Acetazolamide: Uses, Dose and Side Effects For Dogs, Cats & Horses
Overview
Understanding how acetazolamide works and when it is clinically indicated is essential for safe and effective use in veterinary practice, particularly in ophthalmic, neurologic, and metabolic disorders.
Acetazolamide is a carbonic anhydrase inhibitor used in veterinary medicine as a diuretic and antiglaucoma agent. It reduces bicarbonate formation, leading to decreased aqueous humor production in the eye and increased urinary excretion of bicarbonate, sodium, and potassium.
It is mainly used in small animals for glaucoma and metabolic alkalosis, and in horses for prevention and management of hyperkalemic periodic paralysis (HYPP).
A solid understanding of drug mechanisms, indications, and safety profiles is best achieved through standard veterinary pharmacology references.
Uses of Acetazolamide For Dogs, Cats & Horses
Acetazolamide is used in veterinary practice for specific clinical conditions where inhibition of carbonic anhydrase provides therapeutic benefit, particularly in ophthalmic, neurologic, and metabolic disorders.
- Glaucoma: Reduces aqueous humor production and helps lower intraocular pressure in dogs.
- Metabolic alkalosis: Used as part of medical management to correct acidโbase imbalance.
- Episodic Falling Syndrome (CKCS): Used in dogs with frequent collapse episodes refractory to other therapies.
- Paroxysmal dyskinesias: May be used as adjunctive therapy in selected cases.
- Increased cerebrospinal fluid (CSF) pressure: May be used as an adjunctive treatment in dogs with conditions such as syringomyelia.
- Hyperkalemic periodic paralysis (HYPP) in horses: Used for prevention and control of HYPP episodes.
Appropriate case selection and clinical use of drugs like acetazolamide require a solid background in internal medicine and ophthalmology.
Dose of Acetazolamide For Dogs, Cats & Horses
Accurate dosing of acetazolamide is essential due to its effects on electrolyte balance and acidโbase status. Dosage varies according to species and clinical indication and should be adjusted based on patient response and monitoring.
| Species | PO (mg/kg) | IV (mg/kg) | Indication |
|---|---|---|---|
| Dog | 4โ10 | โ | Glaucoma / Metabolic alkalosis |
| Dog (CKCS) | 4โ8 | โ | Episodic Falling Syndrome |
| Dog | 4 | โ | Paroxysmal dyskinesias |
| Cat | 6โ8 | โ | Glaucoma (use with caution) |
| Horse | 2โ4 | โ | HYPP |
- Dog: Oral dosing every 8โ12 hours depending on indication.
- CKCS: Discontinue therapy if no clinical response is observed after 2 weeks.
- Cat: Use with extreme caution due to high risk of adverse effects.
- Horse: Typically administered orally twice daily; frequency may increase based on severity.
Because acetazolamide is commonly used extra-label, accurate dosing and appropriate monitoring should always be guided by authoritative veterinary pharmacology references.
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Side Effects of Acetazolamide For Dogs, Cats & Horses
Like other carbonic anhydrase inhibitors, acetazolamide may cause adverse effects related to electrolyte imbalance, acidโbase disturbance, and systemic drug sensitivity. The likelihood of adverse reactions increases with higher doses or prolonged use.
- Gastrointestinal effects: Nausea, vomiting, diarrhea, and anorexia, especially with oral administration.
- Central nervous system effects: Sedation, depression, weakness, excitement, tremors, or paresthesias.
- Electrolyte disturbances: Hypokalemia, hyponatremia, hyperchloremia, and metabolic acidosis, particularly with chronic therapy.
- Renal effects: Polyuria, crystalluria, dysuria, and renal colic in some animals.
- Hematologic effects: Rare cases of bone marrow suppression.
- Dermatologic and hypersensitivity reactions: Skin rash and, rarely, severe reactions such as StevensโJohnson syndrome.
- Horses: Adverse effects are uncommon at doses used for HYPP, but dehydration and electrolyte imbalance may occur.
Recognition and management of drug-induced adverse effects and toxicities are core components of safe veterinary practice.
Contraindications of Acetazolamide For Dogs, Cats & Horses
Acetazolamide should not be used in certain medical conditions where its effects on electrolyte balance, acidโbase status, or organ function may worsen the patientโs clinical state.
- Hypersensitivity: Contraindicated in animals with known hypersensitivity to carbonic anhydrase inhibitors or sulfonamide-related drugs.
- Hepatic disease: Should not be used in animals with significant liver dysfunction due to the risk of hepatic encephalopathy.
- Renal or adrenocortical insufficiency: Contraindicated because impaired excretion may lead to drug accumulation and electrolyte disturbances.
- Electrolyte imbalances: Avoid use in patients with hypokalemia, hyponatremia, hyperchloremic acidosis, or existing electrolyte imbalance.
- Severe respiratory disease: Contraindicated in animals with severe pulmonary obstruction or respiratory acidosis.
- Cats: Use is generally not recommended due to increased susceptibility to adverse effects.
Contraindications of Acetazolamide For Dogs, Cats & Horses
Acetazolamide should not be used in certain medical conditions where its effects on electrolyte balance, acidโbase status, or organ function may worsen the patientโs clinical state.
- Hypersensitivity: Contraindicated in animals with known hypersensitivity to carbonic anhydrase inhibitors or sulfonamide-related drugs.
- Hepatic disease: Should not be used in animals with significant liver dysfunction due to the risk of hepatic encephalopathy.
- Renal or adrenocortical insufficiency: Contraindicated because impaired excretion may lead to drug accumulation and electrolyte disturbances.
- Electrolyte imbalances: Avoid use in patients with hypokalemia, hyponatremia, hyperchloremic acidosis, or existing electrolyte imbalance.
- Severe respiratory disease: Contraindicated in animals with severe pulmonary obstruction or respiratory acidosis.
- Cats: Use is generally not recommended due to increased susceptibility to adverse effects.
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