Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs
Abstract 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...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-09-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16507 |
| _version_ | 1818017501635674112 |
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| author | Emmanuelle M. Butty Steven E. Suter Nolan V. Chalifoux Alex M. Lynch Katie D. Mauro Rachel B. Moyle Caryn M. Ehrhardt James B. Robertson Christine A. Culler Leonel A. Londoño Alessio Vigani Yu Ueda Mary A. Labato |
| author_facet | Emmanuelle M. Butty Steven E. Suter Nolan V. Chalifoux Alex M. Lynch Katie D. Mauro Rachel B. Moyle Caryn M. Ehrhardt James B. Robertson Christine A. Culler Leonel A. Londoño Alessio Vigani Yu Ueda Mary A. Labato |
| author_sort | Emmanuelle M. Butty |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-14T07:27:56Z |
| format | Article |
| id | doaj.art-053fbcb8cb5d4d9fb4ebdf3a1c2cf6a4 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-14T07:27:56Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-053fbcb8cb5d4d9fb4ebdf3a1c2cf6a42022-12-22T02:05:57ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762022-09-013651641164710.1111/jvim.16507Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogsEmmanuelle M. Butty0Steven E. Suter1Nolan V. Chalifoux2Alex M. Lynch3Katie D. Mauro4Rachel B. Moyle5Caryn M. Ehrhardt6James B. Robertson7Christine A. Culler8Leonel A. Londoño9Alessio Vigani10Yu Ueda11Mary A. Labato12Department of Clinical Sciences Tufts University, Cummings School of Veterinary Medicine, Foster Hospital for Small Animals N. Grafton Massachusetts USADepartment of Clinical Sciences North Carolina State University, College of Veterinary Medicine Raleigh North Carolina USADepartment of Clinical Sciences & Advanced Medicine University of Pennsylvania, School of Veterinary Medicine Philadelphia Pennsylvania USADepartment of Clinical Sciences North Carolina State University, College of Veterinary Medicine Raleigh North Carolina USADepartment of Clinical Sciences & Advanced Medicine University of Pennsylvania, School of Veterinary Medicine Philadelphia Pennsylvania USABluePearl Pet Hospital Cary North Carolina USADepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USADepartment of Clinical Sciences North Carolina State University, College of Veterinary Medicine Raleigh North Carolina USABluePearl Pet Hospital Cary North Carolina USADepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USAClinic for Small Animal Medicine, Vetsuisse Faculty University of Zurich Zurich SwitzerlandDepartment of Clinical Sciences North Carolina State University, College of Veterinary Medicine Raleigh North Carolina USADepartment of Clinical Sciences Tufts University, Cummings School of Veterinary Medicine, Foster Hospital for Small Animals N. Grafton Massachusetts USAAbstract 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.https://doi.org/10.1111/jvim.16507carprofenibuprofennaproxenNSAIDTPE |
| spellingShingle | Emmanuelle M. Butty Steven E. Suter Nolan V. Chalifoux Alex M. Lynch Katie D. Mauro Rachel B. Moyle Caryn M. Ehrhardt James B. Robertson Christine A. Culler Leonel A. Londoño Alessio Vigani Yu Ueda Mary A. Labato Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs Journal of Veterinary Internal Medicine carprofen ibuprofen naproxen NSAID TPE |
| title | Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs |
| title_full | Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs |
| title_fullStr | Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs |
| title_full_unstemmed | Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs |
| title_short | Outcomes of nonsteroidal anti‐inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs |
| title_sort | outcomes of nonsteroidal anti inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs |
| topic | carprofen ibuprofen naproxen NSAID TPE |
| url | https://doi.org/10.1111/jvim.16507 |
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