By Patrick Miles, DVM
An unfortunate, but common emergency in our hospital is the inadvertant and sometimes intentional ingestion of human medications by pets. One of the more frequent types of medications ingested is ibuprofen. Most incidences are due to dogs finding the medication in a purse, gym bag, grocery bag, or accidental spillage of a bottle. Dogs often mistake the medication for treats due to the coating on many of these tablets. Sometimes owners administer these medications to their pet for pain relief. The misconception is that dogs are just small people, so if they only get a small amount it will be fine. Ibuprofen has much narrower margin of safety in our pets, and what seems fine for humans, is not necessarily fine for these animals.
Ibuprofen (Motrin®, Advil®, Midol®, etc.) is a nonsteroidal anti-inflammatory agent (NSAID). It is available over the counter in 50, 100, 200 mg tablets and 100 mg/5 ml suspension. Prescription strength tablets are 400, 600, and 800 mg.
In dogs, an acute exposure of 50-125 mg/kg can result in gastrointestinal signs (vomiting, diarrhea, abdominal pain, anorexia), > 175 mg/kg can result in more severe GI signs (hematemesis, melena) plus kidney damage (PU/PD, oliguria, uremia). Doses of > 400 mg/kg in the dog result in GI, kidney, and CNS signs (seizure, ataxia, coma).
Cats are thought to be twice as sensitive to ibuprofen's toxic effects as dogs due to lack of certain hepatic enzymes in their system. This means that the ingestion of just 2 Advil® could be enough to lead to kidney failure. Ferrets that ingest ibuprofen are at high risk for CNS depression and coma, with or without GI upset. Toxicity may also be more severe if the animal is already on an approved nonsteroidal anti-inflammatory medication for arthritis or pain control
The onset of stomach upset is generally within the first 2-6 hours after ingestion, with stomach ulceration occurring 12 hours to 4 days post ingestion. Kidney failure often occurs within the first 12 hours after massive exposure to an NSAID but may be delayed for 3-5 days.
Vomiting can be induced if the animal has eaten the medication recently (usually within a few hours). Following vomiting, the veterinarian can feed the animal activated charcoal. Activated charcoal is a substance that binds up anything that remains in the intestinal tract. This is often given 2-3 times due to the way ibuprofen is metabolized. If the ingestion is an amount high enough to impact the kidneys, hospitalization with intravenous fluids for 2-3 days is indicated. The prognosis is good if the animal is treated promptly and appropriately.
In general, it is always best to keep medications high in a shelf, away from any potential for a dog to ingest the medications. Keep medication in a child-proof container that your pet cannot chew into. It is also advised to call a veterinarian before giving your pet any human medication, and before trying to induce vomiting at home. Our hospital is open 24 hours a day, 7 days a week and we are always happy to answer questions.
The Animal Poison Control Center can be reached at (888) 426-4435 24 hours a day, 7 days a week if your pet ingests anything of concern