Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications

Abstract This report describes opioid‐induced neurotoxicity (OIN) in two dogs with hydrocephalus undergoing the investigation of recurrent seizures; in both dogs, myoclonus occurred following premedication with butorphanol and remifentanil and resolved following the administration of midazolam. Thor...

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Main Authors: Changhoon Nam, Inhyung Lee, Won‐gyun Son
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Veterinary Medicine and Science
Subjects:
Online Access:https://doi.org/10.1002/vms3.70277
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author Changhoon Nam
Inhyung Lee
Won‐gyun Son
author_facet Changhoon Nam
Inhyung Lee
Won‐gyun Son
author_sort Changhoon Nam
collection DOAJ
description Abstract This report describes opioid‐induced neurotoxicity (OIN) in two dogs with hydrocephalus undergoing the investigation of recurrent seizures; in both dogs, myoclonus occurred following premedication with butorphanol and remifentanil and resolved following the administration of midazolam. Thorough clinical evaluation excluded underlying systemic disease and increased intracranial pressure as possible causes, and opioid‐induced modulation of gamma‐aminobutyric acid (GABA) inhibitory and dopaminergic interneurons was assumed. Benzodiazepines, like midazolam, enhanced GABA and appeared to be effective in managing these symptoms. The findings suggest that even at therapeutic doses, certain opioids can cause OIN in dogs. Caution is advised when using opioids, particularly in dogs with pre‐existing central nervous system disorders, and further research is needed to better understand dosage effects and alternative treatment options for OIN prevention.
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spelling doaj-art-c542e9fd50ba48d5ac2ddf68a7cd1ac22025-08-20T02:30:06ZengWileyVeterinary Medicine and Science2053-10952025-05-01113n/an/a10.1002/vms3.70277Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic MedicationsChanghoon Nam0Inhyung Lee1Won‐gyun Son2Department of Veterinary Clinical Sciences College of Veterinary Medicine, Seoul National University Seoul Republic of KoreaDepartment of Veterinary Clinical Sciences College of Veterinary Medicine, Seoul National University Seoul Republic of KoreaDepartment of Veterinary Clinical Sciences College of Veterinary Medicine, Seoul National University Seoul Republic of KoreaAbstract This report describes opioid‐induced neurotoxicity (OIN) in two dogs with hydrocephalus undergoing the investigation of recurrent seizures; in both dogs, myoclonus occurred following premedication with butorphanol and remifentanil and resolved following the administration of midazolam. Thorough clinical evaluation excluded underlying systemic disease and increased intracranial pressure as possible causes, and opioid‐induced modulation of gamma‐aminobutyric acid (GABA) inhibitory and dopaminergic interneurons was assumed. Benzodiazepines, like midazolam, enhanced GABA and appeared to be effective in managing these symptoms. The findings suggest that even at therapeutic doses, certain opioids can cause OIN in dogs. Caution is advised when using opioids, particularly in dogs with pre‐existing central nervous system disorders, and further research is needed to better understand dosage effects and alternative treatment options for OIN prevention.https://doi.org/10.1002/vms3.70277butorphanolcanineopioid‐induced neurotoxicitypre‐existing brain disorderremifentanil
spellingShingle Changhoon Nam
Inhyung Lee
Won‐gyun Son
Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications
Veterinary Medicine and Science
butorphanol
canine
opioid‐induced neurotoxicity
pre‐existing brain disorder
remifentanil
title Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications
title_full Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications
title_fullStr Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications
title_full_unstemmed Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications
title_short Opioid‐Induced Myoclonus During Premedication in Two Dogs With Hydrocephalus Proactively Managed With Antiepileptic Medications
title_sort opioid induced myoclonus during premedication in two dogs with hydrocephalus proactively managed with antiepileptic medications
topic butorphanol
canine
opioid‐induced neurotoxicity
pre‐existing brain disorder
remifentanil
url https://doi.org/10.1002/vms3.70277
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AT inhyunglee opioidinducedmyoclonusduringpremedicationintwodogswithhydrocephalusproactivelymanagedwithantiepilepticmedications
AT wongyunson opioidinducedmyoclonusduringpremedicationintwodogswithhydrocephalusproactivelymanagedwithantiepilepticmedications