Peer-reviewed veterinary case report
Gastrointestinal side effects in dogs from eye drops ketorolac
By Van Vertloo, Laura R et al.·Published in Journal of the American Veterinary Medical Association·2024·College of Veterinary Medicine·View original on PubMed →
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Original publication title: Systemic absorption and gastrointestinal adverse effects from topical ketorolac and diclofenac ophthalmic solutions in healthy dogs.
- Species:
- dog
Plain-English summary
A group of healthy Beagles developed gastrointestinal (GI) ulcers after receiving eye drops containing ketorolac or diclofenac for 28 days. All dogs treated with ketorolac showed signs of GI erosion, while only one dog treated with diclofenac had similar issues. The study found that higher levels of ketorolac in the blood were linked to more severe GI damage. Although vomiting and decreased appetite were noted, these symptoms were rare and not significantly different between the two treatments. Pet owners should be aware of the potential for GI problems when using these eye drops and consult their vet if they notice any concerning symptoms.
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Abstract
OBJECTIVE: To investigate systemic absorption and gastrointestinal (GI) adverse effects of topical ketorolac 0.5% and diclofenac 0.1% ophthalmic solutions. ANIMALS: 11 healthy purpose-bred Beagles. METHODS: Dogs were randomly assigned to receive either ketorolac (n = 6) or diclofenac (5), 1 drop in both eyes 4 times daily for 28 days. Upper GI endoscopy was performed on days 0 and 29 with mucosal lesion scores (0 to 7) assigned to each region evaluated. Plasma samples were collected on days 14, 21, and 28 for measurement of diclofenac and ketorolac using high-performance liquid chromatography-mass spectrometry. RESULTS: GI erosions and/or ulcers developed in all ketorolac-treated dogs and 1 of 5 diclofenac-treated dogs. Post-treatment mucosal lesion score for the antrum was higher in the ketorolac group than in the diclofenac group (P = .006) but not significantly different for any other region. Post-treatment antral mucosal lesion scores were significantly related to plasma ketorolac concentrations (P < .001). Ketorolac and diclofenac were detected in the plasma at all time points (median ketorolac day 14, 191 ng/mL; day 21, 173.5 ng/mL; and day 28, 179.5 ng/mL; and median diclofenac day 14, 21.1 ng/mL; day 21, 20.6 ng/mL; day 28, 27.5 ng/mL). Vomiting and decreased appetite events were observed uncommonly and were not significantly different between treatment groups. CLINICAL RELEVANCE: GI ulceration and erosion developed after ophthalmic administration of ketorolac and diclofenac, with higher plasma concentrations and more severe GI lesions associated with ketorolac. Clients should be alerted to this potential risk with ophthalmic use and informed to watch for systemic clinical signs that would warrant veterinary reevaluation.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38579753/