Doses - DEXAMETHASONE, DEXAMETHASONE SODIUM PHOSPHATE, DEXAMETHASONE 21-ISONICOTINATE

Dogs:

Low-Dose Dexamethasone Suppression Test:
a) Draw pre-sample. Inject 0.01 - 0.015 mg/kg dexamethasone IV (may dilute dexamethasone 1:10 with sterile saline to insure accurate dosing). Collect samples at 4 hrs. and 8 hrs. post dexamethasone. Usual pre-dose cortisol normals: 0.5 - 4.0 micrograms/dl;post-dexamethasone normals: less than 1.5 micrograms/dl. (Kemppainen and Zerbe 1989a)
b) Draw pre-sample in AM. Inject 0.01 mg/kg dexamethasone sodium phosphate IV.
Draw sample 8 hours post injection. (Feldman 1989), (Morgan 1988), (Feldman,
Schrader, and Twedt 1988)
High-Dose Dexamethasone Suppression Test:
a) Draw pre-dose sample. Inject 0.1 or 1.0 mg/kg IV dexamethasone. Draw post-dosesamples at 4 hours and 8 hours. Use 1.0 mg/kg dose if not suppressed at lower dose(0.1 mg/kg). Use 1.0 mg/kg dose with caution in patients with diabetes mellitus and ifcortisol values are greater than 12 micrograms/dl. (Kemppainen and Zerbe 1989a)
b) Draw pre-dose sample. Administer 0.1 mg/kg IV dexamethasone sodium phosphate.
Draw second sample 8 hours post injection. (Feldman 1989)
c) Draw pre-dose sample. Administer 0.1 mg/kg IV dexamethasone sodium phosphate.
Draw second sample 4 hours post injection. (Morgan 1988)
d) Draw pre-dose sample. Administer 0.1 mg/kg IV dexamethasone sodium phosphate.
Draw second sample 4 or 8 hours post injection. (Feldman, Schrader, and Twedt 1988)
Combined Dexamethasone Suppression-ACTH Stimulation test:(Note: Many clinicians do not recommend using this test)
a) Draw pre-dose sample. Administer 0.1 mg/kg IV dexamethasone; collect post-dexamethasone sample 4 hours later. Immediately give ACTH (gel) 2.2 IU/kg IM. Collectpost-ACTH sample 2 hours later. (Kemppainen and Zerbe 1989a)
For toy breed dogs with hydrocephalus:
a) 0.25 mg/kg tid - qid; reduce dose slowly over 2-4 weeks. (Simpson 1989)
For adjunctive therapy of craniocerebral/spinal trauma:
a) If patient's condition is not improved 30 minutes after receiving water soluble glucocorticoids: 2 mg/kg by slow IV infusion. If patient continues to deteriorate, additionaltherapy is warranted. (Shores 1989)
b) Initially, 0.2 mg/kg bolus, then 0.2 mg/kg daily in 2-3 divided doses. If animal is inshock, give 2.0 mg/kg initially. (Fenner 1986a)
c) For spinal cord trauma: 2 - 3 mg/kg IV followed in 6-8 hours by 1 mg/kg SQ or IVbid-tid for 24 hours. Then 0.2 mg/kg SQ or IV bid-tid for 2-3 days. Then 0.1 mg/kg IVor SQ bid-tid for 3-5 days. (Schunk 1988a)
To reduce intracerebral pressure and edema:
a) In the palliative therapy of intracranial neoplasms: 0.25 - 2.0 mg/kg q6h IV in acuteepisodes(LeCouteur and Turrel 1986)
b) In the adjunctive therapy of status epilepticus: 2 mg/kg IV initially; repeat in 6-8 hourswith 1 mg/kg. Follow with tapering doses. (Schunk 1988b)
For adjunctive therapy of fibrocartilaginous embolic myopathy:
a) 2.2 mg/kg IV, then 6-8 hours later give 1 mg/kg SQ. Repeat 1 mg/kg SQ in 12 hours, then give 0.1 mg/kg SQ bid for 3-5 days. (Schunk 1988a)
For patients with thoracolumbar intervertebral disk disease and acute onset of paraparesis:
a) 2 mg/kg IV followed in 6-8 hours with 0.5 - 1.0 mg/kg SQ, bid-tid for 24 hours, then0.1 mg/kg SQ or PO bid for 3-5 days. (Schunk 1988a)
For medical therapy of cervical spondylopathy:
a) With an acute onset or sudden worsening with moderate to marked tetraparesis: 2.2mg/kg IV once followed in 6-8 hours by 1 mg/kg SQ bid for two doses. Then 0.1 - 0.2mg/kg PO or SQ twice a day for 3-5 days. (Schunk 1988a)
For adjunctive therapy of shock:
a) Dexamethasone sodium phosphate: 4 - 6 mg/kg IV (Kemppainen 1986)
For initial adjunctive treatment of acute adrenocortical collapse:
a) Dexamethasone: 0.5 - 1.0 mg/kg IV or Dexamethasone Sodium phosphate 2 - 4 mg/kg IV. (Schrader 1986), (Feldman, Schrader, and Twedt 1988)
For treatment of acquired thrombocytopenia:
a) 0.25 - 0.3 mg/kg IV or SQ once, then 0.1 - 0.15 mg/kg SQ or PO twice a day for 7days. Decrease oral dose by 1/2 every 5-7 days for 3 weeks, then go to alternate daytherapy for 6 weeks. (Dodds 1988)
For adjunctive therapy of endotoxemia secondary to acute gastric dilatation-volvulus:
a) 5 mg/kg slowly IV (Bellah 1988)
For adjunctive therapy of cholecalciferol (Quintox®, Rampage®) toxicity:
a) 1 mg/kg SQ divided qid (Grauer and Hjelle 1988b)
For labeled indications (anti-inflammatory/glucocorticoid agent) for dexamethasone injection(Azium®):
a) 0.5 - 1 mg IV or IM; may be repeated for 3-5 days. (Package Insert; Azium®¯
Schering)
For labeled indications (anti-inflammatory/glucocorticoid agent) for dexamethasone tablets(Azium®):
a) 0.25 - 1.25 mg daily in single or two divided doses (Package Insert; Azium® Tablets¯
Schering)
For labeled indications (various inflammatory conditions associated with the musculoskeletalsystem) for dexamethasone 21-isonicotinate (Voren®):
a) 0.25 - 1 mg IM; may repeat for 3-5 days. (Package Insert; Voren®¯ Bio-ceutic)

Cats:

High-Dose Dexamethasone Suppression Test:
a) As a screening test for feline hyperadrenocorticism: 0.1 mg/kg IV. A dose of 1 mg/kg IV may differentiate pituitary-dependent hyperadrenocorticism (PDH) from an adrenaltumor. (Zerbe 1989)
Combined Dexamethasone Suppression-ACTH Stimulation test:
a) Collect blood sample, then give dexamethasone 0.1 mg IV, collect sample 2 hours afterdexamethasone. Immediately give ACTH (2.2 IU/kg) and collect samples 1 and 2 hourspost ACTH. (Zerbe 1989)
For endotoxic or septicemic shock:
a) Dexamethasone sodium succinate: 5 mg/kg IV (Jenkins 1985)
As adjunctive therapy for feline neoplasias (lymphosarcoma, acute lymphoid leukemia, mastcell neoplasms):
a) 2 - 6 mg/m2 q24-48h PO, SQ or IV (Couto 1989)
For adjunctive emergency treatment of feline asthma:
a) 1 mg/kg IV (sodium phosphate salt) (Noone 1986)
For chronic therapy of feline allergic bronchitis:
a) 0.25 mg PO once to 3 times daily. Once patient stabilizes, attempt to reduce dose; keepon alternate-day therapy for at least 1-2 months after symptoms have initially resolved.(Bauer 1988)
For alternative therapy for idiopathic feline miliary dermatitis:
a) 1 mg PO once daily for 7 days, then 1 mg PO twice a week. May need to add progestational agent. (Kwochka 1986)
For labeled indications (anti-inflammatory agent) for dexamethasone injection (Azium®):
a) 0.125 - 0.5 mg IV or IM; may be repeated for 3-5 days. (Package Insert; Azium®¯
Schering)
For labeled indications (anti-inflammatory/glucocorticoid agent) for dexamethasone tablets(Azium®):
a) 0.125 - 0.5 mg daily in single or divided doses (Package Insert; Azium® Tablets¯
Schering)
For labeled indications (various inflammatory conditions associated with the musculoskeletalsystem) for dexamethasone 21-isonicotinate (Voren®):
a) 0.125 - 0.5 mg IM; may repeat for 3-5 days. (Package Insert; Voren®¯ Bio-ceutic)

Cattle:

For adjunctive therapy of insect bites or stings:
a) 2 mg/kg IM or IV q4h (use epinephrine if anaphylaxis develops) (Fowler 1993)
For adjunctive therapy of cerebral edema secondary to polioencephalomalacia:
a) 1 - 2 mg/kg intravenously (Dill 1986)
For adjunctive therapy of radial nerve injury, or femoral nerve paralysis:
a) Adult cattle (400-800 kg and not pregnant): 20 - 40 mg IM or IV; Calves: 10 mg IM or IV. Taper or discontinue therapy in 2-3 days. Many cases require only a single dose.(Rebhun 1986)
For adjunctive therapy of obturator nerve paralysis:
a) 10 - 40 mg parenterally once daily for 2-3 days then discontinue. (Rebhun 1986)
For adjunctive therapy of peroneal nerve injuries:
a) 10 - 30 mg parenterally for acute cases when not contraindicated due to pregnancy orinfection. (Rebhun 1986) For elective inducement of parturition or termination of pregnancy:
a) For abortion: 25 mg parenterally with 25 mg prostaglandin F2a after 150 days of gestation. For inducement or parturition from 8th month of gestation on: 20 mg IM. (Drost1986)
b) For inducement of parturition when given within 2 weeks of normal term: 20 - 30 mg IM (Barth 1986)
For adjunctive therapy of aseptic laminitis:
a) 5 - 20 mg IM or IV; continue therapy for 2-3 days (Berg 1986)
For primary bovine ketosis:
a) 5 - 20 mg IV or IM (Package Insert; Azium®¯ Schering)

Horses:

For glucocorticoid therapy:
a) 0.05 - 0.2 mg/kg once daily IV, IM or PO (Robinson 1987)
Dexamethasone suppression test: a) 20 mg IM. Normal values: Cortisol levels decrease 50% in 2 hours, 70% in 4 hours, and80% at 6 hours. At 24 hours levels are still depressed about 30% of original value.(Beech 1987b)
For labeled indications (various inflammatory conditions associated with the musculoskeletalsystem) for dexamethasone 21-isonicotinate (Voren®):
a) 5 - 20 mg IM; may repeat. (Package Insert; Voren®¯ Bio-ceutic)
For labeled indications (anti-inflammatory/glucocorticoid agent) for dexamethasone injection(Azium®):
a) 2.5 - 5 mg IV or IM. (Package Insert; Azium®¯ Schering)
For labeled indications (anti-inflammatory/glucocorticoid agent) for dexamethasone sodiumphosphate injection (Azium®-SP):
a) 2.5 - 5 mg IV. (Package Insert; Azium®¯ Schering)

Swine:

For glucocorticoid therapy:
a) 1 - 10 mg IV or IM (Howard 1986)
Llamas:
For adjunctive therapy of anaphylaxis:
a) 2 mg/kg IV (Smith 1989)

Birds:

For shock, trauma, gram negative endotoxemia:
a) Dexamethasone 2 mg/ml injection: 2 - 4 mg/kg IM or IV once, twice or three timesdaily. Taper off drug when using long-term. (Clubb 1986)

Reptiles:

a) For septic shock in most species: Using Dexamethasone Sodium Phosphate:0.1 - 0.25mg/kg IV or IM (Gauvin 1993)
Dosage Forms/Preparations/Approval Status/Withdrawal Times - Veterinary-Approved Products:
Dexamethasone Oral Tablets 0.25 mg; Azium® Tablets (Schering), generic; (Rx) Approved foruse in dogs and cats
Dexamethasone Chewable Tablets; Pet-Derm III ® (Pfizer) (Rx). 0.25 mg scored tablets.
Approved for dogs only.
Dexamethasone Injection 2 mg/ml; Azium® Solution (Schering), Dexameth-a-Vet® (Anthony)(Rx) generic; (Rx) Approved for use in dogs, cats, horses and cattle. There are no withdrawaltimes required when used in cattle.
Dexamethasone Sodium Phosphate Injection 4 mg/ml (equivalent to 3 mg/ml dexamethasone);
Azium® SP Injection (Schering), Dex-A-Vet Injection (Anthony), generic; (Rx) Approved foruse in horses.
Human-Approved Products: All require a presecription (Rx); many different trade namedproducts are available.
Tablets: 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, & 6 mg
Oral Elixir/Solution: 0.5 mg/5 ml, 0.5 mg/0.5 ml
Dexamethasone Acetate Injection: 8 mg/ml, 16 mg/ml
Dexamethasone Sodium Phosphate Injection: 4 mg/ml, 10 mg/ml, 20 mg/ml, 24 mg/ml