline → 1 d → 2 d

If normal at 2 d i.e. 48 hr, then we can stop the fluids

Question 14

Prognosis for Ibuprofen toxicity?

Answer 14

Good if Rx promptly

ARI is usually reversible

Question 15

ARI is usually irreversible in ibuprofen toxicity. T/F

Answer 15

F

It is reversible USUALLY

Question 16

Liver damage is common in Ibuprofen toxicity . T/F

Answer 16

F

Rare with overdose

Question 17

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Answer 17

• CS & Rx is almost same
• Toxicity of each NSAID is different among species
• For most NSAIDS, minimum toxic dose is not established

Question 18

What dose of Caprofen will cause GI ulcers & ARF in dogs?

Answer 18

20 mg/kg → GI ulcers i.e. 4X

40 mg/kg → ARF i.e. 10X

Question 19

What dose of carprofen will cause :
GI ulcers in cats
ARF in cats

Answer 19

4 mg/kg → GI ulcers

8 mg/kg → ARF

Question 20

NSAID hepatotoxicity is dose dependent. T/F

Answer 20

F

• It is idiosyncratic
• Can be seen with any NSAID
• Very small % of dogs show it

CS usually develop in 1st 3-4 weeks, but can be delayed