Ketorolac
Ketorolac is a nonsteroidal anti-inflammatory drug with prominent analgesic activity. Veterinary systemic use is uncommon and mainly extra-label, with limited clinical experience in short-term postoperative pain management. Ophthalmic preparations have a separate local anti-inflammatory application. The clinical evidence base in veterinary species is smaller than that of commonly used veterinary NSAIDs.
Group
Nonsteroidal anti-inflammatory drug
Mechanism of Action
Ketorolac inhibits cyclooxygenase and reduces production of prostaglandins involved in inflammation and pain sensitization. Systemically, this can reduce inflammatory pain, while local ocular inhibition reduces prostaglandin-mediated inflammatory responses. It is a nonselective cyclooxygenase inhibitor. Its analgesic effect follows suppression of prostanoid signaling rather than direct opioid-receptor agonism.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Short-term postoperative pain | 0.5 mg/kg | PO, IM, IV | Every 8–12 h | Maximum two doses; do not shorten the interval below 8 hours. |
| Short-term postoperative pain | 0.3–0.5 mg/kg | IV, IM | Every 8–12 h | One or two doses only; gastrointestinal and renal toxicity can be considerable. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Short-term postoperative pain | 0.25 mg/kg | IM | Every 8–12 h | One or two doses only; distinct limited-dose reference from the earlier no-established-safe-dose guidance. |
Goats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Analgesia | 0.3–0.7 mg/kg | IV, IM, SC, PO | Every 8 h | Limited veterinary regimen; monitor renal and gastrointestinal tolerance. |
Mice
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Analgesia | 0.7–10 mg/kg | PO | Every 24 h |
Rats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Analgesia | 3–5 mg/kg | PO | Every 12–24 h | |
| Analgesia | 1 mg/kg | IM | Every 12–24 h |
Indications
- Extra-label short-term management of selected postoperative pain in dogs, with limited veterinary safety and efficacy data.
- Selected topical treatment of ocular inflammation with an appropriate ophthalmic formulation.
- Specialist analgesia for selected exotic or zoo patients, based on limited species-specific experience.
Contraindications
- Gastrointestinal ulceration or bleeding
- Dehydration or impaired renal perfusion
- More than two doses
- Feline systemic safety is poorly established; a limited-dose regimen is reported separately
Interactions
- Other NSAIDs and corticosteroids increase gastrointestinal injury.
- Diuretics and ACE inhibitors may have reduced effect and greater renal risk.
Adverse effects
- Vomiting, diarrhoea, gastrointestinal ulceration and bleeding
- Renal injury
Toxicity
Overdose may cause gastrointestinal haemorrhage and acute kidney injury. Stop exposure and assess hydration, renal function and gastrointestinal injury.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Ketorolac 10 mg tablet | Tablet | 10 mg / tablet | PO |
| Ketorolac 15 mg/mL injection Source describes injection formulated in 10% alcohol. | Injection | 15 mg / mL | IV, IM |
| Ketorolac 30 mg/mL injection Source describes injection formulated in 10% alcohol. | Injection | 30 mg / mL | IV, IM |
Monitoring and Administration
Monitor appetite, vomiting, stool colour, hydration and renal function; stop treatment if gastrointestinal bleeding or renal injury develops.
Historical canine alternatives are 0.5 mg/kg IV three times daily or 0.3 mg/kg PO twice daily with misoprostol. They conflict with the more restrictive two-dose guidance and are not a basis for routine prolonged treatment. Ophthalmic ketorolac 0.5% is described as one drop four times at 20-minute intervals preoperatively, then one drop four times daily for postoperative inflammation or uveitis; drop volume is device-dependent.