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Intranasal Midazolam versus Rectal Diazepam for the Management of Canine Status Epilepticus: A Multicenter Randomized Parallel-Group Clinical Trial.
Charalambous, M; Bhatti, S F M; Van Ham, L; Platt, S; Jeffery, N D; Tipold, A; Siedenburg, J; Volk, H A; Hasegawa, D; Gallucci, A; Gandini, G; Musteata, M; Ives, E; Vanhaesebrouck, A E.
Afiliación
  • Charalambous M; Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • Bhatti SFM; Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
  • Van Ham L; Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • Platt S; Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • Jeffery ND; Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
  • Tipold A; Small Animal Department, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
  • Siedenburg J; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
  • Volk HA; Clinical Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria.
  • Hasegawa D; Department of Clinical Science and Services, Royal Veterinary College, London, UK.
  • Gallucci A; Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan.
  • Gandini G; Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
  • Musteata M; Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
  • Ives E; Department of Clinical Veterinary Medicine, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Iasi, Iasi, Romania.
  • Vanhaesebrouck AE; Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
J Vet Intern Med ; 31(4): 1149-1158, 2017 Jul.
Article en En | MEDLINE | ID: mdl-28543780
BACKGROUND: Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. OBJECTIVE: To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available. ANIMALS: Client-owned dogs with idiopathic or structural epilepsy manifesting status epilepticus within a hospital environment were used. Dogs were randomly allocated to treatment with IN-MDZ (n = 20) or R-DZP (n = 15). METHODS: Randomized parallel-group clinical trial. Seizure cessation time and adverse effects were recorded. For each dog, treatment was considered successful if the seizure ceased within 5 minutes and did not recur within 10 minutes after administration. The 95% confidence interval was used to detect the true population of dogs that were successfully treated. The Fisher's 2-tailed exact test was used to compare the 2 groups, and the results were considered statistically significant if P < .05. RESULTS: IN-MDZ and R-DZP terminated status epilepticus in 70% (14/20) and 20% (3/15) of cases, respectively (P = .0059). All dogs showed sedation and ataxia. CONCLUSIONS AND CLINICAL IMPORTANCE: IN-MDZ is a quick, safe and effective first-line medication for controlling status epilepticus in dogs and appears superior to R-DZP. IN-MDZ might be a valuable treatment option when intravenous access is not available and for treatment of status epilepticus in dogs at home.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Epiléptico / Midazolam / Diazepam / Enfermedades de los Perros / Anticonvulsivantes Límite: Animals Idioma: En Revista: J Vet Intern Med Asunto de la revista: MEDICINA INTERNA / MEDICINA VETERINARIA Año: 2017 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Epiléptico / Midazolam / Diazepam / Enfermedades de los Perros / Anticonvulsivantes Límite: Animals Idioma: En Revista: J Vet Intern Med Asunto de la revista: MEDICINA INTERNA / MEDICINA VETERINARIA Año: 2017 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos