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Case of the Month June 2005 Vital information about OTC medications
"Bonzo" is a 9-year-old male, neutered Labrador retriever mix weighing 42 lbs. His owner has had Bonzo since he was 6 months old and reports that he has always been in good health. HISTORY: Bonzo was presented initially 3 months ago with right hind leg lameness. Physical examination revealed no abnormalities. After discussing the differential diagnosis with the owner, he elected to treat Bonzo symptomatically and agreed to return in 10-14 days if Bonzo's condition did not improve. Deramaxx 50 mg once daily was prescribed. A follow-up call was made 4 days later and a message left for the owner to please call with a progress report. Bonzo represented to the clinic 3 months later with a 3 days history of vomiting and anorexia. The owner related that the Deramaxx had not seemed to help Bonzo, so he had started giving Aleve (naproxene) 200 mg once daily about a week ago. PHYSICAL EXAMINATION: Bonzo was alert and responsive at the time of presentation. His temperature was 100.3, pulse-90, and respiration panting. Bonzo mucous membranes were pale pink warm and dry. Chest auscultation and abdominal palpation were non-remarkable. Rectal examination revealed firm stools of very dark color. Bonzo had significant atrophy of the muscles of his right hind leg, consistent with persistent disuse of the limb related to his initial presenting complaint. ASSESSMENT: Problems included vomiting, anorexia, mild dehydration and a history of inappropriate dosing with a non-steroidal anti-inflammatory drug (NSAID). The recommended dose of naproxene for dog is 2.5 mg/lb on day one, then 1.25 mg/lb given on alternating days thereafter. PLAN: Bonzo was admitted to the hospital for diagnostics and treatment. The primary concern for Bonzo was the nature of the effects that excessive Naproxene might have on him. A blood panel and urinalysis were run and radiographs were taken of his hips, back and right hind leg to try to determine the source of the lameness. Bonzo's blood panel and UA revealed no abnormalities. His radiographs revealed normal hips and a large amount of degenerative disc disease in his lumbar spine, which may have been the source of his rear leg lameness. Bozo was given subcutaneous fluids to improve his hydration. Zantac and reglan were used to treat him for suspected NSAID-induced gastritits. Bonzo was discharged that afternoon at which time his owner was counseled on the importance of always consulting with a veterinarian before giving Bonzo any type of medications. DISCUSSION: The case of Bonzo illustrates well the importance of communicating with your veterinarian when caring for your pet. All to frequently, well intentioned owners give their pets medications, supplements or diets that are inappropriate and sometimes very harmful. Bonzo was quite lucky. NSAID's are well known for their potential GI ulcerative effects, but they can also cause irreversible damage to the kidneys. In an older dog like Bonzo, the combination of a high dose of an NSAID and dehydration, resulting from fluid loss due to gastritis-induced vomiting, is a classic scenario for the development of acute kidney failure. Fortunately Bonzo's owner was concerned enough to bring Bonzo in for treatment before serious damage was done. We recently had another client come in and comment that because her 16-year-old cat had started losing weight and seemed to be hungry all the time, she had put him back on a high protein kitten food to see whether the cat could gain back some weight. This cat is likely suffering from some condition common to elderly cats such as hyperthyroidism or renal disease. In both these instances, a high protein diet will not only not help, but may be detrimental to the cat by putting additional demands on its already over taxed kidneys. Again, particularly with older pets, it is important for you the owner to consult with your veterinarian prior to making any major changes in your pet's diet or giving any medications. - The Bay Park Pet Clinic Staff |
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Phone: (619) 276-1616 - 1102 Morena Blvd., San Diego CA 92110 |
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