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Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs

BACKGROUND: Therapeutic plasma exchange (TPE) may be an effective technique for treatment of accidental nonsteroidal anti‐inflammatory drug (NSAID) overdose, but information regarding the use of this technique in veterinary medicine is currently limited. OBJECTIVES: To evaluate the overall outcome f...

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Autores principales: Rosenthal, Melisa G., Labato, Mary A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430928/
https://www.ncbi.nlm.nih.gov/pubmed/30698297
http://dx.doi.org/10.1111/jvim.15420
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author Rosenthal, Melisa G.
Labato, Mary A.
author_facet Rosenthal, Melisa G.
Labato, Mary A.
author_sort Rosenthal, Melisa G.
collection PubMed
description BACKGROUND: Therapeutic plasma exchange (TPE) may be an effective technique for treatment of accidental nonsteroidal anti‐inflammatory drug (NSAID) overdose, but information regarding the use of this technique in veterinary medicine is currently limited. OBJECTIVES: To evaluate the overall outcome for dogs with NSAID overdose treated with TPE and to determine if any presenting factors can predict or influence overall outcome. Secondary objectives included investigating TPE complications as well as the utility of other adjunctive treatments. ANIMALS: Eleven client‐owned dogs presented for NSAID overdose that received TPE. All patients also received additional supportive treatment including IV lipid infusion. METHODS: Retrospective review of medical records. RESULTS: Eleven cases were included in the study. Of these, the NSAID ingested was ibuprofen in 6 (54.5%), naproxen in 4 (36.4%), and deracoxib in 1 (9.1%). All dogs survived to discharge with 3 (27.3%) developing acute kidney injury during hospitalization. A larger initial dose of NSAID ingested was associated with a higher maximum serum creatinine concentration during hospitalization (P = .04) and larger change in serum creatinine concentration from baseline (P = .02). Six dogs (54.5%) developed complications associated with TPE. The use of other treatments did not affect the overall outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: We identified TPE as an effective treatment for NSAID overdose with good outcomes despite high doses of NSAID ingestion in dogs treated with a single TPE treatment. Complications were common but did not affect the final outcome. Therapeutic plasma exchange should be considered in patients presenting for high‐dose NSAID ingestion.
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spelling pubmed-64309282019-04-04 Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs Rosenthal, Melisa G. Labato, Mary A. J Vet Intern Med SMALL ANIMAL BACKGROUND: Therapeutic plasma exchange (TPE) may be an effective technique for treatment of accidental nonsteroidal anti‐inflammatory drug (NSAID) overdose, but information regarding the use of this technique in veterinary medicine is currently limited. OBJECTIVES: To evaluate the overall outcome for dogs with NSAID overdose treated with TPE and to determine if any presenting factors can predict or influence overall outcome. Secondary objectives included investigating TPE complications as well as the utility of other adjunctive treatments. ANIMALS: Eleven client‐owned dogs presented for NSAID overdose that received TPE. All patients also received additional supportive treatment including IV lipid infusion. METHODS: Retrospective review of medical records. RESULTS: Eleven cases were included in the study. Of these, the NSAID ingested was ibuprofen in 6 (54.5%), naproxen in 4 (36.4%), and deracoxib in 1 (9.1%). All dogs survived to discharge with 3 (27.3%) developing acute kidney injury during hospitalization. A larger initial dose of NSAID ingested was associated with a higher maximum serum creatinine concentration during hospitalization (P = .04) and larger change in serum creatinine concentration from baseline (P = .02). Six dogs (54.5%) developed complications associated with TPE. The use of other treatments did not affect the overall outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: We identified TPE as an effective treatment for NSAID overdose with good outcomes despite high doses of NSAID ingestion in dogs treated with a single TPE treatment. Complications were common but did not affect the final outcome. Therapeutic plasma exchange should be considered in patients presenting for high‐dose NSAID ingestion. John Wiley & Sons, Inc. 2019-01-30 2019 /pmc/articles/PMC6430928/ /pubmed/30698297 http://dx.doi.org/10.1111/jvim.15420 Text en © 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle SMALL ANIMAL
Rosenthal, Melisa G.
Labato, Mary A.
Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
title Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
title_full Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
title_fullStr Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
title_full_unstemmed Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
title_short Use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
title_sort use of therapeutic plasma exchange to treat nonsteroidal anti‐inflammatory drug overdose in dogs
topic SMALL ANIMAL
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430928/
https://www.ncbi.nlm.nih.gov/pubmed/30698297
http://dx.doi.org/10.1111/jvim.15420
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