Ibuprofen Toxicity in Cats

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Ibuprofen is a popular and effective over-the-counter medication available to treat pain and inflammation in people. For cats, ibuprofen can easily exceed toxic levels. The most common cause of ibuprofen toxicity is a well-meaning owner trying to alleviate pain in his cat who administers a dose he thinks is adequate without knowing the toxic dose.

The initial toxic effect is bleeding stomach ulcers. In addition to ulcers, increasing doses of ibuprofen eventually leads to kidney failure and, if left untreated, can be fatal.

Cats are more sensitive to the effects of ibuprofen than dogs and one tablet can cause rapid kidney failure and subsequent death.

What to Watch For

  • Poor appetite
  • Vomiting
  • Black tarry stools
  • Vomiting blood
  • Abdominal pain
  • Dehydration
  • Weakness
  • Lethargy

    Diagnosis

    Diagnosis of ibuprofen toxicity is generally based on physical exam findings and a history of access or exposure to ibuprofen.

    Blood tests are done to determine the overall health of the cat. If ibuprofen was ingested, blood tests may reveal anemia from a bleeding ulcer or kidney damage.

    Treatment

  • Expect your veterinarian to recommend hospitalization with continuous intravenous fluids.
  • Activated charcoal may be given if ingestion was recent (less than 2 hours).
  • If the cat is severely anemic due to bleeding ulcers, blood transfusions may be needed.
  • Medications such as sucralfate (Carafate®), cimetidine (Tagamet®) or famotidine (Pepcid®) will be given to treat stomach ulcers.
  • After 1 to 2 days of treatment, repeat blood work may be done to evaluate kidney function after treatment.

    Home Care and Prevention

    There is no home care for ibuprofen toxicity. Veterinary care is strongly suggested to treat kidney failure and bleeding stomach ulcers.

    While recovering from ibuprofen toxicity, feed your cat a bland diet for one to two days. Gradually return to a normal diet. Watch for failure to eat, vomiting and continued black tarry stools.

    The best preventive care is to give your cat medications only if directed by your veterinarian. Medications that may be safe for people can be fatal to pets. Also, make sure that all medications are kept out of the reach of inquisitive pets. Keeping medicine safely stored away can prevent many tragedies.

    Ibuprofen toxicity typically results from administration of an improper dose by well meaning owners or acute overdose from curious animals eating large quantities.

    Ibuprofen belongs to a class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDS). The purpose of these drugs is to reduce the pain associated with inflammation. NSAIDs work by inhibiting the production of prostaglandins. There are different types of prostaglandins and, as a class, are responsible for a wide variety of normal body functions. They are present in areas of trauma to help repair damage. They are also responsible for maintaining proper blood flow to the kidneys and protecting the stomach lining from the effects of stomach acids.

    The primary reason NSAIDs are used is to reduce the presence of prostaglandins in trauma related injuries. Without prostaglandins, there is less inflammation and therefore, less pain. Unfortunately, medicine has yet to make an NSAID that only affects the prostaglandins associated with inflammation. When the prostaglandins for inflammation are inhibited, so are the prostaglandins responsible for normal kidney blood flow and stomach protection. This is the cause of the toxic properties of ibuprofen in pets.

    The toxic signs of ibuprofen include:

  • Vomiting
  • Depression
  • Anorexia
  • Diarrhea
  • Stumbling

    Cats are particularly sensitive to the stomach ulcer effect of ibuprofen. Stomach ulcers can occur within 12 hours of ingestion but sometimes can take up to four days. With massive overdose or ingestion, severe kidney impairment can occur within 12 hours of ingestion but may take up to five days. In severe cases, seizures may occur.

    Treatment

    Treatment is based on the severity of the toxicity. The toxic dose of ibuprofen for stomach ulcers is 50 mg per pound (100 mg/kg) for cats. The toxic dose of ibuprofen for kidney failure is 150 mg per pound (300 mg/kg). Repeated doses of sub toxic levels can eventually result in toxic signs.

    If ingestion of ibuprofen is recent, administration of activated charcoal can help reduce toxin absorption.

    For stomach ulcers

  • Hospitalization with intravenous fluids is frequently recommended.
  • Stomach protectants are used to treat ulcers. These medications include famotidine (Pepcid®), cimetidine (Tagamet®), misoprostol (Cytotec®) and sucralfate (Carafate®).
  • In cases of severe bleeding ulcers resulting in anemia, blood transfusions may be required.

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