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Vetm0407_

Toxicology Brief managing common poisonings in companion animals
P E T F O O D R E C A L LAminopterinand melamine identified in some of thetested samples of the re- called pet foods manufac-tured by Menu Foods (www.menufoods.com). How thesesubstances entered the pet food chainhasn't been determined. Investigatorsalso don't know whether these sub- Metformin is an antihyper-
glycemic prescription med-ication labeled for the treat- stances are the sole cause of the illness agent and an antimetabolite. At highdoses, it can cause crystalluria. MECHANISM OF ACTION
AND PHARMACOKINETICS
utilized in some fertilizers in Asia. The cause of their higher risk of serious ad- crystals in their renal tubules. The pre- cise composition of the crystals hasn’t to insulin.1,4,5 To a lesser degree, met- and urinalysis are recommended insymptomatic animals that have in- help dissolve the renal crystals. Ani-mals that are treated immediately or can be submitted to a diagnostic labora-tory for further analysis, or the body can “Metformin overdose in dogs and cats” was contributed by Jacqueline B. Heller, DVM, ASPCA Animal Poison Control Center, 1717 S.
Philo Road, Suite 3, Urbana, IL 61802. Dr.
Heller’s current address is VCA Aliso Viejo Dr.Volmer is an assistant professor at theCollege of Veterinary Medicine, University of Illinois, Urbana, IL 61802. She depart-ment editor for “Toxicology Brief.” Toxicology Brief PEER-REVIEWED
tion half-life in people is 6.2 hours.
most common nor any deaths have been directly at- CLINICAL SIGNS
AND TOXICITY
in cases of acute overdoses is rare.
(e.g. glyburide or glipizide), met- cose from lactate (via the Cori cycle).
Toxicology Brief PEER-REVIEWED
Drug Dosages for Treating Gastrointestinal Upset
Dosage for Dogs
Dosage for Cats
Metoclopramide
0.1– 0.4 mg/kg every 6 hours orally,
Same as for dogs
subcutaneously, or intramuscularly
Sucralfate
0.5–1 g orally every 8 to 12 hours
0.25–0.5 g orally every 8 to 12 hours
Famotidine
0.5 mg/kg orally, subcutaneously, or
Same as for dogs
intramuscularly every 12 to 24 hours
Ranitidine
0.5–2 mg/kg orally, intravenously, or
2.5 mg/kg intravenously every 12 hours
intramuscularly every 8 to 12 hours
or 3.5 mg/kg orally every 12 hours
Omeprazole
0.5–1 mg/kg orally once daily
0.7 mg/kg orally once daily
TREATMENT
AND MONITORING
PROGNOSIS
In general, an animal’s prognosis after ive care directed toward specific signs.
signs are routinely all that develop.
1. Rosendale M. Diabetes medications. In: Plumlee KH, ed.
Clinical veterinary toxicology. St. Louis, Mo: Mosby, 2004;316-318.
2. Michels GM, Boudinot DF, Ferguson DC, et al. Pharmaco-
kinetics of the antihyperglycemic agent metformin in cats.
Am J Vet Res 1999;60:738-742.
3. Cowan SM, Bunch SE. Oral antidiabetic drugs for cats. Com-
pend Contin Educ Prac Vet 2001;23:633-641.
4. Ellenhorn MJ. Drugs. In: Ellenhorn’s medical toxicology: diag-
such as metoclopramide (Table 1); in- nosis and treatment of human poisoning. 2nd ed. Baltimore, Md: Lippincott, Williams & Wilkins, 1997;728-731.
5. Kirpichnikov D, McFarlane SI, Sowers JR. Metformin: an
update. Ann Intern Med 2002;137:25-33.
fluids, such as lactated Ringer’s solu- 6. Cheng AY, Fantus IG. Oral antihyperglycemic therapy for
type 2 diabetes mellitus. CMAJ 2005;172:213-226.
7. Plumb DC. Veterinary drug handbook. 5th ed. Ames: Iowa
State University Press, 2005;498-499.
8. POISINDEX editorial staff: Metformin and related agents,
POISINDEX System, Vol. 124, MICROMEDEX, Englewood, Colo. Expires 6/2005. Access it at: http://www.mi-cromedex.com/products/poisindex.
9. Glucophage [drug insert]. Bristol-Myers Squibb Co;
Princeton, NJ. Revised March 2004.
10.Greco DS. Treatment of non-insulin dependent diabetes mellitus
using oral hypoglycemic agents. In: Bonagura JD, ed. Kirk’s current vet- erinary therapy XIII. Philadelphia, Pa: WB Saunders Co, 2000;350-354.
11. AHFS drug information. McEvoy GK, ed. American Society
of Health-System Pharmacists, Bethesda, Md 2003;3024-3025.
12. Teale KF, Devine A, Stewart H, et al. The management of
metformin overdose. Anaesthesia 1998;53:698-701.
13. Spiller HA, Weber JA, Winter ML, et al. Multicenter case se-
ries of pediatric metformin ingestion. Ann Pharmacother2000;34:1385-1388.
14. Nelson R, Spann D, Elliott D, et al. Evaluation of the oral
antihyperglycemic drug metformin in normal and diabeticcats. J Vet Intern Med 2004;18:18-24.
15. Phillips SL, Polzin DJ. Clinical disorders of potassium
homeostasis. Hyperkalemia and hypokalemia. Vet Clin NorthAm Small Anim Pract 1998;28:545-564.

Source: http://aspcapro.org/sites/pro/files/zb-vetm0407_231-234_0.pdf

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