Acetylcysteine: Uses, Dosage and Side Effects

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Acetylcysteine for Dogs, Cats, and Horses: Dosage, Uses, and Side Effects Guide

Acetylcysteine For Dogs, Cats, And Horses: Dosage, Uses, And Side Effects Guide

Overview

Acetylcysteine reduces bronchial secretion viscosity, keeps liver glutathione levels stable, and exhibits modest anti-collagenase activity.

Uses of Acetylcysteineย 

  • Pulmonary: Hypersensitivity reactions such as bronchospasm, especially in animals with asthma or bronchitis.
  • Gastrointestinal (GI): Nausea, vomiting, or urticaria (rare).
  • Intravenous Use: May cause changes in blood pressure (hypo/hypertension) or hypersensitivity reactions (e.g., flushing or rash).
  • Horses: Intrauterine use can reduce inflammation without adverse effects on fertility.
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Dose of Acetylcysteine in Dogs, Cats, and Horses

Below are specific doses of acetylcysteine for various conditions:

Species Condition Treated with Acetylcysteine Dosage
Dogs & Cats Mucolytic Instill 1โ€“2 ml of 20% solution into the trachea or nebulize 50 mg as a 2% solution for 30โ€“60 minutes.
Paracetamol poisoning (Initial Dose) 140 mg/kg via slow IV over 15โ€“20 minutes, diluted to 5% with dextrose.
Paracetamol poisoning (Follow-up) 70 mg/kg IV every 6 hours for at least 7 doses.
Keratoconjunctivitis Sicca (KCS) 1 drop of ophthalmic solution in the affected eye every 6โ€“8 hours.
Horses Guttural Pouch Treatment Instill a 20% solution directly into the pouch to dissolve chondroids.
Neonatal Foals Enema containing 8 g of acetylcysteine in sodium bicarbonate to treat refractory meconium impactions.

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Side Effects of Acetylcysteine in Dogs and Cats

  • Pulmonary: Hypersensitivity reactions such as bronchospasm, especially in animals with asthma or bronchitis.
  • Gastrointestinal (GI): Nausea, vomiting, or urticaria (rare).
  • Intravenous Use: May cause changes in blood pressure (hypo/hypertension) or hypersensitivity reactions (e.g., flushing or rash).
  • Horses: Intrauterine use can reduce inflammation without adverse effects on fertility.

Contraindications of Acetylcysteine in Dogs and Cats

  • Hypersensitivity to acetylcysteine.
  • Use with caution in animals with bronchospastic diseases, such as feline asthma.
  • No contraindications reported when used as an antidote for toxicity.

Some Notes:

  1. Dilution and Administration:
    • IV administration requires dilution to 5% and a 0.2-micron in-line filter.
    • Nebulization may leave a sticky residue on the faceโ€”rinse as needed.
  2. Drug Interactions:
    • Activated Charcoal: Reduces the effectiveness of oral acetylcysteine.
    • Nitroglycerin: When administered together, it may enhance hypotensive effects.
  3. Monitoring and Reproductive Safety:
    • Track electrolytes and liver enzymes during long-term use.
    • While acetylcysteine crosses the placenta, no teratogenic effects have been noted in studies. Use with caution during pregnancy and lactation.
  4. Overdose Management:
    • Oral doses above 1 g/kg are generally safe but may cause GI upset. For severe cases, consult poison control.
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