Veterinary Medicine - August 2008 - (Page 431)

Practical Matters clinical advice and reminders from your colleagues PEER-REVIEWED Prudent NSAID use helps prevent adverse effects N onsteroidal anti-inﬂammatory drugs (NSAIDs) are effective analgesics but, in rare cases, can cause serious side effects including gastrointestinal ulceration, renal failure, platelet dysfunction, and hepatotoxicosis.1-3 Newer-generation NSAIDs approved for use in dogs and cats are selective or preferential cyclooxygenase or cyclooxygenase and lipoxygenase inhibitors. They have a reported risk of side effects that are generally dose-related. However, adverse effects may be unpredictable. Clinical experience has demonstrated that a single dose of an NSAID in a stable cat undergoing anesthesia for an ovariohysterectomy can result in renal failure. Conditions that exacerbate NSAID toxicity include hypotension, hypovolemia, dehydration, and preexisting organ disease. A thorough physical examination, a detailed patient history, and baseline laboratory values may help you identify whether a patient is at risk. Avoid NSAIDs in patients with preexisting renal or hepatic disease, gastrointestinal disease, pregnancy, a low volume state (e.g. cardiovascular disease), or a coagulopathy. In addition, avoid NSAIDs in patients undergoing anesthesia in which hypotension is a risk. Do not administer NSAIDs to patients receiving corticosteroids, other NSAIDs, some herbs such as Boswellia and Ginkgo species, or aspirin. When NSAIDs are used in patients for more than a few days or in patients at risk—such as cats, cats or dogs recovering from a traumatic event, and cats or dogs that have previously received corticosteroids or NSAIDs—inform pet owners of the potential side effects. Vomiting or diarrhea or any change in attitude, behavior, or appetite should prompt owners to discontinue the medication and contact you immediately. Periodic reexamination and laboratory monitoring may identify early signs of NSAID toxicosis and reduce the incidence of illness. Editors’ note: For a client handout on using NSAIDs safely in pets, go to www.fda.gov/cvm/ Documents/NSAIDBrochure.pdf. PEER-REVIEWED Identifying dehydration in puppies and kittens P REFERENCES 1. Enberg T, Braun L, Kuzma A. Gastrointestinal perforation in ve dogs associated with the administration of meloxicam. J Vet Emerg Crit Care 2006;16(1):34–43. 2. Mathews KA. Nonsteroidal anti-in ammatory analgesics. Indications and contraindications for pain management in dogs and cats. Vet Clin North Am Small Anim Pract 2000;30(4):783-804. 3. Mathews K. Non-steroidal anti-in ammatory analgesics: a review of current practice. J Vet Emerg Crit Care 2002;12(2):89. Elke Rudloff, DVM, DACVECC Animal Emergency Center and Specialty Services 2100 W. Silver Spring Drive Glendale, WI 53209 SUGGESTED READING 1. Carroll GL, Simonson SM. Recent developments in nonsteroidal antiinammatory drugs in cats. J Am Anim Hosp Assoc 2005;41(6):347-354. 2. Curry SL, Cogar SM, Cook JL. Nonsteroidal antiin ammatory drugs: a review. J Am Anim Hosp Assoc 2005;41(5):298-309. ediatric dogs and cats dehydrate quickly with inappetence or illness, and assessing the hydration status of these animals is difﬁcult. For example, skin tenting is a poor measure of hydration in puppies and kittens because they have little subcutaneous fat, which is responsible for the normal skin tent and relaxation response in well-hydrated animals. The eyes of dehydrated animals may appear sunken, but, of course, this sign is not useful until after the eyelids open at about 2 weeks of age. In addition, this measure is subjective. And although mucous membrane tackiness may be a useful measure of hydration, the small oral cavity in puppies and kittens precludes easy digital investigation, and if the animal has nursed recently, the mucous membranes may be artifactually lubricated with milk. One measure that can indicate dehydration in puppies and kittens is urine color. Normal urine in well-hydrated puppies and kittens is dilute and, thus, colorless. Puppies and kittens less than 2 or 3 weeks old can be induced to Margaret V. Root Kustritz, DVM, PhD, urinate by gently stimDACT ulating the genitalia Department of Veterinary Clinical with a cotton ball. If the Sciences animal’s urine is visibly College of Veterinary Medicine yellow, the animal is University of Minnesota dehydrated and ﬂuid St. Paul, MN 55108 therapy is indicated. Getty Images VETERINARY MEDICINE August 2008 431 http://www.fda.gov/cvm/Documents/NSAIDBrochure.pdf http://www.fda.gov/cvm/Documents/NSAIDBrochure.pdf

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Veterinary Medicine - August 2008 Contents Editors' Note Leading Off ClinQuiz Idea Exchange Practical Matters Diagnosing and Treating Canine Copper-Associated Hepatopathies Canine and Feline Demodicosis CE Form Advertiser Index Product Preview Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - August 2008

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