Pharmapam

As a psychotherapeutic agent:
a) Urine marking and anxiety: 0.2–0.4 mg/kg PO q12–24h (start at 0.2 mg/kg PO q12h) (Overall 2000)
b) For spraying: 1–2.5 mg per cat PO q8–12h; sedation and ataxia should abate within several days (Reisner & Houpt 2000)
c) As a fast-acting anxiolytic: 0.2–0.5 mg/kg PO prn (Neilson 2009)
For treatment of seizure disorders:
a) 0.25–0.5 mg/kg PO q8–12h. To halt an ongoing seizure, diazepam may be administered at 0.5–1 mg/kg IV. If cat has a history of receiving insulin, glucose may be more beneficial. Do not use if cat has been exposed to chlorpyrifos as organophosphate toxicity may be potentiated. (Shell 2000)
b) For maintenance therapy: 0.2–1 mg/kg PO q12h. Use with caution; associated with fatal hepatic necrosis. Phenobarbital is preferred as a maintenance drug in cats. (Mariani 2010a)
Functional urethral obstruction/urethral sphincter hypertonus:
a) 1–2.5 mg (total dose) PO q8h (Osborne et al. 2000)
b) 2.5–5 mg (total dose) PO q8h or as needed, or 0.5 mg/kg IV (Bartges
2003)

For field anesthesia:
a) Sedate with xylazine (1 mg/kg IV; 2 mg/kg IM) given 5–10 minutes (longer for IM route) before induction of anesthesia with ketamine (2 mg/kg IV). Horse must be adequately sedated (head to the knees) before giving the ketamine (ketamine can cause muscle rigidity and seizures).
If adequate sedation does not occur, either 1) Redose xylazine: up to half the original dose; 2) Add butorphanol (0.02–0.04 mg/kg IV). Butorphanol can be given with the original xylazine if you suspect that the horse will be difficult to tranquilize (e.g., high-strung Thoroughbreds) or added before the ketamine. This combination will improve induction, increase analgesia and increase recumbency time by about 5–10 minutes; 3) Diazepam (0.03 mg/kg IV). Mix the diazepam with the ketamine. This combination will improve induction when sedation is marginal, improve muscle relaxation during anesthesia and prolong anesthesia by about 5–10 minutes; 4) Guaifenesin (5% solution administered IV to effect) can also be used to increase sedation and muscle relaxation. (Mathews 1999)

For seizures:
a) Foals: 0.05–0.4 mg/kg IV; repeat in 30 minutes if necessary
b) Adults: 25–50 mg IV; repeat in 30 minutes if necessary (Sweeney & Hansen 1987)
Treatment of seizures secondary to intra-arterial injection of xylazine or other similar agents:
a) 0.10–0.15 mg/kg IV (Thurmon & Benson 1987)
As an appetite stimulant:
a) 0.02 mg/kg IV; immediately after dosing, offer animal food. Keep loud noises and distractions to a minimum. If effective, usually only 2–3 treatments in a 24–48 hour period are required. (Ralston 1987)

a) Sedative in calves: 0.4 mg/kg IV (Booth 1988)
b) As a tranquilizer: 0.55–1.1 mg/kg IM (Lumb & Jones 1984)
c) Treatment of CNS hyperactivity and seizures: 0.5–1.5 mg/kg IM or IV (Bailey 1986)

For treatment of seizures:
a) For cluster seizures or status epilepticus (for client treatment at home): 0.5 mg/kg rectally; if on phenobarbital, use diazepam at 2 mg/kg (using diazepam parenteral solution) per rectum. Administer at the onset of seizure and up to 3 times in a 24-hour period, but should not be given within 10 minutes of the prior dose. Owners should stay with dog for one hour after administration. (Podell 2000), (Podell 2006), (Podell 2009)
b) For cluster seizures (for client treatment at home): 1 mg/kg administered rectally at the onset of seizures; can be given up to 3 times over a 24 hour period. Dogs receiving phenobarbital should receive 2 mg/kg. Because diazepam is inactivated by light and adheres to plastic, it is best to dispense the drug in the original glass vial and instruct the owner to draw the required amount into a syringe when needed. A rubber catheter or teat cannula is then placed on the syringe for rectal administration. (Munana 2010)
c) For refractory status epilepticus using constant rate IV infusion: 0.1– 0.5 mg/kg diluted in D5W. Rate administered per hour should be equal to the maintenance fluid requirement for the patient. Use with caution as diazepam can crystallize in solution and adsorb to PVC tubing. For status or cluster seizure treatment at home: 0.5–2 mg/kg per rectum (Platt & McDonnell 2000)
d) For status epilepticus: Rule out hypoglycemia, electrolyte abnormalities as primary cause. Stop seizure with diazepam or midazolam 0.5–1 mg/kg IV, 1–2 mg/kg rectally or IV if patient on phenobarbital. Place IV catheter and initiate active cooling if necessary. If another seizure occurs, repeat IV diazepam or midazolam. Administer a long-acting anticonvulsant (e.g., phenobarbital at 5–8 mg/kg IV every 4– 6h until seizures are under control regardless of additional therapy). If patient still has seizure activity, consider one or more of the following: 1) continuous rate infusion of diazepam or midazolam, 2) propofol or other means of anesthesia. (Knipe 2006), (Knipe 2009)
e) For status epilepticus: 0.5 mg/kg IV, intranasally or rectally. Dose may be repeated twice, if necessary. Anticonvulsant activity lasts only 15–30 minutes so a longer acting therapy is required if seizures stop. For at home therapy for cluster seizures, diazepam may be given rectally or intranasally at 0.5 mg/kg. Dogs who are on chronic phenobarbital therapy, may require higher doses (1–2 mg/kg). (Mariani 2010b)

Functional urethral obstruction/urethral sphincter hypertonus:
a) 2–10 mg q8h (Polzin and Osborne 1985); (Lane 2000)
b) 2–10 mg PO three times a day; 0.5 mg/kg IV (Chew et al. 1986)
c) 0.2 mg/kg PO q8h or 2–10 mg (total dose) PO q8h (Bartges 2003)
As a psychotherapeutic agent (e.g., situational anxiety):
a) 0.55–2.2 mg/kg PO q8-12h (Haug 2008)
b) 0.5–2.2 mg/kg prn for storms (Sherman & Mills 2008)
c) As a fast-acting anxiolytic: 0.5–2 mg/kg PO prn (Neilson 2009)
For adjunctive treatment of metronidazole toxicity (CNS):
a) Doses of diazepam averaged 0.43 mg/kg in the study and were given as
an IV bolus once, and then PO q8h for 3 days. (Evans et al. 2002)

As a tranquilizer:
a) 0.55–1.1 mg/kg IM (Lumb & Jones 1984)

For Bermuda grass induced toxicosis and tremors:
a) 0.8 mg/kg IV (Booth 1988)
To stimulate appetite:
a) 0.04 mg/kg IV; offer food immediately, duration of effect may last up to
45 minutes (Booth 1988)

For premedication/sedation:
a) 1–2 mg/kg IM; may be given with ketamine (10–20 mg/kg) (Morrisey & Carpenter 2004)
b) For sedation anesthesia: 0.5 mg/kg IM or IV (IV preferred); 0.2 mg/kg if using with ketamine (2–5 mg/kg) (Kaiser-Klingler 2009)

For tranquilization:
a) 5.5 mg/kg IM (will develop posterior ataxia in 5 minutes and then recumbency within 10 minutes) (Booth 1988)
b) 0.55–1.1 mg/kg IM (Lumb & Jones 1984)
c) For sedation prior to pentobarbital anesthesia: 8.5 mg/kg IM (maximized at 30 minutes; reduces pentobarbital dose by 50%) (Booth 1988)
For treatment of CNS hyperactivity and seizures:
a) 0.5–1.5 mg/kg IM or IV (Howard 1986)

a) For adjunctive therapy of pain control (with analgesics): 0.5–2 mg/kg IV or IM (Clyde & Paul-Murphy 2000)
b) For sedation/induction: 0.5–2 mg/kg IV or IM. Doses apply to pet birds to the medium parrots. Adjustments would need to be made for large parrots or wild species such as raptors. (Kaiser-Klingler 2009)

a) Rabbits: Pre-anesthetic: 2–10 mg/kg IM; 1–5 mg/kg IM or IV. Give IV to effect for seizures. (Ivey & Morrisey 2000)
b) Rabbits: For sedation: 0.5–2 mg/kg IV or IM (IV preferred).
For anesthesia: Diazepam 0.5–1 mg/kg with ketamine (20–35 mg/kg) IM or IV.
Hedgehogs: For long anesthesia: Diazepam at 0.5–2 mg/kg with ketamine at 5–20 mg/kg IM (Kaiser-Klingler 2009)
c) Hamsters, Gerbils, Mice, Rats: 3–5 mg/kg IM.
d) Guinea pigs: 0.5–3 mg/kg IM (Adamcak & Otten 2000)

For use of diazepam in zoo, exotic and wildlife medicine refer to specific references, including:
a) Zoo Animal and Wildlife Immobilization and Anesthesia. West, G, Heard, D, Caulkett, N. (eds.). Blackwell Publishing, 2007.
b) Handbook of Wildlife Chemical Immobilization, 3rd Ed. Kreeger, T.J. and J.M. Arnemo. 2007.
c) Restraint and Handling of Wild and Domestic Animals. Fowler, M (ed.), Iowa State University Press, 1995
d) Exotic Animal Formulary, 3rd Ed. Carpenter, J.W., Saunders. 2005
e) The 2009 American Association of Zoo Veterinarian Proceedings by D. K. Fontenot also has several dosages listed for restraint, anesthesia, and analgesia for a variety of drugs for carnivores and primates. VIN members can access them at: http://goo.gl/BHRih or http://goo.gl/9UJse