Ibuprofen is the active ingredient in Advil. Advil is a type of nonsteroidal anti-inflammatory drug that's used to treat pain and inflammation in people. It is popular because it has few side effects and because it is available over the counter without a prescription. But while these benefits are great for us humans, they can be toxic for our furry friends. In dogs, ibuprofen can be very toxic and it should never be given to your dog under any circumstances. Dogs have a much higher risk for adverse reactions from Advil because they metabolize drugs differently than humans do. It's important to seek veterinary attention the moment you believe the dog has ingested this medication so that treatment can begin as soon as possible. Ibuprofen-induced calls to the ASPCA Poison Control Center are one of the most frequent they receive.

Why is Advil (Ibuprofen) toxic to dogs?

Ibuprofen is a broad-spectrum, non-selective anti-inflammatory. Generally speaking, non-steroidal anti-inflammatory drugs (NSAIDs) act by inhibiting two particular enzymes that are responsible for inflammation. The first enzyme however is responsible for producing prostaglandins that are helpful and are protective to the kidneys and gastrointestinal system. The second enzyme produces many of the pro-inflammatory prostaglandins and mediators that result in symptoms of inflammation. Approved NSAIDs for dogs are selective as they will only inhibit the pro-inflammatory prostaglandins and will not inhibit the protective ones. As ibuprofen (Advil) is not selective, when dogs ingest large amounts of an NSAID like ibuprofen, serious health issues can occur.

Why are Advil (Ibuprofen) toxicities common in dogs?

The toxic effects of ibuprofen can occur within hours or as long as days. Advil is an incredibly common pain reliever for people and most people have some form in their home. So it's not surprising that accidental ingestions of this medication happen frequently in dogs. Also, some formulations will have a sugar-like coating that can attract the curiosity of dogs.

What are the symptoms of Advil (Ibuprofen) toxicity in dogs?

Clinical signs of toxicity can occur as low as 25 mg/kg. For example, the toxic dose for a 15kg dog would be 375mg. Massive doses at or around 400 mg/kg can cause seizures and coma.

Some of the most common dangers and toxicities associated with ibuprofen ingestion in dogs include:

  • Gastrointestinal ulceration (stomach ulcers)
  • Kidney damage and kidney failure (renal failure)
  • Liver (hepatic) dysfunction
  • Central Nervous System (CNS) impairment

Gastrointestinal symptoms of toxicity: Expect mild gastrointestinal upset within the first 2-6 hours post-ingestion. You may notice vomiting and a decreased appetite. Significant gastrointestinal hemorrhage and ulceration where you will start seeing blood in the vomit and dark, black tarry stools (melena) occur 12 hours to 4 days after ingestion. Also, be aware of any signs of frank blood in the stool.

Renal (kidney) symptoms of toxicity: If the toxic dose ingested is high, you may notice symptoms related to renal impairment. They are usually detectable 12-24 hours after ingestion and you will notice increased thirst and urination, blood in the urine and general lethargy and malaise.

Liver (hepatic) symptoms of toxicity: Symptoms of liver involvement may occur at any time following exposure and you will see vomiting, anorexia and jaundice (yellowing of the mucous membranes and skin).

Central Nervous System symptoms of toxicity: Neurological symptoms may be noticed after massive ingestion of ibuprofen. Affected dogs will show symptoms of disorientation, seizures and/or coma.

How are Advil (Ibuprofen) toxicities treated in dogs?

As the severity of toxicity is usually related to the amounts ingested, it is first important to deduce approximately how much (in mg) ibuprofen your dog may have consumed. If ingestion has occurred within approximately 30 mins, your veterinarian will recommend inducing vomiting. Your veterinarian will have the necessary drugs to perform this safely. In the unlikely event where you do not have access to a veterinarian, you can give hydrogen peroxide by mouth (2 mL/kg, max dose of 45 mls). Feeding a few pieces of bread before administration of hydrogen peroxide may aid in more complete emptying of the stomach. Hydrogen peroxide should be given only when absolutely necessary as there are risks of irritating the esophagus, stomach and causing an air embolism.

Your veterinarian will also recommend hospital care with intravenous fluids to help provide supportive care. Activated charcoal will also be given to act as an absorbent and prevent the drug from being absorbed through the intestines.

The prognosis is determined by the degree of disease severity, the quantity consumed, and whether or not treatment is available. Occasionally, the prognosis for dogs who experience ibuprofen toxicity can be quite unfavourable. Those who are not able to treat their dog as early or aggressively may result in a poor outcome. Those with symptoms of ibuprofen toxicity must receive appropriate treatment quickly so they can recover fully and get back to feeling healthy again. Your veterinarian will recommend frequent blood tests of your dog's kidneys every few days so that they can determine if any permanent damage has been done.

Advil (Ibuprofen) toxicity in dogs is very common and is one of the most common calls received by ASPCA Poison Control. Prognosis is determined based on many factors such as amount ingestion, symptoms and how quickly therapy was implemented. Accidental ingestion of toxic amounts of interactions with other drugs should always be reported to your veterinarian as soon as possible for appropriate treatment options. If you suspect that your dog ingested Advil (Ibuprofen) and need a veterinarian in Kitchener, please contact us ASAP for advice!