Furosemide (sulphonamide derivative) .

• Loop diuretic.

MOA:

• Furosemide Inhibits the reabsorption of sodium and chloride in the thick, ascending loop of Henle.
• This leads to loss of sodium, chloride, and water into the urine.

Effects:

• Vasodilation followed by diuresis.
• Vasodilation increases renal blood flow and reduces fluid retention.

Side effects:

• Electrolyte imbalance and weakness.
• Serious side effects- loss of balance and collapse.

Drug interaction:

• Concurrent administration of NSAIDs may interfere with furosemide’s prostaglandin-controlled renal vasodilation and reduce the diuretic effect.

Species:

• Many species.

Indication:

• Congestive heart failure (CHF), pulmonary oedema, uraemia, hyperkalaemia and hypertension in dog and cat.
• Exercise induced pulmonary haemorrhage, acute renal failure, oedema due to a variety of causes in horse.
• Udder oedema in cow.

Dose:

• 4–6 mg/kg , IM, or SC in dog, cat and pig.
• 0.5-1mg/kg IV in horse.
• 0.5-1mg/kg IV or IM in cow.

Contraindication:

• Patients on glycosides digoxin and digitoxin.
• Hypokalaemia .
• Dehydration.
• Intestinal colic.
• Hypovolemia.
• Hypotension.
• Urine retention.

Brands:

• Redima 10ml inj vial ( Vetoquinol India).

Composition: Each ml contains 50 mg Frusemide.

• Fural 10ml inj vial( Gee Vet India).

Composition: Each ml contains 50 mg Frusemide .

• Flumide 10ml inj vial ( SSS Vet Science India).

Composition: Each ml contains 50 mg Frusemide .

Bethanechole ( carbamic acid ester of 2-methylcholine).

• Synthetic ester similar to acetylcholine.
• Extra label drug used in Dogs and Cats.

MOA:

• Bethanechole stimulates Muscurinic Acetylcholine receptor. It has no nicotinic action.

Effects:

• Contraction of smooth muscles containing muscarinic receptors e.g detrusor muscles of urinary bladder.

Side effects:

• Diarrhoea.
• Vomiting.
• Loss of appetite.
• Excessive salivation.
• Excessive tears.
• Tighter bladder.

Antidote:

• Atropine.

Species :

• Dog and Cat.

Indication:

• Non Obstructive Urine retention due to bladder atony.

Drug combinations:

• Bethanechole + Diazepam/ Phenoxybenzamine.
• The combination results in bladder contraction and relaxation of the sphincter and urethra.

Dose:

• 5-25 mg/Dog PO TD.
• 2.5- 7.5 mg /Cat PO TD.

Contraindication:

• Ruptured bladder.
• Post cystotomy.
• Compromised intestinal obstruction.
• Stomach ulceration.
• Hyperthyroidism.
• Inflammatory bowel disease.
• Epilepsy.
• Asthma.

Brands:

Available as Human brands in India.

• Bethran-25 tab( Ranbaxy India)

Composition: Each tab contains 25 mg Bethanechole.

• Urivoid-25 tab ( Cipla India).

Composition: Each tab contains 25 mg Bethanechole.

• Macpee-25 tab( Intas India).

Composition: Each tab contains 25 mg Bethanechole.

Phenylpropanolamine( Sympathomimetic amine ).

• Also called as PPA.
• Extra-Label drug.

MOA:

• Phenylpropanolamine releases norepinephrine from nerves.
• Norepinephrine stimulates alpha-adrenergic and beta-adrenergic receptors in a number of organs.

Effects:

• Constriction of blood vessels, increased heart rate and increased blood pressure.
• Constriction of blood vessels in the nasal cavity resulting reduction in nasal congestion.
• An increase in the tone of sphincter muscles, primarily of the bladder, occurs after repeated administration.

Side effects:

• Vomiting, Diarrhea and lack of appetite.
• increased thirst, restlessness, irritability, and difficulty in urinating.
• Serious side effects include seizures, collapse, or stroke-like sign

Species:

• Dog and Cat.

Indication:

• Urine inconsistency.
• Nasal bleeding.

Dose:

• 3 mg/kg body PO OD or 1.5 mg/kg PO BID or 1.0 mg/kg PO TID.

Contraindications:

Use cautiously in following conditions:

• Glaucoma
• Seizure disorders (convulsions)
• High blood pressure
• Thyroid, kidney, or liver disease

Brands:

• Proin 25mg/50mg/75mg tab ( PRN Pharmacal USA).

Composition: Each tab contains 25mg/50mg/75mg phenylpropanolamine.

Prazosin (synthetic piperazine derivative)

MOA:

• Prazosin as an anti-hypertensive agent blocks Alpha-1 receptors in peripheral blood vessels
• Prazosin improves urine flow rates by blocking alpha1 adrenoceptors in the bladder neck and prostate, leading to smooth muscle relaxation.

Effect:

• Pronounced decrease in resistance of the large vessels (i.e. arterioles) that result in a decrease in total systemic vascular resistance (SVR) without a rebound or reflex tachycardia.
• Decrease in the tone of the bladder sphincter, thus relieving the urinary conditions associated with benign prostatic hypertrophy.

Side effects:

• Tachycardia, hyperactivity, or hyperthermia.

Species:

• Dog and Cat.

Indication:

• An idiopathic cystitis blockage in cats.
• Bladder or prostate tumors or with spinal disease.
• High blood pressure
• Management of congestive heart failure.

Dose:

• 0.5–2 mg per animal, PO BD-TD or 0.07 mg/kg, PO, BD-TD.

Contraindication:

• Low B.P animals.
• Dogs with ABCB1 mutation.

Brands:

Human brands:

• Cyber-Cr 5mg tab( Raptakos Bret and Co India).

Composition: Each tab contains 5mg Prazosin.

• Prazopress 2mg tab ( Sun Pharma India).

Composition: Each tab contains 2mg prazosin.

• Minipress 2.5mg tab ( Pfizer India).

Composition: Each tab contains 2.5mg prazosin

• Prazocip 1mg tab( Cipla India).

Composition: Each tab contains 1mg prazosin.

Estriol (Natural estrogen).

• Has high affinity for receptors in cells of the lower urogenital tract.
• Well-absorbed from the gastrointestinal tract.
• Used for treatment of urine leak in female dogs.

MOA:

• Estriol increases the tone of sphincter muscle in urethra thereby preventing the leakage of urine.

Effects:

• Control in leakage of urine.

Side effects:

• GIT upset.
• swelling of vulva.
• behavioral changes.
• estrous signs.
• Mammary hyperplasia.

Species:

• Dog specially spayed female.

Dose:

• 1-2mg oral dose once daily for 14 days, then taper from 2mg to 1mg once daily for 7 days, and then to 0.5mg once daily for 7 days, based on the individual dog’s response. Once the lowest effective daily dose is established, it may be administered once every two days.

Indication:

• Urine incontinence.

Contraindication:

• Cancer that is sensitive to estrogen.
• With other estrogens.
• Pregnant animals.

Brands:

• Incurin 1mg tab ( Merk Animal Health).

Composition: Each tab contains 1mg Estriol.

• Human formulation- Evalon 1mg tab (Sandoz India)