Disal (furosemide) Tablets is primarily used for the treatment of two conditions in dogs: hypertension and edema. Furosemide is the pet medication most often used in dogs with edema due to congestive heart failure.
Disal (furosemide) Tablets are indicated for the treatment of edema (pulmonary congestion, ascites) associated with cardiac insufficiency and acute noninflammatory tissue edema. In cases of edema involving cardiac insufficiency, the continued use of heart stimulants such as digitalis or its glycosides is indicated. The rationale for efficacious use of diuretic therapy is determined by the clinical pathology producing the edema.
The usual oral dosage of DISAL Tablets is 1 to 2 mg/lb body weight (approximately 2.5 to 5 mg/kg). A prompt diuresis usually ensues from the initial treatment.
Administer orally once or twice daily at 6 to 8 hour intervals. The dosage should be adjusted to the individual's response. In severe edematous or refractory cases, the dose may be doubled or increased by increments of 1.0 mg per pound of body weight. The established effective dose should be administered once or twice daily. The daily schedule of administration can be timed to control the period of micturition for the convenience of the client or veterinarian. Mobilization of the edema may be most efficiently and safely accomplished by utilizing an intermittent daily dose schedule, i.e., every other day or 2 to 4 consecutive days weekly.
Diuretic therapy should be discontinued after reduction of the edema, or maintained after determining a carefully programmed dosage schedule to prevent recurrence of edema. For long-term treatment, the dose can generally be lowered after the edema has once been reduced. Re-examination and consultations with the client will enhance the establishment of a satisfactorily programmed dosage schedule. Clinical examination and serum BUN, CO2 and electrolyte determinations should be performed during the early period of therapy and periodically thereafter, especially in refractory cases. Abnormalities should be corrected or the drug temporarily withdrawn.
Dog: One-half to one 50 mg scored tablet per 25 pounds body weight. One 12.5 mg scored tablet per 5 to 10 pounds body weight.
Administer once or twice daily, permitting a 6 to 8 hour interval between treatments. In refractory or severe edematous cases, the dosage may be doubled or increased by increments of 1 mg per pound body weight as recommended in preceding paragraphs, "Dosage and Administration".
Federal law restricts this drug to use by or on the order of a licensed veterinarian.
Animal reproductive studies have shown that furosemide may cause fetal abnormality and the drug is contraindicated in pregnant animals. Furosemide is contraindicated in anuria, furosemide hypersensitivity, hepatic coma, or during electrolytic imbalances. Monitor serum electrolytes, BUN and CO2 frequently. Monitor serum potassium levels and watch for signs of hypocalcemia.
Corticosteroids cause an additive potassium-depletion effect.
DISAL Tablets are a highly effective diuretic and, if given in excessive amounts, as with any diuretic, may lead to excessive diuresis which could result in electrolyte imbalance, dehydration and reduction of plasma volume, enhancing the risk of circulatory collapse, thrombosis and embolism. Therefore, the animal should be observed for early signs of fluid depletion with electrolyte imbalance, and corrective measures administered. Excessive loss of potassium in patients receiving digitalis or its glycosides may precipitate digitalis toxicity. Caution should be exercised in animals administered potassium-depleting steroids. Correct potassium deficiency with proper dietary supplementation. If animal needs potassium supplements, use oral liquid form, do not use enteric-coated potassium tablets.
The concurrent use of furosemide with some antibiotics may be inadvisable. There is evidence that the drug enhances the nephrotoxic potential of aminoglycosides, cephalosporins and polymyxins and increases the ototoxic effects of all aminoglycosides.
Sulfonamide diuretics have been reported to decrease arterial responsiveness to pressor amines and to enhance the effect of tubocurarine. Caution should be exercised in administering curare or its derivatives to patients undergoing therapy with DISAL Tablets and it is advisable to discontinue DISAL Tablets for one day prior to any elective surgery.
DISAL Tablets are contraindicated in anuria. Therapy should be discontinued in cases of progressive renal disease if increasing azotemia and oliguria occur during the treatment. Sudden alterations of fluid and electrolyte imbalance in an animal with cirrhosis may precipitate hepatic coma, therefore, observation during period of therapy is necessary. In hepatic coma and in states of electrolyte depletion, therapy should not be instituted until the basic condition is improved or corrected. Potassium supplementation may be necessary in cases routinely treated with potassium-depleting steroids.
Active or latent diabetes may on rare occasions be exacerbated by furosemide. Transient loss of auditory capacity has been experimentally produced in cats following intravenous injections of excessive doses of furosemide at a very rapid rate.
Furosemide demonstrates a very low order of either acute or chronic toxicity. The drug is rapidly absorbed and excreted by both glomerular filtration and tubular secretion. The rates of excretion are of such magnitude that cumulation of furosemide does not occur despite repeated administrations.
The main effect observed in clinical toxicity is an abnormality of fluid and electrolyte imbalances. Ototoxicity resulting in transient loss of hearing has been reported with furosemide.
A safety study was performed in dogs to determine the effects of DISAL Tablets at increasing dosages and time elements. The dosage levels were 2 mg/lb body weight (upper recommended dosage), 6 mg/lb body weight (3X upper recommended dosage) and 10 mg/lb body weight (5X upper recommended dosage). The treatment period ranged up to nine days in length. Results demonstrate a mild dehydration at the 5X level with a slight elevation of hemoglobin and hematocrit levels. Serum levels of potassium and chloride were slightly lowered in the higher dosage groups. Cumulative evaluation of the data demonstrates that DISAL Tablets are safe when administered at the upper level of the recommended dosage for a duration of nine consecutive days.
To report suspected adverse events, for technical assistance, or to obtain a copy of the Safety Data Sheet, contact Boehringer Ingelheim Animal Health USA Inc. at 1-888-637-4251.
For additional information about adverse drug experience reporting for animal drugs, contact FDA by telephone at 1-888-FDA-VETS or online at www.fda.gov/reportanimalae.
Store at 20° to 25°C (68° to 77°F), excursions permitted between 15° and 30°C (between 59° and 86°F).