Yohn S E, Morrison W B, Sharp P E
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
J Am Vet Med Assoc. 1992 Aug 1;201(3):468-70.
A 4-year-old German Shepherd Dog was evaluated because of chronic hind limb lameness and recurrent seizures. Diagnostic evaluation of the dog confirmed rheumatoid arthritis and idiopathic epilepsy. The rheumatoid arthritis was treated with prednisone and piroxicam. The seizures were treated with phenobarbital plus clonazepam. The seizures were refractory and potassium bromide was substituted for clonazepam. The dog was reevaluated 4 months after initiation of potassium bromide treatment because of recurrence of arthritis signs. During hospitalization, the dog had neurologic signs, which progressed from depression to recumbency and stupor. Anisocoria, muscle pain, and hyporeflexia were noticed. Bromide toxicosis was diagnosed on the basis of toxic serum bromide concentration (2.7 mg/ml; therapeutic range, 1.0 to 2.0 mg/ml). Following cessation of potassium bromide treatment, the neurologic signs resolved. The seizures recurred 6 weeks after potassium bromide was discontinued. Bromide treatment was reinitiated at half the initial dosage. After 6 weeks, the serum bromide concentration was 1.9 mg/ml, and no seizures had been reported by the dog's owners. Therapeutic serum bromide concentrations in dogs has been reported to be 0.5 to 2.3 mg/ml. The serum bromide concentration at which toxic signs are expected is variable in human beings because individuals differ in their tolerance of the drug. Clinical trials are necessary to determine the toxic serum bromide concentrations in dogs. This case of bromism in a dog suggests that the dosage of potassium bromide should be based on serial measurement of serum bromide concentrations.
一只4岁的德国牧羊犬因慢性后肢跛行和反复发作的癫痫发作接受评估。对该犬的诊断评估确诊为类风湿性关节炎和特发性癫痫。类风湿性关节炎用泼尼松和吡罗昔康治疗。癫痫发作用苯巴比妥加氯硝西泮治疗。癫痫发作难以控制，遂用溴化钾替代氯硝西泮。在开始溴化钾治疗4个月后，由于关节炎症状复发，对该犬进行了重新评估。住院期间，该犬出现神经症状，从抑郁发展为卧地不起和昏迷。观察到瞳孔不等大、肌肉疼痛和反射减退。根据血清溴化物中毒浓度（2.7毫克/毫升；治疗范围为1.0至2.0毫克/毫升）诊断为溴化物中毒。停止溴化钾治疗后，神经症状消失。停用溴化钾6周后癫痫复发。以初始剂量的一半重新开始溴化钾治疗。6周后，血清溴化物浓度为1.9毫克/毫升，犬主未报告癫痫发作情况。据报道，犬的治疗性血清溴化物浓度为0.5至2.3毫克/毫升。人类预期出现中毒症状的血清溴化物浓度因人而异，因为个体对该药物的耐受性不同。有必要进行临床试验以确定犬的血清溴化物中毒浓度。这只犬的溴中毒病例表明，溴化钾的剂量应基于血清溴化物浓度的系列测量。
