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Review Article| Volume 42, ISSUE 2, P289-306, March 2012

Toxicology of Frequently Encountered Nonsteroidal Anti-Inflammatory Drugs in Dogs and Cats

      The nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of heterogeneous compounds other than steroids that suppresses one or more substances produced during inflammatory reactions. NSAIDs are extensively used in both human and veterinary medicine for their antipyretic, anti-inflammation, and analgesic properties. Chemically, most NSAIDs are substituted organic acids. Although most NSAIDs consist of a wide range of pharmacologically active agents with diverse chemical structures and properties, they have similar therapeutic and adverse effects associated with their use. Each year the ASPCA Animal Poison Control Center (APCC) receives hundreds of cases involving acute accidental ingestion of human and veterinary approved NSAIDs in dogs and cats. The purpose of this article is provide a brief overview on the classification, mechanism of action, and pharmacologic and toxicologic properties of most commonly encountered human and veterinary NSAIDs in dogs and cats. For this purpose, the top 10 most frequently reported NSAIDs, as reported to the APCC in dogs and cats from 2005 to 2010, were selected. The article discusses general information about NSAIDs—classification, uses, pharmacokinetics, mechanisms of actions, and treatment followed by specific toxicity information involving the top 10 NSAIDs reported to the APCC.

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      References

        • Donovan J.W.
        Nonsteroidal anti-inflammatory drugs and colchicine.
        in: Haddad L.M. Shannon M.W. Winchester J.F. Clinical management of poisoning and drug overdose. 3rd edition. WB Saunders, Philadelphia1998: 687-699
        • Holubek W.
        Nonsteroidal anti-inflammatory drugs.
        in: Nelson L.S. Hoffman R.S. Lewin N.A. Goldfrank's toxicologic emergencies. 9th edition. McGraw-Hill, New York2011: 528-536
        • Bryson P.D.
        Nonsteroidal anti-inflammatory agents.
        in: Comprehensive review in toxicology for emergency clinicians. 3rd edition. Taylor and Francis, Washington, DC1996: 565-575
        • Ellenhorn M.J.
        Nonsteroidal antiinflammatory drugs.
        in: Ellenhorn's medical toxicology: diagnosis and treatment of human poisoning. 2nd edition. Williams & Wilkins, Baltimore1997: 196-206
        • Forrester S.D.
        • Troy G.C.
        Renal effects of nonsteroidal antiinflammatory drugs.
        Compend Cont Educ. 1999; 21: 910-919
        • Johnston S.A.
        • Fox S.M.
        Mechanisms of action of anti-inflammatory medications used for the treatment of osteoarthritis.
        JAVMA. 1997; 210: 1486-1492
        • Lees P.
        • May S.A.
        • McKeller Q.A.
        Pharmacology and therapeutics of non-steroidal anti-inflammatory drugs in the dog and cat: I. General pharmacology.
        J Small Anim Pract. 1991; 32: 183-193
        • MacAllister C.G.
        Nonsteroidal anti-inflammatory drugs: their mechanism of action and clinical uses in horses.
        Vet Med. 1994; (March): 237-240
        • Wolfe M.M.
        NSAIDs and the gastrointestinal mucosa.
        Hosp Pract. 1996; December 15: 37-48
        • Bowersox T.S.
        • Lipowitz A.J.
        • Hardy R.M.
        • et al.
        The use of a synthetic prostaglandin E1 analog as a gastric protectant against aspirin-induced hemorrhage in the dog.
        J Am Anim Hosp Assoc. 1996; 32: 401-407
        • Rubin S.I.
        Nonsteroidal antiinflammatory drugs, prostaglandins, and the kidney.
        JAVMA. 1986; 188: 1065-1068
        • Kore A.M.
        Toxicology of nonsteroidal anti-inflammatory drugs.
        Vet Clin N Am Small Anim Pract. 1990; 20: 419-430
        • Dunayer E.
        Ibuprofen toxicosis in dogs, cats, and ferrets.
        Vet Med. 2004; (July): 580-585
      1. Ibuprofen.
        in: McEvoy G.K. American Hospital Formulary Service drug information. American Society of Healthsystem Pharmacists Inc., Bethesda (MD)2000: 1815
        • Kore A.M.
        Toxicology of nonsteroidal anti-inflammatory drugs.
        Vet Clin North Am Small Anim Pract. 1990; 20: 419-428
      2. Rumack BH, et al, editors. Ibuprofen (toxicologic managements). Poisindex System Vol 100. Englewood (CO): Micromedex. Expires 9/2000.

        • Roush J.K.
        Diseases of joints and ligaments.
        in: Morgan R.V. The handbook of small animal practice. 3rd edition. Churchill Livingstone, New York1997: 813-829
        • Osweiler G.
        • Carson T.L.
        Household drugs.
        in: Morgan R.V. The handbook of small animal practice. 3rd edition. Churchill Livingstone, New York1997: 1279-1283
        • Villar D.
        • Buck W.B.
        Ibuprofen, aspirin, and acetaminophen toxicosis and treatment in dogs and cats.
        Vet Hum Toxicol. 1998; 40: 156-162
        • Smith K.J.
        • Taylor D.H.
        Another case of gastric perforation associated with administration of ibuprofen in a dog.
        JAVMA. 1993; 202: 706
        • Spyridakis L.K.
        • Bacia J.J.
        • Barsanti J.A.
        • et al.
        Ibuprofen toxicosis in a dog.
        JAVMA. 1986; 188: 918-919
        • Adams S.S.
        • Bough R.G.
        • Cliffe E.E.
        • et al.
        Absorption, distribution and toxicity of ibuprofen.
        Toxicol Appl Pharmacol. 1969; 15: 310-330
        • Richardson J.A.
        Management of acetaminophen and ibuprofen toxicoses in dogs and cats.
        Vet Emerg Crit Care. 2000; 10: 285-291
        • Rumbeiha W.K.
        Nephrotoxins.
        in: Bonagura J.D. Kirk's current veterinary therapy XIII Small animal practice. W.B. Saunders Co, Philadelphia2000: 212-217
        • Owens-Clark J.
        • Dorman D.C.
        Toxicity from newer over the counter drugs.
        in: Bonagura J.D. Kirk's current veterinary therapy XIII Small animal practice. W.B. Saunders Co, Philadelphia2000: 227-231
        • Richardson J.A.
        • Balabuszko R.A.
        Ibuprofen ingestion in ferrets: 43 cases (January 1996–March 2000).
        J Vet Emerg Crit Care. 2001; 11: 53-59
        • Cathers T.E.
        Acute ibuprofen toxicosis in a ferret.
        JAVMA. 2000; 216: 1426-1428
      3. Rumack BH, editor. Aspirin (toxicologic managements). Poisindex System Vol 100. Englewood (CO): Micromedex. Expires 9/2000.

        • Booth D.M.
        The analgesic-antipyretic-antiinflammatory drugs.
        in: Richard A.H. Veterinary and pharmacology and therapeutics. 7th edition. Iowa State University Press, Ames (IA)1995: 432-439
        • Plumb D.C.
        Veterinary drug handbook.
        in: 3rd edition. Iowa State University Press, Ames (IA)1999: 56-58 (221, 434, 462, 518–9, 562, 583)
        • Brogden R.N.
        • Heel R.C.
        • Speight T.M.
        • et al.
        Naproxen up to date: a review of its pharmacological properties and therapeutic efficacy and use in rheumatic diseases and pain states.
        Drugs. 1979; 18: 241-277
        • Brogden R.N.
        • Pinder R.M.
        • Sawer P.R.
        • et al.
        Naproxen: a review of its pharmacological properties and therapeutic efficacy and use.
        Drugs. 1975; 9: 326-363
        • Gfeller R.W.
        • Sandors A.D.
        Naproxen-associated duodenal ulcer complicated by perforation and bacteria- and barium sulfate-induced peritonitis in a dog.
        JAVMA. 1991; 198: 644-646
        • Gilmour M.A.
        • Walshaw R.
        Naproxen-induced toxicosis in a dog.
        JAVMA. 1987; 191: 1431-1432
        • Roudebush P.
        • Morse G.E.
        Naproxen toxicosis in a dog.
        JAVMA. 1981; 179: 805-816
        • Steel R.J.S.
        Suspected naproxen toxicity in dogs.
        Aust Vet J. 1981; 57: 100-101
        • Hallesy D.
        • Shott L.
        • Hill R.
        Comparative toxicology of naproxen.
        Scand J Rheumatol Suppl. 1973; 2: 20-28
        • Dye T.L.
        Naproxen toxicosis in a puppy.
        Vet Hum Toxicol. 1997; 39: 157-159
        • Daehler M.H.
        Transmural pyloric perforation associated with naproxen administration in a dog.
        JAVMA. 1986; 189: 694-695
        • Dean S.P.
        • Reid J.F.S.
        Use of naproxen [letter].
        Vet Rec. 1985; 116: 479
        • Smith R.E.
        Naproxen toxicosis [letter].
        JAVMA. 1982; 180: 107
        • Shiltz R.A.
        Naproxen in dogs and cats [letter].
        JAVMA. 1982; 180: 1397
      4. Deramaxx (Decracoxib) package insert.
        Novartis Animal Health, US Inc., Greensboro (NC)2011 (NADA # 141-203, approved by FDA) (Accessed January 10, 2012)
        • Anti-inflammatory agents
        Kahn Cynthia M. The Merck veterinary manual. 10th edition. Merck & Co, New Jersey2010: 2313-2328
        • Plumb D.C.
        Veterinary drug handbook.
        in: 5th edition. Blackwell Publishing, Ames (IA)2005: 222
        • Boehringer Ingelheim Vetmedica, Inc.
        Freedom of information summary new animal drug application Metacam® (meloxicam) 0.5 mg/mL and 1.5 mg/mL oral suspension. 2003.
        (NADA 141–219) (Accessed January 10, 2012)
        • Kirchner T.
        • Argentieri A.
        • et al.
        Evaluation of the anti-inflammatory activity of a duel cyclooxygenase-2 selective/5-lipoxygenaxe inhibitor, RWJ 63556, in a canine model of inflammation.
        J Pharmacol Exp Ther. 1997; 282: 1094-1101
        • Blower P.
        Nabumetone: the science – equivalent efficacy and diminished risk.
        Eur J Rheumatol Inflamm. 1991; 11: 29-37
        • Haddock R.E.
        • Jeffery D.J.
        • Lloyd J.A.
        • et al.
        Metabolism of nabumetone by various species including man.
        Xenobiotica. 1984; 14: 327-337
        • Mangan F.
        • Flack J.
        • Jackson D.
        Preclinical overview of nabumetone: pharmacology, bioavailability, metabolism, and toxicology.
        Am J Med. 1987; 83: 6-10
        • Jackson D.
        • Hardy T.
        • Langley P.
        • et al.
        Pharmacokinetic, toxicological, and metabolic studies with nabumetone.
        Proc. Symp. Held by BPUK Madera, 1983/R Soc. Med. Int. Congr. Symp. Ser. 1985;
        • Adams H.R.
        Veterinary pharmacology and therapeutics.
        in: 7th edition. Iowa State University Press, Ames (IA)1995: 443
        • McKellar Q.A.
        • Lees P.
        • May S.A.
        Pharmacology and therapeutics of non-steroidal anti-inflammatory drugs in the dog and cat: 2 individual agents.
        J Small Anim Pract. 1991; 32: 225-235
        • Boothe D.
        Analgesia/anti-inflammatories.
        CVMA. 1997; (June): 13-20
      5. Piroxicam.
        in: McEvoy G.K. American Hospital Formulary Service drug information. American Society of Healthsystem Pharmacists Inc., Bethesda (MD)2000: 1815
        • Galbraith E.A.
        • McKellar Q.A.
        Pharmacokinetics and pharmacodynamics of piroxicam in dogs.
        Vet Rec. 1991; 128: 561-565
        • Thomas N.W.
        Piroxicam-associated gastric ulceration in a dog.
        Compend Small Anim Pract. 1987; 9: 1028-1030
      6. Diclofenac.
        in: McEvoy G.K. American Hospital Formulary Service drug information. American Society of Healthsystem Pharmacists Inc., Bethesda (MD)2000: 1800
        • Stierlin H.
        • Faigle J.W.
        Biotransformation of diclofenac sodium (Voltaren in animals and man: II. Quantitative determination of the unchanged drug and principal phenolic metabolites, in urine and bile.
        Xenobiotics. 1979; 9: 611-621
        • Stierlin H.
        • Faigle J.W.
        • et al.
        Biotransformation of diclofenac sodium (Voltaren) in animals and in man: I. Isolation and identification of principal metabolites.
        Xenobiotics. 1979; 9: 601-610
      7. Diclofenac. In: RTECS: Registry of Toxic Effects of Chemical Substances. Cincinnati (OH): National Institute for Occupational Safety and Health. CD-ROM. MICROMEDEX, Greenwood Village (CO). Expires 7/02.

      8. Indomethacin.
        in: McEvoy G.K. American Hospital Formulary Service drug information. American Society of Healthsystem Pharmacists Inc., Bethesda (MD)2001: 1924-1934
      9. Etodolac.
        in: McEvoy G.K. American Hospital Formulary Service drug information. American Society of Healthsystem Pharmacists Inc., Bethesda (MD)2001: 1913-1914
        • Mathews K.A.
        Nonsteroidal anti-inflammatory analgesics: indications and contraindications for pain management in dogs and cats.
        Vet Clin N Am Sm Anim Pract. 2000; 30: 783-804
        • Budsberg S.C.
        • Johnston S.A.
        • et al.
        Efficacy of etodolac for the treatment of osteoarthritis of the hip joints in dogs.
        JAVMA. 1999; 214: 206-210
        • Reimer M.E.
        • Johnston S.A.
        • et al.
        The gastroduodenal effects of buffered aspirin, carprofen, and etodolac in healthy dogs.
        J Vet Intern Med. 1999; 13: 472-477