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Digoxin and the other digitalis glycosides have direct effects on cardiac muscle and affect the electrical conduction in the heart. Digoxin increases cardiac output by increasing myocardial contractility. It also decreases sympathetic tone and as a result causes increased diuresis and a reduction of edema. The overall result is a reduction in heart size, heart rate, blood volume, and pulmonary and venous pressures.
The electrocardiac effects of digitalis include slowing the conduction velocity at the AV node and a prolonged effective refractory period. Other electrocardiographic effects are an increased PR interval, decreased QT interval, and depression of the ST segment.
Digoxin traditionally has been used to treat congestive heart failure in both dogs and cats. It usually is used in conjunction with other medications including diuretics and angiotensin-converting enzyme (ACE) inhibitors.
Although digoxin has improved and probably prolonged the quality of life for many veterinary cardiac patients, it remains a drug that requires careful monitoring. It has a narrow margin of safety and there is significant variation in absorption between patients. Cats in particular have a high incidence of toxicity, although toxicity also occurs in approximately 25% of dogs. The absorption of digoxin may be affected by food and by the formulation of the medication. It usually is given on an empty stomach and the dose may need readjustment with any change in formulation or manufacturer. Cats frequently dislike the taste of digoxin elixir and some investigation of flavoring alternatives is helpful. Digoxin dosing should be based on lean bodyweight with adjustment for ascites and fat. Digoxin is excreted by the kidneys and the dose may need to be adjusted downward for animals with renal disease. Serum digoxin levels should be followed carefully in both dogs and cats particularly when starting on treatment. With the advent of newer cardiac medications, some veterinary cardiologists are less likely to use digoxin as a first-line drug.
There are many important drug interactions for digoxin. Additional information should be sought when using digoxin with the following drugs:
Dogs and cats
May Be Prescribed by Vets for:
Congestive heart-failure, cardiac arrhythmias, atrial fibrillation and supraventricular tachycardia.
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Barbara Forney, VMD
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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This content is intended for counseling purposes only. This content is informational/educational and is not intended to treat or diagnose any disease or patient. No claims are made as to the safety or efficacy of mentioned preparations. The compounded medications featured in this content have been prescribed and/or administered by prescribers who work with Wedgewood Pharmacy. You are encouraged to speak with your prescriber as to the appropriate use of any medication. Wedgewood Pharmacy’s compounded veterinary preparations are not intended for use in food and food-producing animals. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them.
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