Retrospective evaluation of labetalol as antihypertensive agent in dogs

Zublena, Francesco; Gennaro, Chiara De; Corletto, Federico

doi:10.1186/s12917-020-02475-4

Cited by 6 publications

(6 citation statements)

References 52 publications

(60 reference statements)

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“…Labetalol performed favourably in a recent cohort of dogs undergoing surgery with intra‐ and postoperative non‐nociceptive hypertension (Zublena et al . 2020). Fenoldopam has been recommended for use in veterinary patients with hypertensive emergency based on its safety profile in patients with AKI (Nielsen et al .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Beeston

Jepson

Cortellini

2022

J of Small Animal Practice

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Hypertensive emergency is well recognised in human medicine, yet there is limited veterinary evidence. This study aimed to determine the presentation, treatment and outcome in dogs and cats with hypertensive emergency. Materials and MethOds:A retrospective case series of dogs and cats with hypertensive emergency identified as follows: acute history with non-invasive Doppler systolic blood pressure greater than 180 mmHg and target organ damage including acute onset seizures, altered mentation with or without lateral recumbency or blindness. Data collected included signalment, history, physical examination and clinicopathological findings, systolic blood pressure, antihypertensive treatment and outcome.results: Seven dogs and eight cats were included presenting with seizures (n=9), blindness (n=4), altered mentation with (n=2) or without (n=2) lateral recumbency. Median age was 9 years (range 1 to 15) and duration of clinical signs before presentation was 1.5 days (range 1 to 15). Median systolic blood pressure on presentation was 230 mmHg (range 190 to 300). Amlodipine was the most common first-line agent (n=10), followed by hydralazine (n=4) and hypertonic saline (n=1). Aetiology of hypertensive emergency was acute kidney injury (n=9), idiopathic hypertension (n=3), hyperthyroidism (n=1), lymphoma (n=1) and suspected cutaneous and renal glomerular vasculopathy (n=1). Five cats and three dogs survived to discharge with an overall survival of 53.3%. clinical significance: Hypertensive emergencies had various presenting signs in this series. AKI was considered to be the cause of hypertension in the majority of patients. Further evaluation of treatment for hypertensive emergencies is warranted, considering almost half of the cases did not survive to discharge.

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Section: Discussionmentioning

confidence: 99%

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Beeston

Jepson

Cortellini

2022

J of Small Animal Practice

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“…A randomized control trial revealed that labetalol control BP (mean systolic and diastolic BP) in pregnant women with chronic hypertension 47 . According to a recent study, labetalol reduced arterial blood pressure in dogs with a non-significant increase in heart rate as a therapy for perioperative non-nociceptive acute hypertension 48 .…”

Section: Practololmentioning

confidence: 99%

Beta-Adrenergic Blockers’ Supportive and Adverse Role in Hypertension: A Review of Three Generations

2022

PJMD

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Hypertension causes significant mortality and morbidity around the world. The β-adrenergic blockers are one of the most commonly prescribed hypertension medications. Several β-adrenergic blockers with different pharmacological qualities have been developed, which may be grouped into three generations based on the differences in pharmacological properties. In this narrative review, we addressed evidence-based literature about the role of various types of β-blockers and related adverse drug reactions (ADRs) in hypertension. PubMed, Scopus, Google Scholar, and MEDLINE are used for articles search. The title was examined first, followed by the abstract, and then the entire study. We concluded that the first-generation β-blockers are non-selective and used as antihypertensive however, not recommended for diabetic, asthmatic, and chronic obstructive pulmonary disease patients. The second-generation β-blockers are β1 receptor-selective which are the effective pharmacological option for the treatment of hypertension, with a lower risk of adverse effects associated with antagonism of β2-receptor. Third-generation β-blockers showed improved effects on patients as compared to the previous two generations. This class of β-blockers (labetalol, carvedilol, and nebivolol) has vasodilatory abilities and has an extra beneficial influence with fewer ADRs. However, the effectiveness and benefit of β-blockers as first‐line therapy for hypertension is still controversial. As a result, further accurate screenings, as well as large randomized control clinical trials (RCTs), are needed to investigate the role of all β-blockers in hypertension. Keywords: Hypertension; Beta-Adrenergic Blockers; Blood Pressure; Literature Review.

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“…Herrera et al reported that dogs pretreated with phenoxybenzamine undergoing adrenalectomy for pheochromocytoma had a mortality rate of 13% compared to 48% of dogs that were not pretreated 10 . Labetalol has also been investigated as a medication to treat acute hypertension peri‐operatively for dogs undergoing adrenalectomy 11 . More recently, the use of pre‐operative alpha‐blocker therapy has been brought into question with pretreatment not associated with increased survival 5 .…”

Section: Introductionmentioning

confidence: 99%

“…3,6 Several studies have investigated the role of medical pretreatment to decrease complications and perioperative mortality, specifically with pheochromocytomas. 5,7,10,11 Despite a growing a body of literature relating to adrenalectomies in dogs, however, a consensus on peri-operative management has not been obtained to reduce surgical risk. Herrera et al reported that dogs pretreated with phenoxybenzamine undergoing adrenalectomy for pheochromocytoma had a mortality rate of 13% compared to 48% of dogs that were not pretreated.…”

Section: Introductionmentioning

confidence: 99%

“…10 Labetalol has also been investigated as a medication to treat acute hypertension peri-operatively for dogs undergoing adrenalectomy. 11 More recently, the use of pre-operative alpha-blocker therapy has been brought into question with pretreatment not associated with increased survival. 5 Additional studies have found a mortality rate of 1.5% in dogs undergoing adrenalectomy for adrenal tumours without pre-operative treatment.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours

Piegols,

Abrams,

Lapsley

et al. 2023

Vet Comparative Oncology

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Adrenalectomies for canine adrenal tumours are associated with peri‐operative morbidity and mortality. Objectives of this study included assessing the prognostic value of tumour‐ or surgery‐related variables in predicting peri‐operative mortality and overall survival in dogs undergoing adrenalectomies for primary adrenal tumours as well as pre‐treatment with phenoxybenzamine on survival to discharge with pheochromocytomas specifically. A multi‐institutional retrospective cohort study was performed across nine institutions. Electronic medical record searches identified 302 dogs which met the inclusion criteria. Data collected included dog‐related, tumour‐related, treatment‐related, surgery‐related, and outcome variables. Univariate and multivariable logistic regression and cox proportional hazards models were used to identify variables associated with death prior to discharge and tumour‐related survival. Overall, 87% of dogs survived to discharge with a tumour‐related survival time of 3.96 years. Post‐operative complications were reported in 25%. Increased surgical time (p = 0.002) and pre‐surgical medical treatment other than phenoxybenzamine (p = 0.024) were significantly associated with increased peri‐operative mortality while ureteronephrectomy (p = 0.021), post‐operative pancreatitis (p = 0.025), and post‐operative aspiration pneumonia (p < 0.001) were significantly associated with decreased overall survival. Phenoxybenzamine pretreatment had no effect on peri‐operative mortality. Thirty‐seven of 45 (82%) dogs with pheochromocytomas not pretreated survived to discharge, and 50 of 59 (85%) dogs with pheochromocytomas pretreated with phenoxybenzamine survived to discharge (p = 0.730). This study provides information on risk factors for death prior to discharge and tumour‐related survival that may help guide clinical management and owner expectations. In addition, the study findings challenge the previously reported benefit of phenoxybenzamine for pretreatment of dogs undergoing adrenalectomies for pheochromocytomas.

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Retrospective evaluation of labetalol as antihypertensive agent in dogs

Cited by 6 publications

References 52 publications

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Beta-Adrenergic Blockers’ Supportive and Adverse Role in Hypertension: A Review of Three Generations

Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours

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