Effect of topical administration of 0.1% diclofenac sodium ophthalmic solution at four frequencies on intraocular pressure in healthy Beagles

Retrospective evaluation of the incidence of gastrointestinal bleeding in dogs receiving ophthalmic nonsteroidal anti-inflammatory drugs

OBJECTIVES

To report the incidence of gastrointestinal (GI) bleeding and associated risk factors in a population of dogs receiving ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs).

ANIMAL STUDIED

Medical records of dogs prescribed ophthalmic NSAIDs (cases), dogs receiving systemic NSAIDs alone and dogs receiving systemic prednisone alone (controls).

PROCEDURES

Data were collected retrospectively from the medical records of 204 dogs prescribed ophthalmic NSAIDs (diclofenac, ketorolac, or flurbiprofen), which were subdivided based on if they received any concurrent systemic NSAIDs or glucocorticoids, 136 dogs receiving a systemic NSAID (carprofen or meloxicam) alone, and 151 dogs receiving a systemic glucocorticoid (prednisone) alone at a referral hospital from 2015 to 2019.

RESULTS

Gastrointestinal bleeds developed in 8/79 (10.1%) of topical NSAID-only cases, 10/136 (7.4%) of systemic NSAID controls, and 14/151 (9.3%) of systemic glucocorticoid controls, with no significant difference between the three groups (p = .6103). There were no significant differences in GI bleed rates between cases treated with ketorolac, diclofenac, or flurbiprofen (p = .160), although severe GI bleeding was only seen in ketorolac-treated dogs. Presence of a known concurrent risk factor for GI bleeding was significantly associated with the development of GI bleed in dogs on ophthalmic NSAIDs (p = .032).

CONCLUSIONS

Dogs treated with ophthalmic NSAIDs developed GI bleeding at a frequency comparable to dogs receiving systemic NSAIDs or systemic glucocorticoids alone, suggesting that dogs receiving ophthalmic NSAIDs may be at increased risk of GI bleeding.

The association of topical flurbiprofen with the incidence of postoperative glaucoma after phacoemulsification in dogs

OBJECTIVE

To investigate the relationship between topical administration of flurbiprofen plus corticosteroids versus corticosteroids alone following phacoemulsification and the development of postoperative glaucoma in dogs.

ANIMAL STUDIED

Thirty-eight/eighty-three (45.8%) eyes were prescribed topical flurbiprofen plus corticosteroids immediately postop while 45/83 (54.2%) eyes received topical corticosteroids alone.

PROCEDURES

Logistic regression models were performed to analyze the relationship between topical flurbiprofen and development of glaucoma and to predict potential risk factors for postoperative glaucoma occurrence.

RESULTS

Eighty-three eyes (65 dogs) were included. The mean age at surgery was 8.2 years, with even gender distribution. Increasing age at the time of surgery significantly increased the probability of postoperative glaucoma occurrence (odds ratio [OR] = 1.344, 95% confidence interval [CI] 1.093-1.652; p = 0.005). Glaucoma occurred in 17/83 (20.5%) eyes; of these, 15/38 (39.5%) and 2/45 (4.4%) eyes were prescribed topical flurbiprofen plus corticosteroids and topical corticosteroids alone, respectively. Immediate postoperative use of topical flurbiprofen was significantly associated with an increased probability of postoperative glaucoma occurrence (OR = 19.183 [95% CI 3.367-109.286], p = 0.001).

CONCLUSIONS

Immediate postoperative use of topical flurbiprofen was a potential predisposing risk factor for the development of glaucoma following phacoemulsification. Restriction of postoperative use of topical flurbiprofen might decrease the possibility of postoperative glaucoma development in dogs.