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Calicivirus, Feline 141

• Gastric lavage: if large number of tablets, Severe bradycardia/AV block: sustained hypotension is possible, such as
which can form concretions • Atropine 0.02-0.04 mg/kg IV, SQ, or IM; myocardial ischemia or chronic kidney disease.
VetBooks.ir • Fluid rate should be guided by BP moni- • Isoproterenol 0.02-0.4 mcg/kg/min IV (quick PEARLS & CONSIDERATIONS Diseases and Disorders
repeat as needed or
Fluid therapy:
rule of thumb: dilute 1 mg in 500 mL 5%
toring; avoid volume overload (iatrogenic
pulmonary edema)
Treatment of hypotension: dextrose and infuse at 0.5 to 1 mL/min IV Comments
• Many preparations of CCBs are sustained-,
to effect) or
• Intravenous (IV) crystalloid fluids • Temporary cardiac pacing controlled-, extended-, or delayed-release
• Colloids (Hetastarch, VetStarch) for persistent Control seizures (p. 903): medications, which may substantially
hypotension despite IV crystalloid fluids • Diazepam 0.5-1 mg/kg IV or pentobarbital lengthen the onset and duration of signs.
(dosage adjusted based on response): 3-15 mg/kg IV slowly to effect • Bezoar formation is possible with ingestion
○ Dogs: initial 5 mL/kg IV bolus over 15-30 • Supplement potassium if serum potassium of large quantities of sustained/controlled/
minutes, followed by 15 mL/kg/day IV < 3 mEq/L (p. 516) extended/delayed-release preparations,
constant rate infusion (CRI) especially nifedipine.
○ Cats: 10 mL/kg/day IV CRI Drug Interactions • Signs of toxicosis can occur at veterinary
• Calcium chloride or calcium gluconate for • CCBs increase blood levels of propranolol therapeutic doses of CCBs. These medica-
refractory hypotension; monitor continuous and digoxin. tions have a narrow margin of safety.
ECG, and discontinue if bradycardia worsens • Propranolol, ketoconazole, and itraconazole • Noncardiogenic pulmonary edema is possible
(p. 515) reduce clearance, thereby increasing CCB as a toxic effect; fluid overload should be
○ Calcium chloride (10% solution; 27.2 mg levels. avoided.
Ca/mL): 0.1-0.5 mL/kg slow IV bolus or • Cimetidine and phenobarbital will increase
CRI of 0.01 mL/kg/h (5 mg/kg/h), or bioavailability of CCBs. Prevention
○ Calcium gluconate (10% solution; 9.3 mg Owners should keep all medications out of
Ca/mL): 50-150 mg/kg (0.5-1.5 mL/kg) Possible Complications reach of pets.
slow IV over 5 minutes to effect or CRI • Pulmonary edema
of 5 mg/kg/h (0.05 mL/kg/h) • Renal insufficiency due to decreased renal Technician Tips
• Insulin administered with dextrose to perfusion It is important to know whether the CCB
maintain euglycemia may be considered for involved in the intoxication is regular or
refractory hypotension; can improve cardiac Recommended Monitoring extended-release medication.
inotropy and decrease capillary vascular • BP
resistance • ECG Client Education
○ Regular insulin 1 U/kg bolus followed • Serum chemistry panel, especially renal Owners should be made aware of possible
by 0.1-10 U/kg/h IV CRI along with parameters and electrolytes adverse effects when patients are prescribed
7%-20% dextrose IV. Blood glucose and • Respiration (rate, lung sounds, pulse CCBs.
potassium should be monitored frequently. oximetry)
Effect may be seen in 30-45 minutes. • Mentation SUGGESTED READING
• If hypotension persists after crystalloids, Hayes CL, et al: Calcium channel blocker toxicity
Hetastarch, insulin/dextrose and calcium PROGNOSIS & OUTCOME in dogs and cats. Vet Clin North Am Small Anim
supplementation, dopamine 1-20 mcg/kg/ Pract 42:263-277, 2012.
min IV CRI titrated to response may be used, • Prognosis is generally good with prompt AUTHOR: Cristine Hayes, DVM, DABT, DABVT
provided the patient is volume-expanded/ treatment. Refractory hypotension, severe EDITOR: Tina Wismer, DVM, MS, DABT, DABVT
well hydrated. hyperglycemia, and pulmonary edema may
Sequestration of toxin: convey a guarded prognosis.
• Consider using 20% intravenous lipid • After recovery, long-term effects are uncom-
emulsion (ILE) solution (p. 1127). mon. Organ dysfunction secondary to

Calicivirus, Feline Client Education
Sheet

BASIC INFORMATION Epidemiology • Poor husbandry practices (e.g., poor
sanitation)
Definition SPECIES, AGE, SEX • Stress
Widespread, highly contagious, single-stranded • Acute oral/respiratory disease and febrile • Immunosuppression
RNA virus of cats limping syndromes more likely in kittens • Other upper respiratory pathogens
or young cats
Synonyms • VS-FCV more severe in adult cats CONTAGION AND ZOONOSIS
FCV, feline upper respiratory tract disease (FCV is Highly contagious but not zoonotic
a single contributing pathogen to URTD), limping RISK FACTORS
kitten syndrome, febrile limping syndrome, • Crowding GEOGRAPHY AND SEASONALITY
virulent systemic feline calicivirus (VS-FCV) • Multi-cat households, colonies, and shelters Worldwide distribution

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