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Dr. Dan
Dr. Dan, Dog Veterinarian
Category: Dog
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My dog ate three 250mg naproxen and we took him to the vet

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My dog ate three 250mg naproxen and we took him to the vet within 20 minutes of him ingesting them. We took him not to our normal vet but another vet and they are recommending him to stay there for three days of blood test, fluid treatment and everything even though no test has shown signs of any kidney damage. In fact his stats have already improved. My dog looks stressed and tired at the vets and I want to bring him home. He is currently on his 2nd day there. What do you think?
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Dan replied 2 years ago.

Hello! Thank you for your question, I'm Dr. Dan and I'll try to help you. Did the vets induce vomiting and cause him to throw up the naproxen? Were his kidney values elevated at all? Dr. Dan

Customer: replied 2 years ago.

Yes the vet induced vomiting already and also gave him activated charcoal. I asked whether they found the tablets and they didn't give me an exact answer.

His kidney values (I think they said Creatinine is what they are looking at), had dropped. They said he is comfortable ands settled and I am not sure whether they are over treating him or not.

Expert:  Dr. Dan replied 2 years ago.
I think we need to find out if the creatinine was ever out of range. If so then my opinion is he needs to stay on his fluids for the full three days. If he we use symptoms to gauge his progress then that is dangerous, symptoms only occur when the kidney has been excessively damaged. If the medicine was vomited up and there were no kidney enzyme elevations then you could make a serious case that the vet is being over cautious and you could argue for taking him home. However the repercussions of stopping treatment too early can be fatal, if the vet felt it necessary to ask you to spend the money (something we all hate to do) then the vet likely had a very good reason or some indication in the exam, vomitus or values that is encouraging this vet to run the fluids for the full three days. I'd be leaning toward "the vet is right" but if the tablets were thrown up in their entirety and the creatinine never rose then you could argue for taking him home early as long as you understand the risks. I hope this helps, if not please feel free to ask followup questions. Dr. Dan
Customer: replied 2 years ago.

What should the creatinine level be? On Friday night it was 103 (not sure what measurement) and now it has dropped 100. The vets (as it was more than one vet passing the case along since it is a 24 hour vet) has not voiced any concern but only wants him there to be monitored.

What question should I ask? And what is the risk of over-treatment in this case?

Expert:  Dr. Dan replied 2 years ago.
Is your dog currently on IV fluids or just there for observation? Dr. Dan
Customer: replied 2 years ago.

He is on IV fluids.

Expert:  Dr. Dan replied 2 years ago.
Thanks for the information. In a perfectly health dog the creatinine should be 44-88. 100 does suggest the kidneys have been affected. At 100 I do think the vet is justified for monitoring and even more important the continuous fluid support. Even though a dog can range in creatinine from 44-176 a healthy dog should be at 44-88 like I indicated. When the creatinine ranges over 176 then more than 75% of the kidney is not working at 100 then 1/2-2/3 of the kidney is not functioning appropriately. I think the safe play is to run the fluids for the full***** Dan
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