Common brand names for naproxen, an over-the-counter NSAID, include Aleve and Midol. Naproxen-containing prescription drugs, available as tablets, capsules, or liquids. Although naproxen is safe for human usage, due to its small margin of safety, it is extremely dangerous to dogs and cats (which means it is very potent). Even in a large dog, as little as one 220mg tablet can result in very serious symptoms or even death.
Naproxen can cause acute kidney failure and severe gastrointestinal ulcers in dogs and cats, which can perforate and rupture the intestines. Clinical symptoms include nausea, vomiting with blood, black-tarry stools (a sign of GI bleeding), diarrhea, loss of appetite, pain in the belly, weakness, pale gums (from anemia), and tiredness. The pet may become septic and pass away if extensive ulcers cause gastrointestinal perforation or rupture. Rarely, there may also be unconsciousness, sadness, seizures, facial twitching in cats, and seizures.
Can a dog get damaged by an Aleve?
A: No. Ibuprofen harms the kidneys and digestive system in canines and is hazardous to them.
A: It varies. Since Tylenol may harm the kidneys, the liver, and the digestive system, it should never be administered to dogs without a veterinarian’s approval.
A: No. Ibuprofen, a component of Motrin, is harmful to dogs and can harm their kidneys and gastrointestinal systems.
A: Yes, but some dogs may develop unfavorable side effects because of digestive problems or blood issues. Only administer aspirin to your dog under a veterinarian’s care, and ask your doctor what dosage is safe.
A: No. Ibuprofen, a component of Advil that can harm the kidneys and digestive system and is harmful to dogs, is also present.
A: Aleve has naproxen in it. In the past, a low dose of Aleve was prescribed for dogs every other day, but due to its toxicity, Aleve is now only advised for dogs that cannot tolerate other NSAIDs. Dogs should only be given Aleve if a veterinarian has prescribed it since it can harm their kidneys and digestive systems.
When does Aleve become poisonous to dogs?
Both ibuprofen and naproxen are NSAIDs and are used in human medicine for a variety of conditions, such as fever, pain, and inflammation. These goods are frequently used to get pets drunk because well-intentioned owners will give them to pets to alleviate illnesses. Ibuprofen is frequently found in Advil and Motrin, while naproxen is present in Aleve.
Due to the potential for toxicity, these products should not be administered to animals. Before giving your pet any medication, always check with your veterinarian. Ibuprofen tablets as little as one 200 mg tablet can be hazardous to cats and tiny dogs.
Additionally thought to be a possible poison for horses who are not eating are NSAIDs. Stomach acid is regularly released by horses. Giving an NSAID to a horse in the absence of meal considerably raises the risk of stomach erosion. It is best to stay away from this at all costs.
Loss of appetite or refusal to eat, stomach pain, vomiting, diarrhea, an increase in salivation, and melena are all warning signs of poisoning (black, tarry stool). Toxicity symptoms, particularly gastrointestinal ones, may appear 2–6 hours after intake. Serious side effects, however, can not appear for 4-5 days after use.
Consumption of toxins:
Ibuprofen: In dogs, a dose of 50 mg/kg (22 mg/lb) and in cats, a dose of 25 mg/kg (11 mg/lb), respectively, may cause hazardous effects. Toxicity has been observed in dogs at dosages as low as 5–6 mg/kg (2–3 mg/lb) when given over an extended period of time.
Naproxen: There is no known hazardous threshold for intake by animals. However, dogs who ingested doses of 5 mg/kg (2 mg/lb) of body weight have shown symptoms of toxicity.
Can I give Aleve or Advil to my dog?
OTC pain relievers and other human drugs can be extremely harmful and even lethal to dogs. Ibuprofen (Advil), acetaminophen (Tylenol), aspirin, or any other painkiller intended for human consumption shouldn’t be given to dogs unless a veterinarian specifically instructs you to do so.
Does naproxen harm dogs?
In human medicine, naproxen is a non-steroidal anti-inflammatory medication (NSAID). Dogs are very sensitive to the NSAID propionic acid naproxen (like ibuprofen). Dogs could accidentally consume it or negligent owners might administer it to their pet to supposedly relieve pain.
The two main side effects of naproxen use in dogs are anemia and gastrointestinal symptoms. By inhibiting the cyclo-oxygenase enzymes involved in prostaglandin synthesis, gastrointestinal effects are caused by a decrease in prostaglandin production. Although the exact cause of the anemia is unknown, it could be related to blood loss (gross or hidden) from the digestive system.
Haematemesis, melaena, vomiting, and diarrhea (which may be hemorrhagic) are the most typical symptoms of naproxen toxicosis. Additionally, there could be pale mucous membranes, tiredness, and gastrointestinal discomfort. There have also been reports of gastrointestinal ulcer perforation. After a big dose, neurological symptoms such depression, weakness, sleepiness, and seizures are unusual but possible. Also possible are liver enzyme elevation and renal dysfunction.
Emesis, repeated doses of activated charcoal, rehydration, monitoring of hematocrit, renal, and liver function, and gastroprotectants are all part of the treatment for naproxen toxicosis (omeprazole and misoprostol). Since naproxen has a lengthy half-life, using gastroprotectants for 14 days is advised.
What takes place if a dog consumes a 200mg ibuprofen?
Ibuprofen dosages are easily harmful for dogs. In dogs, ibuprofen has a small window of safety. Even giving a 25-pound dog half of a 200 mg pill can cause toxicosis symptoms. The most frequent reason for ibuprofen poisoning is a kind owner attempting to make their dog feel better. The owner gives a dose that he believes to be acceptable without realizing it is a toxic dose. The GI tract, kidneys, and liver are the most often affected organs by toxic consequences.
What are the signs of ibuprofen toxicity?
The first symptoms of poisoning may show in as little as 12 hours. Stomach ulcers that are bleeding are the primary harmful consequence. Increased ibuprofen dosages also cause ulcers and kidney failure, which, if unchecked, can be fatal. Ibuprofen poisoning in dogs can cause symptoms such as vomiting, black tarry stools, abdominal pain, weakness, and lethargy as well as increased thirst and urine. Mild to severe symptoms can be present.
How does a veterinarian diagnose ibuprofen toxicity?
Ibuprofen poisoning is typically diagnosed after a physical examination by a veterinarian and a history of ibuprofen access or exposure. To ascertain the dog’s general health, blood tests are performed. Blood tests may show anemia from a bleeding ulcer or abnormalities as a result of renal injury if ibuprofen was consumed.
How is ibuprofen toxicity treated?
The dosage taken and the clinical indicators will determine the course of treatment. Hospitalization with continuous intravenous fluids for one to two days is a possible component of veterinary care. The use of all NSAIDs and steroids must end right away. If ingested recently, activated charcoal may be administered (less than two hours). In dogs with severe anemia brought on by bleeding ulcers, blood transfusion may be advised. Medication to protect the stomach is frequently used.
How long does Naproxen take to start working on a dog?
Naproxen poisoning often occurs when well-intentioned owners administer the drug incorrectly or when curious canines consume an acute overdose.
Naproxen is a member of the non-steroidal anti-inflammatory medicine (NSAID) class of medications (NSAIDs). These medications are designed to lessen inflammation-related pain. NSAIDs function by preventing the synthesis of prostaglandins. Prostaglandins come in various forms and, as a class, are in charge of many typical bodily processes. They are prevalent in traumatized areas to aid in damage restoration. Additionally, they keep the kidneys’ blood flow in the appropriate direction and shield the stomach lining from the effects of stomach acids.
NSAIDs are primarily used to decrease prostaglandin levels in trauma-related injuries. Because there is less inflammation, there is also less pain when prostaglandins are absent. Sadly, there is still no NSAID on the market that specifically targets the prostaglandins linked to inflammation. Prostaglandins that are responsible for regular kidney blood flow and stomach protection are also inhibited when those that cause inflammation are. This is the reason why naproxen is hazardous to animals.
Naproxen hazardous side effects include:
- Vomiting
- Depression
- Anorexia
- Diarrhea
- Stumbling
Dogs are particularly susceptible to the effects of naproxen on stomach ulcers. Although they sometimes take up to four days, stomach ulcers can develop as soon as 12 hours after eating. The effects of naproxen on the kidneys are more noticeable in cats. Severe renal impairment due to huge overdose or consumption can happen within 12 hours of ingesting but can also happen up to five days afterwards. Seizures may happen in extreme instances.
When taken regularly in doses of 2.5 mg per pound (6 mg/kg), naproxen might cause stomach ulcers. Taking naproxen at a level of 7 grams per pound (15 mg/kg) can cause renal failure.
How long does naproxen remain active in a dog’s body?
Dr. DeClementi offers advice on identifying and managing canine naproxen toxicosis.
As an analgesic and antipyretic, naproxen is a nonsteroidal anti-inflammatory medicine (NSAID) used to treat a variety of illnesses in people, including cancer, gout, arthritis, lupus, and musculoskeletal injuries. It is available over-the-counter as naproxen sodium in 220-mg tablets and by prescription for human use as an oral suspension (25 mg/ml), 250, 375, and 500-mg tablets, as well as 750-mg extended-relief tablets. 1 While naproxen was once administered to dogs off-label, most veterinarians now recommend NSAIDs that are approved for canine usage. 2
PHARMACOKINETICS AND MECHANISM OF ACTION
In dogs, oral naproxen is rapidly absorbed and has a 68% to 100% oral bioavailability. It has a modest volume of distribution (0.13 L/kg in dogs) due to its strong protein binding. Naproxen is excreted in urine by the majority of species, including humans and horses. However, naproxen undergoes significant enterohepatic recirculation in dogs and is excreted in the stool. This explains why dogs have a lengthy half-life of 74 hours. 3
When administered orally to dogs, naproxen has been used therapeutically to treat inflammatory musculoskeletal illnesses including osteoarthritis at a dose of 2 mg/kg every other day. However, it is currently advised that veterinarians only take into account prescription naproxen when FDA-approved NSAIDs have proven unsuccessful due to possible negative effects. 2
Similar to other NSAIDs, naproxen inhibits cyclooxygenase to stop the production of prostaglandins. Cyclooxygenase comes in two widely recognized varieties: COX-1 and COX-2. Since COX-1 is a constitutive enzyme, it is constantly present. The production of prostaglandins by COX-1 is essential for healthy physiologic function. They safeguard the kidneys in addition to the GI system. An inducible enzyme is COX-2. It contributes to the production of prostaglandins, which control inflammation. Naproxen inhibits both COX-1 and COX-2.1 because it is a nonselective inhibitor of cyclooxygenases.
Prostaglandins produced by COX-1 shield the GI tract by reducing stomach acid output, boosting epithelial cell production of bicarbonate, raising blood supply to the mucosa, and encouraging epithelial cell renewal and turnover. The absence of these protective prostaglandins can cause ulceration and GI tract discomfort.
Protective prostaglandins function as vasodilators in the kidney. They facilitate the release of renin, regulate renal blood flow and glomerular filtration rate, and participate in electrolyte transfer. Therefore, a decrease in these prostaglandins might result in negative renal consequences such as renal papillary necrosis, acute interstitial nephritis, fluid and electrolyte imbalances, and vasoconstrictive acute renal failure. 4
TOXICITY
The majority of cases analyzed in the literature on canine naproxen toxicosis report numerous exposures over several days. In one of these case reports, a 13-year-old male basenji dog with joint stiffness, arthritis, and mandibular edema was given 125 mg of naproxen twice daily for seven days. 5 Assuming the patient weighed 20 to 25 lb (9.07 to 11.34 kg), which was not stated in the article, the daily dosage would have been roughly 22 to 28 mg/kg.
Anorexia, weight loss, stomach pain, melena, and anemia were among symptoms this patient experienced (most likely related to GI hemorrhage since no other sources of blood loss or destruction were identified). Numerous granular and hyaline casts in the urine on analysis indicated renal tubular injury. A normal blood urea nitrogen (BUN) concentration of 22 mg/dl (reference range2 = 7 to 26 mg/dl) was determined by the results of a serum chemical profile. There was no information on the serum creatinine level. The drug naproxen was stopped.
The dog had improved and put on weight at the three-week follow-up. The melee had ended. The case report has no other treatments that were mentioned. 5
A 9-year-old male Samoyed who experienced occasional shoulder discomfort was treated with 5.6 mg/kg naproxen once daily for seven days, according to a second case report.
6 Vomiting and melena were brought on by the patient. Anemia, elevated BUN and serum creatinine levels, elevated alkaline phosphatase (ALP) and alanine transaminase (ALT) activities, and 1.019 urine specific gravity were some of the clinical pathological alterations. The patient had antacid medication (dimethicone, calcium carbonate, and magnesium hydroxide combination), a blood transfusion, intravenous fluids for four days, and cimetidine. The dog afterwards made a full recovery. 6
The senior dachshund that took 35.7 mg/kg of naproxen was the subject of the only case report involving a dog following a single dose.
7 The dog suffered gastrointestinal pain, vomiting, diarrhea, and excessive hematemesis and melena the following day, along with being lethargic. After receiving supportive care, the dog got better. The report omitted specific therapy information. 7
ASPCA Animal Poison Control Center data
Only the single-exposure instances that the APCC staff felt had a high or medium likelihood of causing the patient’s clinical symptoms are included here. The ASPCA Animal Poison Control Center (APCC) database contains 4,404 cases of naproxen exposures in dogs from 2001 to 2011.8 The most frequently reported side effects of naproxen intake in dogs were anorexia, anorexia, lethargy, and vomiting.
Single dosages of 1 to 7 mg/kg in dogs caused vomiting and lethargic behavior. 7.7 mg/kg of naproxen caused repeated episodes of vomiting that eventually became bloody in a 1-year-old dog. 8. Hemorrhage into the GI tract is catabolized by the body similarly to any other dietary protein source, resulting in increased urea. 9. In two elderly dogs, 7.4 mg/kg of naproxen caused diarrhea, inappetence, and melena in one dog, and melena and a mildly increased BUN concentration (likely due to GI bleeding) in the other dog.
A 2-year-old dog’s BUN (38 mg/dl; reference range: 7 to 26 mg/dl) and serum creatinine (2 mg/dl; reference range: 0.6 to 1.4 mg/dl) concentrations increased slightly after ingesting 13.4 mg/kg of naproxen. It was not possible to ascertain whether the prerenal or renal origin of these increases in BUN and serum creatinine concentrations; still, no GI symptoms, such as vomiting and diarrhea associated with increased risk for dehydration, were recorded in this patient.
Naproxen doses of roughly 14 mg/kg caused azotemia in two 5-year-old dogs. The first dog experienced melena, inappetence, and a little rise un serum creatinine content (2 mg/dl; reference range = 0.6 to 1.4 mg/dl) after receiving naproxen at a dose of 13.9 mg/kg. It is probable that the azotemia in this dog was prerenal in origin according to the presence of GI symptoms. The second dog experienced vomiting and azotemia after receiving 14.2 mg/kg of naproxen. With a urine specific gravity of 1.008, a BUN level of 64 mg/dl (reference range: 7 to 26 mg/dl), and a serum creatinine level of 5.8 mg/dl (reference range: 0.6 to 1.4 mg/dl), it can be assumed that the isosthenuria is of renal origin.
Both times, the APCC recommended GI-protective drugs (sucralfate, H2 blockers, and misoprostol) as well as fluid diuresis. These patients’ actual therapies and outcomes after consultation were not documented.
According to the APCC data, a single dose of 7 mg/kg or more can result in clinical symptoms of GI irritation and ulceration (vomiting, diarrhea, melena, anorexia), whereas doses between 13 and 15 mg/kg can result in azotemia. When other NSAIDs or corticosteroids are used simultaneously, the likelihood of unfavorable GI or renal effects increases.4 Elderly individuals may also be more susceptible to adverse renal effects if renal insufficiency is already present.
DECONTAMINATION
For a dose of less than 7 mg/kg in a dog, decontamination might not be necessary, but it could lower the risk of GI irritation. Apomorphine (0.03 mg/kg intravenously; or, in the conjunctival sac, 0.25 mg/kg after dissolving the tablet in saline solution) or 3% hydrogen peroxide (2 ml/kg orally with a maximum of 50 ml) can be used to induce emesis if naproxen consumption was recent (less than two hours) and the patient exhibits no clinical signs. Consider employing activated charcoal (1 to 3 g/kg orally) if emesis is ineffective. 2
Consider giving activated charcoal (1 to 3 g/kg orally) if the patient shows no clinical indications and the consumption happened more than two hours before the evaluation. Activated charcoal should be taken with a cathartic for the first time. A cathartic should not be administered with repeated doses of activated charcoal, especially if the patient is dehydrated or has diarrhea. 10
An initial dose of activated charcoal (1 to 3 g/kg orally) may be followed by half the first dosage every six to eight hours for 24 to 48 hours following consumption in dogs whose naproxen ingestions were greater than 13 mg/kg in order to stop any enterohepatic recirculation.
MONITORING AND TREATMENT
If activated charcoal is used, keep a close eye on the serum sodium level because this medication may cause hypernatremia. 10 Clinical signs of hypernatremia include muscle tremors, fasiculations, and convulsions. Give the patient access to water if they are not throwing up. 11 The APCC advises warm-water enemas in addition to the administration of the proper intravenous fluids if hypernatremia develops in order to reduce the serum sodium concentration and the consequent detrimental effects on the central nervous system. 12
Sucralfate (0.5 to 1 g orally t.i.d.), misoprostol (2 to 5 g/kg orally every 8 to 12 hours), famotidine (0.1 to 0.2 mg/kg orally, subcutaneously, intramuscularly, or intravenously b.i.d.), or omeprazole (0.5 to 1 mg/kg orally once a day) can be used in conjunction to start GI protection.
2 Due to naproxen in dogs’ lengthy half-life, continue giving GI-protective drugs for at least seven to fourteen days. Antiemetics can be used to stop vomiting as needed. 12 Colloid treatment or blood transfusions might be required if a severe stomach ulceration forms. 4
Before beginning fluid diuresis, get a baseline serum chemistry profile, a complete blood count, and a urinalysis with a urine specific gravity for dosages where unfavorable renal consequences are possible. At 24, 48, and 72 hours, repeat a kidney panel (BUN, serum creatinine, and electrolyte values). If necessary, repeat the complete blood count and urinalysis. Intravenous fluid diuresis should start. The APCC advises twice-daily maintenance fluids for at least 72 hours due to naproxen’s prolonged half-life in dogs. After 72 hours, if the renal panel values are within the reference range, reduce the rate of fluid administration progressively during the following 24 hours.
Following NSAID exposure in humans4 and naproxen intoxication in dogs, increased liver enzyme activity has been documented.
6 If there are noticeable increases in liver enzyme activity, keep an eye on liver enzyme function and start taking liver-protective drugs. S-adenosylmethionine (SAMe) can be given orally once day at a dose of 20 mg/kg.
PROGNOSIS
With the right care, gastrointestinal discomfort or ulceration usually goes away. Patients who experience GI ulcers run the risk of dying from GI bleeding or sepsis as well as GI perforation. If they are caught early and actively treated, NSAID-related renal problems are typically thought to be reversible. 12 Patients who use drugs that interact with NSAIDs as well as those who have underlying GI or renal disease are more at risk.
