Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 163

Treatment involves decontamination (induction of emesis in asymptomatic animals or gastric and colonic lavage in symptomatic animals, administration of activated charcoal with a cathartic) (Table 4.1), methocarbamol or diazepam in animals with excessive tremors (Table 4.1), AEMs (see Table 4.1 and Chapters 12 and 24) in seizuring animals, symptomatic and supportive care. Calcium gluconate (see hypocalcaemia) should be administered if serum-ionized calcium concentration is equal or lower than 0.8 mmol/l (3.2 mg/dl). In addition, administration of sodium bicarbonate or acetamide has shown promising results (O’Hagan, 2004; Parton, 2006). The recommended dosage of sodium bicarbonate is 300 mg/kg (3.6 ml/kg of 8.4% solution) IV over 15–30 min. Alternatively, half of the calculated dose may be given as a bolus and the remainder infused slowly. Administration of sodium bicarbonate may worsen hypocalcaemia and cause hypokalaemia and hyper-natraemia. Serum-ionized calcium, sodium and potassium levels should be monitored regularly in order to implement fluid therapy as well as calcium and potassium supplementations as required.

The recommended dosage of acetamide (15 g of acetamide granules dissolved in 1 l of warmed 5% dextrose) in dogs is 10 to 25 ml/kg IV (infused though a filter following sterilization) over a 60-min period followed by approximately 5 ml/kg/h IV for the next 12 to 18 h until resolution of clinical signs. In cats with fluoroacetate poisoning, the acetamide dose should be reduced by at least 75% (Parton, 2006). Electrolytes should be closely monitored as hyponatraemia may develop due to the large volume of administered free water.

Other treatment modalities are being investigated in Australia and New Zealand due to the higher prevalence of sodium monofluoroacetate poisoning than other countries.