Table Of Content

LLaasstt BBSSAAVVAA uuppddaatteedd MMaayy 22001144 SSmmaallll AAnniimmaall FFFFoooorrrrmmmmuuuullllaaaarrrryyyy 888ttthhh eeedddiiitttiiiooonnn EEddiittoorr--iinn--CChhiieeff IIaann RRaammsseeyy 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 (100 μg/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 (100 μg/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. Covers Spreads 8th edn INSIDE COVERS.indd 1 12/02/2014 15:34 A B C D Small Animal E F Formulary G 8th edition H I Editor-in-Chief: J Ian Ramsey BVSc PhD DSAM DipECVIM-CA FHEA MRCVS K School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH L Published by: British Small Animal Veterinary Association M Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB A Company Limited by Guarantee in England. N Registered Company No. 2837793. Registered as a Charity. O Copyright © 2014 BSAVA First edition 1994 P Second edition 1997 Third edition 1999 Reprinted with corrections 2000 Q Fourth edition 2002 Reprinted with corrections 2003 Fifth edition 2005 R Reprinted with corrections 2007 Sixth edition 2008 Reprinted with corrections 2009, 2010 S Seventh edition 2011 Reprinted with corrections 2012, 2013 Eighth edition 2014 T 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, U photocopying, recording or otherwise without prior written permission of the copyright holder. V A catalogue record for this book is available from the British Library. ISBN 978 1 905 319 65 7 W The publishers, editors and contributors cannot take responsibility for information provided on dosages and methods of application of drugs mentioned or referred to X 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 Y appropriate national legislation and regulations (for example, in the United Kingdom, the prescribing cascade) from time to time in force. Z Printed in India by Imprint Digital Printed on ECF paper made from sustainable forests. 2475MDC14 1 Prelims.indd 1 13/02/2014 10:30 ii BSAVA Small Animal Formulary 8th edition Other titles from BSAVA: A B Guide to Procedures in Small Animal Practice Guide to the Use of Veterinary Medicines (available online) C Manual of Canine & Feline Abdominal Imaging Manual of Canine & Feline Abdominal Surgery D Manual of Canine & Feline Advanced Veterinary Nursing Manual of Canine & Feline Anaesthesia and Analgesia E Manual of Canine & Feline Behavioural Medicine Manual of Canine & Feline Cardiorespiratory Medicine F Manual of Canine & Feline Clinical Pathology Manual of Canine & Feline Dentistry G Manual of Canine & Feline Dermatology Manual of Canine & Feline Emergency and Critical Care H Manual of Canine & Feline Endocrinology Manual of Canine & Feline Endoscopy and Endosurgery I Manual of Canine & Feline Gastroenterology Manual of Canine & Feline Haematology and Transfusion Medicine J Manual of Canine & Feline Head, Neck and Thoracic Surgery Manual of Canine & Feline Musculoskeletal Disorders K Manual of Canine & Feline Musculoskeletal Imaging L Manual of Canine & Feline Nephrology and Urology Manual of Canine & Feline Neurology M Manual of Canine & Feline Oncology Manual of Canine & Feline Ophthalmology N Manual of Canine & Feline Radiography and Radiology Manual of Canine & Feline Rehabilitation, Supportive and Palliative O Care: Case Studies in Patient Management Manual of Canine & Feline Reproduction and Neonatology P Manual of Canine & Feline Surgical Principles Manual of Canine & Feline Thoracic Imaging Q Manual of Canine & Feline Ultrasonography Manual of Canine & Feline Wound Management and Reconstruction R Manual of Exotic Pet and Wildlife Nursing Manual of Exotic Pets S Manual of Feline Practice Manual of Ornamental Fish T Manual of Practical Animal Care Manual of Practical Veterinary Nursing U Manual of Psittacine Birds Manual of Rabbit Medicine V Manual of Rabbit Surgery, Dentistry and Imaging Manual of Raptors, Pigeons and Passerine Birds W Manual of Reptiles Manual of Rodents and Ferrets X Manual of Small Animal Fracture Repair and Management Manual of Small Animal Practice Management and Development Y Manual of Wildlife Casualties Z For information on these and all BSAVA publications please visit our website: www.bsava.com 1 Prelims.indd 2 11/02/2014 14:54 BSAVA Small Animal Formulary 8th edition iii Contents A B Editorial Panel iv Preface to the eighth edition vi C Foreword vii D Introduction Notes on the monographs viii E Distribution categories ix The prescribing cascade xi F Drug storage and dispensing xii Health and safety in dispensing xiii G Drug listings and monographs 1 H (listed A–Z by generic name) I Appendix I: general information Abbreviations 421 J Writing a prescription 422 Topical polypharmaceuticals 423 K Guidelines for responsible antibacterial use 424 Radiographic contrast agents: MRI 427 L Dosing small and exotic animals 429 Composition of intravenous fluids 430 M Safety and handling of chemotherapeutic agents 430 Body weight to body surface area conversion tables 434 N Percentage solutions 434 Drugs usage in renal and hepatic insufficiency 435 O Suspected Adverse Reaction Surveillance Scheme 437 Further reading and useful websites 437 P Appendix II: protocols Q Chemotherapy protocols for lymphoma 439 Immunosuppression protocols 444 R Sedation/immobilization protocols Sedative combinations for dogs 448 S Sedative combinations for cats 450 Sedative combinations for exotic pets 451 T Index: therapeutic class 454 U Index: generic and trade names 462 V W X Y Z 1 Prelims.indd 3 11/02/2014 14:54 iv BSAVA Small Animal Formulary 8th edition Editorial Panel A B Karin Allenspach Drmedvet FVH Dip ECVIM-CA PhD FHEA MRCVS Department of Clinical Sciences and Services, Royal Veterinary C College, Hawkshead Lane, North Mymms AL9 7PT D Sally Anne Argyle MVB CertSAC PhD MRCVS Royal (Dick) School of Veterinary Studies, University of Edinburgh, E Roslin, Midlothian EH25 9RG F Nick Bexfield BVetMed PhD DSAM DipECVIM-CA CBiol FSB MRCVS School of Veterinary Medicine and Science, University of Nottingham, G Sutton Bonington Campus, Leicestershire LE12 5RD H Daniel L. Chan DVM DipACVECC DipACVN FHEA MRCVS Department of Clinical Science and Services, Royal Veterinary I College, Hawkshead Lane, North Mymms, Herts AL9 7TA J John Chitty BVetMed CertZooMed MRCVS Anton Vets, Anton Mill Road, Andover, Hants SP10 2NJ K L Simon Dennis BVetMed MVM DipECVIM-CA(Cardiology) MRCVS Ryan Veterinary Hospital – Cardiology Service, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA M N Heidi J. Featherstone BVetMed DVOphthal DipECVO MRCVS Willows Veterinary Centre & Referral Service, Highlands Road, Shirley, Solihull B90 4NH O P Polly Frowde MA VetMB DipECVIM-CA MRCVS Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Herts SG5 3HR Q R Simon J. Girling BVMS(Hons) DZooMed DipECZM CBiol FSB EurProBiol MRCVS Royal Zoological Society of Scotland, Edinburgh Zoo, S 134 Corstorphine Road, Edinburgh EH12 6TS T Jenny R. Helm BVMS CertSAM DipECVIM-CA FHEA MRCVS School of Veterinary Medicine, University of Glasgow, U Bearsden Road, Bearsden, Glasgow G61 1QH V Hilary A. Jackson BVM&S LRPS DVD DipACVD DipECVD MRCVS Dermatology Referral Practice Ltd, 528 Paisley Road West, W Glasgow G64 4JG X Fraser McConnell BVM&S DVR DipECVDI CertSAM MRCVS Small Animal Teaching Hospital, University of Liverpool, Y Chester High Road, Leahurst, Wirral CH64 7TE Z 1 Prelims.indd 4 11/02/2014 14:54 BSAVA Small Animal Formulary 8th edition v A B Daniel S. Mills BVSc PhD CBiol FSBiol FHEA CCAB DipECAWBM(BM) MRCVS C School of Life Sciences, University of Lincoln, Riseholme Park, Lincoln LN2 2LG D Jo Murrell BVSc(Hons) PhD DipECVAA MRCVS E Department of Clinical Veterinary Science, University of Bristol, Langford, Bristol BS40 5DU F Jacques Penderis BVSc MVM PhD CertVR DipECVN MRCVS G School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH H Ian Ramsey BVSC PhD DSAM DipECVIM-CA FHEA MRCVS I School of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH J Richard A. Saunders BSc(Hons) BVSc CBiol MSB CertZooMed K DZooMed (Mammalian) MRCVS Veterinary Department, Bristol Zoo Gardens, Clifton, L Bristol BS8 3HA M N O P Q R S T U V W X Y Z 1 Prelims.indd 5 11/02/2014 14:54 vi BSAVA Small Animal Formulary 8th edition Preface to the eighth edition A B Welcome to the 8th edition of the BSAVA Small Animal Formulary. Everyone involved in its production hopes you find it a useful C resource. There are 12 new drug monographs and there have been many deletions since the last edition as older drugs become D unavailable or newer drugs make them obsolete. Most of the remaining monographs have had minor revisions and some have had E major changes. The Appendix has been thoroughly revised and some of the information has been moved to the BSAVA website, where it is F accessible to BSAVA members. G The labelling of veterinary medicines has also been examined in greater depth than ever before. The law is clear, but not practical, and H veterinary surgeons must tread a fine line between compliance and practical solutions. Client Information Leaflets (CILs) are available I from the BSAVA for a number of the drugs listed in the Formulary which do not have a marketing authorization for veterinary use in the J UK. These leaflets go a long way towards providing practical information in a client-friendly format. However, they are not a K substitute for explaining the ‘Cascade’ system to owners and the details of the particular drugs that have been prescribed. L Drug formularies are progressively evolving works and the latest M updates are available on the BSAVA website. The doses provided should always be read in conjunction with the rest of the monograph, N which contains important information on the use of the drug. In an ideal world, all the information in this book would be based on O peer-reviewed literature. In reality, we rely on the experience of our Editorial Panel to integrate, and often extrapolate from, the variable P sources of information. Q I would, once again, like to thank the dedication of my colleagues on the Editorial Panel who have examined each monograph for scientific R accuracy, relevance and practical application. I am also grateful to the publishing team at Woodrow House for their assistance and S patience. I am indebted to the many readers and BSAVA members who have taken time to discuss with me and comment on entries in T the Formulary. U Ian Ramsey January 2014 V W X Y Z 1 Prelims.indd 6 11/02/2014 14:54 BSAVA Small Animal Formulary 8th edition vii Foreword A B The BSAVA Small Animal Formulary continues to be one of the Association’s most valued practical resources for veterinary surgeons C and is one of our key membership benefits. The availability of the Formulary as an app version for mobile devices has enhanced D enormously the rapid accessibility of this fundamental information in a practice setting. E Professor Ian Ramsey and his team are to be congratulated on bringing out this new and updated 8th edition of the Formulary. As F with previous editions of the Formulary, a number of new drug monographs have been added, whilst those drugs that are no longer G available to the veterinary profession have been removed. The major new addition to this 8th edition of the Formulary is the introduction of H examples of immunosuppressive protocols to the Appendix. I In recent years the prescribing of veterinary medicines has continued to have political prominence. In particular, concerns over J antimicrobial resistance in human and veterinary medicine have captured attention on a global scale. BSAVA, in collaboration with the K Small Animal Medicine Society (SAMSoc), has led the response of small animal practitioners to this debate. The PROTECT poster and L accompanying literature (freely available on the BSAVA website) provides practitioners with key facts and strategies to minimize M antimicrobial resistance in small animal practice. It is pleasing that the PROTECT concept has been adopted by other UK and N international associations in promoting this important message. O Professor Michael J. Day BSc BVMS(Hons) PhD DSc DipECVP FASM FRCPath FRCVS P BSAVA President 2013–14 Q R S T U V W X Y Z 1 Prelims.indd 7 11/02/2014 14:54 viii Introduction Introduction N O TI Notes on the monographs C U D • Name. The rINN generic name is used where this has been O R agreed. When a choice of names is available the more commonly T N used in the UK has been provided. The list of trade names is not I necessarily comprehensive, and the mention or exclusion of any particular commercial product is not a recommendation or otherwise as to its value. Any omission of a product that is authorized for a particular small animal indication is purely accidental. All monographs were updated in the period July–December 2013. Products that are not authorized for veterinary use by the Veterinary Medicines Directorate are marked with an asterisk. Note that an indication that a product is authorized does not necessarily mean that it is authorized for all species and indications listed in the monograph; users should check individual data sheets. You may also wish to refer to the VMD’s Product Information Database (www.vmd.defra.gov.uk/ ProductInformationDatabase/). • Formulations. Only medicines and formulations that are available in the UK have been included – many others are available outside the UK and some medicines in different formulations. Common trade names of human medicines are provided. In many cases they are available as generic formulations and may be cheaper. However, be careful of assuming that the bioavailability of one brand is the same as that of another. Avoid switching between brands unnecessarily. • Action and Use. Veterinary surgeons using this publication are warned that many of the drugs and doses listed are not currently authorized by the Veterinary Medicines Directorate (VMD) or the European Agency for the Evaluation of Medicinal Products (EMEA) (either at all or for a particular species), or manufacturers’ recommendations may be limited to particular indications. The decision, and therefore the responsibility, for prescribing any drug for an animal lies solely with the veterinary surgeon. Expert assistance should be obtained when necessary. The ‘cascade’ and its implications are discussed below. • Safety and handling. This section only outlines specific risks and precautions for a particular drug that are in addition to the general advice given below in the ‘Health and safety in dispensing’ section. A separate Appendix deals with chemotherapeutic drugs. • Contraindications and Adverse reactions: The list of adverse reactions is not intended to be comprehensive and is limited to those effects that may be of clinical significance. The information for both of these sections is taken from published veterinary and human references and not just from product literature. • Drug interactions. A listing of those interactions which may be of clinical significance. • Doses. These are based on those recommended by the manufacturers in their data sheets and package inserts, or are 2 Intro.indd 8 11/02/2014 14:58