Blood was obtained for carprofen concentration measurement just prior to ILE administration then subsequently at 1, 3, and 6 hours post‐ILE. No adverse events were noted except gross lipemia. An IV catheter (20 g IV Catheter 1′′/25 mm) was placed, and the patient received Intralipid 20% (Intralipid ® 20%, Baxter Healthcare) (1.5 mL/kg over 15 minutes followed by 0.25 mL/kg/min for 1 hour). The cat was hospitalized for continued decontamination and supportive care which included a single dose of AC with sorbitol (Toxiban ® Suspension w/Sorbitol, Lloyd, Inc) (2 g/kg) administered via nasogastric tube (Mila Weighted Nasogastric Feeding Tube 5Fr X 55 cm, MILA International Inc). Emesis induction with hydromorphone (Hydromorphone HCl Injection, USP (2 mg/mL), West‐Ward,) (0.1 mg/kg IM) and dexmedetomidine (Dexdomitor ®) (0.002 mg/kg IM) was unsuccessful.

Given the elapsed time since ingestion was approximately 1 hour, initial therapy centered around GID. General physical examination was unremarkable, and a small bladder was appreciated on abdominal palpation. Rectal temperature, heart rate, and respiratory rate were within normal limits. On presentation, the patient was bright, alert, and responsive. To the author's knowledge, this is the first report on the use of ILE in a cat with NSAID overdose. Since carprofen has a similar mechanism of action and similar chemical properties as other NSAIDS, treatment of toxicosis with ILE should be equally successful. A dog with ibuprofen toxicosis 11 and three dogs with naproxen toxicosis 12 were treated successfully with ILE in combination with GID. 10 Intravenous lipid emulsion (ILE) is also used for treating NSAID toxicosis in dogs. 9, 10 These decontamination methods have been proven to cause a reduction in plasma carprofen concentration. Treatment of NSAID overdose typically consists of gastrointestinal decontamination (GID) using a combination of emesis and activated charcoal (AC). In contrast, a safety study reported no adverse effects in 7 healthy cats administered subcutaneous carprofen at 4 mg/kg once daily. 8 Although this patient also received dexamethasone and flunixin meglumine, they were administered after the onset of clinical signs therefore, their administration was not thought to contribute to duodenal perforation. One case report demonstrated duodenal perforation in a cat receiving carprofen at 2.2 mg/kg orally every 12 hours for an unreported duration of time. 2 Toxicosis has been reported by the ASPCA Animal Poison Control Center at doses as low as 2.9 mg/kg in cats (Toxicology Brief – Volmer, P & Mensching D – Managing acute carprofen toxicosis in dogs and cats – 2009 ). This dosing typically results in an 18‐ to 24‐hour duration of action when given intravenously or subcutaneously 5 however, studies reviewing the dynamics and kinetics from oral administration in the cat are lacking. 4, 7Ĭarprofen is approved for use in cats in Europe, Australia, and New Zealand at 4 mg/kg subcutaneously/intravenously as a single‐use perioperative analgesic.

The elimination half‐life is approximately 18‐20 hours in the cat, 4, 5, 6 whereas the half‐life in dogs is approximately 8‐12 hours. 3 Cats have reduced glucuronidation enzyme activity decreasing their ability to metabolize carprofen.

2Įlimination of carprofen occurs primarily by biotransformation into glucuronide metabolites within the liver. However, reduction in prostaglandins can lead to adverse effects including gastric irritation, hepatic, and renal damage, and prolonged bleeding time by prevention of platelet aggregation. 2 This mechanism accounts for the drug's therapeutic effects of reducing pain and inflammation.

Similar to other NSAIDS, it inhibits the production of cyclooxygenase which in turn decreases prostaglandin synthesis. 1 Carprofen is a popular NSAID prescribed to dogs. Nonsteroidal anti‐inflammatory (NSAID) toxicosis is one of the most common poisonings reported in small animals. Serum concentrations measured pre‐ILE and 1, 3, and 6 hours post‐ILE treatment revealed increasing serum carprofen concentrations. He was treated with activated charcoal, intravenous lipid emulsion (ILE), and general supportive care. A 12‐year‐old, male castrated domestic short hair ingested approximately 12 mg/kg of carprofen.

First lipid emulsion therapy used