Carprofen hepatotoxicity in the dog: what to do
8-year-old Labrador Retriever that started carprofen 3 weeks ago for osteoarthritis. It now has anorexia, vomiting and jaundice, with markedly increased ALT and bilirubin. It takes no other drugs.
What is the most appropriate approach?
chevron_right Show answer and explanation
A. Switch immediately to another NSAID, such as meloxicam
With active acute liver disease any NSAID should be avoided, and switching without a washout also increases gastrointestinal risk.
B. Stop carprofen, give supportive care with antioxidants and non-NSAID analgesia; never give it again
Correct. It is an idiosyncratic, non-dose-dependent reaction that usually appears in the first weeks. Most dogs recover if it is withdrawn in time, with fluids, antiemetics, nutrition and SAMe or N-acetylcysteine.
C. Halve the dose and repeat bloods in a month
Since it is not dose-dependent, reducing the dose does not prevent the injury. Continuing the drug can lead to liver failure.
D. Add prednisolone for possible immune-mediated hepatitis and continue carprofen
Combining an NSAID with a corticosteroid is contraindicated because of the risk of gastrointestinal ulceration, and the obvious cause is the drug.
lightbulb Key takeaway
Carprofen hepatotoxicity was reported more often in Labradors, but it can affect any breed. For analgesia, use gabapentin, amantadine, opioids or anti-NGF antibodies. Record the reaction in the history so the drug is not repeated.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.