Lauren A. Trepanier, DVM, PhD, DACVIM, DACVCP

In humans, the risk of adverse drug interactions multiplies as the number of administered drugs increases. Interactions can occur during IV drug administration, during oral absorption, at the target site, or during hepatic or renal elimination, and may lead to loss of efficacy or increased toxicity.

There is considerable evidence to support the adjustment of drug dosages in human patients with heart failure, hepatic failure, or renal insufficiency. In contrast, similar studies are lacking in dogs and cats. This presentation will discuss veterinary situations in which drug dose adjustments may be warranted.

With the availability of many over-the-counter NSAID's, and several newer, relatively cyclooxygenase-2 (COX-2) selective agents marketed for veterinary patients, there are many choices for controlling acute and chronic pain and inflammation. Because patients are often given NSAID's in the presence of concurrent disease and along with other drugs, the potential for NSAID-related organ toxicity and NSAID-associated drug interactions should always be considered.

The neonatal period is defined as from birth to 2-4 weeks of age for puppies and kittens, with the pediatric period defined as up to 12 weeks of age. Because of major changes in physiology during this period, drug disposition and response are likely to be varied.

Hypovolemia vs. dehydration

The first step in empirical antimicrobial therapy is to first critically ask whether there is good evidence of a bacterial infection. Too often, antimicrobials are prescribed on a 'just in case' basis or because an owner resists additional diagnostics.