ImidocarbDose, contraindications and adverse effects for Cats and Cattle.

Carbanilide antiprotozoal (babesiacide); blocks inositol uptake into infected red blood cells, killing tick-borne piroplasms such as Babesia. Imidocarb is FDA-approved for use in dogs to treat Babesia canis infections (babesiosis), but the drug may also be efficacious against other Babesia spp (eg, Babesia conradae and North Carolina Babesia spp). Imidocarb appears to be more effective against B canis than Ba- besia gibsoni. A prospective, unmasked study in dogs with B gibsoni comparing atovaquone/azithromycin (AA) with a protocol usin

Imidocarb is thought to act by combining with nucleic acids of DNA in susceptible organisms, causing the DNA to unwind and denature. This damage to DNA is believed to inhibit cellular repair and replication. It also appears to alter the parasite’s ability to regulate glucose. Imidocarb has cholinergic properties that contribute to its toxicity profile.

Do not use imidocarb in patients that have been exposed to cholinesterase-inhibiting drugs, pesticides, or chemicals. The manufacturer states to consider risks versus benefits before treating dogs with impaired lung, hepatic, or renal function. Donkeys and mules appear to be more sensitive to the toxic effects of the drug than are horses. Do NOT give imidocarb IV. In cats, puppies, and debilitated dogs, pretreatment with atropine or glycopyrrolate has been advised.

The most commonly reported adverse effects in dogs include pain during injection and mild cholinergic signs (eg, salivation, nasal drip, and brief episodes of vomiting). Less commonly reported effects include panting, diarrhea, restlessness, and injection site inflammation (more common after the second dose and rarely may ulcerate). Hy- poglycemia has been reported. Rarely, severe renal tubular or hepatic necrosis and severe cholinergic signs have occurred.

■ Efficacy. Usually via blood smear in patients with acute infections; however, PCR tests are more sensitive for detecting the presence of the parasite when organism numbers are low.19 ■ Adverse effect profile ■ Baseline and periodic renal and hepatic function tests after treatment until stable