NU06 - Quantitative Assessment of Plasma Carprofen Removal and Clinical Efficacy of Therapeutic Plasma Exchange in Dogs

Abstract:

Background: Accidental carprofen ingestion in dogs may result in severe clinical signs. Therapeutic plasma exchange (TPE) has been used to reduce plasma drug concentrations; however, data remain limited regarding the efficacy of plasma carprofen removal and associated clinical outcomes following TPE.

Objectives: Prospective observational study. To describe the efficacy of carprofen removal by TPE and clinical outcomes in dogs with accidental carprofen ingestion.
Animals: Dogs presented for accidental carprofen ingestion and treated with TPE at a university teaching hospital.

Methods: Signalment, ingested dose, clinical signs, and survival were recorded. Therapeutic plasma exchange was performed using a Spectra Optia apheresis system. Plasma carprofen concentrations were measured before and after TPE using liquid chromatography–mass spectrometry.

Results: Thirteen dogs were included. Median ingested carprofen dose was 128 mg/kg (interquartile range 59 – 215). Median plasma volume exchanged was 1.8 times plasma volume (1.5 – 1.95), and median treatment duration was 148 (112 – 176) minutes. Median reduction of plasma carprofen concentration was 72 (53.9 – 97.3) %. Five dogs exhibited clinical signs before TPE, and four dogs exhibited clinical signs after TPE, including vomiting and diarrhea; three of these dogs had clinical signs present before TPE. Seven dogs experienced TPE-related complications, most commonly mild transfusion reactions (three dogs) and hypocalcemia (two dogs); all complications responded to supportive care. All dogs survived to discharge.

Conclusions and Clinical Importance: TPE was associated with substantial removal of plasma carprofen with excellent short-term prognosis, supporting TPE as a treatment option for dogs with carprofen ingestion.