Carbon hemoperfusion markedly reduces serum meloxicam concentrations in dogs with meloxicam toxicosis

To investigate the efficacy of synthetically derived activated carbon hemoperfusion (cHP) by measuring serum meloxicam concentration in dogs with meloxicam toxicosis.

5 dogs with meloxicam overdose that underwent cHP at 3 teaching hospitals between January 2023 and March 2026 were identified. Dogs that had serum meloxicam concentrations measured were included. For case 1, in-series cHP and hemodialysis were performed. Based on case 1 data, standalone cHP was used for cases 2 to 5. Serum meloxicam concentration was measured via ultra-performance liquid chromatography-tandem mass spectrometry.

Median ingested meloxicam dose was 16.7 mg/kg (range, 1.4 to 168.8). Median blood volumes processed were 2 L/kg (range, 1.36 to 2.56) over 2.2 hours (range, 1.5 to 2.6). During cHP, meloxicam half-life was 0.4 to 1 hour versus 5.1 to 16.6 hours post-cHP, and median clearance was 6.52 mL/kg/min (range, 3.81 to 10.42) versus 0.49 mL/kg/min post-cHP (range, 0.22 to 0.72). Median extracorporeal elimination constant from 5 dogs was 1.24 (range, 0.68 to 1.95), 13.8 times faster than the intrinsic elimination constant of 0.09 from 3 dogs (range, 0.04 to 0.14). After cHP, a rebound phenomenon (47.2% increase, approximately 5 hours later) was noted in 3 dogs. All dogs were discharged in 72 hours, with 1 dog developing International Renal Interest Society Grade II acute kidney injury during hospitalization that recovered with supportive care.

Carbon hemoperfusion markedly reduced serum meloxicam concentrations in dogs with meloxicam toxicosis and substantially shortened meloxicam half-life.

Dogs that underwent timely cHP had excellent short-term outcomes, and cHP should be considered in dogs with high-dose meloxicam ingestion.