Treatment of Ibuprofen Toxicosis in a Dog with IV Lipid Emulsion

A 3 yr old spayed female mixed-breed dog weighing 19.4 kg was evaluated for ingestion of 1,856 mg/kg (180 tablets) of ibuprofen, a human formulated nonsteroidal anti-inflammatory drug (NSAID). At the time of presentation, the patient was alert and hypersalivating, but her mental status rapidly declined to obtunded, stuporous, and then comatose within 30 min of presentation. Initial treatment included supportive therapy with prostaglandin analogs and antiemetics. An IV lipid emulsion (ILE) was administered as a bolus, followed by a constant rate infusion. Clinical signs began to improve approximately 3 hr after completion of the lipid infusion. The patient required supportive care for 3 days before discharge. This case report demonstrates the use of ILE for treatment of ibuprofen toxicosis in a dog. ILE infusion may be a therapeutic option for patients with toxicosis due to lipid-soluble drugs.