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Ate 2 x 200mg ipubrofen 2 nights ago. After 18 hours started…

Ate 2 x 200mg...

Ate 2 x 200mg ipubrofen 2 nights ago. After 18 hours started vomiting. No other symptoms. Looks like bile now. I’m in UK.

Veterinarian's Assistant: I'll do all I can to help. The Expert will know if the dog will be able to digest that. What is the dog's name and age?

Molly, just turned 7, collie cross with ***** *****. Around 44lbs

Veterinarian's Assistant: How old is Molly?

7

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Molly?

No. Very healthy dog

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Answered in 1 hour by:
2/25/2018
Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23,216
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

Can she keep any water down?

Are her gums pink or white/pale? Moist or sticky?

If you press on her belly, any tensing, tenderness, discomfort, or pain?

Any black of bloody stools?

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Customer reply replied 4 months ago
Hi Dr BNot sure on the water - I presume so as the water bowl level has gone down after her being sick and hasn't been sick since overnight.Gums are pink - actually little darker than our other dog (who is fine and is not unwell). Gums are slightly less moist than our healthy dog but I wouldn't say sticky.No discomfort on her belly, it isn't tensing and she seems quite happy.No evidence of blood in her stools.She was very happy yesterday (Saturday) after having the tablets on Friday night. This morning she is still happy, but a little tired as I don't think she slept very well.She kept yesterday's breakfast down, and he vomit yesterday PM was just fluid. Her overnight vomit was a mixture of her dinner - which she didn't keep down - and green fluid, bile.I haven't and probably will not feed her today

Hello again,

Now this is not an ideal situation for Molly. The problem here is that she has had a 20 mg/kg dose for her size and at this time we are past a point where we could block her absorbing the drug and instead have to address the possible fall out from this toxicity. Specifically, to appreciate how severe this is, we have to know that signs of intoxication and damage with this drug start at doses as low as 5-8mg/kg. That said, in laboratory studies, irreversible kidney damage was appreciated once the dose reached ~175 mg/kg. That means while her risk of kidney damage is thankfully less at this dose, we would not be surprised to see vomiting but there is also risk of her developing a bleeding stomach ulcer (possible perforation of the stomach), abdominal pain, bloody or black (digested blood) stools.

With all this in mind, we do need to be proactive and keep a close eye on her this week. We don't want to stave her today because that will just increase the risk of stomach ulceration (we need something in the stomach to block stomach acid damage). Instead we need to stop her vomiting/reduce nausea/reduce stomach acid levels. To do that, you can try giving her an OTC pet safe antacid. [ie Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid), Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac), Milk of Magnesia - 0.5tsp every 8 hours]. Whichever you choose, we’d give this 20 minutes before food to allow absorption. Of course, do double check with your vet if she has a known health issues or is on any medications you haven't mentioned. Though if you give this and she cannot keep it down due to nausea that is usually a red flag that we need to bypass her mouth with injectable anti-vomiting medication from her vet. And if we did get her seen her local vet can also start gastroprotectants for her too.

Afterwards, you can consider starting her on small meals through the day of an easily digestible diet like cooked white rice with boiled chicken, boiled white fish, cottage cheese, scrambled eggs, or meat baby food (as long as its garlic/onion free).

Overall, this is a serious dose for her and could damage her stomach. At this point, we need to settle the nausea and actually make sure she keeps eating so we can reduce ulcer risks. But if she doesn't settle with the above then we need her seen for injectable treatment and gastroprotectants to head off any lasting damage.

Kind regards,

Dr. B

**************************

I aim to provide best care for your pets just as I do for my own patients. If you have any other questions, please ask – I’m happy to help afterwards please take the time rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as otherwise the site does not credit me for helping you. There is no extra charge for this (its included in your question fee). Once you rate, your question will not close & you can still ask follow-up questions. Thank you for helping me to keep helping everyone here. : )**

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Customer reply replied 4 months ago
Thanks for the above Dr B. I will act according to our instructions.I have just come back from 90 minutes outside doing some errands and have found three small droplets of congealed blood on the lounge floor (I am presuming from this morning as I didn't spot this last night, and she has only been in the lounge this morning). Molly is happy and fine but this is worrying - do we stick to the above plan?

You are very welcome,

I would advise a good look over her for hints of where this has come from (any blood dried around her rectum, her mouth, any wounds, damaged nails, etc) and make sure her gums are still pink as before. If we cannot see an obvious source, since it was small, we'd keep on with the above and monitor. Any more blood or any paling then we'd want her seen to be safe.

All the best,

Dr. B.

**************************
Afterwards please take the time rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as otherwise the site does not credit me for helping you. There is no extra charge for this (its included in your question fee). Once you rate, your question will not close & you can still ask follow-up questions. Thank you for helping me to keep helping pets here. : )**

Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23,216
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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