Application of individualized digoxin dosage regimens to canine therapeutic digitalization

Congestive right heart failure was established in three dogs subjected to surgical tricuspid valvectomy and pulmonic stenosis. The eliminative dispositions of digoxin in serum and ascitic fluid were determined after administration of 30 micrograms of digoxin/kg of body weight by IV injection and radioimmunoassay of multiple serum and ascitic fluid samples. Individualized digoxin dosage regimens for the three dogs were calculated from data collected in the present experiment and data from the literature. The regimens were tested on the three dogs after their body weight had been corrected for the volume of ascitic fluid present. An IV maintenance therapy resulted in serum digoxin concentrations slightly lower than anticipated. The administration of digoxin tablets with no food restriction resulted in serum digoxin concentrations mostly in the expected range. The same doses of digoxin in tablet form were given to the three dogs after fasting. Fasting resulted in slight, but significant, increases in serum digoxin concentrations. Serum digoxin concentrations after administration of digoxin elixir were close to anticipated values. These experiments indicate that individualized digoxin dosage regimens may be useful to set serum digoxin concentrations within the therapeutic, nontoxic range.