Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 103

Diazepam (0.5 to 1.0 mg/kg intravenously, up to a maximum total dose of 20 mg, in dogs and cats, repeated to effect or twice within 2 h; see Chapters 21 and 24) can be used to control the tetany and seizures initially while the diagnosis of hypocalcaemia is confirmed. Hypocalcaemia is treated with 10% calcium gluconate at a dose of 0.5–1.5 ml/kg (providing 5–15 mg/kg of calcium) administered slowly IV (over 10 to 30 min) to effect as individual requirements vary. Clinical improvement is generally obvious within minutes of initiating the infusion. Electrocardiographic monitoring is advisable because of the risk of cardiotoxicity. If bradycardia, premature ventricular complexes, increased P-R interval, prolonged QRS complex or shortening of the Q-T interval is observed, the IV infusion should be briefly discontinued. Maintenance therapy of hypocalcaemia involves calcium gluco-nate (at a dosage equal to the one used IV for the control of tetany), diluted in an equal volume of saline, administered SC every 6 to 8 h. Serum calcium concentration should be monitored every 1–3 days to adjust the calcium gluconate dose. Generally, after serum calcium concentrations have been maintained within reference range for 48 h, the administration of calcium gluconate can be gradually tapered off to every 8–12 h. Long-term maintenance treatment with oral calcium (25 mg/kg every 8–12 h) and vitamin D supplementation may be required. Specific treatment for the underlying aetiology of hypocalcaemia should be instituted as promptly as possible.