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Colchicine for Veterinary Use
by Barbara Forney, VMD
Colchicine is a plant derived anti-inflammatory which is used in human medicine for the treatment of gout and Familial Mediterranean Fever. It was originally extracted from the autumn crocus Colchicum autumnale and reportedly was used in human medicine in ancient Egypt. The anti-inflammatory effects of colchicine are due to inhibition of neutrophil motility and activity.
Colchicine also inhibits a key stage of cellular mitosis (microtubule polymerization), and blocks the hepatic synthesis and secretion of serum amyloid. Colchicine is absorbed via the GI tract and is partially metabolized by the liver. It is excreted primarily in the feces with some additional urinary excretion.
Colchicine is used in the early stages of familial renal amyloidosis in Shar-Pei dogs. This inherited inflammatory disease is also called familial Shar-Pei fever (FSF). FSF was once thought to be an animal model for Familial Mediterranean Fever in humans. Research has shown that this is not the case, although both of these inherited diseases are treated with colchicine.
Clinical signs of FSF include fever, with swelling and joint pain, particularly of the hocks. In order to be effective in preventing renal amyloidosis, colchicine therapy must be instituted before any significant kidney damage occurs. Because there is no diagnostic test for FSF, it is recommended that an affected animal begins treatment at the time of the first episode of fever and joint swelling in order to prevent amyloid deposition and to moderate the course of the disease.
Colchicine is also used to prevent hepatic and renal fibrosis in dogs. When used for this purpose, it is thought to decrease fibroblast proliferation and fibrogenesis. The use of colchicine for hepatic cirrhosis or fibrosis is considered somewhat experimental and not all clinicians agree on its use for this purpose.
- The most common side effects are gastrointestinal upset including nausea, vomiting and diarrhea.
- Rare side effects include neutropenia and bone marrow suppression.
- Colchicine should not be used in animals with advanced kidney disease, cardiac dysfunction or gastrointestinal disease.
- Colchicine should be used with caution in older animals and/or debilitated animals.
- Colchicine inhibits mitosis and is considered teratogenic. It should only be used in pregnant animals when the potential benefits outweigh the risks. Colchicine may interfere with spermatogenesis.
- Colchicine should not be used with other medications that may suppress bone marrow such as immunosuppressants, chloramphenicol, and anti-neoplastics.
- Additional possible drug interactions that are cited in the human literature include: macrolide antibiotics, antifungals, cholesterol lowering medications (statins), cyclosporine, digoxin, and diltiazem.
- Colchicine has a narrow therapeutic index, and may be toxic with a relatively small overdose. If recognized promptly, gastrointestinal decontamination, and other supportive measures should be instituted promptly. There is no specific antidote for colchicine toxicity.
- Symptoms due to colchicine overdose generally start within 2-5 hours and initially present with gastrointestinal signs (vomiting diarrhea and abdominal pain), fever, and kidney failure. Multi system organ failure may begin within 24-72 hours.
About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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