In this VetGirl blog, we demonstrate what metronidazole toxicosis looks like in a dog. Metronidazole, an antibiotic commonly used in veterinary medicine, typically has a wide margin of safety. However, with chronic dosing > 62 mg/kg per day, acute presentation of toxicity can be seen in both dogs and cats.
Clinical signs of metronidazole toxicosis include:
- Hypermetric gait
- Peripheral neuropathy
- Conscious proprioceptive deficits
- Head tilt
- Vestibular signs
The use of intravenous (IV) diazepam can be used to help diagnose metronidazole toxicosis; transient, acute improvement of clinical signs can be seen immediately after diazepam administration. Treatment for metronidazole toxicosis includes immediate discontinuation of the drug, symptomatic and supportive care, and diazepam therapy. In dogs, the use of oral diazepam (at approximately 0.43 mg/kg orally every 8 hours for three days) can be used for therapy. However, the use of oral diazepam should not be used in cats due to the rare risk of idiosyncratic acute hepatic necrosis secondary to diazepam.