Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Ketoprofen Plaster Toxicity Induced Gastrointestinal Hemorrhage in a Dog

케토프로펜 플라스터 독성에 의한 개에서의 위장관 출혈

  • Park, Hyung-Jin (College of the Veterinary Medicine, Chungnam National University) ;
  • Choi, Joon-Hyuk (College of the Veterinary Medicine, Chungnam National University) ;
  • Lee, Woo-Nam (College of the Veterinary Medicine, Chungnam National University) ;
  • Song, Kun-Ho (College of the Veterinary Medicine, Chungnam National University) ;
  • Seo, Kyoung-Won (College of the Veterinary Medicine, Chungnam National University)
  • Accepted : 2014.06.09
  • Published : 2014.06.30
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Abstract

A 14 year-old Shih-tzu was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with a history of foreign body ingestion and vomiting. The vomitus contained ketoprofen plaster, which is used for orthopedic analgesia in humans. Supportive care and gastrointestinal (GI) protective agents were administered, including famotidine, misoprostol, sucralfate, omeprazole, and fluid therapy. However, the clinical signs worsened, and anemia, melena, leukocytosis, and azotemia developed. The patient was diagnosed with GI hemorrhage and underwent a whole blood transfusion followed by barium sulfate administration. After administering barium sulfate as a GI protectant, the clinical signs improved, and the patient was discharged.

14년령의 Shih-Tzu 개가 이물섭취 및 구토를 주 증으로 본원에 내원하였다. 구토물은 인의에서 사용되는 부착형 제제인 ketoprofen plaster 였다. 대증치료로 위장관 보호제 투여와 수액요법을 실시하였다. 하지만 임상증상은 점점 악화되어 빈혈 및 흑색변, 백혈구 증가증, 고지혈증이 관찰되었다. 환자는 위장관 출혈이 있는 것으로 평가되었고, 수혈 및 위장관 보호제로 바륨제제를 도포하였다. 바륨제제를 위장관 보호제로 사용한 후 임상증상의 개선이 확인 되었다.

Keywords

References

  1. Al Suleimani YM, Abdelrahman AM, AlMahruqi AS, Alhseini IS, Tageldin MH, Mansour ME, Ali BH. Interaction of nimesulide, a cyclooxygenase-2 inhibitor, with cisplatin in normotensive and spontaneously hypertensive rats. Food Chem Toxicol 2010; 48: 139-144. https://doi.org/10.1016/j.fct.2009.09.030
  2. Boston SE, Moens NM, Kruth SA, Southorn EP. Endoscopic evaluation of the gastroduodenal mucosa to determine the safety of short-term concurrent administration of meloxicam and dexamethasone in healthy dogs. Am J Vet Res 2003; 64: 1369-1375. https://doi.org/10.2460/ajvr.2003.64.1369
  3. Granero GE, Amidon GL. Possibility of enterohepatic recycling of ketoprofen in dogs. Int J Pharm 2008; 349: 166-171. https://doi.org/10.1016/j.ijpharm.2007.08.005
  4. Hackett T. Emergency approach to intoxications. Clin Tech Small Anim Pract 2000; 15: 82-87. https://doi.org/10.1053/svms.2000.6807
  5. Heo SK, Cho J, Cheon JW, Choi MK, Im DS, Kim JJ, Choi YG, Jeon do Y, Chung SJ, Shim CK Kim DD. Pharmacokinetics and pharmacodynamics of ketoprofen plasters. Biopharm Drug Dispos 2008; 29: 37-44. https://doi.org/10.1002/bdd.587
  6. Hur C, Chan AT, Tramontano AC, Gazelle GS. Coxibs versus combination NSAID and PPI therapy for chronic pain: an exploration of the risks, benefits, and costs. Ann Pharmacother 2006; 40: 1052-1063 https://doi.org/10.1345/aph.1G493
  7. Jill EM, Stephen WP, David BC. Non-steroidal anti-inflammatory drugs. In: Small animal clinical pharmacology, 2nd ed. Philadelphia: WB Saunders. 2008: 287-308.
  8. Koperna T, Kisser M, Reiner G, Schulz F. Diagnosis and treatment of bleeding colonic diverticula. Hepatogastroenterology 2001; 48: 702-705.
  9. Lanas A, Panes J, Pique JM. Clinical implications of COX-1 and/or COX-2 inhibition for the distal gastrointestinal tract. Curr Pharm Des 2003; 9: 2253-2266. https://doi.org/10.2174/1381612033453992
  10. Luna SPL, Basilio AC, Steagall PVM, Machado LP, Moutinho FQ, Takahira RK, Brandao CVS. Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. Am J Vet Res 2007; 68: 258-264. https://doi.org/10.2460/ajvr.68.3.258
  11. Myristate M. Final report on the safety assessment of myristyl myristate and isopropyl myristate. J Am Coll Toxicol 1982; 1: 55-80. https://doi.org/10.3109/10915818209021261
  12. Papich MG. An update on nonsteroidal anti-inflammatory drugs (NSAIDs) in small animals. Vet Clin North Am Small Anim Pract 2008; 38: 1243-1266. https://doi.org/10.1016/j.cvsm.2008.09.002
  13. Plumb DC. Plumb's veterinary drug handbook, 6th ed. Iowa: Blackwell. 2008: 700-703.
  14. Radi ZA. Pathophysiology of Cyclooxygenase Inhibition in Animal Models. Toxicol Pathol 2009; 37:34-46. https://doi.org/10.1177/0192623308329474
  15. Reed S. Nonsteroidal anti-inflammatory drug-induced duodenal ulceration and perforation in a mature rottweiler. Can Vet J 2002; 43:971-972.
  16. Rolf C, Engstrom B, Beauchard C, Jacobs LD, Le Liboux A. Intra-articular absorption and distribution of ketoprofen after topical plaster application and oral intake in 100 patients undergoing knee arthroscopy. Rheumatology 1999; 38: 564-567. https://doi.org/10.1093/rheumatology/38.6.564