2022 article
Outcomes of 434 dogs with non-steroidal anti-inflammatory drug toxicosis treated with fluid therapy, lipid emulsion, or therapeutic plasma exchange
Chalifoux, N. V., Butty, E. M., Mauro, K. D., Moyle, R. B., Ehrhardt, C. M., Robertson, J. B., … Lynch, A. M. (2022, December 1). JOURNAL OF VETERINARY INTERNAL MEDICINE.
author keywords: carprofen; ibuprofen; ILE; intoxication; naproxen; NSAID; TPE
MeSH headings : Dogs; Animals; Ibuprofen / adverse effects; Plasma Exchange / veterinary; Retrospective Studies; Creatinine; Emulsions / adverse effects; Anti-Inflammatory Agents, Non-Steroidal / adverse effects; Fluid Therapy / veterinary; Dog Diseases / chemically induced; Dog Diseases / therapy; Dog Diseases / diagnosis; Lipids
TL;DR:
Despite similar outcomes of lower incidence of AKI in the TPE group, and slightly lower maximal creatinine concentration in dogs treated with ILE vs IVF alone, ILE and TPE should be considered in the management of severe NSAID toxicosis.
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UN Sustainable Development Goal Categories
3. Good Health and Well-being
(Web of Science; OpenAlex)
Source: Web Of Science
Added: January 3, 2023
AbstractBackgroundTraditional management of non‐steroidal anti‐inflammatory drug (NSAID) intoxication includes gastrointestinal decontamination, intravenous administration of fluids (IVF), and gastroprotection. Intravenous administration of lipid emulsion (ILE) and therapeutic plasma exchange (TPE) are popular novel therapeutic strategies.HypothesisCompare outcomes of dogs treated with IVF, ILE, and TPE for NSAID intoxications and evaluate outcome predictors for drug subgroups.AnimalsFour hundred thirty‐four dogs with NSAID intoxications (2015‐2020).MethodsMulticenter retrospective study of ibuprofen, carprofen, and naproxen intoxication. An ordinal outcome was defined as mild gastrointestinal, moderate kidney, or signs of severe central nervous system disease.ResultsSigns of neurological disease were overrepresented and acute kidney injury underrepresented in the TPE group among dogs exposed to kidney‐ or CNS‐toxic doses (P = .05), though all TPE dogs with signs of neurological disease had evidence of neurotoxicity at presentation. Dogs treated with IVF had a higher maximal creatinine concentration (median, 1.1 mg/dL; range, 0.4‐8.44 mg/dL) compared with IVF + ILE (median, 0.9 mg/dL; range, 0.4‐6.2 mg/dL; P = .01). Increased maximum time to presentation (P < .001), higher baseline creatinine (P < .001) and PCV (P = .007), and absence of induced emesis (P < .001) were associated with greater clinical severity. Ibuprofen toxicosis was associated with more severe clinical signs compared with carprofen (P = .03). Overall survival rate was 99%.Conclusions and Clinical ImportanceNSAID toxicosis generally carries an excellent prognosis in dogs. Despite similar outcomes of lower incidence of AKI in the TPE group, and slightly lower maximal creatinine concentration in dogs treated with ILE vs IVF alone, ILE and TPE should be considered in the management of severe NSAID toxicosis.