Trazodone (Oleptro®, Desyrel®) for Dogs and Cats

Use of Trazodone in Canines and Felines

  • Trazodone HCl, also known simply as Trazodone and by the brand names of Oleptro®, Desyrel®, is used in dog and cats with behavioral problems or various anxiety related problems including fears and anxiety related to veterinary visits and hospitalization.
  • Trazodone is categorized as a Serotonin 2a antagonist/reuptake inhibitor (SARI). It is an antidepressant that is often used for behavioral disorders. It works by altering chemicals (serotonin) in the brain that may become unbalanced. This drug increases serotonin levels in the brain. Serotonin is a chemical that facilitates transmission of “messages” among brain cells.
  • Behavioral disorders in dogs and cats are common causes for veterinary visits. Behavioral problems are also a frequent reason for euthanasia of pets, especially when unacceptable or dangerous animal behavior is involved. Over the past decade, veterinarians have begun placing increasing emphasis on training and behavior modification, and animal behavior specialists have adopted drugs used in modifying human behavior for animal use. Trazodone is one of these drugs.
  • It is relatively inexpensive making it appealing over some other behavioral modification drugs.
  • Trazodone is used to treat depression, insomnia, alcohol withdrawal, cocaine withdrawal, and migraine prevention, as well as other uses which can make it available for accidental exposure in dogs. For more information about Trazodone Toxicity – go to: What to Do if Your Dog Eats Trazodone® Medication? (ADD ARTICLE AND LINK)
  • Trazodone is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration (FDA) but it is prescribed legally by veterinarians as an extra-label drug.

Brand Names and Other Names of Trazodone

  • This drug is registered for use in humans only.
  • Human formulations: Oleptro, Desyrel®, Desyrel Dividose and various generic equivalents.
  • Veterinary formulations: None.

Uses of Trazodone in Dogs and Cats

  • Trazodone is used for behavior modification of dogs. Trazodone may be used for separation anxiety and other anxiety-related conditions (such as fear of fireworks).  Learn more about – Is Your Dog Suffering From Anxiety?
  • Other uses may include for the treatment of anxiety during hospitalization and for short-term relief of anxiety associated with activity restriction such as cage rest after surgery, especially orthopedic surgery.
  • Studies documenting use of Trazodone in cats was limited, however Trazodone is being frequently used in cats for travel anxiety and trips to the veterinarian for cats who are very fearful and anxious.  Data shows that it is safe and well tolerated for use in cats.

Precautions and Side Effects of Trazodone

  • While generally safe and effective when prescribed by a veterinarian, Trazodone can cause side effects in some animals.
  • Trazodone should not be used in animals with known hypersensitivity or allergy to the drug.
  • Trazodone should be used with caution in dogs and cats with a history of liver, kidney, or heart disease. Trazodone can cause priapism (prolonged erection) in humans and therefore should be used with caution in male breeding dogs.
  • Trazodone may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with Trazodone. Such drugs include drugs classified as diuretics, antibiotics (enrofloxacin, ciprofloxacin, erythromycin, clarithromycin), monoamine oxidase inhibitors (selegiline and amitraz), diazepam, phenylbutazone, digoxin or buspirone. Certain anti-fungal medications (i.e. ketoconazole, fluconazole itraconazole) can change the metabolism of Trazodone and require that a lower dose be used. Additional drugs that have potential interactions include aspirin, cisapride, metoclopramide, nonsteroidal anti-inflammatory drugs (e.g. carprofen, Rimadyl®, Novox®, Deramaxx®, Meloxicam and more), ondancetron, tramadol, and/or fluoxetine (Prozac®).
  • Side effects associated with Trazodone include lethargy, sedation, vomiting, diarrhea, panting, hyperactivity, ataxia, increased anxiety, increased appetite, shaking, restlessness, and/or agitation.
  • Side effects will generally improve with time so may veterinarians recommend waiting a few days to determine response if the side effects are mild.
  • When large quantities of Trazodone are ingested, pets may seizure or even go into a coma state. It is recommended that overdoses should be promptly treated by your veterinarian.

How Trazodone Is Supplied

  • Trazodone is available as both brand name and generic formulations.
  • Common tablets sizes include 50mg, 100 mg, 150 mg, and 300 mg.
  • Trazodone extended-release oral tablets sizes include 150 mg & 300 mg.

Dosing Information for Trazodone in Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • In dogs, there is a range of doses. They include 2.5 mg per pound per day to 15 mg per pound every 24 hours. The average dose is approximately 3.5 mg per pound per day. Lower doses are used when combined with other behavioral modification medications. Most veterinarians prescribe Trazodone at the lower dosage range to minimize side effects and may gradually taper the dose up after 3 to 5 days.
  • Another method to dose dog is by total mg size based on weight. For example, initial dosing for dogs less than 22 pounds is total dose of 25 mg every 8 to 24 hours, dogs 22 to 44 pounds the total dose of 50 mg every 12 to 24 hours, dogs over 44 pounds may be prescribed 100 mg every 12 to 24 hours. After 3 to 5 days of the initial dosing, a higher target dose may be recommended. Target dosing for dogs less than 22 pounds is a total dose of 50 mg every 8 to 24 hours, dogs 22 to 44 pounds the total dose of 100 mg every 8 to 24 hours, dogs 44 to 88 pounds may be prescribed 200 mg every 8 to 24 and dogs over 88 pounds may be prescribed a total dose of 200 – 300 mg every 8 to 24 hours.
  • Trazodone may be given on an empty stomach or with food. If your dog gets nauseated or vomits after dosing, give Trazodone with a small meal or treat.
  • For cats, Trazodone has been infrequently used. The documented doses used in cats is 50-100 mg total dose for short term use.
  • Pets must receive Trazodone for 2 weeks before it can be determined that the medication is ineffective.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed.
  • Dose should be gradually withdrawn or withdrawal symptoms made occur.

Resources & References:

  • Plumb’s Veterinary Handbook by Donald C. Plumb, 9th Edition.
  • Use of oral Trazodone for sedation in cats: a pilot study. J Feline Med Surg. 2015;0(0): Jillian M Orlando1; Beth C Case2; Andrea E Thomson3; Emily Griffith4; Barbara L Sherman5
  • Textbook of Veterinary Internal Medicine, Ettinger & Felman
  • Current Veterinary Therapy XIV, Bonagura and Twedt
  • Current Veterinary Therapy XV, Bonagura and Twedt
  • ASPCA Pet Poison Hotline
  • Pet Poison Helpline

Interesting Related Articles:

Capromorelin Oral Solution (Entyce®) for Dogs and Cats

Overview of Capromorelin (Entyce®) for Canines and Felines

  • Capromorelin Oral Solution, commonly known as Entyce®, is used as an appetite stimulant in dogs and in cats as an extra-label. Capromorelin is can be used in combination with anti-vomiting or acid-reducing drugs.
  • Capromorelin is an orally administered drug belonging belongs to the ghrelin receptor agonist group of drug compounds that finds to receptors and induces the signal in the hypothalamus of the brain to cause appetite stimulation. Capromorelin also binds to the growth hormone secretagogue receptor in the pituitary gland to increase levels of growth hormone. In human studies, this is thought to have therapeutic value in the elderly who have less muscle mass, which can lead to weakness. Human studies have not only found an increased appetite and weight gain, but also improved balance and coordination.
  • Although most drug studies on Capromorelin where short-term studies, additional studies have suggested that it can be used successfully for long-term use. One study demonstrated that capromorelin was well-tolerated in dogs dosed up to 52.4 mg/kg for 12 months. This study also suggested that there is a wide margin of safety as capromorelin was dosed at approximately 17.5X the clinical dose.
  • Capromorelin is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian. It came to the veterinary market by Aratana Therapeutics in 2017 and has slowly gained acceptance in the veterinary market.
  • Capromorelin should be used in combination with other measures to encourage appetite. Special foods and nutrition requirements should be part of the treatment plan that you discuss with your veterinarian.

Brand Names and Other Names for Capromorelin

  • This drug FDA approved for use in dogs. Although only approved for use in dogs, it has been used successfully off-label for cats to increase appetite.
  • Human formulations: None
  • Veterinary formulations: ENTYCE® by Aratana Therapeutics

Uses of Capromorelin for Dogs and Cats

  • Capromorelin is used as an appetite stimulant in dogs and cats. It is commonly used for dogs with inappetence secondary to cancer (neoplasia), endocrine disease (such as diabetes), heart disease, kidney disease, liver disease, respiratory disease, pain, fever, nausea, and more. Read more about Anorexia in Dogs and Anorexia in Cats.
  • Capromorelin also had benefits of improving strength and coordination.

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, Capromorelin can cause side effects in some animals.
  • Capromorelin should not be used in animals with known hypersensitivity or allergy to the drug.
  • While giving Capromorelin to stimulate your dog’s appetite, it is important that your veterinarian also help you diagnose the underlying condition causing the inappetence. Your veterinarian may want to perform blood work, urinalysis, radiographs (X-rays), and/or ultrasound to help determine the underlying cause of anorexia.
  • Capromorelin may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with Capromorelin. Antifungal drugs such as itraconazole, fluconazole and ketoconazole should be used with caution in dogs taking Lower doses may be used in dogs with liver disease.
  • The most common side effect of Capromorelin in dogs and cats is diarrhea, vomiting, elevated blood urea nitrogen, and excessive drinking (increased thirst). Other side effects include hypersalivation (drooling), nausea, flatulence (gas), abdominal discomfort, lethargy and/or depression.
  • The safety of Capromorelin use in pets pregnant or lactating has not been established.
  • Capromorelin is commonly used with other antiemetic (anti-vomiting) and anti-nausea drugs.

How Capromorelin is Supplied

  • Capromorelin is available as oral solution concentrated at 30 mg/ml.
  • Available in 10 mL, 15mL and 30 mL bottle sizes.

Dosing Information of Capromorelin for Dogs and Cats

  • Medication should never be administered without first consulting with your veterinarian.
  • For use in dogs as an appetite stimulant, the most common dosing is 3 mg/kg (1.4 mg/pound) orally every 24 hours. This works out to be 0.1 mL/kg body weight.
  • The dose being used in cats is 2 mg/kg (0.9 mg/pound).
  • To administer Capromorelin Oral Solution (Entyce®), shake to bottle then withdraw the recommended amount in the provided syringe. The syringe can be reused and should be washed between treatments.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.
  • Can be stored at room temperature. Keep away from light and moisture.

References:

  • CAPROMORELIN, AN ORALLY ACTIVE GHRELIN AGONIST, CAUSED SUSTAINED INCREASES IN IGF-1, INCREASED FOOD INTAKE AND BODY WEIGHT IN CATS. Conference Proceedings from the American College of Veterinary Internal Medicine (ACVIM) 2015. Bill Zollers, Julie Allen, Chelsey Kennedy, Linda Rhodes.
  • A Prospective, Randomized, Masked, Placebo-Controlled Clinical Study of Capromorelin in Dogs with Reduced Appetite. J Vet Intern Med. November 2016;30(6):1851-1857.B Zollers 1, J A Wofford 1, E Heinen 1, M Huebner 2, L Rhodes 1
  • Evaluation of the safety of daily administration of capromorelin in cats.
  • Language: English, J Vet Pharmacol Ther. October 2017;0(0):.J A Wofford 1, B Zollers 1, L Rhodes 1, M Bell 2, E Heinen 1
  • Long-term effects of ghrelin and ghrelin receptor agonists on energy balance in rats. Am J Physiol Endocrinol Metab. July 2008;295(1):E78-84. Sabine Strassburg1, Stefan D Anker, Tamara R Castañeda, Lukas Burget, Diego Perez-Tilve, Paul T Pfluger, Ruben Nogueiras, Heather Halem, Jesse Z Dong, Michael D Culler, Rakesh Datta, Matthias H Tschöp.
  • Effects by daily long term provision of ghrelin to unselected weight-losing cancer patients: a randomized double-blind study. April 2010;116(8):2044-52. Kent Lundholm 1, Lena Gunnebo, Ulla Körner, Britt-Marie Iresjö, Cecilia Engström, Anders Hyltander, Ulrika Smedh, Ingvar Bosaeus.

Pimobendan (Vetmedin®) for Dogs and Cats

Overview of Pimobendan for Canines and Felines

  • Pimobendan, commonly known by the brand name Vetmedin®, is a phosphodiesterase III inhibitor with calcium sensitizing properties. It has been shown to improve survival times and quality of life (lowered syncope, dyspnea, exercise intolerance, and ascites) in dogs and cats suffering from congestive heart failure(CHF).  Pimobendan is an oral medication commonly used in combination with other drugs such as an ACE-inhibitor and diuretic (furosemide).
  • Pimobendan has also resulted in significant improvement in signs of heart failure when added to standard therapy for dogs with dilated cardiomyopathy and has contributed to improved survival in some dogs (Doberman Pinschers).
  • Phosphodiesterase inhibitors block the inactivation of cyclic AMP increasing sympathetic tone and thus cardiac output.
  • Following oral administration of pimobendan to a pet with CHF, the heart rate decreases and the contractility of the heart increases.
  • The oral bioavailability of pimobendan in dogs is 60–63%. It is highly protein bound in plasma (93%) and has a plasma elimination half-life of approximately 30 minutes. The half-life of its principal active metabolite is approximately 2 hours. Virtually the entire administered dose is eliminated in feces.
  • In humans with CHF, pimobendan has been shown to be associated with a slightly increased risk of death (1.8 x) vs. untreated controls. The balance between benefit and risk of treatment with pimobendan remains to be established in humans and in dogs.
  • Pimobendan is approved in Europe and Canada to treat dogs with heart failure due to dilated cardiomyopathy or valvular insufficiency (mitral and/or tricuspid regurgitation).
  • Pimobendan is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug has recently been approved for use in animals by the Food and Drug Administration.

Brand Names and Other Names of Pimobendan

  • Veterinary formulations: Vetmedin® (Boehringer Ingelheim)
  • Pimobendan may also be registered under the trade names UDCG-115 or Acardi®.
  • Human formulations: None

 

Uses of Pimobendan for Dogs and Cats

  • Treatment of heart failure due to dilated cardiomyopathy or valvular insufficiency (chronic mitral valve insufficiency).

 

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, pimobendan can cause side effects in some animals.
  • Pimobendan should not be used in animals with known hypersensitivity or allergyto the drug.
  • Also, it is contraindicated in hypertrophic cardiomyopathiesand clinical conditions where an augmentation of cardiac output is not possible for functional or anatomical reasons (e.g. aortic stenosis).
  • Doses of pimobendan over 0.8 mg/kg/day over a period of 2 to 4 weeks may be associated with exaggerated myocardial contractility and jet lesions to the myocardium.
  • Dogs in CHF should be monitored for arrhythmiasduring therapy. If detected, such arrhythmias should be treated appropriately.
  • Vomiting, diarrhea, and inappetance are possible side effects of treatment with pimobendan.
  • Pimobendan has not been evaluated in dogs used for breed or are lactating or pregnant.
  • Nervous system signs, including in coordination and seizures may also occur. Behaviorally pimobendan may cause uneasiness.
  • Renal side effects include polyuria and polydypsia.

 

Drug Interactions

Pimobendan may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with pimobendan.

Such interactions may include:

  • Pimobendan should be employed with caution with other positive inotropes.
  • Because it is highly protein-bound, careful monitoring is necessary if it is to be used with other drugs that are highly protein bound.
  • Concurrent use of beta-blockers or calcium-channel blockers may decrease pimobendan-induced effects on myocardial contractility.

How Pimobendan is Supplied

  • Pimobendan is available in 1.25 mg, 2.5 mg and 5.0 mg capsules.

Dosing Information of Pimobendan for Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • The dosage prescribed may vary depending on the reason for prescribing.
  • In dogs, the dose is may range from 0.05 to 0.15 mg per pound (0.1 to 0.3 mg/kg) every 12 hours. It recommended that each dose be given 1 hour before food.
  • In cats, the dose is similar to that of dogs being 0.0125 mg per pound (0.25 mg/kg) oral every 12 hours. This often works out to be 1.25 mg tablet per cat twice daily.
  • It is recommended to give Pimobendan on an empty stomach if possible.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.
  • It is recommended that your pet’s heart disease be monitored while on Pimobendan with periodic electrocardiograms (ECG)’s, blood pressure, clinical signs, weight, respiratory rate, heart rate, and echocardiograph findings.

 

Pimobendan (Vetmedin®) for Dogs and Cats

pimobendan for dogs and cats

Overview of Pimobendan for Canines and Felines

  • Pimobendan, commonly known by the brand name Vetmedin®, is a phosphodiesterase III inhibitor with calcium sensitizing properties. It has been shown to improve survival times and quality of life (lowered syncope, dyspnea, exercise intolerance, and ascites) in dogs and cats suffering from congestive heart failure(CHF).  Pimobendan is an oral medication commonly used in combination with other drugs such as an ACE-inhibitor and diuretic (furosemide).
  • Pimobendan has also resulted in significant improvement in signs of heart failure when added to standard therapy for dogs with dilated cardiomyopathy and has contributed to improved survival in some dogs (Doberman Pinschers).
  • Phosphodiesterase inhibitors block the inactivation of cyclic AMP increasing sympathetic tone and thus cardiac output.
  • Following oral administration of pimobendan to a pet with CHF, the heart rate decreases and the contractility of the heart increases.
  • The oral bioavailability of pimobendan in dogs is 60–63%. It is highly protein bound in plasma (93%) and has a plasma elimination half-life of approximately 30 minutes. The half-life of its principal active metabolite is approximately 2 hours. Virtually the entire administered dose is eliminated in feces.
  • In humans with CHF, pimobendan has been shown to be associated with a slightly increased risk of death (1.8 x) vs. untreated controls. The balance between benefit and risk of treatment with pimobendan remains to be established in humans and in dogs.
  • Pimobendan is approved in Europe and Canada to treat dogs with heart failure due to dilated cardiomyopathy or valvular insufficiency (mitral and/or tricuspid regurgitation).
  • Pimobendan is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug has recently been approved for use in animals by the Food and Drug Administration.

Brand Names and Other Names of Pimobendan

  • Veterinary formulations: Vetmedin® (Boehringer Ingelheim)
  • Pimobendan may also be registered under the trade names UDCG-115 or Acardi®.
  • Human formulations: None

 

Uses of Pimobendan for Dogs and Cats

  • Treatment of heart failure due to dilated cardiomyopathy or valvular insufficiency (chronic mitral valve insufficiency).

 

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, pimobendan can cause side effects in some animals.
  • Pimobendan should not be used in animals with known hypersensitivity or allergy to the drug.
  • Also, it is contraindicated in hypertrophic cardiomyopathies and clinical conditions where an augmentation of cardiac output is not possible for functional or anatomical reasons (e.g. aortic stenosis).
  • Doses of pimobendan over 0.8 mg/kg/day over a period of 2 to 4 weeks may be associated with exaggerated myocardial contractility and jet lesions to the myocardium.
  • Dogs in CHF should be monitored for arrhythmias during therapy. If detected, such arrhythmias should be treated appropriately.
  • Vomiting, diarrhea, and inappetence are possible side effects of treatment with pimobendan.
  • Pimobendan has not been evaluated in dogs used for breeding or are lactating or pregnant.
  • Nervous system signs, including in coordination and seizures may also occur. Behaviorally pimobendan may cause uneasiness.
  • Renal side effects include polyuria and polydipsia.

 

Drug Interactions

Pimobendan may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with pimobendan.

Such interactions may include:

  • Pimobendan should be employed with caution with other positive inotropes.
  • Because it is highly protein-bound, careful monitoring is necessary if it is to be used with other drugs that are highly protein bound.
  • Concurrent use of beta-blockers or calcium-channel blockers may decrease pimobendan-induced effects on myocardial contractility.

How Pimobendan is Supplied

  • Pimobendan is available in 1.25 mg, 2.5 mg, and 5.0 mg capsules.

Dosing Information of Pimobendan for Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • The dosage prescribed may vary depending on the reason for prescribing.
  • In dogs, the dose is may range from 0.05 to 0.15 mg per pound (0.1 to 0.3 mg/kg) every 12 hours. It recommended that each dose be given 1 hour before food.
  • In cats, the dose is similar to that of dogs being 0.0125 mg per pound (0.25 mg/kg) oral every 12 hours. This often works out to be 1.25 mg tablet per cat twice daily.
  • It is recommended to give Pimobendan on an empty stomach if possible.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.
  • It is recommended that your pet’s heart disease be monitored while on Pimobendan with periodic electrocardiograms (ECG)’s, blood pressure, clinical signs, weight, respiratory rate, heart rate, and echocardiograph findings.

 

Osurnia Otic Suspension (Florfenicol, Terbinafine, Betamethasone) for Dogs

Overview of Osurnia Medication for Dogs

  • Osurnia is a medication to treat ear infections in dogs. Otitis externa (outer ear infections) commonly include infection with both bacteria and yeast organisms. Many medications designed to treat these infections will include multiple medications to treat all aspects of the infection. You can learn more about otitis externa in these articles from the Petplace library: Otitis Externa (Ear Infections) in Dogs and Otitis Externa (Ear Infections) in Cats. 
  • Osurnia contains 3 medications to treat your pet’s otitis externa:

    • Florfenicol – a bacteriostatic antibiotic that will treat a wide variety of bacteria types found in ear infections.
    • Terbinafine – an antifungal medication used to treat infections caused by fungi (yeasts and molds). It is effective in the treatment of the common skin and ear yeast Malassezia pachydematitis.
    • Betamethasone – a glucocorticosteroid that will help reduce inflammation and itching in the ear canal. Inflammation is a large source of the pain associated with otitis, this will help your pet become comfortable more quickly.
  • Osurnia is specifically used to treat of otitis externa caused by susceptible strains of yeast (Malassezia pachydermatis) and bacteria (Staphylococcus pseudointermedius).

Brand Names

  • Osurnia® – Elanco Animal Health
    Similar multi-drug products include:

    • Tresaderm (Merial) which includes Neomycin sulfate, dexamethasone and thiabendazole
    • Otomax Ointment (Intervet-Schering-Plough) which includes Gentamicin sulfate, betamethasone valerate and clotrimazole
    • Posatex (Intervet/Schering-Plough Animal Health) which includes Orbifloxacin, posaconazole, mometasone furoate monohydrate
    • Generic formulations which contain Neomycin, polymyxin B, and hydrocortisone (generics)
    • Surolan (Vetoquinol) which includes Miconazole nitrate, polymyxin B sulfate, prednisolone acetate
    • Mometamax (Elanco Animal Health) which includes clotrimazole, gentamicin and mometasone

Uses of Osurnia in Dogs

  • Osurnia is prescribed to treat or control infections caused by susceptible yeast and bacterial ear infections (otitis externa). The product is currently labeled for use in dogs only.
  • Osurnia is not effective against infections caused by viruses or parasites (such as worms or mites).
  • Identification of the cause of an ear infection should be undertaken by your veterinarian.

Precautions and Adverse (Side-) Effects of Osurnia

  • The combination of florfenicol, terbinafine, betamethasone found in Osurnia® is generally safe for use in dogs.
  • Your pet should be examined by your veterinarian before starting this medication, it should not be used in animals with a ruptured ear drum (tympanic membrane).
  • Signs of allergy to Osurnia® may include skin reactions, hives and redness of the treated area.
  • Use of Osurnia® can potentially be associated with partial hearing loss in a small number of dogs. It can be temporary in some dogs.
  • If you notice hearing loss, head tilt or dizziness in your pet undergoing treatment with Osurnia® stop the treatment and call your veterinarian immediately.
  • The steroid component of Osurnia®, betamethasone can cause suppression if the adrenal gland and interfere with testing for disorders of the adrenal gland.
  • This medication has not been evaluated for use in breeding, pregnant or lactating dogs.

How Osurnia® is Supplied

Osurnia® is available in single use tubes with a flexible soft tip.
The ear canal should be cleaned and dried before the topical use of this product.

Osurnia

Dosing Information for Osurnia for Dogs

  • This drug should only be used under direction of a veterinarian. It may not be safe to administer the combination of florfenicol, terbinafine, betamethasone to pets with certain medical problems.
  • The typical dose of Osurnia® is the same for all dogs, the entire tube is squeezed into the ear canal. This dose is repeated in 7 days. The ear canal should not be cleaned for 45 days for all the gel to contact the canal.
  • The duration of administration depends on the severity of the infection, response to the medication, and the presence of any adverse effects. Be certain to complete the prescription.


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Lactulose (Cephalic, Kristalose) for Dogs and Cats

Overview of ​Lactulose for Canines and Felines

  • Lactulose, also known as Chronulac®, Cephulac®, Constilac® or Kristalose®,  is a special type of laxative used to treat constipation and to assist in the management of a disorder called hepatic encephalopathy in dogs and cats.
  • Lactulose is a sugar solution, a disaccharide, created from two separate sugars. It is synthetically derived from lactose and represents a combination of the simple sugars galactose and fructose.
  • Unlike other sugars, lactulose is not absorbed from the intestinal tract into the blood. Instead, it passes unchanged to the large intestine (the colon).
  • In the large intestine, lactulose is broken down by bacteria resulting in the production of various acids. These acids draw water into the colon, softening the stool and increasing the volume and resulting in a laxative effect.
  • The formed acids also attract ammonia, causing this by-product of protein metabolism to migrate from the blood into the colon. Once in the colon, the acids change ammonia to ammonium, which is then passed out in the feces.
  • Lactulose is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

Brand Names and Other Names of Lactulose

  • This drug is registered for use in humans only.
  • Human formulations: Chronulac® (Merrill Dow), Cephulac® (Merrill Dow), Constilac® (Alra), Cholac® (Alra), Constulose® (Barre), Enulose® (Barre), Kristalose® and various generics.
  • Veterinary formulations: None

Uses of Lactulose for Dogs and Cats

  • Lactulose is most commonly used in the treatment of hepatic encephalopathy, a liver disorder that causes toxic products (like ammonia) to accumulate in the blood. Hepatic encephalopathy causes an abnormal mental state that may progress to coma.
  • This drug is also used as a laxative to treat constipation (infrequent or hard bowel movements caused by a relative lack of water in the stool).

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, lactulose can cause side effects in some animals.
  • Lactulose should not be used in animals with known hypersensitivity or allergy to the drug.
  • Lactulose may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with lactulose. Such drugs include other laxatives and certain antibiotics.
  • Lactulose should be used with caution in diabetic animals.
  • Since lactulose can cause diarrhea, caution must be used if lactulose is given to patients with salt (electrolyte) imbalances.
  • The most common adverse effects of the drug are abdominal cramping and flatulence (“gas”). This problem generally passes with time.
  • Diarrhea and dehydration may occur if excessive amounts of lactulose are given or water is withheld from the pet.
  • Lactulose can be difficult to administer to cats as the taste is offensive and administration can lead to profuse drooling.

How Lactulose Is Supplied

  • Lactulose is available in a syrup containing 666 mg per ml. A variety of container sizes are available.
  • Lactulose crystals for oral solution.

Dosing Information of Lactulose for Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • For hepatic encephalopathy in dogs, lactulose is dosed at 15 to 30 ml per dog four times daily. With time, this dose can be altered to produce two to three soft stools per day.
  • For hepatic encephalopathy in cats, lactulose is dosed at 0.25 to 1 ml per cat. The frequency of dosing is based on the frequency of stool production. It is typically started at three times daily and then adjusted.
  • For treatment of constipation, 1 ml per 10 pounds of body weight (1 ml per 4.5 kg) is given three times daily. The dose is adjusted as needed.
  • The liquid product is often distasteful to cats. Many cat owners have better luck using the crystals sprinkled on the food. One gram of the lactulose crystals is equivalent to 1.5 mL of the liquid. The dose of the lactulose crystals is 1/2 to 3/4 tsp twice daily mixed with food. Doses are adjusted to maintain the stool consistency desired.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.

 

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Milbemycin & Spinosad (Trifexis®, ComboGuard®) for Dogs

Overview
of Milbemycin & Spinosad for Canines

  • Trifexis® is one of the most commonly used flea, heartworm and worm treatment/prevention medication used in dogs. Trifexis contains a combination of two drugs including milbemycin & spinosad. Trifexis comes as a chewable pill in weight-dependent sizes. Below is some detailed information about the two drugs that make up Trifexis, Milbemycin & Spinosad.
  • Milbemycin acts by disrupting nerve transmission within the parasite leading to death of the parasite.
  • Spinosad™ is a drug that provides flea control for dogs. It contains antiparasiticagents used to kill and prevent fleas. Spinosad is a member of the spinosyns class of insecticides. The effects of Spinosad™ last about 30 days against fleas. It is documented to begin killing fleas within 30 minutes with 100% effectiveness within 4 hours.
  • Parasitic infections are common in dogs and cats and include external parasites (fleas, ticks, mites), and internal parasites (intestinal worms, lungworms and heartworms).
  • Trifexis® is a Prescription drugand can only be obtained from a veterinarian or by prescription from a veterinarian.

Brand Names and Other Names
of Milbemycin & Spinosad

  • This drug is Registered for use in animals only.
  • Human formulations: None
  • Veterinary formulations: Trifexis®, ComboGuard®,

Uses of Milbemycin & Spinosad
for Dogs

  • Trifexis® is used in the control and treatment of adult flea infestations, control of hookworm, roundworm, and certain whipworm infections and as a highly effective preventative of heartworm disease.
  • Trifexis® contains milbemycin which is a potent **microfilariacidal** drug, meaning it can kill the microscopic offspring of heartworms. Microfilaria circulate in the blood of infected dogs and are typically treated after killing the adult heartworm parasite with another drug (melarsamine). Milbemycin is one of the drugs veterinarians use to kill the microfilaria as there are no drugs approved for this use by the FDA.
  • For more information on flea infestations, please see Flea Infestation in Dogs and Flea Allergy Dermatitis.

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, Trifexis® can cause side effects in some animals.
  • Trifexis® should not be used in animals with known hypersensitivity or allergy| to the drug.
  • Trifexis® should not be given to dogs with allergies to soy or pork as the pill is flavored.
  • Animals should be tested for heartworm infection before beginning prevention with Trifexis.
  • Trifexis® is approved for use in dogs and puppies over 8 weeks of age and 5 pounds of body weight or greater. It should be used with caution in breeding females. Milbemycin has been found safe in collie breeds and in collie mixed breeds.
  • Trifexis® may interact with other medications. Consult with your veterinarian to discuss using other medications when your pet is on Spinosad™. One interaction of note is when used with high doses of ivermectin – have resulted in signs of ivermectin toxicity in some dogs.
  • Trifexis® is an oral agent. The most common side effect noted was vomiting. Other adverse reactions included decreased appetite, inflammation or redness of the skin, redness of the ears and/or diarrhea. Documented reactions are general mild.

How Milbemycin & Spinosad is Supplied

Trifexis® is available as an oral chewable tablet. Trifexis® can be given to dogs and puppies 8 weeks or older. It is dosed by body weight. Minimum weight for Trifexis® is 5 lb. Available sizes include:

  • 5 to 10 pounds – 140 mg tablet
  • 10.1 to 20 pounds – 270 mg tablet
  • 20.1 to 40 pounds – 560 mg tablet
  • 40.1 to 60 pounds – 810 mg tablet
  • 60.1 to 120 pounds – 1620 mg tablet
  • Dogs over 120 pounds should be given the appropriate combination of tablets.

Dosing Information of Milbemycin & Spinosad for Dogs

  • Medication should never be administered without first consulting your veterinarian.
  • The dose of Trifexis® is based on weight and administered every 4 weeks throughout the flea season.
  • Treatment can begin any time of year but should ideally begin 1 month prior to flea season.
  • Trifexis® should be administered with food to maximize effectiveness.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. The manufacturer suggests monthly treatments to protect against flea re-infestation. Be certain to complete the prescription unless specifically directed by your veterinarian.


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Amoxicillin + Clavulanate (Clavamox®, Augmentin®) for Dogs and Cats

 

Overview of Amoxicillin & Clavulanate for Canines and Felines

  • Amoxicillin + clavulanate is commonly used in dogs and cats to treat a variety of infections and its most common brand name is Clavamox® and Augmentin®.
  • Amoxicillin + clavulanate is a combination of two drugs that act together (synergistically) to treat or prevent bactercatial infections in animals. Amoxicillin is an antibiotic related to penicillin, except that it has a somewhat broader spectrum of antibacterial action.
  • Clavulanate is an inhibitor of an enzyme produced by bacteria. This enzyme, beta-lactamase, would ordinarily render amoxicillin inactive. Clavulanate has no antibacterial effects; it simply acts as an inhibitor of an important resistance mechanism.
  • The combination of these two drugs in the same tablet means they act synergistically to treat bacterial infections that would otherwise have been resistant to amoxicillin alone.
  • As with similar penicillin drugs, amoxicillin + clavulanate kills bacteria by inhibiting production of the bacteria cell wall. Other related drugs include ampicillin, penicillin G and ticarcillin.
  • Amoxicillin + clavulanate is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.

Brand Names and Other Names of Amoxicillin & Clavulanate

  • This drug is registered for use in humans and animals.
  • Human formulation: Augmentin® (SK-Beecham)
  • Veterinary formulation: Clavamox® (Beecham), Clavamox-Drops® (Beecham)

Uses of Amoxicillin + Clavulanate for Dogs and Cats

  • Amoxicillin + clavulanate is administered to treat infections caused by susceptible bacteria.
  • Infections treated with amoxicillin + clavulanate may include skin infections, bone infections, wound infections, infections in the mouth, pneumonia and bladder infections.
  • Amoxicillin + clavulanate is not effective for viruses and parasitic infections (such as worms or mites).
  • Despite the combination of amoxicillin plus clavulanate, resistance may still occur with some bacteria and infections unresponsive to treatment are possible.

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, amoxicillin + clavulanate can cause side effects in some animals.
  • Amoxicillin + clavulanate should not be used in animals with known hypersensitivity or allergy to the drug.
  • Some animals may vomit shortly after administration of amoxicillin + clavulanate. This may occur in as many as 10 percent of dogs. In these cases, it may be helpful to feed the animal some food prior to drug administration to decrease stomach irritation. If vomiting after administration continues to occur, contact your veterinarian.
  • It is common for animals to develop diarrhea or loose stools from oral amoxicillin, and the same reaction may occur with amoxicillin + clavulanate. This is caused by a change in the bacterial population in the animal’s intestine.
  • Amoxicillin + clavulanate may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with amoxicillin + clavulanate. Such drugs include chloramphenicol and tetracycline.

How Amoxicillin with Clavulanate is Supplied

  • The veterinary form of amoxicillin + clavulanate is supplied in various size tablets ranging from 62.5 to 400 mg and a 50 mg/ml liquid oral suspension. These forms contain an amoxicillin to clavulanate ratio of 5 to 1.
  • The human form has a slightly different ratio of the amoxicillin to clavulanate; however this drug should also be safe for animals. Augmentin® is available in tablets in a range of sizes that vary from 250 to 875 mg (amoxicillin content), chewable tablets ranging in size from 125 to 400 mg, and oral liquid suspension that contains from 25 to 80 mg amoxicillin per ml. Clavulanate content in these preparations varies from 2:1 to 7:1 (amoxicillin:clavulanate).

 

Dosing Information for Clavamox® in Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • The dose of amoxicillin ranges from 5 to 12 mg per pound (10 to 25 mg/kg) two or three times a day orally.  The most common dose of clavamox® used in dogs and cats is 6.875 mg per pound (13.75 mg/kg) every 12 hours.
  • Doses are determined according to amoxicillin content of the tablet since ratios of clavulanate in the preparation may vary.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.

 

 

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ermatology & Integumentary diseases
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Multiple organ systems can be affected

Methylprednisolone (Medrol®, Depo-Medrol®) for Dogs and Cats

 

Overview of Methylprednisolone for Canines and Felines

  •  Methylprednisolone, also known as Medrol® or Depo-Medrol®, is a steroid drug used in dogs and cats to treat inflammation, autoimmune diseases of the skin, and feline bronchial asthma. Methylprednisolone comes in both an oral and injectable form.
  • The immune and inflammation systems of pets and people constitute essential safeguards against infections and disease.
  • However, in some situations, inflammation is dangerous and leads to severe damage in tissues and organs.
  • Similarly, the immune system, often for no apparent reason, can attack the body and cause great damage or even death. Many of the resultant medical conditions are called autoimmune diseases.
  • Drugs that control inflammation and suppress the immune system are often needed to treat diseases in animals. Methylprednisolone is one of these drugs. This drug is classified as a glucocorticoid because it is related to cortisone and contains glucose in the molecule.
  • Effects of glucocorticoids can be observed in every organ system and these drugs should only be used when necessary.
  • Methylprednisolone is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.

Brand Names and Other Names of Methylprednisolone

  • This drug is registered for use in humans and animals.
  • Human formulations: Medrol® (Upjohn), Depo-Medrol® (Upjohn) and generics
  • Veterinary formulations: Medrol® (Upjohn), Depo-Medrol® (Upjohn) and generics

Uses of Methylprednisolone for Dogs and Cats

Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, methylprednisolone can cause side effects in some animals.
  • Methylprednisolone should not be used in animals with known hypersensitivity or allergy to the drug.
  • This drug should not be used in animals with glaucoma, diabetes, Cushing’s syndrome (hyperadrenocorticism), pregnancy, congestive heart failure, corneal ulcers, high blood pressure and kidney failure.
  • Methylprednisolone should not be used in combination with non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin.
  • Methylprednisolone should be avoided in animals with viral and fungal infections.
  • In general, glucocorticoids are not used before surgical procedures because these drugs may delay the healing process.
  • Methylprednisolone may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with methylprednisolone. Such drugs include furosemide, insulin, phenobarbital, non-steroidal anti-inflammatories, other steroids and certain antibiotics.
  • Common adverse side effects of methylprednisolone include vomiting, behavior modification, lethargy, increased water intake, increased frequency of urination, increased appetite and panting.
  • Common adverse effects of long term treatment with methylprednisolone include hair loss, skin thinning and pigmentation, muscle weakness, diarrhea and complications related to diabetes.
  • Glucocorticoids may exacerbate gastrointestinal ulcers by stimulating the production of gastric enzymes and impairing wound healing.

How Methylprednisolone Is Supplied

  • Methylprednisolone is availabe in tablets, an intravenous injection (methylprednisolone sodium succinate) and a “repositol” (longer-acting) injection form (methylprednisolone acetate).
  • Methylprednisolone is available in variety of sizes from 1 mg to 32 mg.
  • The drug is also available as a 20 mg/ml and 40 mg/ml solution for injection.

Dosing Information of Methylprednisolone for Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • The doses of methylprednisolone used in dogs and cats depend on the condition, severity, preparation, route of administration (oral or injectable) and other factors.
  • Doses range from 0.5 mg per pound (1 mg/kg) to 15 mg per pound (30 mg/kg).
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your dog or cat feels better, the entire treatment plan should be completed to prevent relapse.

 

Metaflumizone (ProMeris® and ProMeris Duo™) for Dogs and Cats

NOTE: Pfizer Animal Health, the maker of ProMeris flea and tick control products, discontinued production of ProMeris in 2011. The Journal of Veterinary Dermatology published an article at North Carolina State University researchers who found that ProMeris has the potential to trigger a variant of pemphigus foliaceus in dogs. The information about ProMeris is below but the drug is no longer available. 

Overview of Metaflumizone for Canines and Felines

  • Metaflumizone, better known asProMeris™, is a drug that was on the market that provided broad spectrum flea and tick control to dogs and flea control to cats. It contains antiparasitic agents used to kill adult fleas and ticks.
  • ProMeris™ for Dogs is a product labeled for dogs only (Promeris Duo™) that contains two active ingredients that include metaflumizone and amitraz. The product labeled for cats (Promeris®) contains metaflumizone.
  • Metaflumizone works by interfering with the nerve function of fleas, ultimately resulting in death.
  • Amitraz kills ticks by disrupting their nervous system function that results in their inability to feed causing them to detach from the dog, become paralyzed and die.
  • ProMeris™ is a topical solution that is water proof.
  • The effects last about 30 days against ticks and 30 to 45 days against fleas.
  • Promeris is a Prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian, available in March of 2008.
  • Brand Names and Other Names of Metaflumizone

  • This drug is Registered for use in animals only.
  • Human formulations: None
  • Veterinary formulations: ProMeris® (Fort Dodge), Promeris Duo™ (Fort Dodge)
  • Uses of Metaflumizone for Dogs and Cats

  • ProMeris is used in the control and treatment of adult flea and tick infestations in dogs and flea infestations in cats. For more information on flea infestations, please see Flea Infestation in Cats and/or Flea Infestation in Dogs. For more information on tick infestations, please read Tick Infestations in Dogs.
  • ProMeris may benefit pets with Flea Allergy Dermatitis
  • Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, ProMeris Duo™ and ProMeris®can cause side effects in some animals.
  • ProMeris Duo ™ and ProMeris® should not be used in animals with known hypersensitivity or allergy to the drug.
  • ProMeris Duo ™ and ProMeris® is not recommended for use in kittens and puppies less than 8 weeks of age.
  • ProMeris Duo™ and ProMeris® may interact with other medications. Consult with your veterinarian to
  • ProMeris Duo ™ and ProMeris® is a topical agent and temporary irritation at the site of application is possible. Promeris has been associated with triggering a variant of pemphigus foliaceus in dogs. 
  • Spotted areas may appear wet or oily for up to 24 hours.
  • Overdose is rare and no adverse effects have been reported even up to 5 times the dose.
  • How ProMeris is Supplied

  • ProMeris is available as a topical solution available in five sizes depending on the weight of the pet. Each card contains 3 or 6 pipettes.

    ProMeris Duo ™ for dogs, the sizes are:

    Extra small (XS) = < 11 pounds)

    Small = > 11 – 22 pounds

    Medium = > 22 – 55 pounds

    Large = > 55 to 88 pounds

    Extra large (XL) = > 88 to 110 pounds

    ProMeris® for cats, the sizes are:

    Small* = under 9 pounds

    Large = 90 pounds and over

    *Kittens 8 weeks to 6 months should be treated with the Small size.

  • Dosing Information of Metaflumizone for Dogs and Cats

  • Medication should never be administered without first consulting your veterinarian.
  • The dose of Promeris for preventative flea control is administration of the product every 4 to 6 weeks throughout the flea season. The dose for flea prevention in dogs is administration every 4 weeks throughout the tick season.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. The manufacturer suggests monthly treatments to protect against flea re-infestation although the product may be effective for up to six weeks. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance. 
  • IMPORTANT NOTE: Pfizer Animal Health, the maker of ProMeris flea and tick control products, discontinued production of ProMeris and thus is no longer available.

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