Blackwell's Five-Minute Veterinary Consult Clinical Companion by Horwitz Debra Horwitz Debra

Author:Horwitz, Debra,Horwitz, Debra.
Language: eng
Format: epub
ISBN: 9781118854211
Publisher: John Wiley & Sons, Inc.
Published: 2018-01-08T00:00:00+00:00

Clomipramine: Canine: 1–3 mg/kg q 12 h.

Feline: 0.25–1 mg/kg q 24 h.

Contraindications/Precautions

Most medications that are used to treat canine and feline behavioral conditions are not FDA approved for this use. Therefore the clinician should advise the owner of any use of off-label medication, and document this communication.

Prior to medicating a pet, the animal should be examined and laboratory screenings conducted to evaluate the ability of the pet to metabolize and excrete the medication adequately. A minimum database should include CBC, chemistry panel, urinalysis and thyroid evaluation.

Transdermal doses have not been established, and poor absorption is a concern.

Use of TCAs such as amitriptyline or clomipramine in patients with cardiac abnormalities, seizures, or glaucoma should be avoided if possible, or only undertaken with extreme caution, as these drugs may potentiate pre-existing cardiac conduction problems.

Paradoxical reactions to and unacceptable side effects of the medications are possible. Side effects can include increased anxiety or aggression. The pet's response to therapy should be monitored, and treatment modified or discontinued when indicated.

Serotonin-enhancing medications should be used with caution and if possible avoided in animals that suffer from epileptiform seizures, as these drugs may aggravate the seizures.

Due to the potential for serious side effects, including fatal serotonin syndrome, concomitant use of multiple serotonin-enhancing medications should be undertaken with caution. This includes concurrent use with other SSRIs or TCAs, as well as MAO inhibitors (e.g., amitraz, selegiline) and tramadol.

TCA overdoses can cause profound cardiac conduction disturbances that lead to death. Therefore all medications should be stored and managed carefully.

Use caution when prescribing benzodiazepines for animals that are exhibiting any level of aggression, as these drugs may disinhibit aggression if they reduce fear-based inhibition of biting.

About 10% of animals exhibit a paradoxical reaction to benzodiazepines, and become anxious and agitated instead of calm and relaxed.

Diazepam-induced hepatotoxicity has been reported in some cats after oral administration. Therefore this drug and other benzodiazepines should be used with caution in cats.

Benzodiazepines are lipophilic, and their effects may be potentiated by other lipophilic drugs. If combination treatment is warranted, use lower dosages.

Benzodiazepines are a controlled substance and pose a risk of human abuse.

Use caution when prescribing alpha-2-adrenergic receptor agonists (e.g., clonidine) for patients with hypertension or cardiac disease, and in combination with drugs that increase norepinephrine levels.

Caution is advised when using psychotropic medications in conjunction with other CNS-active drugs, including general anesthetic, neuroleptic, anticholinergic, and sympathomimetic drugs.

Medications that are given for any substantial period of time should ideally be tapered down in dose rather than abruptly withdrawn.

For pets that are on long-term medication, an annual or semi-annual recheck (including physical examination, CBC, and chemistry panel) is recommended.

Consult individual drug monographs for complete lists of contraindications and precautions.

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