Dobutamine

Dobutamine: Uses, Dosage and Side Effects

Overview

• Dobutamine is a synthetic catecholamine with direct beta-1 adrenergic agonist effects and mild beta-2 and alpha-1 adrenergic effects at standard dosages.
• Stimulation of the beta-1 adrenoreceptors of the heart is predominantly responsible for inotropy, while the chronotropic, arrhythmogenic, and vasodilatory effects are less pronounced.
• Dobutamine does not induce endogenous noradrenaline secretion.

Uses of Dobutamine

• It supports myocardial function during anesthesia in hypotensive animals when reduced myocardial contractility is suspected to be the primary cause.
• Short-term inotropic support for heart failure related to systolic dysfunction (e.g., dilated cardiomyopathy), sepsis, and cardiogenic shock.

Dose of Dobutamine in Dogs and Cats

Dogs:

• The lower end of the dose range is 2.5–5 μg (micrograms)/kg/min i.v. by constant rate infusion.
• Start at the bottom end of the dose range and increase slowly until the desired effect is achieved.
• Higher-end dose ranges up to 20 μg/kg/min i.v. by constant rate infusion have
  been reported.
• Adverse effects (tachycardia, arrhythmia) are commonly seen at doses >10 μg/kg/min.
• Administer with an i.v. infusion pump or other i.v. flow controlling device.

Cats:

• 1–5 μg (micrograms)/kg/min i.v. by constant rate infusion.
• Start at the bottom end of the dose range and increase slowly until the desired effect is achieved.
• Adverse effects are commonly seen at doses >2.5 μg/kg/min.
• Administer with an i.v. infusion pump or other i.v. flow controlling device.
• Doses over 5 μg/kg/min i.v. by constant rate infusion are reported; may cause seizures.

Side Effects of Dobutamine in Dogs and Cats

• Due to the short duration of action of dobutamine, adverse effects such as tachycardia, arrhythmia, and hypertension can typically be managed by discontinuing drug infusion.
• With prolonged use, hypokalemia can develop; this can increase the risk of tachyarrhythmias.
• Additionally, complex ventricular arrhythmias are treatable with lidocaine.
• Use with caution in atrial fibrillation, as it may increase ventricular rate.
• Prior and concurrent digoxin treatment is recommended.
• Also possible are nausea, vomiting, and seizures, particularly in cats.

Contraindications of Dobutamine in Dogs and Cats

• Avoid in patients with a cardiac outflow obstruction (e.g. aortic stenosis).

Some Notes:

• Patients with diabetes who are treated with dobutamine may require more insulin.
• If dobutamine is administered with beta-blockers such as propranolol, doxapram, or monoamine oxidase inhibitors (e.g. selegiline), systemic vascular resistance may increase.
• Use concurrently with halothane may increase the incidence of arrhythmias.