Gastric or duodenal perforation and secondary septic peritonitis following therapeutic nonsteroidal anti-inflammatory drug administration

J Vet Emerg Crit Care (San Antonio). 2022 Nov;32(6):764-768. doi: 10.1111/vec.13217. Epub 2022 Jun 16.

Abstract

Objective: To report which nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with gastric or duodenal perforation (GDP) in dogs presented to a university teaching hospital and to report the frequency of prescription of NSAIDs by the corresponding referring veterinary community during the same time period.

Design: Retrospective cohort study of dogs from January 2007 to March 2020.

Setting: Single university teaching hospital.

Animals: A total of 30 dogs met inclusion criteria.

Measurements and main results: Four dogs were administered more than 1 NSAID within 7 days of GDP, 3 dogs received a combination of an NSAID and a corticosteroid, and 1 dog received 2 NSAIDs and a corticosteroid. Four dogs received an overdose of an NSAID. One dog received an overdose of 1 NSAID and received an additional NSAID at the labeled dose within 7 days of GDP. Eighteen dogs received only 1 NSAID at the labeled dose. In these 18 dogs, meloxicam was administered in 44.4% (8/18), firocoxib in 27.8% (5/18), deracoxib in 16.7% (3/18), and piroxicam in 11.1% (2/18). One hundred and sixty surveys on NSAID prescribing practice were returned. Carprofen was the most commonly prescribed NSAID (70.6%), followed by meloxicam (10.6%), deracoxib (8.4%), firocoxib (7.8%), aspirin (1.5%), and other (0.9%).

Conclusions: NSAID administration, even at labeled doses, appears to be a precipitating factor for GDP. Despite carprofen being the most frequently prescribed NSAID over the study period, no case of GDP received it as a single therapeutic agent. Further prospective evaluation is needed to verify these findings.

Keywords: anti-inflammatory drugs; gastroenterology; gastrointestinal; perforation; pharmacology; septic peritonitis.

MeSH terms

  • Adrenal Cortex Hormones
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Dog Diseases* / chemically induced
  • Dog Diseases* / drug therapy
  • Dogs
  • Meloxicam / adverse effects
  • Peritonitis* / drug therapy
  • Peritonitis* / veterinary
  • Retrospective Studies

Substances

  • Meloxicam
  • deracoxib
  • firocoxib
  • Anti-Inflammatory Agents, Non-Steroidal
  • Adrenal Cortex Hormones