Peer-reviewed veterinary case report
Combination of mexiletine and sotalol controls inherited heart
By Gelzer, Anna R M et al.·Published in Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology·2010·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Combination therapy with mexiletine and sotalol suppresses inherited ventricular arrhythmias in German shepherd dogs better than mexiletine or sotalol monotherapy: a randomized cross-over study.
- Species:
- dog
Plain-English summary
A group of 12 German Shepherd puppies, around 20 weeks old, with inherited heart rhythm issues were treated with either mexiletine, sotalol, or a combination of both medications to see which worked best. The combination therapy significantly reduced dangerous heartbeats, with more puppies showing improvement compared to those on just one medication. In fact, while sotalol alone sometimes made the problem worse, the combination therapy helped most puppies feel better and have fewer irregular heartbeats. This suggests that using both medications together is more effective for managing these heart issues in young German Shepherds.
People also search for: German Shepherd puppy heart problems · mexiletine and sotalol for dogs · inherited arrhythmias treatment in dogs
Abstract
OBJECTIVES: To determine the spontaneous variability of ventricular arrhythmias (VA) and evaluate anti-arrhythmic efficacy of mexiletine, sotalol, and a mexiletine-sotalol combination in German shepherd dogs (GSD) with inherited arrhythmias. ANIMALS, MATERIALS AND METHODS: 12 affected GSD, median age 20 weeks, received mexiletine (8 mg/kg PO q8 h), sotalol (2.5 mg/kg PO q12 h), and combination therapy for 6 days in random order. Pre- and post-treatment 24 h Holter recordings were acquired, allowing determination of VA variability and reduction in 24 h VA for each treatment. Drug concentrations during each arm were measured. RESULTS: An anti-arrhythmic effect could be inferred if ventricular premature complexes (VPC), ventricular couplets (V(cpl)), ventricular tachycardia runs (VT(runs)) and total ventricular ectopy (VE(tot)) frequency were reduced by 61%, 97%, 98%, and 63% (1 control Holter model), by 53%, 94%, 95%, and 54% (4 control Holter model) and by 54%, 95%, 96% and 56% (3 control Holter model). Combination therapy reduced VPC and VE(tot) in more dogs (5/12 and 6/12) than mexiletine (1/11 and 2/11) or sotalol (2/9 and 1/9) (p < 0.05). The combination therapy reduced the mean number of VPC, V(cpl), and VE(tot). Sotalol monotherapy produced an increase in VT(runs). Plasma mexiletine concentration was higher during combination therapy than with monotherapy. CONCLUSIONS: Combination therapy reduced VPC in affected GSD. Sotalol monotherapy increased VT(runs). Combination therapy increased plasma mexiletine concentrations.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/20663731/