Page 2810 - Cote clinical veterinary advisor dogs and cats 4th

Diazepam (Valium, Diastat) Diltiazem hydrochloride (Cardizem, Dilacor XR) 1473

Generic Name (Brand Administration/
Name, Synonyms) Canine Dosages Feline Dosages Adverse Effects/Warnings Availability
VetBooks.ir Diazepam (Valium, Diastat) Cluster seizures or status Due to fatal idiosyncratic Adverse effects include sedation, Tablets, injection, or rectal gel.
CSS-IV.
ataxia, CNS excitement (dogs),
epilepticus: 0.5-1 mg/kg
hepatic failure in some
increased appetite, hepatic failure
rectally; 0.5 mg/kg intranasally;
cats, many clinicians avoid
0.5-1 mg/kg IV, 0.1-2 mg/kg/h
IV as a CRI use of oral diazepam in (cats). Tolerance to the antiepileptic
effects over time limits usefulness.
cats.
Adjunctive treatment of For anesthesia in Use with caution in hepatic or renal
metronidazole toxicity (CNS): combination with other disease; in aggressive, debilitated, or
0.43 mg/kg IV and then PO q drugs: 0.1-0.3 mg/kg IV geriatric patients; or in patients with
8h for 3 days significant respiratory depression.
Premedication in combination Diazepam injection is physically
with other sedatives: incompatible with many other
0.1-0.3 mg/kg IV injectable drugs.
Diazoxide (Proglycem) Insulinoma: Initially 5 mg/kg PO q Malignancy-associated Adverse effects are more likely in dogs Oral suspension
12h. May gradually increase to hypoglycemia: Initially with hepatic dysfunction and include
50 mg/kg PO q 12h. 5 mg/kg PO q 12h. May GI upset, tachycardia, hematologic
gradually increase to abnormalities, DM, cataracts,
40 mg/kg PO q 12h. and sodium and water retention.
Contraindicated in hypoglycemia
secondary to insulin overdosage. Use
with extreme caution in CHF or renal
disease.
Diethylstilbestrol (DES) Sphincter mechanism Use is not described in cats. Adverse effects include blood Available only through
incompetence: 0.1-1 mg/DOG dyscrasias, GI effects, and pyometra compounding
(0.02 mg/kg, to a maximum (nonspayed females). DES was
of 1 mg) PO q 24h for 3-5 removed from the human market due
days as an induction dose to carcinogenicity in the offspring
and then decreased to lowest of exposed pregnant women.
dose that will maintain urinary Other drugs usually preferred to
continence, often once or twice DES for urinary incontinence (e.g.,
a week phenylpropanolamine, estriol).
Digoxin (Lanoxin) Atrial fibrillation: Initially, CHF associated with DCM: GI upset is commonly associated Tablets and oral elixir
0.0025-0.005 mg/kg PO q cats <3 kg, 1 4 of a with high blood concentration, and
12h (alternatively in dogs 0.125-mg tablet PO q arrhythmias may occur. Use with
weighing > 20 kg, dose digoxin 48h; cats 3-6 kg, 1 4 of extreme caution in animals with
2
using BSA at 0.22 mg/m ). a 0.125-mg tablet PO q renal disease, complex ventricular
Do not exceed 0.25 mg/DOG 24h; cats >6 kg, 1 4 of arrhythmia, or subaortic stenosis.
(regardless of size) in a 12-hour a 0.125-mg tablet PO q Digoxin is relatively contraindicated
period. Base dose on lean BW. 12-24h in cats with hypertrophic
cardiomyopathy. Monitor blood
concentrations. Toxicity more likely
with hypokalemia.
Dihydrotachysterol Hypoparathyroidism: Initially, give Hypoparathyroidism: Hypercalcemia, nephrocalcinosis, Available only through
0.03 mg/kg PO q 24h until Initially, give 0.03 mg/ and hyperphosphatemia can occur. compounding
effect is demonstrated, then kg PO q 24h until effect May only be obtained through
0.02 mg/kg PO q 24h for 2 is demonstrated, then compounding. Use with extreme
days, then 0.01 mg/kg/d PO 0.02 mg/kg PO q 24h for caution in hyperphosphatemia, renal
thereafter 2 days, then 0.01 mg/kg/d dysfunction (when receiving the drug
PO thereafter for nonrenal indications).
Diltiazem hydrochloride Acute SVT: 0.05 mg/kg IV over Arrhythmias of HCM: Oral diltiazem is available in a wide Available in immediate-release
(Cardizem, Dilacor XR) 1-2 minutes; repeat prn to total 0.8-2.5 mg/kg PO q 12h variety of dosage forms with different and sustained-release
dose of 0.75 mg/kg IV to q 8h; 10 mg/kg PO q release profiles. Clinicians should tablets, and injection
Chronic supraventricular 24h, in sustained-release ensure that the correct dosage
tachycardia: Initially, 1 mg/kg form form is dispensed. XR capsules
PO q 8h and titrated upward contain inner tablets that may be
to a maximum of 4 mg/kg PO fractionated for dosing cats and
q 8h small dogs. Contraindicated in severe
Tachycardia of atrial fibrillation: hypotension, sick sinus syndrome,
0.5-1.5 mg/kg PO q 8h of or second- and third-degree AV
immediate-release tablets; block, acute myocardial infarction
or 3-5 mg/kg PO q 12h for (MI), radiographically documented
sustained-release products pulmonary congestion. Use with
caution in geriatric patients or in
those with heart failure (particularly if
also receiving beta-blockers) or with
Drug Compendium
hepatic or renal impairment.

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