Oh, no! It happened again this week. A well-meaning person inadvertently caused a serious health problem in his pet by self-medicating it. Usually, I see this sort of problem when pet owners administer Tylenol (acetaminophen) to their cats. This week, I met a dog owner who gave his Beagle the NSAID Aleve.
I had seen this dog last spring for back pain related to intervertebral disc disease. He was an old guy, and the owner has been aware of his arthritis for some time, but in the last two days, the dog seemed to be in more pain and now was falling frequently, so the owner brought him in. As part of our check-in form, we always ask if the pet is on any medication, and we were told "No."
"But Daddy," piped up the four year old boy, "you gave him a pill."
"Oh, yeah," the owner admitted, "I gave him an Aleve yesterday, and again today."
My heart sank when the tech relayed this to me. I got more depressed when she listed the dog's symptoms: Staggering and falling, not eating, diarrhea, and vomiting "black stuff."
I thought to myself: This guy has just killed his dog.
You see, naproxen (Aleve, Naprosen) is one of the most toxic of the NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) out there. It causes perforating ulcers of the duodenum (upper small intestine) at doses as low as 5.6 to 11mg/kg. This dog received 12mg/kg. Twice. A major sign of an ulcer is vomiting the digested blood which comes from the perforation. This blood appears as black fluid. Other signs of toxicity include nausea, diarrhea, black tarry stools (also due to digested blood), abdominal pain, weakness and stumbling. Our patient has most of these signs.
In dogs, naproxen is absorbed in as little as 30 minutes, or up to three hours after ingestion. Because the drug undergoes enterohepatic recirculation (is picked up from the intestines by the blood stream, filtered by the liver, excreted into the bile, then returned to the intestines) naproxen has a half-life of 34 to 72 hours. That means it takes between a day and a half to three days for HALF of the ingested drug to be removed from the body. As well as causing the perforating ulcer, kidney and liver damage can occur from the constant bombardment of the organs by this potent medication.
After a brief explanation of what was going on in his dog and an outline of my initial treatment plan, Mr. Beagle elected humane euthanasia for his pet. It was the best choice, given the circumstances, but all I could think was what a waste. A five minute phone call could have prevented this dog's suffering and ultimate death.
The take-home lessons from this sad post are twofold:
Number One and most important: NEVER, EVER give your pet any medication without consulting with your vet first.
And secondly, when we ask you if you have given your pet anything, please confess. We won't yell, really, but we need to know. Had the small boy not brought up the pills his daddy had given the Beagle, I would have loaded the dog up on steroids for his neurologic signs while I waited for lab work. This would have been the absolute wrong approach, as it would have made the ulcer worse.
When the veterinarian or staff member asks you if your pet is receiving any medication, we are including heartworm and flea products, vitamins, supplements, herbal products, and drugs, whether for humans or other pets. Don't be embarassed or ashamed to tell us if you have self-medicated your cat with the dog's arthritis medicine or if you dewormed your dog with the paste you use for your horse. It's important that we know what your pet has been given, so we can correctly diagnose and treat it.
Pleas. Just Say "No!" to Aleve, in any pet, in any form.