Feline Digoxin Toxicity: Vet Guide 2025 🐱⚠️💊

Hello devoted cat caregivers! I’m Dr Duncan Houston BVSc 🩺. Digoxin can support cats with heart conditions—but it comes with risks. This comprehensive guide helps you understand causes, warning signs, ECG features, treatment, recovery, and safe home care, all wrapped in emoji-enhanced clarity! 😊

🔍 What Is Digoxin & Why Toxicity Happens

Digoxin is a cardiac glycoside that strengthens heart contractions and slows AV conduction :contentReference[oaicite:2]{index=2}. Cats require careful dosing due to narrow safety margins (~0.5–2 ng/mL). Toxicity arises from overdoses, drug or formulation changes, electrolyte imbalances (low K⁺/Mg²⁺, high Ca²⁺), and kidney issues :contentReference[oaicite:3]{index=3}.

⚠️ Risk Factors & Vulnerable Cats

• Elderly cats or those with kidney/heart disease :contentReference[oaicite:4]{index=4}.
• Electrolyte imbalances heighten toxicity risk :contentReference[oaicite:5]{index=5}.
• Formulation changes (tablet → elixir) and drug interactions can unpredictably change blood levels :contentReference[oaicite:6]{index=6}.

👀 Warning Signs to Watch For

• 💓 Cardiac: irregular pulse, slow or fast heartbeats, AV block, PVCs, ventricular tachycardia :contentReference[oaicite:7]{index=7}.
• 🍽️ GI: anorexia, vomiting, diarrhea, drooling :contentReference[oaicite:8]{index=8}.
• 😵 CNS: lethargy, confusion, weakness, seizures (rare) :contentReference[oaicite:9]{index=9}.
• 🫁 Worsened heart failure: breathing trouble, collapse :contentReference[oaicite:10]{index=10}.

📊 ECG & Diagnostic Look-Outs

• Digoxin effect: scooped ST depression, flattened/inverted T waves, short QT :contentReference[oaicite:11]{index=11}.
• Toxic patterns: bradycardia, AV block (1°, 2°, 3°), PVCs, bidirectional VT, atrial tachycardia with block :contentReference[oaicite:12]{index=12}.
• Blood tests: digoxin level (8–10 hrs post-dose), electrolytes (K⁺, Mg²⁺, Ca²⁺), kidney/liver values :contentReference[oaicite:13]{index=13}.

🏥 Emergency & Hospital Treatment

1. Stop Digoxin

Discontinue dosing for at least 48 hours or until signs resolve and levels normalize :contentReference[oaicite:14]{index=14}.

2. Supportive Care

• Hospitalize, monitor ECG and vitals, administer IV fluids and oxygen :contentReference[oaicite:15]{index=15}.
• Correct electrolytes—especially potassium and magnesium :contentReference[oaicite:16]{index=16}.

3. Treat Life-Threatening Arrhythmias

• Atropine for bradycardia or AV block :contentReference[oaicite:17]{index=17}.
• Magnesium for PVCs/VT; temporary pacing if needed :contentReference[oaicite:18]{index=18}.
• Lidocaine or phenytoin in severe ventricular arrhythmias :contentReference[oaicite:19]{index=19}.

4. Antidote: Digoxin‑Specific Antibody (Fab)

Fab fragments (Digibind/DigiFab) bind free digoxin and reverse toxicity in life-threatening cases :contentReference[oaicite:20]{index=20}.

5. GI Decontamination

Consider activated charcoal or cholestyramine if ingestion was recent (<2 hrs) :contentReference[oaicite:21]{index=21}.

📈 Prognosis & Follow-Up

• With early intervention and electrolyte correction, many cats recover well; severe arrhythmias may complicate outcome :contentReference[oaicite:22]{index=22}.
• Recheck digoxin levels, electrolytes, ECG frequently before restart :contentReference[oaicite:23]{index=23}.
• Future dosing should be cautious—use lean body weight, monitor formulation, and follow-up labs :contentReference[oaicite:24]{index=24}.

🏡 Home Care & Prevention

• Use the **Ask A Vet app** 📱 for reminders, symptom logs, and after-care guidance.
• Maintain consistent diet & dosing routine—never use human digoxin formulations :contentReference[oaicite:25]{index=25}.
• Log appetite, vomiting, breathing rate, behavior, and energy.
• Adhere to scheduled blood tests and ECGs.
• Create a calm, comfortable environment—**Woopf & Purrz** bedding encourages rest 🛏️.

📝 Key Takeaways

• Digoxin tox is serious: narrow margin, requires careful monitoring 💉.
• Watch for GI upset, arrhythmias, breathing issues, lethargy.
• ECG changes like scooped ST, PVCs, AV block, VT are classic.
• Stop drug, treat arrhythmias, correct electrolytes, use antibody antidote if needed.
• Restart cautiously with close follow-up to ensure safety.

📞 When to Contact Ask A Vet

If your cat vomits, shows odd behavior, breathes fast, has an irregular pulse, or collapses—use the **Ask A Vet app** 💬 immediately for expert help.

✨ Final Thoughts

Digoxin can help your cat’s heart—but toxicity is dangerous. With prompt veterinary care, targeted treatment, and caring home support, recovery is often possible. Ask A Vet, Woopf & Purrz, and compassion are with you every step of the way. ❤️🐾