NU09 - Outcomes of Non-Steroidal 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 non-steroidal 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 206 mg/kg (range, 25–4857 mg/kg), 78 mg/kg (range, 11–625 mg/kg) and 81 mg/kg (range, 8–3000 mg/kg). Two (3.2%), 14 (22.6%) and 46 (74.2%) dogs ingested a gastrointestinal, renal, and neurological toxic dose, respectively. The median time elapsed between ingestion and presentation was 4 hours (range, 1–20 hours). The median total replacement volume was 1300 mls (range, 220–3208 mls) which equated to 1.6 plasma volumes (range, 0.4–2.2). The median duration of TPE sessions was 2 hours (range, 1–4.5 hours). Adverse events were reported during 29 (46.7%) TPE sessions, comprising circuit clotting (12.9%), urticaria (12.9%), 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 re-hospitalized. Thirty-three (97%) of the 34 dogs with at least one follow-up visit were not azotemic at the time of recheck.




Conclusions and clinical importance – Our TPE–treated population had an excellent outcome, despite exposure to high NSAID doses. When TPE is available and the time frame is adequate, this extracorporeal modality should be recommended in cases of severe NSAID overdose.