Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 179

Treatment of lead toxicosis involves prevention of further exposure, decontamination of the individual (e.g. bathing in case of lead-laden dust coat exposure, administration of cathartics and/or enemas, endoscopic or surgical removal of lead-containing foreign bodies), decontamination of the environment, supportive care and chelation therapy to remove lead from the blood and soft tissues. The cathartic magnesium sulfate (250–500 mg/kg PO in dogs and 200 mg/kg PO in cats) can help to decrease lead absorption by forming insoluble lead sulfate. Treatment with the chelating agent, calcium disodium ethylene diamine tetraacetate (CaNa2EDTA), using a dose of 25 mg/kg intravenously or orally, four times a day for 2 to 5 days, has resulted in recovery within 36 to 48 h. However, in some animals, CaNa2EDTA has initially worsened neurologic signs. The most recently available chelator, succimer (meso-2,3-dimercaptosuccinic acid), administered at 10 mg/kg of body weight, orally, every 8 h, for 10 days, has been reported to be safe and effective in the treatment of lead poisoning in dogs and cats (Ramsey et al., 1996; Knight et al., 2001). Succimer may also be administered rectally as a solution in patients that are vomiting or that are unable to take oral medications. Chelation therapy with calcium EDTA (27 mg/kg SC for 5 days) alone or in association with D-penicillamine (33–55 mg/kg/day divided every 6–8 h) has also been reported. Seizures should be treated promptly with diazepam and/or other AEMs (see Table 4.1, and Chapters 12 and 24). Thiamine supplementation (1–2 mg/kg IM or 2 mg/kg PO every 24 h) can contribute to neurological improvement.