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CONTRIBUTOR(S): Hayleigh Green, Louise O'Leary,

Medication: Ketorolac

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Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that veterinarians use to manage pain and inflammation in dogs. It works similarly to other NSAIDs by reducing inflammation and blocking pain signals in your dog's body. Ketorolac can be given as an injection, tablets or eye drops. It is commonly used in eye drops in dogs.

Key points:

  • Ketorolac is used for eye conditions such as uveitis (including uveitis caused by cataracts). It can also be given to treat pain and inflammation after a surgery, such as cataract surgery.
  • It is usually given as eye drops. It can be given as tablets, but this is rare.
  • Ketorolac is not licensed for use in dogs. Your vet can explain what "off-licence use" means.
ℹ️ This information sheet is designed to help answer commonly asked questions and help you give the medication safely and effectively to your pet. It does not contain all the available information for this medication. If you have other questions or need more information, contact your veterinarian or pharmacist. ⚠️Always follow the dosing instructions provided by your veterinarian.

Name, Brand names, Class of medication and Storage

Name

  • Ketorolac/Ketorolac tromethamine.

Brand name

  • Acular (Europe & UK) - 0.5% ketorolac tromethamine eye drops.
  • Acuvail - 0.45% ketorolac tromethamine preservative-free eye drops.
  • Generic eye drop formulations also exist.

Class of drug

  • Non-steroidal anti-inflammatory drug (NSAID).

Storage

  • Store below 25°C/77°F.
  • Keep out of direct sunlight.
  • Shelf life depends on brand of product, check the data sheet. Usually 28-90 days shelf life.

Why has my dog been prescribed Ketorolac?

Your veterinarian might recommend ketorolac when your dog needs an anti-inflammatory or pain relief. It's mostly used in eye drops called Acular. Acular is a human medication and is used off license in pets. Your vet can explain “off-license use” to you. It can help with inflammation of the eye including conjunctivitis and uveitis. It is often used long-term in dogs with cataracts, to prevent or treat uveitis caused by the cataracts. It is also often used in dogs after eye surgery, like cataract surgery.

How is the medication given?

Eye drops should be applied to your pets' eyes as recommended by your veterinarian. If your dog is prescribed more than one type of eye drop, your veterinarian will be able to advise which order the medication should be given in. You should wait at least 5 minutes between eye drops. If your dog is taking the tablet version of ketorolac, it should be given with or after food to prevent their stomach becoming upset.

Are there any side-effects or drug interactions?

While ketorolac is effective for treating inflammation, you need to watch for potential side effects. If your dog is taking ketorolac tablets,if they have had an injection, or if they are receiving eye drops possible side effects include:

  • Vomiting and diarrhea.
  • Dark stool.
  • Inappetence.
  • Drinking or urinating more.
If you notice any of these signs, contact your veterinarian, they may prescribe an alternative drug or dose. If your dog has ketorolac eye drops, additional possible side effects for the eye include:
  • Transient eye irritation after application (usually mild and resolves within 2-5 minutes).
  • Allergic reaction – swelling, redness, skin irritation.
  • Delayed wound healing.
  • Increased pressure inside the eye.
If a pet has a bleeding disorder, caution should be used when prescribing and administering products with ketorolac tromethamine. If your pet has a corneal ulcer, caution should be used when prescribing and administering eye drops with ketorolac tromethamine as they can delay corneal ulcer wound healing. If your pet has glaucoma, caution should be used when prescribing and administering products with ketorolac tromethamine, as they can worsen the glaucoma. Your veterinarian will do a full assessment before using ketorolac. Ketorolac tablets should not be used if your pet:
  • Is taking steroids.
  • Is taking another NSAID medication such as meloxicam.
  • Has had a GI ulcer or kidney disease.
  • Has liver disease.
  • Has a bleeding disorder.
  • Has a known allergy to ketorolac, any other topical NSAIDs, or systemic NSAIDs.
Eye drops are less likely to cause side effects, so may be used with caution if your pet has some of the above contraindications. Your veterinarian will be able to assess if ketorolac is the right medication for your pet. Ketorolac as an eye drop can cause complications if your pet has a corneal ulcer, glaucoma, bleeding in the eye, or if they have an allergic reaction or a skin reaction. The risk of systemic complications such as vomiting, diarrhea, inappetance are less likely with eye drops than an injection or tablets, since a much smaller amount of the drug is absorbed into the body when administered as an eye drops but they can still occur. These are more likely in dogs who are receiving doses of ketorolac eye drops more often, such as when both eyes are treated or are prescribed eye drops more frequently. The side effects are also more likely in dogs who have underlying diseases that may them more at risk or who are receiving other anti-inflammatory medications such as a steroid or NSAID tablet at the same time.

How long will my dog need to receive this medication?

Your veterinarian will determine the appropriate dose based on your dog's weight and specific condition. It's crucial to follow their instructions exactly and never adjust the dose without consulting your veterinarian first. The eye drops are usually applied 1-4 times a day.

How can I ensure safe use of Ketorolac?

Keep all medications, including ketorolac, in a secure place away from both pets and children. Always maintain a record of when you give the medication to prevent other members of the household giving the medication again. Close all medication containers after use and store as recommended. Do not use your mouth to open a medication container, if you are unable to open the product, please return it to your veterinarian for assistance or a new product.

How should I dispose of this medication if I don’t use it all?

Dispose of any unused ketorolac safely by returning it your veterinary clinic or a local pharmacy. Medicines should not be disposed of in your household bin, as they can contaminate landfill.

What if I miss a dose or give an extra dose?

If your pet misses a dose of the tablet, contact your veterinarian. Do not administer a double dose. If your pet misses a dose of the eye drop, apply it as soon as possible and return to your regular dosing schedule.

My dog is unwell, should I still use this treatment?

If your pet is unwell, contact your veterinarian before administering ketorolac. If they have any of the listed side effects, do not administer the medication and speak to your veterinarian. If you suspect your pet is having an allergic reaction or skin reaction to the ketorolac, you can wipe around their eye with a wet piece of cotton wool. You should contact your veterinarian. They may also provide some additional medication to stop the reaction.

What should I do if this medication is accidentally given to another pet or taken by a human?

Never share medications between pets or use medication prescribed for a different condition. If a pet is given the incorrect medication, please contact your veterinarian or local pet poison line. Do not try to make your pet sick at home. If you or another person in your household has used your pet’s medication, contact your doctor, local health professional or accident and emergency department. Take the medicine you have taken with you so that the treating physician can advise you.

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