DEBATE ON DEX / SOLU-DELTA / CORTICO-STEROIDS

[bulldoghistorian]

Why don't you post the dosages of dex you would administer for anti shock purposes?

i follow my vet advise 4mg/kg

[bulldoghistorian]

When I said 10x the dose, I misread the original message sent to me, so that's my bad in regards to that statement.

I've personally never seen OR heard of anyone using Solu Medrol for any anti-shock therapy. Considering it also comes in 120mg bottles, what difference does it make. If it were the only thing I had to use, and I had the correct information, I would use it. I'd rather use it and possibly save the dog as opposed to not using it and the dog dying.

The dex dose is a lot higher than a swelling dose because it's a possible LIFE SAVING dose. No one ever suggested to stop giving the dogs fluid. If your dog is needing anti-shock therapy, it is certainly needing fluids. You don't stop giving fluids simply because of the medicine. I have seen both types of Dex used for aftercare for shows. The dogs lived without any issues. I've seen Solu Delta used after shows. Some dogs lived and some didn't due to simply being too far gone. Given my druthers, I'd use Solu Delta also, but if I don't have any, I can simply use what I have on hand. Being in the medical profession, I've seen most of these drugs used for one purpose or another. Some people start off at the highest dose and work their way down. Some start at the lowest and work their way up. That is more based on personal experience and what has worked for someone time and time again. I personally start at the mid way point when it comes to dosages and adjust from there.

Any anti-shock therapy is BEST used IV and not IM. IM should be a last resort not a first one. Learn how to hit veins in your animal. Giving your dog IV fluids, and not sq, will go a lot further in saving your dog. I've seen some dogs pass simply due to not having any fluids to flush their kidneys free of myoglobin.

I would like to add also that I've given 1mL of dex many times, and I've never seen a dog lose 2.2 kilos from 1mL.

no max a pound but that was more than 1ml

[Officially Retired]

i follow my vet advise 4mg/kg

That is a reasonable dose, and on the high-end, given the 0.05 mg/kg - 5.0 mg/kg recommended range.

At your vet's recommended dose, this means a 42 lb dog would get 76.4 mg.

42 lb = 19.09 kg
19.09 kg x 4 mg/kg = 76.4 mg

If you had a 2 mg/ml bottle of dex, this would mean your dog would get 38.2 ml of dex for shock.

With a 4 mg/ml bottle of dex, your dog would get 19.1 ml for shock.

Jack

[Officially Retired]

When I said 10x the dose, I misread the original message sent to me, so that's my bad in regards to that statement.

I've personally never seen OR heard of anyone using Solu Medrol for any anti-shock therapy. Considering it also comes in 125mg bottles, what difference does it make. If it were the only thing I had to use, and I had the correct information, I would use it. I'd rather use it and possibly save the dog as opposed to not using it and the dog dying. I also have some dex that is 10mg/mL. Lower strength med = give more.

The dex dose is a lot higher than a swelling dose because it's a possible LIFE SAVING dose. No one ever suggested to stop giving the dogs fluid. If your dog is needing anti-shock therapy, it is certainly needing fluids. You don't stop giving fluids simply because of the medicine. I have seen both types of Dex used for aftercare for shows. The dogs lived without any issues. I've seen Solu Delta used after shows. Some dogs lived and some didn't due to simply being too far gone. Given my druthers, I'd use Solu Delta also, but if I don't have any, I can simply use what I have on hand. Being in the medical profession, I've seen most of these drugs used for one purpose or another. Some people start off at the highest dose and work their way down. Some start at the lowest and work their way up. That is more based on personal experience and what has worked for someone time and time again. I personally start at the mid way point when it comes to dosages and adjust from there.

Any anti-shock therapy is BEST used IV and not IM. IM should be a last resort not a first one. Learn how to hit veins in your animal. Giving your dog IV fluids, and not sq, will go a lot further in saving your dog. I've seen some dogs pass simply due to not having any fluids to flush their kidneys free of myoglobin.

I would like to add also that I've given 1mL of dex many times, and I've never seen a dog lose 2.2 kilos from 1mL.

Nicely said. I have some comments, that I will save for later, but surprised to hear what you said on Solu-Medrol.

Very much appreciate your response.

That said, Solu-Medrol and Solu-Delta are almost the same thing:

Solu-Delta = Prednisolone sodium succinate
Solu-Medrol = MethylPrednisolone sodium succinate

I am curious what difference the "Methyl" prefix brings to the table?

It is my understanding that Solu-Medrol offers a medium between the anti-swelling properties of Dex, and the anti-shock properties of Solu-Delta.

I have used Dex on innumerable occasions, Solu-Delta only a handful of times, but never used Solu-Medrol.

Doc is the one who extolled the use of Solu-Medrol, and he did use it regularly.

Just curious on your thoughts, thanks.

Jack

[Officially Retired]

PS: Solu-Medrol actually comes in a variety of sizes.

And here is the benefit (as Doc told me) stated on the product label:

"Methylprednisolone is a potent anti-inflammatory steroid with greater anti-inflammatory potency than prednisolone and even less tendency than prednisolone to induce sodium and water retention."

[Officially Retired]

Just to clarify for other readers:

• Dexamethasones = best choice for swelling / not as active for shock (better than nothing, though);
  
  • Dex (straight Dexamethasone) doesn't act as fast, but lasts longer in the system;
  • Azium (Dexamethasone sodium phosphate) is faster-acting, but doesn't last as long.
  
  
• Solu-Delta (Prednisolone sodium succinate) = fast-acting / best choice for shock / disappates quickly / not so good for swelling;
• Solu-Medrol (Methylprednisolone sodium succinate) = excellent choice for shock also, with superior anti-swelling than Solu-Delta (though not quite as good as Dex).

That is the best of my understanding, based what I have been told, my experience, as well as what I have researched.

I have never used Solu-Medrol, but trust what Doc told me about it, which info is confirmed on the label indications I posted above.
I also know that Frosty's own training makes him an invaluable resource here, so maybe he can help shed some more light on these topics.

What Frosty said about hitting the vein is critical, because NONE OF THIS MATTERS unless you can hit a vein reliably and consistently. One of the best ways to practice hitting the vein is doing progesterone tests on your bitches. Like anything else, you get better with practice. Don't think you can have no experience and suddenly hit the vein on a dying dog, with collapsed veins, in a critical emergency. You will fail. Make sure you have practiced this often enough to get it right whenever you want.

Jack

[Officially Retired]

Shock Therapy & Cortico-Steroids
(now-Revised)

PS: I have highlighted more areas in color that people seem to miss.
Please read it over, and give any corrections, and I will tweak it again if need be. Thanks.

[S_B]

Great information, thank you Jack for addressing it here and Frosty for your contribution.

[Officially Retired]

Great information, thank you Jack for addressing it here and Frosty for your contribution.

Absolutely.

We're all laymen here. We're all trying to do the best we can.

Doc was a vet tech, who actually did many full-on veterinary operations/procedures where he worked, and (I believe) is now in the pharmaceutical sales industry. He opened the doors for me many moons ago. He was an invaluable resource for me, even though he is out of dogs now.

Frosty has his own medical training now, that I am sure will continue to be a boon for all of us here.

I made this matter "public" so that everyone could benefit.
It doesn't do the community any good to speak of these things "in private" with one person.

If anyone (including me) is wrong, we should be helping to correct the errors, not kicking each other in the ass, so that we may continuously improve the community data for one and all, so that everyone can benefit. It boggles the mind to think of all the great dogs that have been lost to inadequate care, ignorant application of meds, and straight malpractice. The whole idea behind my book, this place, and continuously upgrading articles is to keep current as best we can as laymen, and adjust where necessary.

If this info helps someone here adjust their own methods, and by doing so helps them save one game dog that would otherwise have been lost, than it was worth all this typing and effort

[FrostyPaws]

Here's an interesting viewpoint:

Generalized trauma / Heat Stroke. There is no data supporting the use of GC in generalized trauma (i.e. hit by car, dog fights, etc.) or heat stroke. In fact GC may increase morbidity and mortality due to the numerous adverse effects. Supportive care such as crystalloids and colloids, pain management with opioids, and body temperature are the primary recommendations along with stabilization of blood loss and fractures. Antimicrobials may also be indicated.