Acute nephrotic-range glomerular proteinuria following ibuprofen intoxication in two cats

Abstract

Case series summary In this report we describe the origin of protein loss and development of acute kidney injury after ibuprofen intoxication in two cats. Two 13-month-old neutered male domestic shorthair siblings were presented with acute kidney injury (AKI) and severe glomerular proteinuria following witnessed ibuprofen intoxication 3 days prior. Both cats presented with severe azotaemia (creatinine >900 µmol/l [>10 mg/dl]) and severe proteinuria (urine protein:creatinine [UPC] >20, normal <0.5). Urine protein electrophoresis upon presentation revealed mainly albumin and primary glomerular protein losses. The proteinuria and azotaemia resolved completely within 5 days of hospital treatment (8 days after ingestion). Urine protein electrophoresis, once the azotaemia and proteinuria resolved (UPC 0.11; normal <0.5), had a similar pattern to the one from admission. Both cats made a full recovery with supportive care. Relevance and novel information This is the first clinical report of AKI with nephrotic-range protein losses following ibuprofen intoxication in cats. We propose that this finding is due to idiosyncratic glomerular injury, as described in humans.