Peer-reviewed veterinary case report
Diphenhydramine does not reduce heart rhythm problems
By Jennifer Lindley Willcox et al.·Published in Frontiers in Veterinary Science·2020·Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States, CH·View original on DOAJ →
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Original publication title: Intramuscular Diphenhydramine Does Not Affect Acute Doxorubicin Infusion-Related Arrhythmia Number or Severity in a Prospective Crossover Study in Canine Lymphoma: A Pilot Study
- Species:
- dog
Plain-English summary
A group of dogs with high-grade lymphoma received a chemotherapy drug called doxorubicin, which can sometimes cause heart rhythm problems during treatment. To see if giving diphenhydramine (an allergy medication) beforehand would help reduce these issues, the researchers monitored the dogs' heart activity before and after the drug was given. The study found that diphenhydramine did not significantly change the number or severity of heart rhythm problems caused by doxorubicin. Overall, the dogs tolerated the treatment well without major heart issues, suggesting that careful heart screening can help manage risks during chemotherapy.
People also search for: dog lymphoma treatment · doxorubicin side effects in dogs · diphenhydramine for dog chemotherapy
Abstract
Background: Doxorubicin (DOX) is one of the most effective chemotherapeutics for canine high-grade lymphoma. In addition to dose-dependent chronic cardiotoxicity, DOX can trigger acute cardiac arrhythmias during drug infusion. Diphenhydramine premedication is commonly used, as histamine release is a proposed mechanism for DOX-associated arrhythmogenesis.Hypothesis/Objectives: The study objectives were to evaluate the incidence and severity of DOX infusion-related cardiac arrhythmias in dogs with high-grade lymphoma and evaluate the effect of diphenhydramine premedication on arrhythmia frequency and severity during and after DOX infusion.Animals: Twenty-two client-owned dogs with cytologically/histopathologically confirmed high-grade lymphoma were recruited, of which 19 were enrolled and 9 completed the study.Methods: Dogs were screened by echocardiogram and concurrent electrocardiogram for this randomized prospective crossover study. Group A received no premedication for DOX #1 and was premedicated with diphenhydramine for DOX #2; Group B received diphenhydramine with DOX #1 and no premedication for DOX #2. For both visits, Holter monitor data were collected for 1 h pre-DOX and 3 h post-DOX administration.Results: Nineteen dogs were enrolled and 9 dogs [Group A (5), Group B (4)] completed the protocol. There was no statistical difference between the DOX alone and DOX + diphenhydramine when evaluating the total number of ventricular premature complexes (VPCs, P = 0.34), change in VPCs/hour (P = 0.25), total number of atrial premature complexes (APCs, P = 0.5), change in APCs/hour (P = 0.06), or ventricular arrhythmia severity score (P > 0.99).Conclusions and clinical importance: This study demonstrates that in these dogs with rigorous pretreatment cardiovascular screening, DOX infusion did not induce significant arrhythmias. Furthermore, these data suggest that, with this screening approach, diphenhydramine may not alter the arrhythmia number or severity in canine DOX recipients.
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Search related cases →Original publication on DOAJ: https://doi.org/10.3389/fvets.2020.00368