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Verapamil Toxicity in Cats and Dogs

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Verapamril has been shown to be effective treatment for supraventricular tachyarrhythmias, angina, variant angina, cardiomyopathy, and hypertension. Despite its wide use, systematic evaluation of the therapy of the toxic effects of verapamil has not been reported.

Pathophysiology: Verapamil is a negative inotropic agent but with therapeutic doses in man and conscious animals this effect is usually offset by baroreceptor-mediated increases in inotropy and heart rate. Verapamil is an calcium channel blocker used for treatment of cardiovascular disease. A cat that ingested a large dose of this agent developed clinical symptoms.

Species affected: Canine, Feline

Symptoms: Anorexia (complete, partial); Bradycardia; Dullness, depression, lethargy, depressed, lethargic, listless; Generalized weakness (paresis, paralysis); Inability to stand, prostration; Third degree (complete) atrioventricular heart block;

Public health importance: Verapamil intoxication produces severe haemodynamic deterioration in man and experimental animals due to its effects on both the heart and the peripheral circulation.

Treatment: 4-aminopyridine

References

  1. Gay R., et al., 1986, “Treatment of verapamil toxicity in intact dogs,” Journal of Clinical Investigation; 77(6): 1805-1811. [Web Reference]
  2. King A.M., Menke N.B., Katz K.D. and Pizon A.F., 2012, “4-aminopyridine toxicity: a case report and review of the literature,” Journal of Medical Toxicology; 8(3): 314-21. [Web Reference]
  3. Lee J.A., 2013, “Emergency Management and Treatment of the Poisoned Small Animal Patient,” Veterinary Clinics of North America: Small Animal Practice; 43:757-771 [Web Reference]
  4. MacPhail C. and Hackett T.B., 1998, “Verapamil toxicity in a cat,” Feline Practice; 26(5):16-17
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