Canine · Gastrointestinal · Toxicology
NSAID toxicosis
Dose determines the syndrome: low doses cause gastrointestinal ulceration, higher doses cause acute kidney injury, and very high doses cause CNS signs.
Cyclooxygenase inhibition removes protective prostaglandins that maintain gastric mucosal blood flow and renal medullary perfusion. Ibuprofen and naproxen ingestion in dogs is common; cats are far more sensitive because of limited glucuronidation. Early decontamination with emesis and activated charcoal is useful for recent ingestion, and repeated charcoal helps for drugs with enterohepatic recirculation. Treatment is a proton pump inhibitor, misoprostol for high-risk cases, sucralfate for existing ulcers, and 48 hours of intravenous fluid diuresis at the nephrotoxic dose range with serial renal values. Client education matters: most cases come from owners dosing human medication at home.