re: Veterinarians…a Question About Nsaid Poisoning for Dogs .UPDATE : Rimadyl poisoning.

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2 mg per kg of body weight per day.

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That seems low. It may be safer to go 2mg per kg per day especially if long term usage (so 110 pound / 50 kg dog would max out at 100mg a day divided up throughout the day), but I usually see 2mg per pound/lb per day which is also probably limited to 200mg per day max even for dogs above 100 pounds.

Thanks for the reply. My goal is to understand why the dog died.We’re waiting on the necropsy results.

He was 11.5 years old. His bloodwork was good leading in to this treatment. All normal in early September preparing to report for daily radiation to treat a recurrent grade 2 sarcoma on the right front leg that we couldn’t eradicate with surgery.

He was on no medication. He was very active. No arthritis. Had good hearing and sight. Still an excellent hunter.No prior disease.

I’ll post his pre admission workup.

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Information CBC: No clinically significant abnormalities Chemistry: Mild, static elevation in ALT; otherwise no clinically significant abnormalities Cytology (right antechbrial mass): Soft tissue sarcoma Chest radiographs: No evidence of metastasis, otherwise unremarkable Abdominal ultrasound: ??Nodular hyperechoic hepatopathy may represent vacuolar hepatopathy, regeneration, nodular hyperplasia, hepatitis, or neoplasia. ??Heterogeneous splenomegaly has differentials of sedation, lymphoid hyperplasia, splenitis, or infiltrative neoplasia. ??Mild bilateral adrenomegaly may be a normal variant and measuring artefact due to panting, may represent benign hyperplasia, or may represent hyperadrenocorticism. : Benign prostatic hyperplasia with small prostatic cysts. Intact male status. Mild bilateral chronic nephropathy and nephrocalcinosis

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He was sailing through the radiation treatment without any complications. The nsaid treatment began Friday evening. He stopped eating Sunday, I think. By Tuesday he’s in ICU with highly elevated liver values. Downhill quickly from there.

Why did they start nsaids?

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Why did they start nsaids?

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To address the skin irritation/burn from the radiation treatment.

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My goal is to understand why the dog died.

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He was 11.5 years old.

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Is old age possible???

Obviously won’t bring back your dog but I always tell people cancer doesn’t play fair no matter what the circumstances it can do whatever the heck it wants to. That’s for pets and people. I have someone who I know that was going thru chemo for rectal cancer and was in his mid 30s in really good shape. So much so that no one except his family even knew he had cancer and was undergoing treatment. He died in his sleep. I have seen dogs as young as 2 die from cancer that came in completely normal a month before. Cancer is impossible to predict no matter what anyone says.

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Is old age possible???

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He acted/hunted as thought was 7 or 8. He died from an acute injury. He had all the symptoms of nsaid toxicity.

Otis i'll try to gleam what i can for you here.

Rimadyl is not a particularly strong nsaid. think of it as the doggy equivalent of advil. That very reductive, but it not far off. While some healthy dog do have strong reactions to it, and it can cause hepatic(liver) damage, that is usually reversed easily with stoppage of ramdyl and supportive care.

my concern with rimadyl more than liver is kidney as that is where you will see most damage usually.

on the ultra sound i see that he had significant changes to his liver. the ultrasound interpretation is a bit lacking imho. There was also some mention of kidney chronic pathology.

With those two findings would i have started the dog on rimadyl? No. i would not have. i would have opted for topical treatments to manage the skin irritation.

Do i think the rimadyl killed your dog? I do not know. I suspect the liver was probably more compromised with metastasis than what they may have been expecting. Thus reducing its function and ability to handle oral medications. Could that have been the tipping point for the rimadyl, or was it just coincidence and the liver was on its way out anyway.

Necropsy will tell a lot. If you wouldnt mind sharing the results id like seeing them.

Thanks Otis. i know there a couple of us vets on here and this kind of spread of information is helpful.

i am sorry about your pup. Try not to beat yourself up or your vets up too much. You did good by treating your dog, and your vets made a decision to improved the quality of life of your dog. Like i said, the rimadyl might not have even been a real contributing factor. If they are like almost every other vet out there, they are beating themselves up enough about it while they wait for the necropsy results.

UPDATE…necropsy confirmed “idiosyncratic injury “ to the liver killed my dog. He died from nsaid poisoning caused by Rimadyl. Beware of this drug.