BSAVA Small Animal Formulary 7th edition Editor-in-Chief Ian Ramsey Emergency doses for dogs and cats ALWAYS read the relevant monographs. Cardiac emergencies ■■ Asystole or pulseless electrical activity Adrenaline: 20 μg (micrograms)/kg i.v. – this is equivalent to 1 ml/5 kg using 1:10,000 concentration (1000 mg/ml). Double dose if used intratracheally. ■■ Hyperkalaemic myocardial toxicity Calcium: 50–150 mg/kg calcium (boro)gluconate = 0.5–1.5 ml/kg of a 10% solution i.v. over 20–30 min or Soluble insulin: 0.5 IU/kg i.v. followed by 2–3 g of dextrose/unit of insulin (for urinary tract obstruction but not hypoadrenocorticism). Half the dextrose should be given as a bolus and the remainder administered i.v. over 4–6h. ■■ Other bradyarrhythmias Atropine: 0.01–0.03 mg/kg i.v. – this is equivalent to 0.3–1 ml/20 kg using 0.6 mg/ml solution. ■■ Ventricular tachycardia Lidocaine: Dogs: 2–8 mg/kg i.v. in 2 mg/kg boluses, followed by a constant rate i.v. infusion of 0.025–0.1 mg/kg/min. Cats: 0.25–2.0 mg/kg i.v. slowly in 0.25–0.5 mg/kg boluses followed by a constant rate i.v. infusion of 0.01–0.04 mg/kg/min. Pulmonary emergencies ■■ Respiratory arrest Doxapram: 5–10 mg/kg i.v., repeat according to need; duration of effect is approximately 15–20 min. Neonates: 1–2 drops under the tongue (oral solution) or 0.1 ml i.v. into the umbilical vein; this should be used only once. Metabolic emergencies ■■ Anaphylaxis Adrenaline: 10 μg/kg i.v. – this is equivalent to 1 ml/10 kg using 1:10,000 concentration (1000 mg/ml). ■■ Hypocalcaemia Calcium: 50–150 mg/kg calcium (boro)gluconate = 0.5–1.5 ml/kg of a 10% solution i.v. over 20–30 min. ■■ Hypoglycaemia Glucose: 1–5 ml 50% dextrose i.v. slowly over 10 min. Neurological emergencies ■■ Seizure control Diazepam: 0.5 mg/kg i.v. or rectal – repeat after 3 minutes for up to 3 doses or Midazolam: 0.3 mg/kg i.v. or rectal – repeat after 3 minutes for up to 3 doses. If the seizures have been controlled, maintain on an i.v. infusion of midazolam at 0.3 mg/kg/h. If seizures not controlled by above: Propofol: induce with 1–4 mg/kg i.v. and then maintain on 0.1–0.4 mg/kg/min. ■■ Raised intracranial pressure (impending herniation) Mannitol: 0.25 g/kg i.v. infusion of 15–20% solution over 30–60 min. May repeat 1–2 times after 4–8 hours as long as hydration and electrolytes monitored. (For acute glaucoma see monograph.) Anaesthesia emergencies ■■ Reversing agents Naloxone: 0.015–0.04 mg/kg i.v., i.m., s.c., intratracheal (give to effect). Atipamezole: Five times the previous medetomidine or dexmedetomidine dose i.m.; if that dose unknown, use 100 μg(micrograms)/kg i.m. or very slow i.v. Small Animal Formulary 7th edition Editor-in-Chief: Ian Ramsey BVSc PhD DSAM DipECVIM-CA FHEA MRCVS School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH Published by: British Small Animal Veterinary Association Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB A Company Limited by Guarantee in England. Registered Company No. 2837793. Registered as a Charity. Copyright © 2011 BSAVA First edition 1994 Second edition 1997 Third edition 1999 Reprinted with corrections 2000 Fourth edition 2002 Reprinted with corrections 2003 Fifth edition 2005 Reprinted with corrections 2007 Sixth edition 2008 Reprinted with corrections 2009, 2010 Seventh edition 2011 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in form or by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission of the copyright holder. A catalogue record for this book is available from the British Library. ISBN 978 1 905319 33 6 The publishers, editors and contributors cannot take responsibility for information provided on dosages and methods of application of drugs mentioned or referred to in this publication. Details of this kind must be verified in each case by individual users from up to date literature published by the manufacturers or suppliers of those drugs. Veterinary surgeons are reminded that in each case they must follow all appropriate national legislation and regulations (for example, in the United Kingdom, the prescribing cascade) from time to time in force. Printed by: HSW Print, Tonypandy, Rhondda CF40 2XX. Printed on ECF paper made from sustainable forests. ii BSAVA Small Animal Formulary 7th edition Other titles from BSAVA: Guide to Procedures in Small Animal Practice Guide to the Use of Veterinary Medicines (available online) Manual of Canine & Feline Abdominal Imaging Manual of Canine & Feline Abdominal Surgery Manual of Canine & Feline Advanced Veterinary Nursing Manual of Canine & Feline Anaesthesia and Analgesia Manual of Canine & Feline Behavioural Medicine Manual of Canine & Feline Cardiorespiratory Medicine and Surgery Manual of Canine & Feline Clinical Pathology Manual of Canine & Feline Dentistry Manual of Canine & Feline Emergency and Critical Care Manual of Canine & Feline Endocrinology Manual of Canine & Feline Endoscopy and Endosurgery Manual of Canine & Feline Gastroenterology Manual of Canine & Feline Haematology and Transfusion Medicine Manual of Canine & Feline Head, Neck and Thoracic Surgery Manual of Canine & Feline Infectious Diseases Manual of Canine & Feline Musculoskeletal Disorders Manual of Canine & Feline Musculoskeletal Imaging Manual of Canine & Feline Nephrology and Urology Manual of Canine & Feline Neurology Manual of Canine & Feline Oncology Manual of Canine & Feline Rehabilitation, Supportive and Palliative Care: Case Studies in Patient Management Manual of Canine & Feline Reproduction and Neonatology Manual of Canine & Feline Thoracic Imaging Manual of Canine & Feline Ultrasonography Manual of Canine & Feline Wound Management and Reconstruction Manual of Exotic Pets: A Foundation Manual Manual of Farm Pets Manual of Ornamental Fish Manual of Practical Animal Care Manual of Practical Veterinary Nursing Manual of Psittacine Birds Manual of Rabbit Medicine and Surgery Manual of Raptors, Pigeons and Passerine Birds Manual of Reptiles Manual of Rodents and Ferrets Manual of Small Animal Dermatology Manual of Small Animal Diagnostic Imaging Manual of Small Animal Fracture Repair and Management Manual of Small Animal Ophthalmology Manual of Wildlife Casualties Textbook of Veterinary Nursing For information on these and all BSAVA publications please visit our website: www.bsava.com BSAVA Small Animal Formulary 7th edition iii Contents Editorial Panel iv Preface to the seventh edition vi Foreword vii Introduction How to use the Formulary viii Distribution categories ix The cascade xi Drug storage and dispensing xiii Health and safety in dispensing xiii Drug listings and monographs 1 (listed A–Z by generic name) Appendix Abbreviations 375 Writing a prescription 376 Topical polypharmaceuticals 377 Pancreatic enzyme supplements 378 Guidelines for antimicrobial use 379 Radiographic contrast agents: MRI 382 Dosing small and exotic animals 384 Composition of intravenous fluids 385 Safety and handling of chemotherapeutic agents 385 Chemotherapy protocols for lymphoma 388 Body weight to body surface area conversion tables 394 Percentage solutions 394 Drugs usage in renal and hepatic insufficiency 395 Sedation/immobilization protocols Sedative combinations for dogs 397 Sedative combinations for cats 399 Sedative combinations for exotic pets 401 Suspected Adverse Reaction Surveillance Scheme 402 Further reading and useful websites 404 Index sorted by therapeutic class 405 Index (alphabetical by generic and trade names) 413 iv BSAVA Small Animal Formulary 7th edition Editorial Panel Sally Anne Argyle MVB CertSAC PhD MRCVS Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian EH25 9RG Nick Bexfield BVetMed DSAM DipECVIM-CA MRCVS Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES Daniel L. Chan DVM DipACVECC DipACVN FHEA MRCVS Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Herts AL9 7TA John Chitty BVetMed CertZooMed CBiol MSB MRCVS JC Exotic Pet Consultancy Ltd, Wombourne, Allington Track, Allington, Salisbury, Wilts SP4 0DD Simon Dennis BVetMed MVM CertVC DipECVIM-CA(Cardiology) MRCVS Department of Veterinary Clinical Studies, Royal Veterinary College, Hawkshead Lane, North Mymms, Herts AL9 7TA Clive M. Elwood MA VetMB MSc PhD CertSAC DipACVIM DipECVIM-CA MRCVS Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Herts SG5 3HR Heidi J. Featherstone BVetMed DVOphthal DipECVO MRCVS Willows Veterinary Centre & Referral Service, Highlands Road, Shirley, Solihull B90 4NH Simon J. Girling BVMS(Hons) DZooMed CBiol MSB MRCVS Royal Zoological Society of Scotland, Edinburgh Zoo, 134 Corstorphine Road, Edinburgh EH12 6TS Jenny Helm BVMS CertSAM MRCVS School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH Hilary A. Jackson BVM&S DVD DipACVD MRCVS Dermatology Referral Practice, 528 Paisley Road West, Glasgow G64 4JG Brigitte Lord BVetMed(Hons) CertZooMed MRCVS Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian EH25 9RG Fraser McConnell BVM&S DVR DipECVDI CertSAM MRCVS Small Animal Teaching Hospital, University of Liverpool, Chester High Road, Leahurst, Wirral CH64 7TE BSAVA Small Animal Formulary 7th edition v Daniel S. Mills BVSc PhD CBiol FIBiol FHEA CCAB DipECVBM-CA MRCVS Department of Biological Sciences, University of Lincoln, Riseholme Park, Lincoln LN2 2LG Jo Murrell BVSc(Hons) PhD DipECVAA MRCVS Department of Clinical Veterinary Science, University of Bristol, Langford, Bristol BS40 5DU Jacques Penderis BVSc MVM PhD CertVR DipECVN MRCVS School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH Ian Ramsey BVSc PhD DSAM DipECVIM-CA FHEA MRCVS School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH Molly Varga BVetMed DZooMed(Mammalian) MRCVS Cheshire Pet, Manor Lane, Holmes Chapel, Cheshire CW4 8AB vi BSAVA Small Animal Formulary 7th edition Preface to the seventh edition Welcome to the 7th edition of the BSAVA Small Animal Formulary.