Open AccessOutcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs
Author(s) -
Butty Emmanuelle M.,
Suter Steven E.,
Chalifoux Nolan V.,
Lynch Alex M.,
Mauro Katie D.,
Moyle Rachel B.,
Ehrhardt Caryn M.,
Robertson James B.,
Culler Christine A.,
Londoño Leonel A.,
Vigani Alessio,
Ueda Yu,
Labato Mary A.
Publication year - 2022
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.16507
Subject(s) - medicine , carprofen , adverse effect , population , naproxen , ibuprofen , ingestion , asymptomatic , anesthesia , pharmacology , environmental health , alternative medicine , pathology
Background Therapeutic plasma exchange (TPE) is gaining popularity for the management of nonsteroidal anti‐inflammatory drug (NSAID) overdose in dogs. Hypothesis/Objectives Describe a population of dogs treated with TPE for NSAID overdose. Animals Sixty‐two dogs with NSAID overdose treated with TPE. Methods Multicenter retrospective study of dogs treated with TPE for ibuprofen, carprofen, or naproxen overdose. Results The median dose of ibuprofen, carprofen or naproxen ingested was 533 mg/kg (range, 36‐4857 mg/kg), 217 mg/kg (range, 88‐625 mg/kg) and 138 mg/kg (range, 26‐3000 mg/kg), respectively. Based on previously established toxic ranges for each NSAID, 2 (3.2%), 14 (22.6%), and 46 (74.2%) dogs ingested a gastrointestinal, renal, and neurological toxic dose, respectively. The median time between ingestion and presentation was 4 hours (range, 1‐20 hours). The median number of plasma volumes processed was 1.6 (range, 0.4‐2.2). The median TPE session duration was 2 hours (range, 1‐4.5 hours). Circuit clotting developed during 8 (12.9%) sessions. Patient adverse events reported during 21 (33.8%) sessions consisted of urticaria (12.9%), asymptomatic hypocalcemia (9.6%), and hypotension (9.6%). The median duration of hospitalization was 2.25 days (range, 1‐11 days). Sixty‐one (98.4%) dogs survived to discharge, and none were rehospitalized. Thirty‐one (91.1%) of the 34 dogs with at least 1 follow‐up visit were not azotemic at the time of reevaluation. Conclusions and Clinical Importance This population of dogs managed with TPE had excellent outcomes, even in cases of high NSAID dose ingestion. When TPE is available and the time frame is appropriate, this extracorporeal modality should be considered for the management of NSAID overdose.