Open Access
Subscription Access
Open Access
Subscription Access
Reversal of Hepato-renal Impairment Induced by Meloxicam Paracetamol Toxicity in a Labrador Dog
Subscribe/Renew Journal
An 8 years old male Labrador dog was referred to Small animal Medicine Referral Clinic, Veterinary Clinical complex, Veterinary College and Research Institute, Orathanadu for fever, anorexia, hematemesis and melenic stools. The dog on treatment with 2 ml of Meloxicam Paracetamol combination IM, along with Injection Oxytetracycline and fluid therapy for 3 days by locally and did not respond to treatment thus was referred. Clinical dullness, lethargy, respiratory distress, visible mucosal jaundice, ecchymosis on ventral abdomen was noticed. Physical examination revealed, halitosis, ulceration in the tip of the tongue, dehydration, pre scapular LN enlargement, distended abdomen, fluid thrill and splenomegaly. Hematology revealed anemia and thrombocytopenia. Biochemical analysis revealed Hyperbilirubinemia, Elevated BUN, Creatinine, AST, ALT, ALP and hypoalbuminemia. Abdominal ultrasound reveled splenomegaly, focal hyperechoic liver parenchyma, cortex echogenicity of right kidney and perirenal fluid accumulation. ECG revealed peaked T wave. Radiography revealed hepatosplenomegaly. Hemato-biochemical alteration was monitored before and after therapy. Animal was managed with fluid therapy, Acetylcysteine, Amino acid and supportives and the dog had an uneventful recovery.
Keywords
Dog, Hepatotoxicity, Hyperbilirubinemia, Meloxicam, Paracetamol .
User
Subscription
Login to verify subscription
Font Size
Information
- Mathews KA. Non‐steroidal anti‐inflammatory analgesics: A review of current practice. JVECC. 2002; 12(2):89–97. https://doi.org/10.1046/j.1435-6935.2002.0 0007.x.
- Altman RD. A rationale for combining acetaminophen and NSAIDs for mild-to-moderate pain. Clin Exp Reumatol. 2004; 22:110–7.
- Kannan K, Saravanan M, Ram Kumar PK, Arul Kumar T, Senthil Kumar S, Premalatha N. Meloxicam toxicity in labrador dog due to dispensing error and its reversal by Misoprostol. Indian Vet J. 2019; 96(10):78–80.
- Salem SI, Elgayed SSA, El-Kelany WM, Abd El-Baky AA. Diagnostic studies on acetaminophen toxicosis in dogs. Glob. Vet. 2010; 5(2):72–83.
- Khan SA, McLean MK. Toxicology of frequently encountered nonsteroidal anti-inflammatory drugs in dogs and cats. Vet Clin North Am Small Anim Pract. 2012; 42:289–306. PMid: 22381180. https://doi. org/10.1016/j.cvsm.2012.01.003.
- Monteiro-Steagall BP, Steagall PVM, Lascelles BDX. Systematic review of nonsteroidal anti-inflammatory drug-induced adverse effects in dogs. J Vet Intern Med. 2013; 27:1011–9. PMid: 23782347. https://doi. org/10.1111/jvim.12127.
- Curry SL, Cougar SM, Cook JL. Nonsteroidal anti-inflammatory drugs: A review. J Am Anim Hosp Assoc. 2005; 41:298–309. PMid: 16141181. https://doi. org/10.5326/0410298.
- Talcott PA, Gwanltney-Brant SM. Non steroidal antiinflammatories. Peterson ME, Talcott PA. eds. Small Animal Toxicology, 3rd ed. St. Louis, MO: Elsevier Saunders; 2013. p. 687–708. https://doi.org/10.1016/ B978-1-4557-0717-1.00065-X.
- Satirapoj BMD, Lohachit PMD, Ruamvang TMD. Therapeutic dose of acetaminophen with fatal hepatic necrosis and acute renal failure. J Med Assoc Thai. 2007; 90:6.
- Jahr JS, Lee VK. Intravenous acetaminophen. Anesthesiol Clin. 2010; 28:619–45. PMid: 21074742. https://doi.org/10.1016/j.anclin.2010.08.006.
- Hjelle JJ, Grauer GF. Acetaminophen-induced toxicosis in dogs and cats. J Am Vet Med Assoc. 1986; 188 (7): 742-746.
- Hernandez-Avalos I, Valverde A, IbancovichiCamarillo JA, Sanchez-Aparicio P, Recillas-Morales S, Osorio-Avalos J. Clinical evaluation of postoperative analgesia, cardiorespiratory parameters and changes in liver and renal function tests of Paracetamol compared to Meloxicam and carprofen in dogs undergoing ovario hysterectomy. PLoS ONE. 2020; 15(2):e0223697. PMid: 32059002 PMCid: PMC7021320. https://doi. org/10.1371/journal.pone.0223697.
- Kaboli Y. Modern aspects of the pharmacology of acetaminophen: Mechanism of action, metabolism toxicity. J Clin Med. 2017; 3(2):1030.
- Miranda HF, Margarita M. Puig B, Juan Carlos Prieto A, Gianni Pinardi. Synergism between Paracetamol and nonsteroidal anti-inflammatory drugs in experimental acute pain. Pain, 2006; 121: 22–8. PMid: 16480830. https://doi.org/10.1016/j.pain.2005.11.012.
- Schlesinger DP. Methemoglobinemia and anemia in a dog with acetaminophen toxicity. Can Vet J. 1995; 36(8):515–7.
- Bolfer L, McMichael M, Ngwenyama TR, O’Brien MA. Treatment of ibuprofen toxicosis in a dog with IV lipid emulsion. J Am Anim Hosp Assoc. 2014; 50(2):136–40. PMid: 24446399. https://doi.org/10.5326/JAAHA-MS-5979.
- Herring JM, Mcmichael MA, Corsi R, Wurlod V. Intravenous lipid emulsion therapy in three cases of canine naproxen overdose. JVECC. 2015; 25(5):672–8. PMid: 25974838. https://doi.org/10.1111/vec.12307.
- Webster CRL, Cooper J. Therapeutic use of cytoprotective agents in canine and feline hepatobiliary disease. Vet Clin Small Anim. 2009; 39:631–52. PMid: 19524797. https://doi.org/10.1016/j.cvsm.2009.02.002.
- Beuers U. Drug insight: Mechanisms and sites of action of ursodeoxycholic acid in cholestasis. Nat Clin Pract Gastroenterol Hepatol. 2006; 3:318–28. PMid: 16741551. https://doi.org/10.1038/ncpgasthep0521.
- Rosenthal MG, Labato MA. Use of therapeutic plasma exchange to treat nonsteroidal anti-inflammatory drug overdose in dogs. J Vet Intern Med. 2019; 33(2):596– 602. PMid: 30698297 PMCid: PMC6430928. https://doi. org/10.1111/jvim.15420.
- Chan DL, Freeman LM. Nutrition in critical illness. Vet Clin Small Anim. 2006; 36:1225–41. PMid: 17085231. https://doi.org/10.1016/j.cvsm.2006.08.009.
Abstract Views: 107
PDF Views: 0