Nonsteroidal Anti-Inflammatory Drug Toxicity in Cats

Successful treatment of NSAID toxicity in your cat will depend on quick and rapid veterinary care. If you believe your cat has ingested inappropriate medication you should seek immediate emergency veterinary care.

Nonsteroidal anti-inflammatory drug toxicity, or NSAID toxicity, occurs when your cat ingests an amount of a drug greater than their body can properly process. In the case of some NSAIDS, such as ibuprofen and naproxen (commonly marketed under the Aleve brand name), cats have an extreme intolerance and will have symptoms of poisoning almost immediately. For other medications, such as aspirin and some NSAIDs prescribed by your vet, toxicity occurs when your cat ingests more than the recommended or prescribed amount. 

The exact symptoms of NSAID toxicity in your cat will vary depending on the substance and amount ingested. The effects of NSAID toxicity can range from mild to severe and life-threatening. Signs to watch for include:

• Vomiting
• Diarrhea
• Blood in the stool
• Shock
• Lethargy
• Difficulty breathing
• Signs of discomfort or pain such as severe restlessness, incessant meowing, or panting

While NSAIDS are generally safe for human consumption in moderate doses, many common household pain relievers are harmful or poisonous to your cat. Cats lack a certain type of enzyme, called hepatic glutathione-dependent enzyme, which helps metabolize or break down many NSAIDS in the body. This means that toxic levels are allowed to build up within your cat, causing damage to vital bodily organs. The toxicity occurs partially due to the way that NSAIDs inhibit the production of prostaglandins, important chemicals that protect the kidneys and gastrointestinal tract. 

While, in some cases, your cat may receive an accidental excess dose of a prescribed NSAID, most times NSAID toxicity occurs from accidental ingestion of a human medication due to their widespread use and the fact that they are commonly found in household medicine cabinets. Cats are curious by nature and will often chase and ingest small NSAID pills if dropped by their owners.

Diagnosis of NSAID toxicity in your cat will require you to provide your vet with a complete history of any potentially harmful substances your cat may have come in contact with. You will also need to thoroughly document your cat’s symptoms, including approximate time of onset and any worsening. While your veterinarian may be able to confirm a diagnosis of NSAID toxicity, given the rapid effects and danger of the condition, any combination of the above symptoms, along with visual evidence from the owner or a high suspicion that the cat ingested an NSAID, is enough to take action.

Treatment of NSAID toxicity in cats will occur in two stages. First, your vet will work to induce vomiting in your cat. This is done by administering various injectable drugs that stimulate your cat’s gag reflex. 

After they have vomited the contents of the stomach, your vet will administer a substance called activated charcoal. Charcoal is highly absorbent and is known to leach and soak up certain substances from your cat’s stomach, including NSAIDs and other poisons. Since activated charcoal is not palatable to your cat, it will need to be administered with the use of a feeding tube inserted into your cat’s throat. This can be a difficult procedure and will require a team of veterinary assistants to immobilize and correctly insert the tube through the mouth and throat, ending in the stomach. Next, the charcoal solution is injected through the tube, directly into the stomach.

Next, your vet will insert an IV needle into your cat’s leg so that they can be administered supportive fluids. This will be important to help dilute the concentration of NSAID in your cat’s system and to replace vital fluids lost during the treatment process. Your cat will need to be hospitalized during all of these procedures due to the high potential for kidney and other organ failure and the need for continuous monitoring and treatment. 

The prognosis for recovery from NSAID toxicity in your cat is guarded to poor. Full recovery is possible if veterinary care was received immediately or shortly after ingestion. Some cats may experience long-term health consequences if toxicity isn’t caught in time or if the dosage was severe. These pets may require treatment with medications that promote kidney or heart health. Unfortunately, many cats that suffer from NSAID toxicity will not survive. Once shock and organ failure has set in, chances of survival lower exponentially. Rapid and thorough treatment provides the best chance of your cat living a long and healthy life.