Severe lamotrigine toxicosis in a dog

Danielle Sawyer, Kathryn Gates Emergency and Critical Care Department, Advanced Critical Care and Emergency Specialty Services, Culver City, CA, USA Objective: The objective of this study was to describe a case of severe lamotrigine toxicosis in a dog, which was successfully treated using minimal me...

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Autores principales:	Sawyer D, Gates K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Arrhythmia Toxicity Multifocal Ventricular Tachycardia Poison Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/0537d6a98d874f0aa2995c0113a11f40
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spelling	oai:doaj.org-article:0537d6a98d874f0aa2995c0113a11f402021-12-02T01:41:32ZSevere lamotrigine toxicosis in a dog2230-2034https://doaj.org/article/0537d6a98d874f0aa2995c0113a11f402017-04-01T00:00:00Zhttps://www.dovepress.com/severe-lamotrigine-toxicosis-in-a-dog-peer-reviewed-article-VMRRhttps://doaj.org/toc/2230-2034Danielle Sawyer, Kathryn Gates Emergency and Critical Care Department, Advanced Critical Care and Emergency Specialty Services, Culver City, CA, USA Objective: The objective of this study was to describe a case of severe lamotrigine toxicosis in a dog, which was successfully treated using minimal medical interventions. Case summary: A 7-month-old male, intact, Labrador mix was evaluated because of acute onset of vomiting, rigidity, and dull mentation after ingesting lamotrigine tablets. The estimated oral dose that had been ingested was 278 mg/kg (611.6 mg/lb). Physical examination was unremarkable other than abnormalities noted in the cardiovascular and neurological systems. Neurological examination revealed dull mentation, vertical nystagmus, four-legged extensor limb rigidity, and alligator rolling. Cardiovascular examination revealed pale pink mucous membranes and multifocal ventricular tachycardia. Intravenous (IV) fluids were started at three times maintenance (180 mL/kg/day). Methocarbamol (100 mg/kg [220 mg/lb], rectally) and lidocaine (2 mg/kg [4.4 mg/lb, IV]) were administered. Twenty-four and seventy-two hours after presentation, the dog was clinically normal with no ventricular tachycardia being noted. Conclusion: Lamotrigine (6-[2,3-dichlorophenyl]-1,2,4-triazine-3,5-diamine) is an anticonvulsant medication used in humans, which inhibits voltage-gated sodium channels. The clinical success of this case suggests that administration of only methocarbamol for the neurologic effects and lidocaine for the arrhythmias, as well as supportive IV fluid therapy, could be a successful treatment strategy for dogs, even with severe lamotrigine toxicosis. Keywords: arrhythmia, toxicity, multifocal ventricular tachycardia, poisonSawyer DGates KDove Medical PressarticleArrhythmiaToxicityMultifocal Ventricular TachycardiaPoisonVeterinary medicineSF600-1100ENVeterinary Medicine: Research and Reports, Vol Volume 8, Pp 27-30 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arrhythmia Toxicity Multifocal Ventricular Tachycardia Poison Veterinary medicine SF600-1100
spellingShingle	Arrhythmia Toxicity Multifocal Ventricular Tachycardia Poison Veterinary medicine SF600-1100 Sawyer D Gates K Severe lamotrigine toxicosis in a dog
description	Danielle Sawyer, Kathryn Gates Emergency and Critical Care Department, Advanced Critical Care and Emergency Specialty Services, Culver City, CA, USA Objective: The objective of this study was to describe a case of severe lamotrigine toxicosis in a dog, which was successfully treated using minimal medical interventions. Case summary: A 7-month-old male, intact, Labrador mix was evaluated because of acute onset of vomiting, rigidity, and dull mentation after ingesting lamotrigine tablets. The estimated oral dose that had been ingested was 278 mg/kg (611.6 mg/lb). Physical examination was unremarkable other than abnormalities noted in the cardiovascular and neurological systems. Neurological examination revealed dull mentation, vertical nystagmus, four-legged extensor limb rigidity, and alligator rolling. Cardiovascular examination revealed pale pink mucous membranes and multifocal ventricular tachycardia. Intravenous (IV) fluids were started at three times maintenance (180 mL/kg/day). Methocarbamol (100 mg/kg [220 mg/lb], rectally) and lidocaine (2 mg/kg [4.4 mg/lb, IV]) were administered. Twenty-four and seventy-two hours after presentation, the dog was clinically normal with no ventricular tachycardia being noted. Conclusion: Lamotrigine (6-[2,3-dichlorophenyl]-1,2,4-triazine-3,5-diamine) is an anticonvulsant medication used in humans, which inhibits voltage-gated sodium channels. The clinical success of this case suggests that administration of only methocarbamol for the neurologic effects and lidocaine for the arrhythmias, as well as supportive IV fluid therapy, could be a successful treatment strategy for dogs, even with severe lamotrigine toxicosis. Keywords: arrhythmia, toxicity, multifocal ventricular tachycardia, poison
format	article
author	Sawyer D Gates K
author_facet	Sawyer D Gates K
author_sort	Sawyer D
title	Severe lamotrigine toxicosis in a dog
title_short	Severe lamotrigine toxicosis in a dog
title_full	Severe lamotrigine toxicosis in a dog
title_fullStr	Severe lamotrigine toxicosis in a dog
title_full_unstemmed	Severe lamotrigine toxicosis in a dog
title_sort	severe lamotrigine toxicosis in a dog
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/0537d6a98d874f0aa2995c0113a11f40
work_keys_str_mv	AT sawyerd severelamotriginetoxicosisinadog AT gatesk severelamotriginetoxicosisinadog
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Severe lamotrigine toxicosis in a dog

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