Anti-inflammatories are medications commonly used to treat pain and fever in people as well as dogs and cats. However, many of those that are safe in people can be dangerous to cats. Additionally, giving more than the recommended dose can also be dangerous. Speak to a vet straight away if you think your cat may have ingested a human medication or a higher-than-recommended dose of an anti-inflammatory. Immediate treatment is essential to prevent serious problems. Cats are especially vulnerable to intoxication from some types of anti-inflammatories. Examples include Ibuprofen (Nurofen, Brufen), Naproxen or Aspirin. Even medications that are usually safe for cats, such as Meloxicam (Metacam, Loxicom, Rheumocam) or Robenacoxib (Onsior) can be dangerous if more than the recommended dose is given. In some cases, it can take as little as 2-3 times the recommended dose to cause serious side effects.

What is anti-inflammatory intoxication in cats?

Anti-inflammatory medications prevent the body from producing substances (prostaglandins) that create swelling and increased blood flow to injured areas. This way, they limit some of the negative effects of excessive inflammation, like pain and fever. On the other hand, these substances also have important protective functions in some parts of the body. When these functions are also limited, damage can happen to organs such as the stomach, intestines, kidneys, liver and in some cases the brain.

• These are some of the most common intoxications to affect cats

• Treatment should be started as soon as possible to prevent as much damage as possible.

• Symptoms usually start within hours, but the full extent may take days to develop.

Symptoms of anti-inflammatory intoxication in cats

• Vomiting, sometimes with blood

• Lack of appetite

• Lack of energy

• Diarrhoea

• Black or tarry stools

• Excessive thirst

• Excessive peeing

• Pale gums

• Jaundice (yellow tinge to the skin, gums or the white part of the eyes)

• Lack of coordination or trouble moving

• Seizures

• Collapse

Cats at higher risk of anti-inflammatory intoxication

• Taking other medications at the same time can increase the risk of damage, especially steroids or other anti-inflammatory drugs, which significantly raise that risk.

• Cats that have diseases affecting the stomach, intestines, kidneys, liver or heart are much more likely to have severe intoxication.

• Young kittens and older cats are also at greater risk.

Diagnosis of anti-inflammatory intoxication in cats

• Intoxication is usually diagnosed based on known ingestion and observed symptoms, as there is no readily available test to confirm it.

• Routine blood tests that check for signs of kidney and liver damage will usually detect the consequences of the intoxication and allow for monitoring of progression.

Veterinary treatment of anti-inflammatory intoxication in cats

• The first and most important step in treating intoxication is stopping the poison from entering the blood and organs. The stomach should be emptied as quickly as possible, ideally within 30-90 minutes. This can be done by injection or by pumping the stomach under anaesthesia.

• The next step is administering activated charcoal. This sticks to anti-inflammatories in the gut and prevents them from being absorbed. This may need to be repeated every 4-6 hours, depending on the product that was ingested.

• Cats may need intensive hospital care for 1-3 days to control the symptoms. Intravenous fluids are administered to protect the kidneys and help the body eliminate the product.

• Medications may be given to protect the stomach and intestines from further damage, such as antacids and anti-emetics.

• Misoprostol is a medication that specifically protects the stomach from damage caused by anti-inflammatories.

• If there is significant bleeding from stomach or intestinal ulcers, blood transfusions may be required.

• More advanced techniques to remove the drug directly from the blood (total plasma exchange) may be available in a few specialist referral centres.

Home treatment of anti-inflammatory toxicity in cats

Always contact a vet for advice immediately if you think your pet has ingested a human anti-inflammatory or more than the recommended dose of a cat one. Most cases will require immediate emergency care. Cats that overcome a toxic ingestion may have a prolonged recovery or be left with kidney damage. They may require a special diet or other supportive long-term treatments.

Prevention of anti-inflammatory intoxication in cats

• Always store medications in a safe place and out of reach of your pets, even if they don’t look appetising.

• Always check with a vet before giving your pet any medication and follow instructions carefully. If there are any doubts, it’s always best to ask for advice.

• Cats may ingest significant amounts of toxins by grooming themselves. If your cat has liquid medicine on their fur, use a buster collar or something similar to prevent grooming. Remove as much of the medicine as you can and contact a vet immediately for further advice.

• Be very vigilant when giving medicines with food if you have more than one pet.

When to worry about anti-inflammatory intoxication in cats

Always contact a vet for advice immediately if you think your pet has ingested a human medication or more than the recommended dose of their medication, so the risk can be assessed and treatment advice given. Speak to a vet for advice immediately if your cat is:

• Vomiting

• Not eating anything

• Drooling excessively

• Behaving abnormally

If your cat develops any of the following symptoms, see a vet as soon as possible:

• Weakness or collapse

• Trouble breathing

• Seizures

• Vomiting and/or diarrhoea with blood

• Abnormal colour in their gums or the white of their eyes