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Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) and cyclo-oxygenase inhibitor. It is a potent analgesic, antipyretic and anti-inflammatory. Ketoprofen is most commonly prescribed for musculoskeletal pain from soft tissue injury, osteoarthritis or other bone and joint problems. It may be used to reduce or control fevers due to viral or bacterial infections.
NSAID's work by inhibiting the body's production of prostaglandins, thromboxane and other inflammatory mediators. Some of these actions are dose dependent. Ketoprofen may be given by injection or orally. Following oral administration, pain relief and fever reduction usually start within one to two hours.
Ketoprofen is used in dogs and cats for the short-term management of post surgical pain. On occasion it may be used for the longer-term management of chronic pain particularly due to osteoarthritis. About 20% of adult dogs are affected with osteoarthritis, which makes management of musculoskeletal pain a major component of companion animal practice. There is a very narrow margin of safety for all NSAIDs in the dog and there are other NSAIDs that are more commonly used (Etodolac, and Rimadyl). GI protectant drugs such as Misprostal, Cimetidine, Omeprazole, Ranitidine, or Sucralfate are frequently included as a part of treatment with any NSAID.
Ketoprofen is commonly used for the management of musculoskeletal pain due to soft tissue injury, synovitis, and osteoarthritis in horses. It is also used as an antipyretic. Ketoprofen may also be used in the management of colic for protection from bacterial toxins (endotoxemia), however, flunixin meglumine is more commonly used for this purpose.
Injectable ketoprofen is only labeled for short-term use. The package insert recommends a maximum of 5 days. Although ketoprofen is labeled for intra-venous use, it has been used in the muscle with occasional injection site reactions.
• The most common side effects include ulceration of the GI tract and a drop in the red blood cell count due to GI bleeding.
• Rare side effects include kidney damage, bleeding disorders, and protein loss.
• Injection site reactions can occur if blood or the drug leaks back at the injection site.
• Ketoprofen is less likely to cause side effects in the horse than either flunixin or phenylbutazone.
• NSAIDS should be avoided or very carefully monitored in animals with liver disease, kidney disease, or GI problems.
• Studies in laboratory animal species showed no harmful effects in pregnant animals when used at normal doses. These studies have not been repeated in dogs, cats or horses, and the manufacturer cautions against ketoprofen's use in breeding animals. Ketoprofen is found in canine milk. No adverse effects on sperm production were found in male rats. Ketoprofen should be used in breeding animals with caution, when the potential benefits outweigh the potential risks.
• Ketoprofen may be used in foals, but it should be used with particular caution to avoid GI ulceration and maintain kidney function. Premature foals, septicemic foals, foals with questionable kidney or liver function and foals with diarrhea require careful monitoring. Drugs to protect the GI tract such as omeprazole, cimetidine, and sucralfate are frequently used with NSAIDs particularly with foals.
• Pony breeds may be more susceptible to side effects from NSAIDs than horses. When NSAIDs are used in ponies, they should be used with caution and at the lowest effective dose.
• When ketoprofen is used in older horses it should be used carefully and at the lowest effective dose.
• Some veterinarians and many horse owners, particularly those involved in showing, use more than one NSAID in combination, for example, ketoprofen and phenylbutazone given together. Although there is little experimental evidence to support this practice, the theory is that different NSAIDs may act differently on different body systems. Particular care needs to be taken in this situation to avoid additive toxicity.
• Avoid combining with other anti-inflammatory drugs that tend to cause GI ulcers, such as corticosteroids and other NSAIDs.
• Avoid combining with anticoagulant drugs, particularly coumarin derivatives such as warfarin.
• Do not use in animals known to be allergic to aspirin.
Overdoses of ketoprofen can cause GI ulcers, protein loss, and kidney and liver damage. Early signs of toxicity include loss of appetite, and depression.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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