Metronidazole neurotoxicosis in two cats

Caylor, K B; Cassimatis, M K

doi:10.5326/15473317-37-3-258

Cited by 60 publications

(38 citation statements)

References 20 publications

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“…16 Central nervous system (CNS) side effects associated with metronidazole toxicosis have been reported in humans 2,9,[11][12][13][14] and in veterinary species, including rats, 19 dogs, 5,6,8,21,25 and cats. 4,20 Peripheral neuropathies are frequently reported in human cases of metronidazole toxicosis; however, nausea, dizziness, tremors, ataxia, and seizures have also been reported. In dogs and cats, central vestibular and cerebellar dysfunctions resulting in ataxia, nystagmus, head tilt, tremors, and seizures are commonly reported in cases of metronidazole toxicosis.…”

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confidence: 99%

Putative Metronidazole Neurotoxicosis in a Cat

Olson

Morales²,

McVey

et al. 2005

Vet Pathol

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Abstract.A presumptive case of metronidazole toxicity in a 3.4-kg adult cat is described. The cat had been treated for suspected inflammatory bowel disease with an anti-inflammatory dose of prednisone and metronidazole (73.5-147 mg/kg PO q24h) for approximately 40 days prior to presentation. Clinical signs were primarily related to the central nervous system, including acute tetraparesis, unresponsiveness, tremors, and vocalization. The patient was euthanatized after 12 days of supportive care. Necropsy revealed no significant macroscopic lesions. Histologic evaluation revealed multifocal, fairly well-demarcated foci of necrosis in the brainstem, extending from the diencephalon to the medulla oblongata. To our knowledge, this is the first report to document histologic lesions associated with metronidazole administration in a cat.

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confidence: 99%

Putative Metronidazole Neurotoxicosis in a Cat

Olson

Morales²,

McVey

et al. 2005

Vet Pathol

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“…O metronidazol é usado na medicina veterinária para o tratamento de uma grande variedade de doenças, incluindo infecções protozoárias, infecções anaeróbias, gastrite por Helicobacter, doença intestinal inflamatória e encefalopatia hepática (CAYLOR;CASSIMATIS, 2001).…”

Section: Introductionunclassified

“…Neste estudo, postulou-se que o metronidazol liga-se ao RNA neuronal e inibe a síntese protéica, causando posteriormente a degeneração axonal. Foi proposto que essa especificidade pode ser responsável por uma possível interferência do metronidazol com processos metabólicos (CAYLOR;CASSIMATIS, 2001). Outros autores propuseram que o mecanismo incluiria a ligação do metronidazol com o RNA, DNA e neurotransmissores inibitórios, como nos receptores GABAérgicos nos sistemas vestibular e cerebelar (OLSON et al, 2005;SARNA;BROWNELL;FURTADO, 2009).…”

Section: Introductionunclassified

Intoxicação por metronidazol em cão – relato de caso

Heckler

Costa

et al. 2012

Sem. Ci. Agr.

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ResumoO metronidazol é um antibiótico nitronidazólico usado na medicina veterinária para o tratamento de uma variedade de doenças. A causa da neurotoxicidade pelo metronidazol ainda não foi determinada. Relata-se o caso de um cão, fêmea, da raça Teckel, de cinco anos de idade, com histórico de dorsoflexão da cauda, ataxia, rigidez de musculatura, decúbito, nistagmo vertical, apatia e anorexia, que estava sendo medicada há sete dias com metronidazol em dose maior que a máxima recomendada, sendo que os sinais neurológicos iniciaram-se após esse período. As alterações neurológicas foram compatíveis com disfunção vestibular central causada pelo metronidazol, tais como ataxia e nistagmo vertical. Além das alterações neurológicas, o quadro de anorexia e apatia é condizente com a administração de doses excessivas do fármaco. O diagnóstico da intoxicação por metronidazol é baseado na história de administração de doses normais a aumentadas, nos sinais clínicos e na resolução destes após a suspensão da droga. Geralmente, o prognóstico é favorável após a suspensão do medicamento e com o diagnóstico precoce. Alguns cães podem morrer e outros podem se recuperar completamente. O cão apresentou resolução completa do quadro de neurotoxicose após a suspensão da terapia e o tratamento de suporte. Os médicos veterinários devem estar alertas sobre as complicações potenciais associadas ao uso deste medicamento, bem como limitar seu uso crônico ou em altas doses para os casos mais graves, e diagnosticar o problema o mais rápido possível para instituir o tratamento precocemente. Palavras-chave: Cães, neurologia, sistema nervoso, toxicidade de drogas AbstractMetronidazole is a nitronidazolic antibiotic used in veterinary medicine to the treatment of a variety of diseases. The cause of metronidazole neurotoxicity has not been determined. We report the case of a dog, female, Teckel, five-year-old, with a history of dorsiflexion of the tail, ataxia, muscle stiffness, recumbency, vertical nystagmus, apathy and anorexia, which was being medicated for seven days with metronidazole in a dose higher than the maximum recommended, and the neurological signs began after this period. Neurological signs were consistent with central vestibular dysfunction caused by metronidazole, such as ataxia and vertical nystagmus. In addition to the neurological changes, the clinical signs of anorexia and apathy are consistent with the administration of excessive doses of the medicine. The diagnosis of metronidazole-induced toxicosis is based on the history of normal to increased doses, clinical signs and resolution after discontinuation of the drug. In general, the prognosis is good after drug withdrawal and early diagnosis. Some dogs may die and others may recover completely. The neurotoxicosis has disappeared after the suspension of the medicine and supportive treatment. Veterinarians must be aware of potential complications associated with the use of this medicine, as well as limit their chronic use or high doses for the most severe cases, and diagnose the p...

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“…In overdose the spectrum of clinical signs involves also mydriasis, proprioception deficit, rigidity or seizures. Less common effects described in humans include pancreatitis, pseudomembranous colitis, peripheral neur-opathy (Caylor and Cassimatis 2001). Moreover, metronidazole was revealed as a potential teratogen in the studies on laboratory animals.…”

Section: Metronidazolementioning

confidence: 99%

“…These symptoms may appear in acute overdose, but also during the chronic treatment with therapeutic doses (Plumb 1999). Reports on neurotoxicity are known for dogs, cats and also humans (Caylor and Cassimatis 2001, Evans et al 2003, Olson et al 2005, Kuriyama et al 2011) but the mechanism of toxic action remains unclear. In overdose the spectrum of clinical signs involves also mydriasis, proprioception deficit, rigidity or seizures.…”

Section: Metronidazolementioning

confidence: 99%

The toxicity and adverse effects of selected drugs in animals – overview

Široká¹,

Svobodová²

2013

Polish Journal of Veterinary Sciences

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Therapeutic products quite often are causes of poisoning in both small and large animals. Drug poisonings in animals occur commonly due to off-label use of medicines, wrong dosage, negligence, accidental ingestion and deliberate poisonings. Toxicity of veterinary drugs may become evident also in therapeutic doses when adverse effects may occur. The aim of this review is to inform veterinary specialists about both veterinary and human drugs, specifically antiparasitics, non-steroidal anti-inflammatory drugs and other medicinal substances, which are most often reported to cause acute poisonings or adverse reactions in animals and to contribute to their broader knowledge and more accurate use of medicines, improving instructions to the animal owners and, hopefully, decrease the incidence of drug poisonings in animals.

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Metronidazole neurotoxicosis in two cats

Cited by 60 publications

References 20 publications

Putative Metronidazole Neurotoxicosis in a Cat

Putative Metronidazole Neurotoxicosis in a Cat

Intoxicação por metronidazol em cão – relato de caso

The toxicity and adverse effects of selected drugs in animals – overview

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