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Author: Subject: DIY Veterinary Medecine
DoctorOfPhilosophy
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[*] posted on 10-10-2019 at 19:24
DIY Veterinary Medecine


I've got a friend who's considering giving their dog reagent grade potassium bromide directly, rather than spending a fortune (also hard to get in their country) on prescription pills. It is indicated for canine epilepsy.

I've taken it upon myself to find possible reasons why this might be a bad idea, and suggestions on how to proceed if they're going to do it anyway.

I haven't started doing research yet, but I want to invite others to chime in and I will post my own findings. The obvious concerns right away are 1) what could the possible harmful impurities be in reagent grade KBr that wouldn't be in food grade KBr? 2) the possibility of getting the dose wrong since it comes in bulk 3) are the original dosage units slow release? 4) are there other ingredients in the doses that contribute to efficacy or prevent harmful side effects?

[Edited on 11-10-2019 by DoctorOfPhilosophy]
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j_sum1
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[*] posted on 10-10-2019 at 20:02


I think dosage will be the key issue. You need to get it right. Triple check the calculations.

Commercial tablets are going to have a lot of fillers and probably flavours etc. This does make it easier to administer. But you can get around this easily enough. My inclination would to make up a meaty broth with gelatine and add the KBr. You can then set the broth using ice cubes or something similar in the required dosage.

There is a possibility that the commercial tablets will be sustained release, but probably not. It is a highly soluble salt and its half life in the system will be in the order of hours rather than weeks. That is why it needs to be administered daily rather than three-monthly like say, some flea medications. If you are worried about the detrimental effect of fluctuations of Br- in the system you could minister a half dose twice a day.

As for other ingredients that contribute to efficacy: I can't see that is likely for something as simple as KBr. You could always check to see if other active ingredients are listed on the label. If there is nothing there, then I would not bother.

Personally, if it is going to save money and be minimal hassle, I would not hesitate to make your own for something like this.
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DoctorOfPhilosophy
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[*] posted on 11-10-2019 at 04:00


That makes sense, it's better to prepare a quantity of doses rather than measuring out each time.

The monograph mentions it contains an unspecified quantity of vitamin B12 and for smaller dogs, the liquid solution contains B6. I wasn't able to find any reason for that online. I also wasn't able to find the original FDA approval documents online anywhere.

I found a modern study (March, P. A., Podell, M., & Sams, R. A. (2002). Pharmacokinetics and toxicity of bromide following high-dose oral potassium bromide administration in healthy Beagles. Journal of Veterinary Pharmacology and Therapeutics, 25(6), 425–432. ) where the KBr was administered as an appropriate amount of 200 mg/mL stock (KBr in distilled water) mixed into 2-3 tablespoons of canned food. This was reassuring that there are no special requirements for dosing.

Further, from reading other papers, moderate overdoses are well tolerated with full recovery if treated promptly.
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fusso
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[*] posted on 11-10-2019 at 04:22


What about recrystalise once before proceeding?



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[*] posted on 11-10-2019 at 04:59


Once I tasted sodium bromide, out of curiosity. It was bitter. Potassium chloride also felt bitter, so potassium bromide may be bitter too. How a dog perceives the taste of these compounds I'm not sure.

As far as I know the high water solubility is not a big problem in bromide therapy, no need to put it in slow-release formulations because bromide level in neurons fluctuates more slowly than in the blood. Bromide overdose can cause skin problems in humans, maybe in dogs as well. (Besides the obvious cns symptoms, it acts as a general sedative.)

Bromide was used in humans too, before the advent of modern sedatives.
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[*] posted on 11-10-2019 at 05:14


Quote: Originally posted by Pumukli  
Once I tasted sodium bromide, out of curiosity. It was bitter.


You should watch Tdep's investigation of this. A bit of a classic IMO.
https://www.youtube.com/watch?v=RJh9yTIBY48
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karlos³
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[*] posted on 11-10-2019 at 07:04


About DIY veterinary medicine:

I am treating an 18 year old bitch with ephedrine I synthed myself for her incontinence.
Side effects, she does not behave like an old dog anymore and doesn't sleep all day, also others said she looks happier and she started to play again, which she hasn't done for over a year.
Her appetite is still there, even so much that she still eats the food when the few mg of the crystals are sprinkled on it, only that she always sneezes once initially due to the bitter taste. :D
Sleeping still works good at night.

I am using racemic dl-ephedrine easily made from its ketone analogue by reduction, and this works just as good as the chiral l-ephedrine that was initially tried.

Reason I do this, is that her stupid doctor doesn't want to give out ephedrine for incontinence, only some not working hormone containing crap, which did absolutely nothing.
With ephedrine, it worked surprisingly well, actually initially and now she stays dry the whole day.
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[*] posted on 20-10-2019 at 11:34


In human medicine, urinary incontinence is treated by e.g. solifenacin (Vesicare). Opposite problem (urinary retention) is treated by e.g. neostigmin (acetylcholinesterase inhibitor).
Ephedrine is psychostimulant, that explains why your bitch feels better (appetite, activity). Honestly said, I have never seen using ephedrine in human medicine as a cure for incontinence, but your bitch improved and this matters. More than 1 decade ago ephedrine was commonly present in nasal drops used for treatment of nasal congestion (in my country there was Mucoseptonex E), but was later banned as a precursor.
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karlos³
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[*] posted on 20-10-2019 at 13:12


In europe, ephedrine is actually the standard treatment for canine incontinence.
The usual medicine here is called(how fitting) caniphedrine, and I adjusted the dosage according to her weight and the leaflet of that medicine.
I don't know exactly why it acts and I do not care really, I am just happy that it works more than well.
Just today I met her again(she was my childhood dog and now lives with my mum), and seeing this canine smile when she sees ne made me knew it was more than worth it :)
I really feel like she knows I am responsible for this... at least I know for sure how bad she felt before, having tiny wet spots on her fur just after waking up and all... you can see this affecting her mental condition if you know a dog long enough.
Now she smiles immediately when she recognises me(of course I do not only smile but grin broadly), and that is the best I could do for her ever.
That tiny animals knows me for well over 16 years when we got her and I would of course synth far more difficult molecules if it just would help her enjoy her age unharmed.

In america, the standard treatment is as far as I know racemic norephedrine, I don't know how the medicine is called, I just would know how I would make the stuff if I would be in america.
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[*] posted on 20-10-2019 at 13:19


I love a happy ending.......:)

Quote:


a-Adrenergic agonists such as phenylpropanolamine (PPA), ephedrine, pseudoephedrine, and phenylephrine act directly on smooth muscle receptors to increase urethral tone and maximal urethral closure pressure. Although often more clinically effective than DES, their action is short lived, usually requiring dosing bid-tid. Of this class of drugs, PPA is the most effective and results in fewer cardiovascular adverse effects. Previously available in over-the-counter cold medications and appetite suppressants, it was withdrawn from the human market because of toxicity associated with overuse as a diet aid. Ephedrine, pseudoephedrine, or phenylephrine may be tried but are less efficacious than PPA. Adverse effects of α-adrenergic drugs include excitability, restlessness, hypertension, and anorexia.



https://www.merckvetmanual.com/pharmacology/systemic-pharmac...


/CJ




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