The U.S. Food and Drug Administration alerted pet owners Friday to the dangers of flurbiprofen, a nonsteroidal anti-inflammatory drug (NSAID) for humans that has been blamed for sickening or killing several cats. Flurbiprofen is used in some topical medications to treat muscle and joint pain in people, and it occasionally is prescribed for pets as an ophthalmic solution to treat inflammatory eye conditions. In the two cases cited by FDA, the cream or lotion containing flurbiprofen was not applied to the cats but instead was used on the owners’ neck or feet. How the cats were exposed to the drug was not known. The products also contained the muscle relaxer cyclobenzaprine and active ingredients such as baclofen, gabapentin, lidocaine or prilocaine. Pet Poison Helpline, a Bloomington, Minn., organization that advises pet owners and veterinarians about poisoning issues and treatments, called flurbiprofen a very potent NSAID that is not recommended for oral use in dogs or cats because of their extreme sensitivity. “Pet Poison Helpline receives thousands of calls each year about pets accidentally exposed to human NSAIDs, especially over-the-counter products such as ibuprofen or naproxen,” said Ahna Brutlag, DVM, MS, Dipl. ABT, Dipl. ABVT. Dr. Brutlag, Pet Poison Helpline’s associate director of veterinary services and a University of Minnesota adjunct assistant professor, said most NSAID exposures occur when a dog or cat chews a bottle or tube of product or ingests a pill that dropped on the floor. “Occasionally, well-intentioned but misinformed pet owners will give their pets NSAIDs meant for people,” she said. FDA specified two cases in its advisory about flurbiprofen: Two cats in one household that suffered kidney failure but recovered with veterinary care. Two cats in a second household that were reluctant to eat and displayed lethargy, vomiting, anemia and black, bloody stools. The cats saw a veterinarian but died. A third cat died after the owner stopped using the medication. Necropsies found evidence of NSAID toxicity in the three cats’ kidneys and intestines, FDA stated. The agency advised pet owners to: Store all medications away from pets. Safely discard or clean any medication applicator. Avoid leaving residue on clothing, carpeting or furniture. Ask whether the treated area should be covered. Bathe or clean pets exposed to topical medications containing flurbiprofen and consult a veterinarian. Understand that exposure to even a small amount of flurbiprofen may be life-threatening. Report any adverse events to the FDA at http://1.usa.gov/1Iy1UN1. Pet Poison Helpline has handled 22 flurbiprofen cases involving 24 patients, Brutlag said. “Most of our calls are due to dogs ingesting flurbiprofen tablets or ophthalmic solutions but, over the past three years, we have started to receive more calls about pets exposed to topical flurbiprofen-containing creams as were described in FDA’s warning,” she said. “Some of our most notable cases include a dog that suffered poisoning after a pharmacy dispensed flurbiprofen tablets instead of the canine NSAID carprofen … that the veterinarian had prescribed,” Brutlag said. “The dog developed bleeding in the gastrointestinal tract after the third day of dosing. “The most serious and life-threatening cases we’ve been consulted on have involved compounded flurbiprofen topical creams that also contain muscle relaxants and other pain relievers. In these cases, dogs have developed bleeding GI ulcers, kidney damage and severe neurological signs resulting in coma and the need for mechanical ventilation. “To date, we are not aware of any Pet Poison Helpline flurbiprofen cases that have resulted in death but have had many pets hospitalized, some in critical condition.”
