What is ibuprofen?
Ibuprofen (brand names: Advil®, Motrin®, Midol®) is a common nonsteroidal anti-inflammatory drug (NSAID). It is frequently used to treat headaches, pain, colds, flu, fever, inflammation (swelling), and menstrual discomfort in humans.
Ibuprofen is available over-the-counter and by prescription. It may be the sole ingredient or part of a combination product, which can include opioids, antihistamines, decongestants, and acetaminophen.
What is ibuprofen poisoning?
Despite its relative safety in humans, ibuprofen and other NSAIDs can be extremely harmful in cats, with small doses causing adverse effects and poisoning. Well-meaning owners may accidentally poison their pet by administering ibuprofen without veterinary advice.
Cats tend to be more discriminating eaters than dogs and are less likely to get into their owner’s medications. Cats are not able to metabolize ibuprofen well, resulting in more serious poisonings compared to dogs. Pet Poison Helpline, a 24/7 animal poison control center, receives a high volume of calls per year for potential ibuprofen exposure in cats.
What causes ibuprofen poisoning?
Ibuprofen and other NSAIDs act by blocking the production of prostaglandin and other chemical mediators. Unfortunately, these mediators are also important in maintaining normal gastrointestinal, kidney, liver, and blood clotting functions. Poisoning can occur from a single dose or repeated dosing. Cats that are already taking steroids or another NSAID also have a higher risk of developing signs, including gastrointestinal ulceration.
What are the clinical signs of ibuprofen poisoning?
Ibuprofen poisoning can affect many organ systems, resulting in variable clinical signs. The organs affected and clinical signs expected are dependent on the amount ingested.
At lower doses, signs occur related to irritation and ulceration of the gastrointestinal tract. These signs may include decreased appetite, vomiting (sometimes with blood), diarrhea, depression, abdominal pain, dark tarry stools, pale gums, and bloody stools.
Higher doses can result in liver, kidney, and neurologic damage. Clinical signs can include incoordination, increased or decreased drinking and urination, yellow discoloration of the skin and mucous membranes (jaundice/icterus), pale mucous membranes, agitation, tremors, seizures, and coma.
How is ibuprofen poisoning diagnosed?
Most cases of ibuprofen poisoning have a known or suspected exposure to ibuprofen. However, certain clinical signs and bloodwork changes can raise suspicion of NSAID poisoning. Diagnostic tests include bloodwork to evaluate organ function and blood cell counts. A urinalysis may also be recommended to help evaluate kidney function.
There are tests to measure blood ibuprofen levels, but these tests are rarely used or helpful, as they must be submitted to a special laboratory, and they only confirm exposure.
How is ibuprofen poisoning treated?
Early decontamination and treatment are key to reducing the risk of serious illness. Decontamination can include inducing vomiting by a veterinarian, if ingestion was very recent, and administration of medical-grade activated charcoal and cholestyramine. Never attempt to induce vomiting in cats at home. Activated charcoal should only be administered by a veterinarian, to minimize the risk of aspiration into the lungs and life-threatening changes in sodium levels.
"Early decontamination and treatment are key to reducing the risk of serious illness."
The dose of ibuprofen ingested will determine the care needed. Some cases may only require decontamination and treatment with anti-nausea medications and gastrointestinal protectants. Higher doses may require hospitalization with intravenous fluids. Neurologic toxic doses may require the addition of anticonvulsants and muscle relaxants. Cats that develop severe signs will require intensive therapy.
If you believe your pet ingested ibuprofen, it is important to immediately call your veterinarian or Pet Poison Helpline, a 24/7 animal poison control center, at 1-800-213-6680, to have the risk of poisoning assessed.
What care will my cat require after treatment?
Typically, gastrointestinal protectants and a bland diet will be recommended for several days following exposure. However, higher doses and chronic exposures may require monitoring for liver or kidney damage after the cat is discharged.
Cats with liver damage will often be prescribed supplements to help protect the liver. Depending on the cat’s condition, medications and monitoring may be continued for several days to months. In some cases, liver or kidney damage may be permanent in cats who have recovered from ibuprofen toxicity.
Pet Poison Helpline, an animal poison control center based out of Minneapolis, MN, is available 24/7 for pet owners and veterinary professionals that require assistance treating a potentially poisoned pet. The staff provides treatment advice for poisoning cases of all species, including dogs, cats, birds, small mammals, large animals, and exotic species. As the most cost-effective option for animal poison control care, Pet Poison Helpline’s per-incident fee includes follow-up consultations for the duration of the poison case. Pet Poison Helpline is available in North America by calling 800-213-6680. Additional information can be found online at www.petpoisonhelpline.com
