lactaluse and megacolon

Gautam Unny Megacolon a case of chronic obstipation currently being treated with lactulose and cisapride.

SAVIN- Small Animal Veterinary Information Network photos

25 December at 09:57 ·

Subbu Ayyappan

Gautam, Nice pict. Megacolon is more common in cats. The case also seems to have lumbar spondylosis.Try the usual protocols such as high fibre low residue diet.The best treatment of choice is colectomy. You can remove up to 70% of the intestines.

25 December at 16:56

Swarupmay Majumdar

sir, what will be the side effect of such operations.. dog may have frequent defecations? correct?

Sat at 12:49 ·

Saurabh Saxena

http://www.vetsurgerycentral.com/megacolon.htm

Sat at 12:55

Sivashankar Ramakrishnan

how abut lactulose

Sat at 22:01

Sivashankar Ramakrishnan

in combination with ursdexycholic acid and l arginine tablets
it works great in dogs

Sat at 22:07

Gautam Unny

doc can u provide tradenames please, would appreciate it.

Sun at 09:31

Sivashankar Ramakrishnan

Dear Dr Gautam
Lactulose alone is effective for mega colon but if it is there with signs of anorexia indicative of Hepatic Encephalopathy (due fecal toxins) the above combination could be used and available in India as
Lactulose -Rapiduce
L-Ornithine L-Aspartate (Hepamerz)
Ursdeoxychlic acid (Udoxyl)... See More
Other essential amino acids for liver ( Essentiale L)

Sun at 13:33

Swarupmay Majumdar

great work, keep it up friends. The group is standing up

Yesterday at 13:18 ·

Tinocordin (immumod) for immunity stimulation

SAVIN Board 3: Immune modulators in Skin Diseases

Board innitiated by Dr Swarupmay Majumdar.

Swarupmay Majumdar Boxer, Male, 4 yrs. H/ O- regular skin problems, been treated by many vets with antibiotics and steroids. relapses aftre initial improvements, frustrated owner wants something to be done.
P/E finding : generalized & symmetrical areas of alopecia & epidermal collarette. nodules all over dorasum, greasiness, typical smell,... halitosis, weight loss over 1 month, trebling on standing, interdigital ulcerated wound. already on predinsolone, bayrocin. regular food: on beef ,rice, eggs, biscuits,milk.

how to go ahead, what an all to think, shall do blood work ,urine tests, any suggestions please.

Sat at 13:04 ·

Saurabh Saxena

this is wat i wud do-a hot warm bath with petben shampoo for atleast 20 minutes followed by amitraz dip.dental cleaning and appl. of silverex cream on open wound.stop predni and beef.

Sat at 18:25 ·

Swarupmay Majumdar

ok, good. But I would like you to go more deep, why is it coming again and again. can it be anything related to diabetes? food allergy? what else....

Sat at 18:27 ·

Saurabh Saxena

doc ,ur principle -keep things simple...follow the bath atleast 2 times in week for a month.notice the progress

Sat at 18:33 ·

Sivashankar Ramakrishnan

Majum Thyrid Check Kiya Kya?

Sun at 13:35 ·

Swarupmay Majumdar

I am going to do that.

Yesterday at 13:16 ·

Swarupmay Majumdar

Actully I did not think abt thyroid, as he was loosing wt. I just put him on fatty acids, bayrocin, no steroids,kidspro food, and rantac. discussed with owner about food related allergy and advised them avoid the list of food and if possible change to Hypoallergenic from RC. Dog is better. yesterday I just tried on him Levamisole just to see whether it improves its immunity!!

Yesterday at 13:39 ·

Gautam Unny

try tinocordin (immumod) for immunity stimulation, its very good and effective. i have always wondered why vets ever use steroids on the skin, unless really needed. its the simplest way to disaster. would like the dog on griseofulvin 50mg/kg/day for 21 days with fat in the diet.

Yesterday at 18:33 ·

Swarupmay Majumdar

I had stopped using unnecessary steroids long back in the college days and been laughed at. I will try immumod. Is it a syp or tablet or injection? dose ?

Yesterday at 20:24 ·

Gautam Unny

Immumod is available as a tab nd syrup. I dont know the exact dose as its not there in any text. I use 100mg for 10 kg dog. available as a 100 nd 500 mg tab

Yesterday at 20:25 ·

Sucralfate

For Veterinary Use

	Overview Therapeutic Class Local gastro-protectant Species Dogs, cats and horses Commonly prescribed by vets for: Ulcers within the gastro-intestinal tract FDA Status No veterinary approved products available.

Basic Information

Sucralfate is a hydroxy aluminum salt of sucrose octasulfate that acts as a local-mucosal adherent. In an acidic environment, sucralfate forms a sticky viscose gel that adheres to protenacious exudates within an ulcer crater. This "band aid" effect lasts about six hours. At a higher pH, sucralfate may remain in suspension, but may improve the gastric environment by adsorbing pepsin, buffering hydrogen ions, stimulating prostaglandin E, increasing bicarbonate secretion, stimulating mucous secretion and binding epidermal growth factor. The absorption of sucralfate is minimal; its actions are local rather than systemic and it does not affect gastric acid output or enzyme activity. Sucralfate is used in the treatment of oral, esophageal, gastric, duodenal and colonic ulcers. Usually, sucralfate is given on an empty stomach.

Dogs and Cats

Sucralfate is used for the treatment of ulcers and upper GI disorders of dogs and cat. Common causes of GI erosion and ulceration in dogs include drugs (particularly NSAIDs and corticosteroids), toxic chemical ingestion, liver disease, renal failure, carcinoma, stress (trauma, shock, sepsis and burns), inflammatory bowel disease, mast-cell tumors, hypoadrenocorticism and any condition causing an excessive secretion of gastric acid.

Side Effects

Side effects are rare. Constipation and hypo-phosphatemia may occur in a small percentage of patients.

Precautions

• Sucralfate may decrease the rate of gastric emptying and slow GI transit time.

Drug Interactions

• Sucralfate may affect the absorption of many drugs and, in general, administration should be separated for other oral drugs including: NSAIDs, H2 receptor antagonists, fluoroquinolones, digoxin, ketoconazole, levothyroxine, penicillamine, tetracyclines, fat-soluble vitamins and warfarin.

Overdose

• It is unlikely that an overdose of sucralfate will cause clinical problems because it is so poorly absorbed. Very high doses (50X) have been administered to laboratory animals without mortality.

Acepromazine Maleate

For Veterinary Use

	Overview Therapeutic Class Phenothiazine tranquilizer Species Dogs, cats and horses Commonly prescribed by vets for: Tranquilization, sedation, anti-anxiety, and anti-emetic.

Basic Information

Acepromazine maleate is a phenothiazine derivative that is used as a neuroleptic agent in veterinary medicine. It is a commonly used tranquilizer for dogs, cats and horses. Phenothiazines decrease dopamine levels and depress some portions of the reticular activating system. Acepromazine is metabolized by the liver and excreted in the urine.

In addition to tranquilization, acepromazine has multiple other important systemic effects including anti-cholinergic, anti-emetic, antispasmodic, antihistaminic, and alpha-adrenergic blocking properties. Acepromazine causes hypotension due to decreased vasomotor tone. It may change heart and respiratory rate, and thermoregulatory ability allowing for either hypo- or hyperthermia.

Acepromazine may be given intramuscularly, intravenously or orally. It provides no analgesia and the tranquilizing effect of the drug can be overcome unexpectedly particularly by sensory stimulation. Acepromazine is usually less effective if given after the animal is excited. There is a great deal of individual variability in the response to acepromazine and despite being a very commonly used medication there are important species and even breed differences in response to acepromazine that need to be taken into consideration (see precautions).

Dogs and Cats

Acepromazine is one of the most commonly used tranquilizers for cats and dogs. It decreases anxiety, causes central nervous system depression, and a drop in blood pressure and heart rate. It may be used in conjunction with atropine as a pre-operative medication for anxiety and for its antidysrhythmic effects. Oral acepromazine may be prescribed to prevent motion sickness, to temporarily reduce itching and scratching due to allergies, or prior to office visits, nail trimming or grooming appointments if the animal is too fractious to handle safely without sedation. Some veterinarians are reluctant to prescribe acepromazine for travel anxiety when the animal may be exposed to temperature extremes, such as during plane travel, or when there may be limited access to veterinary care. Other drugs used for travel anxiety/motion sickness include meclizine, diphenhydramine, and diazepam. Occasionally, animals (particularly cats) may have a paradoxical response to acepromazine and become excited, or aggressive.

Horses

Acepromazine is one of the most commonly used tranquilizers for horses.
It may be used alone or in combination with other sedative drugs such as xylazine, detomidine, or butorphanol. Because acepromazine lowers blood pressure by dilating small blood vessels, it is sometimes prescribed in the early treatment of laminitis in order to diminish vaso-spasm and possibly improve circulation within the hoof. Acepromazine is also used in horses that are prone to exertional rhabdomyolysis both as a preventative, and as a part of the treatment due to its vasodilatory properties. When acepromazine is used in the treatment of more severe cases of exertional rhabdomyolysis, intravenous fluids may be desirable to increase hydration and support renal function.

Onset of action of acepromazine varies with route of administration: oral acepromazine may take 30 minutes to an hour. The effects of acepromazine will last from 1 to 4 hours, but this varies significantly with dose and among individual horses. Acepromazine is a prohibited substance in most sanctioned competition. Oral administration or long-term, repeated dosing may increase detection time.

Side Effects

• Common: Acepromazine will cause hypotension, decreased respiratory rate and bradycardia. Dogs are particularly sensitive to cardiovascular side effects but cardiovascular collapse has also occurred in cats. Sudden collapse, decreased or absent pulse and breathing, pale gums, and unconsciousness may occur in some animals.

• Rare: fatal interactions with anesthetics have been reported.

• Acepromazine will cause a dose dependent decrease in hematocrit in both dogs and horses. This effect occurs within 30 minutes of administration and may last for 12 hours or more. The hematocrit in horses may decrease by as much as 50%.

• Penile paralysis is a rare but recognized adverse side effect of acepromazine use in the horse. This drug should be avoided in breeding stallions.

Precautions

• Acepromazine lowers blood pressure: it should not be used in animals that are dehydrated, anemic or in shock.

• Acepromazine should be avoided or used with extreme caution in older animals, or those with liver disease, heart disease, injury, or debilitation. If it is used in these animals, it should be given in very small doses. In some older animals, a very small dose can have a marked and very prolonged effect.

• Acepromazine should not be used in animals with a history of epilepsy, those prone to seizures, or those receiving a myelogram because it may lower the seizure threshold.

• Acepromazine should not be used in animals with tetanus or strychnine poisoning.

• Acepromazine should be avoided in pregnancy or lactation. It should be avoided or used with extreme caution in young animals due to its effects on an animal's ability to thermo regulate.

• Dogs: Giant breeds and greyhounds may be extremely sensitive to acepromazine, while terriers may require higher doses. Brachycephalic breeds, especially Boxers, are particularly prone to cardiovascular side effects (drop in blood pressure and slow heart rate). Acepromazine should be avoided or used with great caution in these breeds.

• Horses: Draft horse breeds are especially sensitive to most sedatives including acepromazine. Pony breeds do not appear to differ from horses in their response to acepromazine.

Drug Interactions

• Animals receiving acepromazine will require lower doses of barbiturates, narcotics, and other anesthetics. These combinations increase central nervous system depression.

• Antidiarrheal mixtures like Kaopectate and Pepto-Bismol, or antacids decrease the absorption of oral acepromazine.

• Acepromazine should not be used within one month of deworming with organophosphate compounds.

• Quinidine, epinephrine, propanolol, procaine hydrochloride and phenytoin have all been shown to have significant drug interactions with phenothiazines. Further information should be sought before concomitant administration.

Overdose

• Overdose will cause excessive sedation, slow respiratory and heart rate, pale gums, unsteady gait, poor coordination, and inability to stand. It may also cause sudden collapse, unconsciousness, seizures and death.

• Oral overdose should be treated by emptying the stomach along with monitoring and other supportive care.

• Phenylephrine and norepinephrine are the drugs of choice to treat acepromazine-induced hypotension. Barbiturates, or diazepam may be used for the treatment of seizures associated with overdose.

Enalapril For Veterinary Use

Overview

Therapeutic Class
Angiotensin-converting enzyme (ACE) inhibitor
Species
Dogs and Cats
Commonly prescribed by vets for:
Congestive heart failure (CHF), hypertension, chronic renal-failure, protein-losing nephropathies.
Vet drug status Status
Approved for use in the dog; however, no veterinary products are commercially available.

Basic Information

Enalapril is an ACE inhibitor that blocks the formation of angiotensin II. It is used as a vasodilator in the treatment of CHF and systemic hypertension. It is also used in animals with chronic renal failure and protein-losing nephropathies.

Enalapril acts as a competitive inhibitor of the ACE responsible for converting angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor and when its concentrations are decreased, peripheral vascular resistance decreases, blood pressure decreases, aldosterone levels are reduced and plasma-renin activity is increased.

Dogs and cats

Enalapril is used in dogs and cats for the treatment of CHF, occult-dilated cardiomyopathy and systemic hypertension. In large studies of dogs with moderate to severe heart disease due to mitral regurgitation or dilated cardiomyopathy, enalapril improved survival by greater than 100 percent, improved quality of life, improved exercise tolerance and decreased pulmonary edema. When treating CHF in dogs, enalapril is frequently combined with other drugs, such as furosemide, spironolactone or a positive-inotropic drug. Enalapril may be combined with beta-blockers in the treatment of occult-dilated cardiomyopathy or systemic hypertension. The value of enalapril in the treatment of degenerative-mitral valve disease of small breed dogs is still being investigated. While enalapril may be used to treat mild hypertension in cats, alodipine may be more effective for cats with severe hypertension.

Enalapril is used to treat chronic renal failure and proteinuria. By blocking the production of angiotensin II, enalapril causes vasodilation of the glomerular-efferent arterioles, decreases intraglomerular pressure and reduces the glomerular filtration rate (GFR). The improvement in renal function is postulated to be due to the anti-hypertensive effect, the reduction in mesangial-cell proliferation and renal vasodilation, which causes a decrease in renal-filtration pressure and decreased proteinuria.

Side Effects

The most common side effects are hypotension, weakness, lethargy, GI upset (anorexia, vomiting or diarrhea), hyperkalemia and renal dysfunction. Although enalapril is used to treat chronic renal failure, there are instances of mild to moderate reversible renal failure, which may be precipitated by volume depletion superimposed on dilatation of the efferent arterioles.

Precautions

• Patients receiving enalapril should be monitored regularly for arterial blood pressure, renal function and serum electrolytes.

• If an animal shows adverse effects due to enalapril, withdrawal followed by a lower dose or a longer dosing-interval may be helpful. Severely azotemic animals should start with once-a-day dosing while being closely monitored for renal function.

• Some dogs appear to be dependant on the effects of angiotensin II for maintaining GFR. While this is unusual, this subpopulation will not tolerate ACE-inhibitor drugs.

• Enalapril should be avoided in pregnant or lactating animals.

Drug Interactions

• Diuretics and other vasodilators may increase the incidence of hypotension or hyperkalemia. Careful monitoring and adjustment of drug therapies may be necessary to reach the optimal therapeutic balance.


• NSAIDs, including aspirin, should be avoided in animals on enalapril.

Overdose

• If an overdose is recognized promptly, gut-emptying protocols should be attempted. Hypotension is the most clinically significant problem when managing an overdose of enalapril. Hospitalization with volume expansion, blood-pressure monitoring and supportive care may be necessary.

Board 3- popttasium bromide in epilepsy

board 3: KBr in epilepsy

innitiated by Dr Swarupmay Majumdar
18.12.2009

Swarupmay Majumdar I am treating many cases of Epilepsy. Recently KBR is available in Bangalore in tablet form for dogs. It is giving good result.

18 December at 19:50 ·

Gautam Unny

whats the tradename doc? i have not found it here

19 December at 09:34 · Report

Kumar Vikas

Are you using of chemical origin, what protocol you are following

19 December at 15:39 ·

Kumar Vikas

Detail article avaible on epilepsy at http://www.ivis.org/advances/Vite/berendt/chapter_frm.asp?LA=1 this may be help ful review

19 December at 15:48 ·

Swarupmay Majumdar

there is company called progeny in bangalore ( pharma corporation of India) makes this generic medicine without any trade names. it comes in 60 tablets bottle. cost around 175 rupees.
Actually KBr is the oldest drug in epilepsy but not used in human beings. It is the drug of choice for dogs for long run. I have an article on this.

http://www.whereincity.com/medical/topic/brain-health/articles/758.htm

19 December at 16:27 ·

Swarupmay Majumdar

actually I had been treating a GSD M 2 yrs old with epilepsy. Its full blood data was normal. I put him on regualr Known therapy of gardenal 45mg bid with Ventriliv, provicalpet.
for sometimes he was finding vey difficult to manage the fits and we increased the dose to 60 mg bid. he was also on homeopathic medicine Verbena Mt, R33 and rescue remedy. Nothing worked still KBr was in . 300mg KBr tablets bid with 30mg gardenal bid. its takes some time ... 3 months atleast to reach steady KBr level. dog has no fits now but he finds difficult walking and lots of itching. Some how it was briught from the euthenesia table with KBr.

Need more disscussion on
1. KBr Vs NBr... See More
2. home care when dog is in fits
3.managing fits in clinic.
5. why these pets are best pets
6.rescu remedy and how it can help

19 December at 16:35 ·

Kumar Vikas

As suggested by Dr Dinesh Dadarwal there is good article on epilesy at http://neuro.vetmed.ufl.edu/Neuro/courses/vem5384/VEM5384-lecture-4-seizure-cerebral.pdf

Sun at 09:02 ·

Board 2- vaccination reactions

Board 2:: innitiated by Dr Swarupmay Majumdar

Date 21.12.2009

Swarupmay Majumdar I am going to look after a pug. Its 6 years now.This is the time for his regular vaccination, and owner brings to my clinic for his shots but inform me ,whenever he had his shots he had tough time.. breathless, vomiting, crying... how Do I go ahead and what shall I ask the owner to do? vaccination reactions related

Mon at 20:41 ·

Gautam Unny

give him a dose of avil before starting the vaccine. keep him aat the clinic for an hour aand keep adrenaline handy.

Yesterday at 09:13 ·

Swarupmay Majumdar

can I give dexa, its short acting and may not affect vaccination?

8 hours ago ·

Gautam Unny

doc, im long out of college but if i remember right dexa is long acting and prednisolone intermediate acting. try this link. thats why i suggeseted pred

http://www.globalrph.com/corticocalc.htm

7 hours ago ·

Swarupmay Majumdar

Actually I meant, If I use it once, will there be any problem with vaccination? I read your link also.

6 hours ago ·

Gautam Unny

prednisolone would be better as its shorter acting and will not supress antigen formation for long. i prefer it over dexa.

2 hours ago ·