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BSAVA Small Animal
Formulary
10th edition • Part A:
Canine and Feline
Editor:
Fergus Allerton
Emergency doses for dogs and cats
ALWAYS read the relevant monographs.
Cardiac emergencies
■ Asystole or pulseless electrical activity
Adrenaline: 10 μg (micrograms)/kg i.v every 3–5 minutes until return of
spontaneous circulation – this is equivalent to 1 ml/10 kg using 1:10,000
concentration (100 μg/ml). Double dose if used intratracheally.
■ Hyperkalaemic myocardial toxicity
Calcium: 50–150 mg/kg calcium (boro)gluconate = 0.5–1.5 ml/kg of a
10% solution i.v. over 20–30 min
or Soluble insulin: 0.5 IU/kg i.v. followed by 2–3 g of dextrose/unit of
insulin (for urinary tract obstruction but not hypoadrenocorticism). Half
the dextrose should be given as a bolus and the remainder administered
i.v. over 4–6h.
■ Other bradyarrhythmias
Atropine: 0.01–0.03 mg/kg i.v. – this is equivalent to 0.3–1 ml/20 kg using
0.6 mg/ml solution.
■ Ventricular tachycardia
Lidocaine:
Dogs: 2–8 mg/kg i.v. in 2 mg/kg boluses, followed by a constant rate i.v.
infusion of 0.025–0.1 mg/kg/min.
Cats: 0.25–2.0 mg/kg i.v. slowly in 0.25–0.5 mg/kg boluses followed by a
constant rate i.v. infusion of 0.01–0.04 mg/kg/min.
Pulmonary emergencies
■ Respiratory arrest
Doxapram: 5–10 mg/kg i.v., repeat according to need; duration of effect
is approximately 15–20 min. Neonates: 1–2 drops under the tongue (oral
solution) or 0.1 ml i.v. into the umbilical vein; this should be used only
once.
Metabolic emergencies
■ Anaphylaxis
Adrenaline: 10 μg/kg i.v. – this is equivalent to 1 ml/10 kg using 1:10,000
concentration (100 μg/ml).
■ Hypocalcaemia
Calcium: 50–150 mg/kg calcium (boro)gluconate = 0.5–1.5 ml/kg of a
10% solution i.v. over 20–30 min.
■ Hypoglycaemia
Glucose: 1–5 ml 50% dextrose i.v. slowly over 10 min.
Neurological emergencies
■ Status epilepticus control
Diazepam: 0.5 mg/kg i.v. or rectal – repeat after 3 minutes for up to 3
doses or Midazolam: 0.3 mg/kg i.v. or rectal – repeat after 3 minutes for
up to 3 doses.
If the seizures have been controlled, maintain on an i.v. infusion of
midazolam at 0.3 mg/kg/h while establishing or changing maintenance
therapy
If seizures not controlled by above: Propofol: induce with 1–4 mg/kg i.v.
and then maintain on 0.1–0.4 mg/kg/min.
■ Raised intracranial pressure (impending herniation)
Mannitol: 0.25–0.5 g/kg i.v. infusion of 15–20% solution over 30 min. May
repeat 1–2 times after 4–8 hours as long as hydration and electrolytes
monitored. (For acute glaucoma see monograph.)
Anaesthesia emergencies
■ Reversing agents
Naloxone: 0.015–0.04 mg/kg i.v., i.m., s.c., intratracheal (give to effect).
Atipamezole: Five times the previous medetomidine or dexmedetomidine
dose i.m.; if that dose unknown, use 100 μg(micrograms)/kg i.m. or very
slow i.v.
Small Animal
Formulary
10th edition – Part A: Canine and Feline
Editor-in-Chief:
Fergus Allerton BSc BVSc CertSAM DipECVIM-CA MRCVS
European Veterinary Specialist in Small Animal Internal Medicine
Willows Veterinary Centre and Referral Service,
Highlands Road, Shirley, Solihull, West Midlands B90 4H
Published by:
British Small Animal Veterinary Association
Woodrow House, 1 Telford Way, Waterwells Business Park,
Quedgeley, Gloucester GL2 2AB
A Company Limited by Guarantee in England.
Registered Company No. 2837793.
Registered as a Charity.
Copyright © 2020 BSAVA Small Animal Formulary
First edition 1994
Second edition 1997
Third edition 1999
Fourth edition 2002
Fifth edition 2005
Sixth edition 2008
Seventh edition 2011
Eighth edition 2014
Small Animal Formulary – Part A: Canine and Feline
Ninth edition 2017
Tenth edition 2020
Small Animal Formulary – Part B: Exotic Pets
Ninth edition 2015
Tenth edition 2020
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted, in form or by any means, electronic, mechanical, photocopying, recording or
otherwise without prior written permission of the copyright holder.
A catalogue record for this book is available from the British Library.
ISBN 978-1-910443-70-5
The publishers, editors and contributors cannot take responsibility for information provided on
dosages and methods of application of drugs mentioned or referred to in this publication. Details
of this kind must be verified in each case by individual users from up to date literature published
by the manufacturers or suppliers of those drugs. Veterinary surgeons are reminded that in each
case they must follow all appropriate national legislation and regulations (for example, in the
United Kingdom, the prescribing cascade) from time to time in force.
Printed in the UK by Cambrian Printers, Aberystwyth SY23 3TN
Printed on ECF paper made from sustainable forests. 10009PUBS20
ii BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline
Contents
Editorial Panel iii
Preface v
Foreword vi
Introduction
Notes on the monographs vii
Distribution categories viii
The prescribing cascade ix
Drug storage and dispensing xii
Health and safety in dispensing xiii
Drug listings and monographs 1

(listed A–Z by generic name)
Appendix I: general information

Abbreviations 441
Writing a prescription 442
Topical polypharmaceuticals for ear disease 443
Guidelines for responsible antibacterial use 444
Guidelines on prescribing glucocorticoids 445
Radiographic contrast agents: MRI 448
Composition of intravenous fluids 451
Safety and handling of chemotherapeutic agents 451
Body weight to body surface area conversion tables 455
Percentage solutions 455
Drugs usage in renal and hepatic insufficiency 456
Suspected Adverse Reaction Surveillance Scheme 458
Further reading and useful websites 458
Appendix II: protocols

Chemotherapy protocols for lymphoma 460
Immunosuppression protocols 467
Sedation/immobilization protocols 471
Sedative combinations for dogs 471
Sedative combinations for cats 474
Index sorted by therapeutic class 476

Index (alphabetical by generic and trade names 484
BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline iii
Editorial Panel
Fergus Allerton BSc BVSc CertSAM DipECVIM-CA MRCVS
Willows Veterinary Centre and Referral Service, Highlands Road,
Shirley, Solihull, West Midlands B90 4NH
Daniel Batchelor BVSc PhD DSAM DipECVIM-CA MRCVS

Department of Small Animal Clinical Sciences, University of
Liverpool, Leahurst, Neston, Wirral CH64 7TE
Nick Bexfield BVetMed PhD DSAM DipECVIM-CA PGDipMEdSci PGCHE

FHEA MRCVS
Department of Veterinary Medicine, University of Cambridge,
Madingley Road, Cambridge CB3 OES
Daniel L. Chan DVM DipACVECC DipECVECC DipACVN FHEA MRCVS

The Royal Veterinary College, Hawkshead Lane, North Mymms,
Hatfield, Hertfordshire AL9 7TA
Heidi Featherstone BVetMed DVOphthal DipECVO MRCVS

The Ralph Veterinary Hospital, Fourth Avenue,
Globe Business Park, Marlow SY7 1LG
Polly Frowde MA VetMB DipECVIM-CA MRCVS

Davies Veterinary Specialists Limited, Manor Farm Business Park,
Higham Gobion, Hertfordshire SG5 3HR
Jenny Helm BVMS CertSAM DipECVIM-CA FHEA MRCVS

College of Medical, Veterinary & Life Sciences, University of
Glasgow, Bearsden Road, Glasgow G61 1QH
Hannah Hodgkiss-Geere BVM&S MSc PhD DipECVIM-CA FHEA MRCVS

Institute of Veterinary Science, University of Liverpool,
Chester High Road, Neston CH64 7TE
Andrew Kent BVSc DipECVIM-CA MRCVS

David Killick BVetMed PgCELTHE PhD CertSAM DipECVIM-CA(Onc)

MRCVS
Institute of Veterinary Science, University of Liverpool, Leahurst,
Chester High Road CH64 7TE
Hilary Jackson BVM&S DVD DipACVD DipECVD MRCVS

The Dermatology Referral Service, 528 Paisley Road West,
Glasgow G51 1RN,
Daniel S. Mills BVSc PhD CBiol FRSB FHEA CCAB DipECAWBM(BM) FRCVS
Joseph Banks Laboratories, School of Life Sciences,
University of Lincoln, Lincoln LN6 7DL
iv BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline
Jo Murrell BVSc(Hons) PhD DipECVAA MRCVS

Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch,
Bristol BS14 9BE
Catherine Stalin MA VetMB DipECVN FHEA MRCVS

Small Animal Hospital, University of Glasgow,
Bearsden Road, Glasgow G61 1BD
Andrew Tanner BSc(Hons)

Angelika von Heimendahl MScAg BVM DipECAR MScVet (Cons) MRCVS

Veterinary Reproduction Service, Reed Veterinary Surgery,
London Road, Herts SG8 8BD
James Warland MA VetMB Dip-ECVIM-CA MRCVS

Wellcome – MRC Cambridge Stem Cell Institute, Jeffrey Cheah
Biomedical Centre, University of Cambridge, Puddicombe Way,
Cambridge CB2 0AW
BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline v
Preface
Welcome to Part A of the 10th edition of the BSAVA Small Animal
Formulary, providing up-to-date information about the drugs used
for cats and dogs. I would like to start by thanking Professor Ian
Ramsey for his tremendous work over the previous four editions of
the Formulary, cementing this book as a superbly useful tool for
small animal veterinary surgeons.
In revising the latest edition, several new drug monographs have
been added, including additional chemotherapeutic agents. The
introduction of bullet points within the description of uses should
highlight where certain drugs have multiple, reported indications.
Through ongoing veterinary research data relating to drug use,
adverse reactions and drug interactions is developed regularly;
veterinary surgeons and nurses are reminded to also consult other
sources when confronted with a medication with which they are
unfamiliar. As well as the cited references, textbooks such as the
excellent series of manuals published by the BSAVA can provide a
wealth of pertinent information.
This year, the guidelines on antibacterial use have been adapted to
reflect the 2018 launch of the PROTECT ME initiative. Antimicrobial
resistance is likely to represent a major challenge to human and
animal healthcare in this new decade. Veterinary surgeons have a
responsibility to pursue rational antibacterial use at all times and
are encouraged to refer to the latest recommendations regarding
the need for and selection of antibacterial medication for any
particular condition.
An illustrative flowchart has been added to the information regarding
the prescribing cascade following the clarifications published by the
Veterinary Medicines Directorate in 2019. Veterinary surgeons are
reminded of the need to ensure that their prescribing policies and
practices comply with existing guidelines and legislation. The
Formulary provides information about many drugs not authorized for
use in animals. Authorized products should be considered first for
every patient; when such products are not available, or not clinically
suitable, unauthorized medicines may be used in accordance with
the cascade. In such cases, a clear clinical justification, made on an
individual basis, should be recorded in the clinical notes or on the
prescription.
I would like to thank the Editorial Panel members for their efforts on
this edition. I would also like to thank Alessandra Mathis, Jacques
Ferreira, Gwen Covey-Crump, Tim Nuttall, Charlotte Robinson and
James Swann for their invaluable advice with particular sections.
My gratitude also goes to the editorial team members at BSAVA for
their generous and enthusiastic assistance.
I would welcome all comments and feedback from BSAVA members
on this latest edition of the Small Animal Formulary.
Fergus Allerton
January 2020
vi BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline
Foreword
The BSAVA Small Animal Formulary for the cat and dog, which was
first published over twenty years ago, is recognized as an invaluable
asset for the small animal clinician and is one of the Association’s
most useful member benefits. Available as both a hard copy and as
an App, it can be accessed quickly by the busy clinician as a resource
to help with immediate prescribing advice, as well as by veterinary
students during their training. As the numbers of licensed
medications available to the small animal vet has increased, a
reference source such as this can be a life saver during a hectic
working day.
The 10th edition of the Formulary sees Fergus Allerton take up the
reins from Ian Ramsey who has guided the editorial team for many
years. Fergus has assembled a knowledgeable and experienced
group of subject experts to review the Formulary, which has been
fully updated. Thirteen new drug monographs have been added
together with client information leaflets for a further nine drugs.
The launch of the Small Animal Formulary: Part A – Canine and
Feline, together with the updated Small Animal Formulary: Part B
– Exotic Pets, provides primary care veterinary surgeons and
specialists alike with a complete guide to prescribing across all of
species encountered by veterinary surgeons in clinical practice.
Fergus and his team are to be congratulated on bringing out this
new and updated 10th edition of the Formulary.
Sue Paterson MA VetMB DVD DipECVD FRCVS

BSAVA President 2019–2020
Introduction vii
Introduction
INTRODUCTION
Notes on the monographs
• Name. The rINN generic name is used where this has been
agreed. When a choice of names is available the more
commonly used in the UK has been provided. The list of trade
names is not necessarily comprehensive, and the mention or
exclusion of any particular commercial product is not a
recommendation or otherwise as to its value. Any omission of a
product that is authorized for a particular canine or feline
indication is purely accidental. All monographs were updated in
the period July–December 2019. Products that are not
marketed for use in animals (whether authorized by the
Veterinary Medicines Directorate or not) are marked with an
asterisk. Note that an indication that a product is authorized
does not necessarily mean that it is authorized for all species
and indications listed in the monograph; users should check
individual data sheets. You may also wish to refer to the VMD’s
Product Information Database (www.vmd.defra.gov.uk/
ProductInformationDatabase/).
• Formulations. Only medicines and formulations that are
available in the UK have been included – many others are
available outside the UK and some medicines in different
formulations. Common trade names of human medicines are
provided. In many cases they are available as generic
formulations and may be cheaper. However, be careful of
assuming that the bioavailability of one brand is the same as
that of another. Avoid switching between brands unnecessarily.
• Action and Use. Veterinary surgeons using this publication are
warned that many of the drugs and doses listed are not
currently authorized by the Veterinary Medicines Directorate
(VMD) or the European Agency for the Evaluation of Medicinal
Products (EMEA) (either at all or for a particular species), or
manufacturers’ recommendations may be limited to particular
indications. The decision, and therefore the responsibility, for
prescribing any drug for an animal lies solely with the
veterinary surgeon. Expert assistance should be obtained when
necessary. The ‘cascade’ and its implications are discussed
below. For information on combination drugs, it is important to
refer to all relevant monographs.
• Safety and handling. This section only outlines specific risks
and precautions for a particular drug that are in addition to the
general advice given below in the ‘Health and safety in
dispensing’ section. A separate Appendix deals with
chemotherapeutic drugs.
• Contraindications and Adverse reactions: The list of adverse
reactions is not intended to be comprehensive and is limited to
those effects that may be of clinical significance. The
information for both of these sections is taken from published
veterinary and human references and not just from product
literature.
viii Introduction
• Drug interactions. A listing of those interactions which may be

INTRODUCTION
of clinical significance.
• Doses. These are based on those recommended by the
manufacturers in their data sheets and package inserts, or are
based on those given in published articles or textbooks, or are
based on clinical experience. These recommendations should
be used only as guidelines and should not be considered
appropriate for every case. Clinical judgement must take
precedence. Doses for small mammals, birds, reptiles and other
groups of animals should never be extrapolated from the doses
provided in this book for dogs and cats. The BSAVA Small
Animal Formulary: Part B – Exotic Pets and other sources
should be consulted where such doses are required.
Distribution categories
Authorized small animal medicines within Great Britain now fall
within the first four categories below and all packaging supplied by
drug manufacturers and distributors was changed in 2008. Medical
products not authorized for veterinary use retain their former
classification (e.g. GSL, P, POM). Other laws apply in other
jurisdictions. Some nutritional supplements (nutraceuticals) are not
considered medicinal products and therefore are not classified.
Where a product does not have a marketing authorization it is
designated ‘general sale’.
AVM-GSL: Authorized veterinary medicine – general sales list. This

may be sold by anyone.
NFA-VPS: Non-food animal medicine – veterinarian, pharmacist,

Suitably Qualified Person (SQP). These medicines for companion
animals must be supplied by a veterinary surgeon, pharmacist or
SQP. An SQP has to be registered with the Animal Medicines Training
Regulatory Authority (AMTRA). Veterinary nurses can become SQPs
but it is not automatic.
POM-VPS: Prescription-only medicine – veterinarian, pharmacist,

SQP (formerly PML livestock products, MFSX products and a few P
products). These medicines for food-producing animals (including
horses) can only be supplied on an oral or written veterinary
prescription from a veterinary surgeon, pharmacist or SQP and can
only be supplied by one of those groups of people in accordance
with the prescription.
POM-V: Prescription-only medicine – veterinarian. These medicines

can only be supplied against a veterinary prescription that has been
prepared (either orally or in writing) by a veterinary surgeon to
animals under their care following a clinical assessment, and can
only be supplied by a veterinary surgeon or pharmacist in
accordance with the prescription.
CD: Controlled Drug. A substance controlled by the Misuse of Drugs

Act 1971 and Regulations. The CD is followed by (Schedule 1),
(Schedule 2), (Schedule 3), (Schedule 4) or (Schedule 5) depending
Introduction ix
on the Schedule to The Misuse of Drugs Regulations 2001 (as
INTRODUCTION
amended) in which the preparation is included. You could be
prosecuted for failure to comply with this act. Prescribers are
reminded that there are additional requirements relating to the
prescribing of Controlled Drugs. For more information see the BSAVA
Guide to the Use of Veterinary Medicines at www.bsavalibrary.com.
Schedule 1: Includes LSD, cannabis, lysergide and other drugs that
are not used medicinally. Possession and supply are prohibited
except in accordance with Home Office Authority.
Schedule 2: Includes etorphine, ketamine, morphine, methadone,

pethidine, secobarbital (quinalbarbitone), diamorphine (heroin),
cocaine and amphetamine. Record all purchases and each individual
supply (within 24 hours). Registers must be kept for 2 calendar years
after the last entry. Drugs must be kept under safe custody (locked
secure cabinet), except secobarbital. There are specific requirements
regarding the destruction of Schedule 2 Controlled Drugs, which
may require an independent veterinary surgeon or person
authorized by the Secretary of State to witness.
Schedule 3: Includes buprenorphine, tramadol, the barbiturates (e.g.

pentobarbital and phenobarbital but not secobarbital – which is
Schedule 2), midazolam, gabapentin and others. Buprenorphine,
with some others, must be kept under safe custody (locked secure
cabinet) and it is advisable that all Schedule 3 drugs are locked away
(although not compulsory for the rest). Retention of invoices for 2
years is necessary.
Schedule 4: Includes most of the benzodiazepines except

midazolam (which is Schedule 3), and androgenic and anabolic
steroids (e.g. nandralone). Exempted from control when used in
normal veterinary practice.
Schedule 5: Includes preparations (such as several codeine

products) which, because of their strength, are exempt from virtually
all Controlled Drug requirements other than the retention of
invoices for 2 years.
The prescribing cascade

Veterinary medicinal products must be administered in accordance
with the prescribing cascade, as set out in the Veterinary Medicines
Regulations 2013. These Regulations provide that when no
authorized veterinary medicinal product exists for a condition in a
particular species, veterinary surgeons exercising their clinical
judgement may, in particular to avoid unacceptable suffering,
prescribe for one or a small number of animals under their care other
suitable medications in accordance with the following sequence:
• A veterinary medicine authorized in the UK for use in another
species with the same condition, or for a different condition in
the same species
• If there is no such product:
■ A medicine authorized in the UK for human use
x Introduction
■ A veterinary medicine not authorized in the UK, but

INTRODUCTION
authorized in another EU member state for use in any

species in accordance with the Special Import Scheme.
• A veterinary medicine prepared extemporaneously by a properly
authorized person as prescribed by the veterinary surgeon
• In exceptional circumstances, medicines may be imported from
outside Europe via the Special Import Scheme.
UK authorized
veterinary medicine
A product licensed A product licensed

for another condition for another animal species
in the same species with the same condition
A UK human licensed product

or
A medicine authorized for veterinary
use in another European Union (EU)
member state in accordance with
the Special Import Scheme
A product prepared extemporaneously by a

veterinary surgeon, a pharmacist or a person
holding a manufacturer’s authorization,
as prescribed by the veterinary surgeon
In exceptional circumstances
A veterinary medicine A human medicine can

can be imported from be imported from any
outside the EU via the other country with a
Special Import Scheme Special Import
Certificate
This flowchart shows the steps that should be taken when no authorized
veterinary medicine is available or clinically suitable.
Introduction xi
‘Off-label’ use of medicines
INTRODUCTION
‘Off-label’ use is the use of medicines outside the terms of their
marketing authorization. It may include medicines authorized
outside the UK that are used in accordance with an import
certificate issued by the VMD. A veterinary surgeon with detailed
knowledge of the medical history and clinical status of a patient,
may reasonably prescribe a medicine ‘off-label’ in accordance with
the prescribing cascade. Authorized medicines have been
scientifically assessed against statutory criteria of safety, quality and
efficacy when used in accordance with the authorized
recommendations on the product literature. Use of an unauthorized
medicine provides none of these safeguards and may, therefore,
pose potential risks that the authorization process seeks to minimize.
Medicines may be used ‘off-label’ for a variety of reasons including:
• No authorized product is suitable for the condition or specific
subpopulation being treated
• Need to alter the duration of therapy, dosage, route of
administration, etc., to treat the specific condition presented
• An authorized product has proved ineffective in the
circumstances of a particular case (all cases of suspected lack of
efficacy of authorized veterinary medicines should be reported
to the VMD).
Responsibility for the use of a medicine ‘off-label’ lies solely with
the prescribing veterinary surgeon. He or she should inform the
owner of the reason why a medicine is to be used ‘off-label’ and
record this reason in the patient’s clinical notes. When electing to
use a medicine ‘off-label’ always:
• Discuss all therapeutic options with the owner
• Use the cascade to determine your choice of medicine
• Obtain signed informed consent if an unauthorized product is
to be used, ensuring that all potential problems are explained to
the client
• Administer unauthorized medicines against a patient-specific
prescription. Do not administer to a group of animals if at all
possible.
An ‘off-label’ medicine must show a comparative clinical advantage
to the authorized product in the specific circumstances presented
(where applicable). Medicines may be used ‘off-label’ in the
following ways (this is not an exhaustive list):
• Authorized product at an unauthorized dose
• Authorized product for an unauthorized indication
• Authorized product used outwith the authorized age range
• Authorized product administered by an unauthorized route
• Authorized product used to treat an animal in an unauthorized
physiological state, e.g. pregnancy (i.e. an unauthorized
indication)
• Product authorized for use in humans or a different animal
species to that being treated.
Adverse effects may or may not be specific for a species, and
idiosyncratic reactions are always a possibility. If no adverse effects
xii Introduction
are listed, consider data from different species. When using novel or
INTRODUCTION
unfamiliar drugs, consider pharmaceutical and pharmacological

interactions. In some species, and with some diseases, the ability to
metabolize/excrete a drug may be impaired/enhanced. Use the
lowest dose that might be effective and the safest route of
administration. Ensure that you are aware of the clinical signs that
may suggest toxicity.
Information on ‘off-label’ use may be available from a wide variety of
sources (see Appendix).
Drug storage and dispensing

For further information on the storage and dispensing of medicines
see the BSAVA Guide to the Use of Veterinary Medicines available at
www.bsavalibrary.com. Note the recent change in legislation, which
states that veterinary surgeons may only supply a veterinary
medicine from practice premises that are registered with the RCVS
and that these premises must be inspected. It is recommended that,
in general, medications are kept in and dispensed in the
manufacturer’s original packaging. Medicines can be adversely
affected by adverse temperatures, excessive light, humidity and
rough handling. Loose tablets or capsules that are repackaged from
bulk containers should be dispensed in child-resistant containers
and supplied with a package insert (if one exists). Tablets and
capsules in foil strips should be sold in their original packaging or in
a similar cardboard box for smaller quantities. Preparations for
external application should be dispensed in coloured fluted bottles.
Oral liquids should be dispensed in plain glass bottles with child-
resistant closures.
All medicines should be labelled. The label should include:

• The owner’s name and address
• Identification of the animal
• Date of supply (and, if applicable, the expiry date)
• Product name (and strength)
• Total quantity of the product supplied in the container
• Instructions for dosage
• Practice name and address
• The name of the veterinary surgeon who prescribed the
medication (if not an authorized use)
• Any specific pharmacy precautions (including storage, disposal,
handling)
• The wording ‘Keep out of reach of children’ and ‘For animal
treatment only’
• Withdrawal period, if relevant
• Any other necessary warnings.
The words ‘For external use only’ should be included on labels for
products for topical use. All labels should be typed. If this
information cannot be fitted on a single label, then it is permissible
to include the information on a separate sheet.
Introduction xiii
For medicines that are not authorized for veterinary use, and even
INTRODUCTION
for some that are, it is useful to add to the label or on a separate
sheet the likely adverse effects, drug interactions and the action to
be taken in the event of inadvertent mis-dosing or incorrect
administration written in plain English. Samples of such Client
Information Leaflets (shown as in the monographs) for many
commonly used, but unauthorized, drugs are available for BSAVA
members to download from www.bsavalibrary.com.
In order to comply with the current Veterinary Medicines Regulations,

records of all products supplied on prescription must be kept for 5
years. When a batch is brought into use in a practice, the batch
number and date should be recorded. It is not necessary to record
the batch number of each medication used for a given animal.
Health and safety in dispensing

All drugs are potentially poisonous to humans as well as animals.
Toxicity may be mild or severe and includes carcinogenic and
teratogenic effects. Warnings are given in the monographs. However,
risks to humans dispensing medicines are not always well
characterized and idiosyncratic reactions may occur. It is good
practice for everyone to wear protective clothing (including gloves)
when directly handling medicines, not to eat or drink (or store food
or drink) near medicines, and to wash their hands frequently when
working with medicines. Gloves, masks and safety glasses should be
worn if handling potentially toxic liquids, powders or broken tablets.
Do not break tablets of antineoplastic cytotoxic drugs and use
laminar flow cabinets for the preparation and dispensing of these
medications. See Appendix for more information.
Many prescribers and users of medicines are not aware of the

carcinogenic potential of the drugs they are handling. Below are
lists of medicines included in the BSAVA Formulary that are known
or potential carcinogens or teratogens. The lists are not all-
inclusive: they include only those substances that have been
evaluated. Most of the drugs are connected only with certain kinds
of cancer. The relative carcinogenicity of the agents varies
considerably and some do not cause cancer at all times or under
all circumstances. Some may only be carcinogenic or teratogenic if
a person is exposed in a certain way (for example, ingesting as
opposed to touching the drug). For more detailed information,
refer to the International Agency for Research on Cancer (IARC) or
the National Toxicology Program (NTP) (information is available on
their respective websites).
xiv Introduction
Examples of drugs known or suspected to be human carcinogens

INTRODUCTION
(c) or teratogens (t):
• ACE inhibitors (t), e.g. benazepril, enalapril, ramipril

• Androgenic (anabolic) steroids (t, c)
• Antibiotics (c), e.g. metronidazole, chloramphenicol
• Antibiotics (t), e.g. aminoglycosides, doxycycline, trimethoprim,
sulphonamides
• Antifungals (c), e.g. fluconazole, itraconazole, flucytosine
• Antineoplastic drugs (c, t) – all
• Antithyroid drugs (t), e.g. carbimazole/methimazole
• Beta-blockers (t)
• Deferoxamine (t)
• Diltiazem (t)
• Finasteride (t)
• Immunosuppressives (c), e.g. azathioprine, ciclosporin
• Lithium (t)
• Methotrexate (t)
• Misoprostol (t)
• NSAIDs (t)
• Penicillamine (t)
• Phenoxybenzamine (c)
• Progestagens (c) and some oestrogens (c)
• Vitamin A (t)
Note that most carcinogens are also likely to be teratogens.

BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline 1
Acepromazine (ACP) A
(Acecare, ACP) POM-V B
Formulations: Injectable: 2 mg/ml solution. Oral: 10 mg, 25 mg
tablets. C
Action: Phenothiazine with depressant effect on the CNS, thereby D
causing sedation and a reduction in spontaneous activity.
Use: E
• Sedation or pre-anaesthetic medication in dogs and cats. F
• ACP raises the threshold for cardiac arrhythmias and has
antiemetic properties.
G
• Sedation is unreliable when ACP is used alone; combining ACP
with an opioid drug improves sedation (neuroleptanalgesia) and H
the opioid provides analgesia.
• Also used for the management of thromboembolism in cats I
because of its peripheral vasodilatory action.
The depth of sedation is dose-dependent up to a plateau (0.1 mg/ J
kg). Increasing the dose above 0.1 mg/kg does little to improve the
predictability of achieving adequate sedation but increases the risk K
of incurring adverse effects, the severity of adverse effects and the
duration of action of any effects (desirable or adverse) that arise. The L
lower end of the dose range should be used for giant-breed dogs to
allow for the effects of metabolic body size. Onset of sedation is M
20–30 minutes after i.m. administration; clinical doses cause
sedation for up to 6 hours. The oral dose of ACP tablets required to N
produce sedation varies between individual animals, and high doses
can lead to very prolonged sedation. The use of ACP in the O
management of sound phobias in dogs, such as firework or thunder
phobia, is not recommended. P
Safety and handling: Normal precautions should be observed. Q
Contraindications: Hypotension due to shock, trauma or
cardiovascular disease. Avoid in animals <3 months and animals with R
liver disease. Use cautiously in anaemic animals as it will exacerbate
the anaemia by sequestration of red blood cells in the spleen. In S
Boxers, spontaneous fainting and syncope can occur due to sinoatrial
block caused by excessive vagal tone; use low doses or avoid. T
Adverse reactions: Rarely, healthy animals may develop U
profound hypotension following administration of phenothiazines.
Supportive therapy to maintain body temperature and fluid balance V
is indicated until the animal is fully recovered.
Drug interactions: Other CNS depressant agents (e.g. W
barbiturates, propofol, alfaxalone, volatile anaesthetics) will cause
additive CNS depression if used with ACP. Doses of other
X
anaesthetic drugs should be reduced when ACP has been used for
premedication. Increased levels of both drugs may result if
Y
propranolol is administered with phenothiazines. As phenothiazines
Z
block alpha-adrenergic receptors, concomitant use with adrenaline
2 BSAVA Small Animal Formulary 10th edition: Part A – Canine and Feline
may lead to unopposed beta activity, thereby causing vasodilation

A and tachycardia. Antidiarrhoeal mixtures (e.g. kaolin/pectin,
bismuth salicylate) and antacids may cause reduced GI absorption
B of oral phenothiazines.
C DOSES
When used for sedation and premedication is generally given as
D part of a combination with opioids. See Appendix for sedation
protocols in cats and dogs.
E Dogs (not Boxers), Cats: 0.01–0.02 mg/kg slowly i.v.; 0.01–0.05
mg/kg i.m., s.c.; 1–3 mg/kg p.o. Boxers: 0.005–0.01 mg/kg i.m.
F
G Acetaminophen see Paracetamol
H
Acetazolamide
I (Diamox*) POM
J Formulations: Oral: 250 mg tablets, capsules.
K Action: Systemic carbonic anhydrase inhibitor.
Use:
L • Used as treatment for the management of episodic falling in the
Cavalier King Charles Spaniel experiencing a high frequency of
M collapse episodes which are refractory to other treatments
(clonazepam and diazepam). If there is no favourable response
N after 2 weeks on q12h dose, then the drug should be stopped.
• May be beneficial for other paroxysmal dyskinesias.
O
No longer used for canine glaucoma.
P Safety and handling: Normal precautions should be observed.
Q Contraindications: Avoid in anorexic dogs, those with hepatic or
renal dysfunction and those with sulphonamide hypersensitivity.
R Cats are particularly susceptible to the adverse effects of systemic
carbonic anhydrase inhibitors; avoid in this species.
S Adverse reactions: Weakness, GI disturbances (anorexia,
vomiting, diarrhoea), panting, metabolic acidosis, diuresis,
T electrolyte disturbances, in particular, potassium depletion.
U Drug interactions: Acetazolamide alkalinizes urine; thus,
excretion rate of weak bases may be decreased but weak acid
V excretion increased. Concomitant use of corticosteroids may
exacerbate potassium depletion, causing hypokalaemia.
W DOSES
X Dogs: CKCS episodic falling syndrome: 4–8 mg/kg p.o. q8–12h.
Cats: Do not use.
Y References
Emilie Royaux, Sofie Bhatti, Robert Harvey et al. (2016) Acetazolamide-responsive
Z paroxysmal dyskinesia in a 12-week-old female golden retriever dog. Veterinary
Quarterly 36, 45–49
Acetylcysteine A
(Ilube*, Parvolex*) POM
B
Formulations: Injectable: 200 mg/ml solution. Topical: 5%
ophthalmic solution in combination with 0.35% hypromellose C
ophthalmic drops in 10 ml bottle.
Action: Decreases the viscosity of bronchial secretions, maintains D
glutathione levels in the liver and has some anticollagenase activity.
E
Use: Reduces the extent of liver injury in cases of paracetamol
poisoning and other forms of liver toxicity involving oxidative F
damage or impaired glutathione synthesis (e.g. xylitol poisoning).
• Has been used in non-specific acute hepatopathies of suspected G
toxic origin.
• Can also be used as a mucolytic in respiratory disease. H
• Acetylcysteine may be useful in the treatment of
keratoconjunctivitis sicca (KCS) (dry eye), or in ‘melting’ corneal I
ulcers although there is limited in vivo work to confirm this.
Oral solution should be diluted to a 5% solution and given via a
J
stomach tube as it tastes unpleasant. In the eye it may be used in
conjunction with hypromellose.
K
Safety and handling: Normal precautions should be observed. L
Contraindications: No information available. M
Adverse reactions: Acetylcysteine has caused hypersensitivity
and bronchospasm when used in the pulmonary tree (use with care N
in bronchospastic respiratory disease, e.g. feline asthma). When
given orally for paracetamol poisoning it may cause GI effects O
(nausea, vomiting) and, rarely, urticaria.
P
Drug interactions: In cases of paracetamol poisoning, the
concurrent administration of activated charcoal is controversial as it Q
may also reduce acetylcysteine absorption.
DOSES R
Dogs, Cats:
• Mucolytic: either nebulize 50 mg as a 2% (dilute with saline)
S
solution over 30–60 min or instil directly into the trachea
1–2 ml of a 20% solution.
T
• Paracetamol poisoning: (after inducing emesis if appropriate,
i.e. presented within 2 hours of ingestion) give 140–280 mg/kg
U
diluted to a 5% solution using 5% dextrose by slow i.v. infusion
over 15–20 min, followed by further slow infusions of 70 mg/kg
V
(similarly diluted) every 6 hours for at least 7 doses, depending
on dose of paracetamol consumed (seek advice from a poisons
W
information service). The intravenous solution can be
administered orally but should be diluted to improve palatability;
X
however, i.v. administration is preferred for serious intoxications
Y
as bioavailability is reduced with oral administration in cats.
• KCS: 1 drop of the ophthalmic solution topically to the eye
Z
q6–8h. Rarely used now for this indication.
• Melting corneal ulcers: 1 drop of the ophthalmic solution q1–4h

A in the affected eye for 24–48 hours. Topical autologous serum
is more effective for the treatment of a melting corneal ulcer
B and is preferred.
C References
Dunayer EK (2006) New Findings on the effects of xylitol ingestion in dogs. Veterinary
Medicine 101, 791–796
D Richardson JA (2000) Management of acetaminophen and ibuprofen toxicoses in dogs
and cats. Journal of Veterinary Emergency and Critical Care 10, 285–291
E
F Acetylsalicyclic acid see Aspirin
G
H Aciclovir
(Zovirax*) POM
I
Formulations: Ophthalmic: 3% ointment in 4.5 g tubes.
J Action: Inhibits viral replication (viral DNA polymerase); depends
on viral thymidine kinase for phosphorylation.
K
Use:
L • Management of ocular feline herpesvirus-1 (FHV-1) infections.
The clinical efficacy of aciclovir is questionable but frequent
M application (0.5% ointment 5 times daily) may achieve corneal
concentrations. Aciclovir is virostatic and is unable to eradicate
N latent viral infection. Consider ganciclovir and famciclovir before
aciclovir. In refractory and severe cases of FHV-1 ulceration,
O combined therapy including antiviral medication can be used.
P Safety and handling: Normal precautions should be observed.
Q Contraindications: No information available for the ophthalmic
preparation. Systemic aciclovir is toxic in cats.
R Adverse reactions: Ocular irritation may occur and the frequency
of application should be reduced if this develops. Treatment should
S not be continued for >3 weeks.
T Drug interactions: No information available.
U DOSES
Dogs: Not applicable.
V Cats: Apply a small amount to affected eye 5 times daily for a
maximum of 3 weeks.
W References
Thomasy SM and Maggs DJ (2016) A review of antiviral drugs and other compounds with
X activity against feline herpesvirus type 1. Veterinary Ophthalmology 19, 119–130
Y
ACP see Acepromazine
Z
ACTH see Tetracosactide
Actinomycin-D see Dactinomycin A

Activated charcoal see Charcoal
ADH see Desmopressin B
C
Adrenaline (Epinephrine) D
(Adrenaline*, Epinephrine*) POM
E
Formulations: Injectable: Range of concentrations for injection:
0.1–10 mg/ml, equivalent to 1:10,000 to 1:100. F
Action: Adrenaline exerts its effects via alpha-1, -2 and beta-1 and G
-2 adrenoreceptors.
Use: H
• Cardiac resuscitation, status asthmaticus and to offset the effects
of histamine release in severe anaphylactoid reactions.
I
• The ophthalmic preparation is used in open-angle glaucoma.
J
The effects of adrenaline vary according to dose. Infusions of low
doses mainly result in beta-adrenergic effects (increases in cardiac K
output, myocardial oxygen consumption, and a reduced threshold for
arrhythmias with peripheral vasodilation and a fall in diastolic blood L
pressure). At high doses alpha-1 effects predominate, causing a rise in
systemic vascular resistance, diverting blood to the central organs; M
however, this may improve cardiac output and blood flow. Adrenaline
is not a substitute for fluid replacement therapy. Respiratory effects N
include bronchodilation and an increase in pulmonary vascular
resistance. Renal blood flow is moderately decreased. The duration of O
action of adrenaline is short (2–5 min). Beware of using in animals
with diabetes mellitus (monitor blood glucose concentration), P
hypertension or hyperthyroidism. Use with caution in hypovolaemic
animals. Overdosage can be fatal so check dose, particularly in small Q
patients. Intracardiac injection is not recommended.
Safety and handling: Do not confuse adrenaline vials of different R
concentrations. Adrenaline is sensitive to light and air: do not use if it
is pink, brown or contains a precipitate. It is unstable in 5% dextrose. S
Contraindications: The use of human adrenaline pen injections T
is not recommended for the treatment of suspected anaphylaxis.
The doses in such pens are usually too small to be effective in most U
normal animals and by the time the dog has collapsed would be
unlikely to have any effect on outcome. If such pen injections are V
administered by owners, then, in common with medical practice,
patients must be carefully monitored for at least 6 hours. Do not W
administer adrenaline directly into the myocardium because of the
risk of arrhythmias. X
Adverse reactions: Increases myocardial oxygen demand and Y
produces arrhythmias including ventricular fibrillation. These may be
ameliorated by administering oxygen and slowing the heart rate with
Z
beta-2 antagonists. Other adverse effects include tachycardia,
arrhythmias, dry mouth and cold extremities. Repeated injections

A can cause necrosis at the injection site.
B Drug interactions: Toxicity may occur if used with other

sympathomimetic amines because of additive effects. The effects of
C adrenaline may be potentiated by antihistamines and thyroxine.
Propranolol may block the beta effects of adrenaline, thus
D facilitating an increase in blood pressure. Alpha blocking agents or
diuretics may negate or diminish the pressor effects. When
E adrenaline is used with drugs that sensitize the myocardium (e.g.
halothane, high doses of digoxin) monitor for signs of arrhythmias.
F Hypertension may result if adrenaline is used with oxytocic agents.
G DOSES
Dogs, Cats:
H Cardiopulmonary arrest (CPA):
• 10 μg (micrograms)/kg of a 1:1000 solution (1000 μg/ml) given
I i.v. or intraosseously every 3–5 min. Peripheral administration
into a vein should be followed by a fluid bolus to push the drug
J into the central circulation. High dose epinephrine (0.1 mg/kg
i.v.) maybe considered after prolonged CPA. Can be given
K intratracheally for resuscitation of intubated animals, but higher
doses may be required. A long catheter should be used to
L ensure the drug is delivered into the bronchi beyond the end of
the endotracheal tube.
M Bronchoconstriction and anaphylaxis:
• 10 μg (micrograms)/kg of a 1:1000 solution (1000 μg/ml) i.v. or
N i.m. The i.v. route is preferred if hypotension accompanies an
anaphylactoid reaction.
O References
Fletcher DJ, Boller M, Brainard BM et al. (2012) RECOVER evidence and knowledge gap
P analysis on veterinary CPR. Part 7: Clinical guidelines. Journal of Veterinary Emergency
and Critical Care (San Antonio) 22(S1), 102–131
Q
R Afoxolaner
S (Nexgard, Nexgard Spectra) POM-V
T Formulations: Oral: 11.3 mg, 28.3 mg, 68 mg, 136 mg tablets
(Nexgard), also available in 5 tablet sizes with milbemycin oxime
U (Nexgard Spectra).
Action: Acts at ligand-gated chloride channels, in particular those
V gated by the neurotransmitter GABA, thereby blocking pre- and
post-synaptic transfer of chloride ions across cell membranes.
W
Use:
X • Used in the treatment of fleas and ticks in dogs. Kills fleas within
8 hours and ticks within 48 hours.
Y • Treatment of sarcoptic acariasis and demodicosis in dogs.
Z Safety and handling: Normal precautions should be observed.
The tablets should not be divided.
Contraindications: Do not use in dogs <8 weeks old or <2 kg

body weight. A
Adverse reactions: Rare mild gastrointestinal signs (vomiting, B
diarrhoea), lethargy, anorexia, pruritus, neurological (convulsions,
ataxia). C
Drug interactions: No information available. D
DOSES
Dogs: Administer monthly. The tablets supply 2.5–6.9 mg/kg of E
afoxolaner.
Cats: Do not use. F
References G
Beugnet F, Halos L, Larsen D et al. (2016) Efficacy of oral afoxolaner for the treatment of
canine generalised demodicosis. Parasite 23, doi: 10.1051/parasite/2016014
H
I
Aglepristone
(Alizin) POM-V J
Formulations: Injectable: 30 mg/ml solution. K
Action: Progesterone receptor blockage leads to elimination of
progesterone support for up to 7 days. L
Use: M
• Termination of pregnancy throughout pregnancy.
• Treatment of pyometra in dogs, although recurrence is not N
unusual especially in older bitches.
• Induction of parturition in cats and dogs. O
• Treat of progesterone-induced acromegaly in dogs and
progesterone-induced fibroadenomatous mammary hyperplasia P
in cats.
Best given in bitches at the end of oestrus or beginning of Q
metoestrus and straight after suspected mating in queens as they
are induced ovulators. When used after 30 days, bitches and queens R
will abort rather than absorb. May be unsuccessful when used in
pro-oestrus and early oestrus in bitches as progesterone has not yet S
risen or sperm survival may be longer than activity of aglepristone.
In bitches confirmed as pregnant, a partial abortion may occur in up T
to 5% of cases. In late abortions, clinical examination (ultrasound) is
recommended 10 days after treatment in order to confirm U
termination. After induced abortion, an early return to oestrus is
frequently observed (the oestrus-to-oestrus interval may be V
shortened by 1–3 months). Bitches will usually be able to carry
subsequent pregnancies successfully. W
Safety and handling: Use with care. Accidental injection may be X
a hazard to women who are pregnant or intending to become
pregnant. Y
Contraindications: Consider avoiding in dogs with diagnosed or Z
suspected hypoadrenocorticism.
Adverse reactions: Transient pain at the injection site; any local

A inflammation produced resolves uneventfully. In bitches/queens
treated beyond the 20th day of gestation, abortion may be
B accompanied by the physiological signs of parturition, i.e. fetal
expulsion, anorexia, mammary congestion.
C
Drug interactions: Aglepristone binds to glucocorticoid
D receptors and may therefore interfere with the actions of
glucocorticoids; however, the clinical significance of this is unclear.
E
DOSES
F Dogs: Maximum of 5 ml injected at any one site.
• Pregnancy termination: 10 mg/kg s.c. within 24 hours for
G 2 doses.
• Progesterone-induced acromegaly: 10 mg/kg s.c. q24h for
H 2 doses and then q7d for 3 more doses.
• Pyometra: 10 mg/kg s.c. on days 1, 2 and 7. Additional doses
I may be given on days 14 and 21 if there is an inadequate
response.
J Cats: Maximum of 5 ml injected at any one site.
• Pregnancy termination: 15 mg/kg s.c. within q24h for 2 doses.
K • Fibroadenomatous hyperplasia: 20 mg/kg s.c. q7d (also
consider atenolol if cat is tachycardic with heart rate >200 bpm).
L • Pyometra: 15 mg/kg s.c. on days 1, 2 and 7. Additional doses
may be given on days 14 and 21 if there is an inadequate
M response.
N References
Gogny A and Fiéni F (2016) Aglepristone: a review on its clinical use in animals.
Theriogenology 85, 555–566
O
P Alendronate (Alendronate sodium)
Q (Fosamax*) POM
R Formulations: Oral: 10 mg, 70 mg tablets, 0.7 mg/ml solution.
Action: Primary action is to inhibit osteoclastic bone reabsorption
S (through inhibiting osteoclast function). Also promotes apoptosis,
inhibits angiogenesis, cancer cell division and osteoclastogenesis.
T
Use:
U • Treatment of idiopathic hypercalcaemia.
• To reduce pain associated with osteolytic conditions (e.g. bone
V tumours).
There is limited information in the literature regarding the use of
W alendronate in dogs. Poor absorption after oral administration limits
efficacy in this species.
X
Safety and handling: Store at room temperature.
Y Contraindications: Alendronate is contraindicated in humans
with oesophageal disease; however, it is unknown if this is necessary
Z
for dogs and cats. Use with caution in patients with renal
insufficiency and avoid in patients with renal failure. Avoid in patients

with a history of hypersensitivity to bisphosphonates. A
Adverse reactions: Alendronate is thought to cause oesophageal B
irritation (oesophagitis) and upper GI ulcers. There are limited
reports of vomiting, and inappetance in dogs. Pathological fractures C
reported in cats after prolonged use (5–9 years). Other potential
adverse effects include osteonecrosis and musculoskeletal pain. D
Hypocalcaemia is also possible.
Drug interactions: Do not use in combination with aspirin E
(increased risk of upper GI adverse events) and use with caution with
other NSAIDs. Avoid drugs/supplements/diets that contain calcium F
as this is likely to decrease the bioavailability of alendronate.
G
DOSES
Dogs: Hypercalcaemia and/or to reduce bone pain: 0.5–1 mg/kg H
p.o. q24h on an empty stomach.
Cats: Hypercalcaemia: 5–10 mg/cat p.o. weekly on an empty I
stomach. Follow with a syringe of water (at least 6 ml). If tolerated
well the dose can be increased to 30 mg/cat p.o. weekly. J
References K
Council N, Dyce J, Drost WT et al. (2017). Bilateral patellar fractures and increased
cortical bone thickness associated with long-term oral alendronate treatment in a cat.
Journal of Feline Medicine and Surgery Open Reports 3, 1–6 L
Hardy BT, de Brito Galvao JF, Green TA et al. (2015) Treatment of ionized hypercalcemia
in 12 cats (2006–2008) using PO-administered alendronate. Journal of Veterinary
Internal Medicine 29, 200–206
M
N
Alfaxalone O
(Alfaxan) POM-V
Formulations: Injectable: 10 mg/ml solution; the alfaxalone is
P
solubilized in a cyclodextrin.
Q
Action: Anaesthesia induced by the CNS depressant effect of the
alfaxalone. R
Use:
• Induction agent used before inhalational anaesthesia, or as a S
sole anaesthetic agent for examination or surgical procedures.
As with all i.v. anaesthetic drugs, premedication will reduce the dose
T
required for induction and maintenance of anaesthesia. The drug
should be given slowly and to effect in order to prevent inadvertent
U
overdose. The dose recommended by the manufacturer for
induction of anaesthesia can usually be reduced in all animals.
V
Analgesia is insufficient for surgery: other analgesic drugs such as
opioids should be incorporated into the anaesthetic protocol.
W
Alfaxalone can be given i.m. or s.c. to provide sedation in cats and
dogs although it is not licensed for these routes. Do not use in
X
combination with other i.v. anaesthetic agents. Although not
Y
licensed for animals <12 weeks of age, safety in dogs between 6 and
12 weeks old has been demonstrated using a similar dose for
Z
induction of anaesthesia as adult dogs.
Safety and handling: One preparation of alfaxalone does not

A contain an antimicrobial preservative; thus it is recommended that
the remainder of an opened bottle is discarded after single use. A
B multidose preparation of alfaxalone is also available with a shelf life
of 28 days once the vial has been broached.
C
Contraindications: No information available.
D
Adverse reactions: An increase in heart rate can occur
E immediately after i.v. injection as a compensatory response to
maintain blood pressure in the face of mild hypotension. This effect
F can be minimized by slow i.v. injection. As with all anaesthetic drugs,
respiratory depression can occur with overdoses.
G Drug interactions: No information available.
H DOSES
See Appendix for sedation protocols in cats and dogs.
I Dogs:
• Induction of anaesthesia: 3 mg/kg i.v. in unpremedicated dogs;
J 2 mg/kg i.v. in premedicated dogs, although commonly lower
doses can be used.
K • Maintenance: 6–9 mg/kg/h is recommended as a continuous
rate infusion or top-up boluses of 1–1.5 mg/kg q10min.
L Cats:
• Induction of anaesthesia: 2–5 mg/kg i.v.; the lower end of the
M dose range is often adequate.
• Maintenance: 7–10 mg/kg/h is recommended as a continuous
N rate infusion or top-up boluses of 1–1.5 mg/kg q10min.
O References
Ramoo S, Bradbury LA, Anderson GA et al. (2013) Sedation of hyperthyroid cats with
subcutaneous administration of a combination of alfaxalone and butorphanol. Australian
P Veterinary Journal 91, 131–136
Ribas T, Bublot I, Junot S et al. (2015) Effects of intramuscular sedation with alfaxalone
Q and butorphanol on echocardiographic measurements in healthy cats. Journal of Feline
and Medicine Surgery 17, 530–536
R
S Alfentanil
T
(Rapifen*) POM CD SCHEDULE 2
Formulations: Injectable: 0.5 mg/ml solution, available in 2 ml or
U 10 ml vials.
V Action: Pure mu agonist of the phenylpiperidine series.

Use: Very potent opioid analgesic (10–20 times more potent than
W morphine) used to provide intraoperative analgesia during
anaesthesia in dogs and cats. Use of such potent opioids during
X anaesthesia contributes to a balanced anaesthesia technique but
they must be administered accurately. It has a rapid onset (15–30
Y seconds) and short duration of action. It is best given using
continuous rate infusions. The drug is not suited to provision of
Z
analgesia in the postoperative period.
Safety and handling: Normal precautions should be observed.

A
Contraindications: No information available.
Adverse reactions: A reduction in heart rate is likely whenever
B
alfentanil is given; atropine can be administered to counter
C
bradycardia if necessary. Respiratory depression leading to cessation
of spontaneous respiration is likely following administration. Do not
D
use unless facilities for positive pressure ventilation are available
(either manual or automatic). Rapid i.v. injection can cause a severe
E
bradycardia, even asystole.
Drug interactions: Alfentanil reduces the dose requirements of F
concurrently administered anaesthetics, including inhaled
anaesthetics, by at least 50%. In humans it is currently G
recommended to avoid giving alfentanil to patients receiving
monoamine oxidase inhibitors due to the risk of serotonin toxicity. H
DOSES I
Dogs: 0.001–0.005 mg/kg i.v. as a single bolus or 0.001–0.0025
mg/kg/min continuous rate infusion. J
Cats: 0.001 mg/kg i.v. as a single bolus or 0.001 mg/kg/min
continuous rate infusion. K
References L
Padilha ST, Steagall PVM, Monteiro BP et al. (2011) A clinical comparison of remifentanil
or alfentanil in propofol-anaethetised cats undergoing ovariohysterectomy. Journal of
Feline Medicine and Surgery 13, 738–743 M
N
Allopurinol O
(Zyloric*) POM
P
Formulations: Oral: 100 mg, 300 mg tablets.
Action: Xanthine oxidase inhibition decreases formation of uric Q
acid by blocking the conversion of hypoxanthine to xanthine, and of
xanthine to uric acid. R
Use: S
• Treatment and prevention of recurrent uric acid uroliths and
hyperuricosuric calcium oxalate urolithiasis in dogs. T
• In combination with meglumine antimonite or miltefosine, to
treat leishmaniosis. U
Use with caution in patients with impaired renal function.
V
Contraindications: No information available. W
Adverse reactions: May predispose to xanthine urolithiasis X
especially if used for several months and not fed a purine
restricted diet. Y
Drug interactions: In humans, allopurinol may enhance the Z
effects of azathioprine and theophylline.
DOSES
A
Dogs:
B • Uric acid urolithiasis:
■ Dissolution: 10 mg/kg p.o. q8h or 15 mg/kg p.o. q12h for up
C to 4 weeks.
■ Prevention: 10–15 mg/kg p.o. q24h.
D • Leishmaniosis: 10 mg/kg p.o. q12h for at least 6–12 months
with meglumine antimonate for 1–2 months, or miltefosine
E for 1 month (NB: this does not result in complete
parasitological cure).
F Cats: Leishmaniosis: 10–20 mg/kg p.o. q12–24h has been shown to
be effective (although experience is limited in this species).
G References
Reguera RM, Moran M, Perez-Perteio Y et al. (2016) Current status on prevention and
H treatment of canine leishmaniasis. Veterinary Parasitology 227, 98–114
I
Alphaxalone see Alfaxalone
J
K Alprazolam
L (Alprazolam*, Xanax*) POM
M Formulations: Oral: 0.25 mg, 0.5 mg, 1 mg, 2 mg tablets.
Action: Increases GABA activity within the CNS, resulting in
N anxiolysis and a range of cognitive effects including the inhibition of
memory.
O
Use:
P • Treatment of anxiety and fear-related disorders in dogs and cats,
especially where there are signs of panic.
Q • As an adjunct to clomipramine or specific serotonin reuptake
inhibitors for the management of phobic responses.
R • It can also be used for the management of urine spraying in cats
but a high relapse rate upon withdrawal should be expected.
S Best if used approximately 30 minutes before a fear-inducing event
although absorption characteristics have not been described for
T cats or dogs. Its short half-life and rapid onset of action make it
useful for the management of acute episodes, with treatment given
U as needed within the dosing limits described. However, dosing limits
and responses are very variable, with some animals showing no
V measurable effect at the recommended doses. Its anterograde and
retrograde amnesic properties, especially on subjective memory,
W mean it can be used before (<1 hour), during or immediately
following an aversive experience to minimize the emotional impact
X of such exposure. This may be necessary during a long-term
behavioural therapy programme to avoid relapses due to exposure
Y to an intense fear-inducing stimulus during treatment. In
experimental circumstances, single higher range doses (>0.25 mg/
Z
kg) have been found to block memory significantly and may be
useful in companion animals, but may result in temporary sedation.

As imepitoin is now licensed for use in the treatment of fears in A
dogs, if a benzodiazepine is indicated, it is preferable to use this.
B
Contraindications: Hypersensitivity to benzodiazepines, C
glaucoma, significant liver or kidney disease, although appears to be
less hepatotoxic than diazepam or clorazepate. Not recommended
D
in pregnant or lactating animals. There is concern over its use with
E
anxiously aggressive animals due to the potential for disinhibition.
Adverse reactions: Drowsiness and mild transient incoordination F
may develop. A general concern with benzodiazepines concerns
disinhibition and the subsequent emergence of aggression. G
Idiosyncratic hepatotoxicity associated with benzodiazepines
(largely diazepam, but not alprazolam) has been reported in the cat. H
Drug interactions: Caution is advised if used in association with I
antifungals such as itraconazole, which inhibit its metabolism.
DOSES J
Dogs: For anxiolysis an initial dose within the range of 0.01–0.1 mg/ K
kg p.o. as needed up to 4 times a day is recommended; the dose can
be titrated up or down to the minimum effective dose, which may be L
below this level.
Cats: For anxiolysis an initial dose in the range of 0.125–0.25 mg/kg M
p.o. as needed up to twice a day is suggested, but doses as low as
0.25 mg/cat p.o. q8–12h and as high as 0.6 mg/kg p.o. have been N
reported. After initial medication, the dose should be titrated down
to the minimum effective dose. O
References P
Crowell-Davis SL, Seibert LM, Sung W et al. (2003) Use of clomipramine, alprazolam, and
behavior modification for treatment of storm phobia in dogs. Journal of the American
Veterinary Medical Association 222, 746–748 Q
Dale AR, Walker JK, Farnworth MJ et al. (2010) A survey of owners’ perceptions of fear of
fireworks in a sample of dogs and cats in New Zealand. New Zealand Veterinary Journal
58, 286–291 R
S
Aluminium antacids T
(Aluminium hydroxide)
U
(Alucap*. With alginate: Acidex*, Gastrocote*,
Gaviscon Advance*, Peptac*. With magnesium V
salt: Asilone*, Maalox*, Mucogel*) P, GSL W
Formulations: Oral: Aluminium hydroxide is available as a dried
gel. Other products are composite preparations containing a variety
X
of other compounds including magnesium oxide, hydroxide or
trisilicate, potassium bicarbonate, sodium carbonate and
Y
bicarbonate, alginates and dimeticone. Aluminium hydroxide
Z
content varies.
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finally driven out from the rest of the country by the insane King
Charles VI., at the end of the fourteenth century.
1394–5
In Germany wherever the dead body of a Christian
was found, the murder was promptly laid at the door of the Jews,
who on such occasions were bidden to be baptized or die. So firm a
hold had the blood-accusation got upon the minds of the people that
there was no mystery which could not be cleared up by a simple
reference to the Jews. The outbreak of the Black Death in Germany
also was attributed to Jewish malevolence. It is now held that this
scourge originated in India and was conveyed to Europe by trade
routes and armies, or that it arose from the insanitary conditions of
mediaeval life. But the mediaeval world was convinced that it could
only be the work of the Jews. Their comparative immunity from the
disease, due perhaps to their superior temperance, lent colour to the
theory; confessions extorted by torture dissipated all doubts on the
subject. It was commonly believed that the Jews of Spain, those
redoubtable professors of the Black Art, had invented this fiendish
method for the extermination of Christianity; that they had
despatched emissaries with boxes of poison concocted of basilisks
and lizards, or even of Christian hearts, to all the Jewish
congregations in Europe and had persuaded or compelled them to
disseminate death among the Christians by poisoning the wells and
springs. The arch-poisoner was even indicated by name. The Jews
were in consequence subjected to a widespread persecution, at the
hands of a mob maddened by the terrible and mysterious epidemic.
Despite the Emperor’s energetic efforts to save his
1348–50
serfs, the more disinterested exertions of humane
burgomasters, sheriffs, and municipal councils, and Pope Clement
VI.’s Bull in which the absurdity of the poison charge was solemnly
exposed, the wretched people were slaughtered and burnt by
thousands in many parts of Germany, and at last they were banished
from the Empire. Yet their services were so valuable that they
gradually returned, only to submit to new social restrictions and
contumelious enactments on the part of the Church.
Similar scenes were performed through the length and breadth
of Switzerland and Belgium.
In Poland alone, which had long been a haven of refuge to the
hunted Jews, these abominable calumnies found a very limited
market as yet. It was there enacted that a charge of ritual murder
brought by a Christian against a Jew, unless the accuser succeeded
in substantiating it, should be punished with death. This generous
treatment of the Polish Jews, it is said, was partly due to King
Casimir IV.’s love for a Jewish mistress. Through her influence the
children of Israel obtained many privileges which placed them on a
footing of social equality with the Christians. At a time when they
were oppressed, reviled and butchered in almost every Western
country, in Poland their lives and liberties were as safe as those of
the nobility itself. Whilst the native peasants were still treated as
serfs, the Jews were allowed the aristocratic privilege of wearing
rapiers. Any Jew might, by simply renouncing his religion, become a
nobleman. As stewards of the estates belonging to the Polish
magnates, the Jews possessed even the power of inflicting capital
punishment on the Christian slaves of the soil: so much so that
during the terrible pestilence not more than ten thousand Jews were
massacred in Poland.
CHAPTER VIII
USURY AND THE JEWS
Another cause of the hatred inspired by the mediaeval Jew was

usury, a term which was then synonymous with money-lending
generally.
For an age accustomed to regard lending money at interest as a
purely economic transaction, the rate of interest as an economic
phenomenon obeying the law of demand and supply, and the whole
thing as a question of commerce rather than of ethics, it is not easy
to understand the theological wrath vented on money-lenders in old
times. Yet in the Middle Ages trade in money was treated as a
heinous sin, and those engaged in this occupation, to us perfectly
legitimate, as criminals of the deepest dye. Dante, in whom “ten
silent centuries found a voice,” expresses the mediaeval feeling on
the subject by placing Cahors, a city of Provence, notorious in the
thirteenth century as a nest of usurers, beside Sodom in Hell:
“E pero lo minor giron suggella,

56
Del segno suo e Sodomma e Caorsa.”
It was a superstition of very ancient growth, and its origin can be

traced back to the constitution of primitive society. In the youth of the
human race, when the members of each community looked upon
themselves as members of one family, it was naturally very bad form
for those who had more than they needed to refuse a share of their
superfluity to a brother in want. The sentiment, once rooted,
continued from generation to generation, and survived the tribal
system in which it arose. From a social law it became a religious
tenet, and inspired legislators lent to it the sanction of their authority.
It is found incorporated both in the Old Testament and in the Koran.
Moses said: “Thou shalt not lend upon usury to thy brother; usury of
57
money, usury of victuals, usury of anything that is lent upon usury;”
and, many centuries after, the Psalmist sang: “Lord, who shall abide
in thy tabernacle? Who shall dwell in thy holy hill?... He that putteth
58
not out his money to usury.” Mohammed, following Moses,
emphatically declares that “They who devour usury shall not arise
from the dead, but as he ariseth whom Satan hath infected with a
touch: this shall happen to them because they say, Truly selling is
but as usury: and yet God hath permitted selling and forbidden
usury. He therefore who, when there cometh unto him an admonition
from his Lord, abstaineth from usury for the future, shall have what is
past forgiven him, and his affair belongeth unto God. But whoever
return to usury, they shall be the companions of Hell fire, they shall
59
continue therein for ever.”
Philosophy in this case failed to rise superior to theology. Plato
regards usury as a source of distress, discontent and unrest, usurers
as creating, by their extortions, a dangerous class of “drones and
60
paupers” in the State, and in his laws forbids “lending money at
61
interest.” Although the Greek for interest is “offspring” (τόκος),
Aristotle pronounced that money was “barren,” and therefore to
62
derive profit from lending it out was to put it to an unnatural use.
The tradition was carried on through succeeding ages, and Plutarch
in the midst of his numerous labours found time to denounce
usurers.
The Fathers of the Church adopted a sentiment which accorded
so well with the communistic ideals of early Christianity, and St.
Chrysostom anathematizes money-lenders as men who “traffic in
other people’s misfortunes, seeking gain through their adversity:
under the pretence of compassion they dig a pit for the
63
oppressed.” The Mediaeval Church, as was natural, inherited the
venerable doctrine of the sinfulness of lending money at interest and
of speculative trade, and prohibited such transactions in theory. But
in practice the prohibition was found impossible; nay, in many cases,
injurious. No capitalist would part with his money, or tradesman with
his goods, without profit. In the absence of loans and middlemen
commerce would come to a standstill, and large numbers of people
would be doomed to choose between a sinful life and virtuous
starvation. The dilemma was an awkward one, but not too awkward
for scholastic subtlety, and the sophists of the Church devoted much
time and ingenuity to hair-breadth distinctions, attempting to explain
the inexplicable and to reconcile the irreconcilable, by arguing that
rent for a house or a horse was lawful, but interest on money
unlawful, and, like their brethren of the law, they tried to avoid
practical mischief by the sacrifice of intellectual sincerity. The
scholastic position, being absurd, met with general acceptance.
However, in the earlier Middle Ages there was little temptation
for transgression, little scope for commercial speculation, while, on
the other hand, casuistry afforded abundant devices for evasion. The
Church was, as a rule, content to enforce the law on clerics, but
towards laymen she was more lenient. Nay, she encouraged traders
to buy and sell goods unaltered, despite St. Chrysostom’s sentence
that such traders are “ejected from the temple of God.” And yet she
refused, as much as Mohammed did, to accept the commonsense
view that “selling is but as usury,” and, while sanctioning the one,
continued to condemn the other. But so long as the Papacy was too
weak to persecute, the condemnation remained a dead letter, the
Church being obliged to connive at a sin which she was powerless to
conquer.
Meanwhile, as European society developed, money-lending
went on increasing. And what would now be regarded as the
inevitable accompaniment of material activity was then denounced
as a symptom of moral degeneracy. At the same time the power of
the Church grew, and her eagerness to suppress what she
considered a sin grew with her ability. Under Gregory VII., the hurler
of thunderbolts, the Papacy entered upon that career of political
conquest which achieved its highest triumphs under Innocent III.
Gregory had been on the throne for ten years when
1083
one of those missiles fell upon usurers, a term which, it
must be remembered, in that age applied to all money-lenders alike.
The warfare inaugurated by Hildebrand was carried on with
unabated vigour by his successors. A decree issued by the Lateran
General Council of 1139 deprived usurers of the consolations of the
Church, denied them Christian burial, and doomed them to infamy in
this life and to everlasting torment in the next. The religious
enthusiasm aroused by the Crusades, and the economic ruin which
they threatened, accentuated the common prejudice against the
outlaws of the Church. Many of the holy warriors were obliged to
resort to the usurer’s hoard for the expenses of these campaigns,
and the Church felt that it was her duty to see that her champions
were not left destitute and homeless. Pope after Pope, throughout
the twelfth century, from Eugenius III. onwards, absolved Crusaders
from their financial embarrassments, and Innocent III. went so far as
to ordain that the Jews should be compelled to refund to their
debtors any interest that might have already been paid to them.
The prejudice was further strengthened and disseminated by the
religious Orders of St. Francis and St. Dominic, which soon attained
a degree of official and unofficial influence calculated to enforce their
precepts. Members of both orders compiled moral codes, which
were accepted throughout Western Christendom as manuals of
Christian ethics and guides of Christian conduct. One of the principal
sins condemned in those books was usury, and the doctrine,
thundered from the pulpit, preached in the market-place, and
whispered in the confessional, carried with it all the weight which
attaches to the words of persons invested with the power of loosing
and binding in this world and in the world to come.
And yet, despite pontifical anathemas and public opinion, things
pursued their natural course, and usurers were to be found even
among the tenants of ecclesiastical and monastic estates, until
Gregory X., in 1274, issued a Bull forbidding the letting of lands or
houses to the accursed tribe. But though the pious execrated the
money-lender, the needy could not dispense with his services. The
chief effect of the prohibition of money-lending, and of the
superstitious disrepute in which it was held, was to force this
important branch of economic life into the hands of the least
respectable members of the community. Usury was by no means
eschewed by the Christians, as Dante shows. But the masses of
mediaeval Europe, especially in the north and centre, were too
superstitious to brave the ban of the Church, too stupid and ignorant
and thriftless to succeed in a business requiring dexterity, alertness,
and economy. Thus trade in money, as most other kinds of European
trade, fell from the very first into the hands of the Jews—the only
people who had capital to lend and no caste to lose. Moreover, there
was little else for the Jew to do in feudal Europe. The laws and the
prejudices which in many countries forbade him to own land or to
engage in various handicrafts and trades on one hand, and his own
religious scruples on the other, narrowed his range of activity, and
the current of energy and intelligence, compressed into one channel,
ran with proportionately greater force. The reputation of the Jews for
usury dates from the sixth century. But money-lending really became
their characteristic pursuit since the commencement of the
persecution already narrated. Then the Jews, by the periodical
enactments of councils and the frequent publications of
ecclesiastical edicts, were excluded from the markets, and thus,
being unable to compete with the Christian merchants, were driven
to deal only in second-hand articles, while others, possessed of
some capital but forbidden to invest it in goods, were compelled to
put it out to interest.
As has been seen, the money-lending transactions of the Jews
had long continued to be carried on with the connivance of the
Church and under the protection of the State, many princes being
only too glad to avail themselves of the Jews’ skill in pecuniary
dealings for the improvement of their own finances. Under mediaeval
conditions of financial administration the Jew was literally
indispensable to the State. The sovereigns of Europe, as yet
unversed in the mysteries of systematic taxation, needed a class of
men who would for their own sake collect money from the king’s
subjects and keep it, as it were, in trust for the king’s treasury. At the
worst, the Jews in a mediaeval country might be described as
sponges which imbibed the wealth of the nation and then were
squeezed for the benefit of the crown. At the best, they fulfilled the
function of the clouds which collect the water in small drops and then
yield it back to the earth in rich showers, the rainfall being only too
often accelerated by artificial explosives. In either case it was the
duty of a Jew to be wealthy.
The growing wealth of the Jews must have always excited the
envy and the cupidity of their neighbours. But it was not until the
awakening of religious bigotry by the Crusades and the Mendicant
Orders that the dormant animosity declared itself in wholesale
persecution. Nor is the violence of the popular feeling, apart from
religious motives, quite inexplicable or inexcusable. The Jews from
the earliest times evinced a fierce contempt for the Gentile. Despite
the doctrine of universal love inculcated by certain Hebrew teachers,
the bulk of the community clung to the older lesson. Jewish tolerance
of outsiders, like Christian tolerance, was the glory and the property
of the few. A Jehuda Halevi or a Maimonides might preach broad
humanitarianism, but it would be unreasonable to suppose that their
preaching was more effective on their co-religionists than the similar
preaching of a Thomas Aquinas or a St. Bernard was on theirs. And
it is important not to forget that in every-day life it is not the minds of
the cultured few but the instincts of the masses that count. With the
ordinary mediaeval Jew, as with the ordinary mediaeval Christian,
charity not only began but ended at home. The tribal spirit of their
religion made the Jews hard to the non-Jew and callous to his
needs. Moses had already said: “Thou shalt not lend upon usury to
thy brother,” and Rabbinical law enforced the commandment; but the
prohibition was accompanied by a significant permission: “Unto a
stranger thou mayest lend upon usury,” an ominous distinction of
which the Jews took full advantage, though Jewish moralists and
Rabbis constantly opposed the extent to which reliance was placed
upon it.
The racial and religious antagonism, in which the Jew found
himself engaged from his earliest contact with the nations, widened
the gulf. The grievous persecution to which he found himself
periodically exposed since his advent in Europe further embittered
his soul, and sore experience taught him that peace could only be
purchased by gold. He had nothing but avarice to oppose to the
fanaticism of those under whom he lived, and he strove to raise a
wall of gold between himself and tyranny. He took shelter behind his
shekels, and, naturally, endeavoured by all means, fair or foul, to
make that shelter as effective as he could. Even supposing that the
Jew omitted no opportunity of fleecing the Gentile, he was more than
justified in doing so—he was compelled by the Gentile’s own
treatment of him. It was the Gentile who taught the Jew the supreme
virtue of money as a preservative against oppression, exile, and
death; and he had no right to complain of the disciple’s wonderful
quickness in learning his lesson and “bettering the instruction.” His
hatred of the Gentile, thus combined with love of gain and love of
life, rendered him impervious to compassion. The Gentile merited
little mercy at the hands of the Jew, and he got no more than he
merited. The exploitation of the Gentile, begun as a necessity and
promoted as a means of self-defence, thus found an abiding place
among the lower orders of the mediaeval Jews.
Besides, in the Middle Ages borrowing for commercial purposes
was rare. As a rule, a loan was resorted to only on an emergency,
and the interest was determined by the necessity of the borrower.
Under the circumstances exorbitant rates were unavoidable. The
discouragement of money-lending, coupled with the scarcity of
capital, by limiting competition, would in any case have tended to
64
raise the normal rate of interest to a distressing height, in
obedience to the law of demand and supply which now is one of the
commonplaces of political economy. The uncertainty of recovery
raised it to a greater height still. Like the Christian bankers in the
Turkey of not long ago, the Jewish money-lenders of the Middle
Ages must have lent their money at considerable risk, sometimes
amounting to certainty of loss. The mediaeval baron, far more than
the mediaeval burgess, was largely beholden to the Jew both in
peace and in war. The pomp and pride of chivalry could not be
maintained without money. For the pageant of a tournament, as for
the more costly splendour of a campaign, the usurer’s purse was
appealed to. But, if the baron found himself obliged to coax and
flatter the Jew and to submit to exorbitant terms when he wanted a
loan, he revenged himself when he had the Jew in his power. Such
opportunities were not rare, and then the borrower repayed himself
with interest. The conditions of the transaction were such as to tempt
avarice, but not to encourage moderation. A loan to a mediaeval
pasha was a speculation which might result either in wealth or in
penury and death.
This a priori reasoning is amply confirmed by history. Among the
Jews’ clients none were more conspicuous than the sovereigns of
Christendom; and the devices to which these crowned robbers
descended in their attempts to reconcile expediency with conscience
would be highly amusing were they less tragic. King
1169
Louis VII. of France, though a Crusader, protected the
Jews and disregarded the decree of the Lateran Council, which
forbade them to employ Christian servants. His example was at first
followed by his son Philip Augustus, who, however, gradually
changed his attitude. Though nominally Lord Paramount of France,
the French King in reality could call nothing but a small tract of the
country his own; the royal domain being surrounded by the territories
of the great feudatory Dukes and Counts. Philip wished to convert
this theoretical suzerainty into actual possession, and to this end he
needed money. The wealth of the Jews suggested to him a short-cut
to the accomplishment of his desire. Though not the only usurers in
the kingdom, the Jews were the most unpopular. He, therefore,
caused a number of them to be cast into prison, and held them to
ransom. On paying 1500 marks, they were set at
1180
liberty. The success of the experiment induced Philip to
try operations on a larger scale. A few months later he
1181
conceived the happy thought of ridding himself of his
sins and of his debts at once by cancelling the claims of the Jews, by
compelling them to give up the pledges held by them, by confiscating
their real property, and by expelling them from his Kingdom. Some
years after, in consistency with the principle of
1198
expedience, he thought it advisable to mortify the Pope
and to enrich himself by recalling the exiles, and forbidding them to
leave his dominions.
Louis IX., as became a king and a saint of unquestionable
respectability, released all his subjects of one-third of the money
which they owed to the Jews “for the salvation of his own soul, and
those of his ancestors,” and, in 1253, he sent from Palestine an
order banishing all Jews, except those who would take to legitimate
commerce and handicrafts.
Philip the Fair, whose cruel rapacity and vindictiveness were
exemplified in the ruin of the Knights Templars, accompanied as it
was by the torture and cremation of their persons and the
confiscation of their treasures, showed the same tyrannical and
predatory spirit towards the Jews. They had just
1306
concluded their severe fast on the Day of Lamentation
in remembrance of the destruction of the Temple, when the King’s
constables seized them, young and old, women and children, and
dragged them all to prison, where they were told that they should
quit the country within a month, under penalty of death. They were
plundered of all their possessions, save the clothes which they wore
and one day’s provisions, and were turned adrift—some hundred
thousand souls—leaving to the King cartloads of gold, silver, and
precious stones. A few embraced Christianity, and some who
ventured to tarry after the prescribed date suffered death; but the
majority chose to lose all, and quit the country in which their
forefathers had lived from time immemorial, rather than be false to
their faith. Their communal buildings and immoveable property were
confiscated, and Philip the Fair made a present of a synagogue to
his coachman.
Most of the exiles settled in the neighbourhood, waiting for a
favourable opportunity of returning to their devastated homes. Nor
had they to wait long. Financial necessity overcame
1315
fanaticism, and nine years later Philip’s successor,
Louis X., was glad to have them back and to help them in the
collection of the moneys due to them, on condition that two-thirds of
the sums collected should be surrendered to the Royal Exchequer.
In Germany, also, the Emperors time and again performed their
duty to the Church by cancelling their debts to the Jews. But it would
be a mistake to suppose that piety was an indispensable cloak for
plunder. A law enacted in France condemned Jewish converts to
Christianity to loss of all their goods for the benefit of the King or
their Lord Paramount; for it was felt that conversion would exempt
the victims from extortion. Thus even the interests of religion were at
times subordinated to rapacity.
CHAPTER IX
THE JEWS IN ENGLAND
The first mention of Jews on this side of the Channel is said to occur
in the Church Constitutions of Egbert, Archbishop of York, towards
the middle of the eighth century; the second in a monastic charter of
some hundred years later. But they do not seem to have crossed
over in any considerable force till the Norman Conquest. Among the
foreigners who followed William to his new dominions
1066
were many families of French Jews. Their ready
money and their eagerness to part with it rendered them welcome to
the king and his barons. The former received from them advances,
when his feudal dues were in arrear; the latter had recourse to the
Jew’s money-bag whenever the expense of military service or the
extravagance of their life made a loan necessary. To men of lower
rank also, such as litigants who were obliged to follow the King’s
Court from county to county, or to repair to Rome in order to plead
their cases before the Pope’s Curia, the Jew’s purse was of constant
help. No less useful was the Jew to the English tax-payer. In those
days of picturesque inefficiency taxes were levied at irregular
intervals and in lump sums. The subject, suddenly called upon to pay
a large amount at short notice, was only too glad to borrow from the
Jew.
However, such intercourse with the Gentiles, high and low,
notwithstanding, the Jews formed in England, as they did on the
Continent, a people apart. In each town the synagogue formed a
centre round which clustered the colony. Newcomers gravitated
towards the same centre, and thus spontaneously grew the Jewries
of London, Norwich, York, Northampton, and other English cities.
These Jewish quarters were the King’s property and, like his forests,
they were outside the jurisdiction of the common law. But, while their
judicial and financial interests were under royal control, the Jews
were allowed full liberty of worship, were permitted to build
synagogues and to conduct their religious affairs under their own
Chief Rabbi, thus constituting a self-governing and self-centred
community. The literary activity of the Jews during their sojourn in
England reveals a marvellous detachment from their environment.
Commentaries and super-commentaries on the Old Testament and
the Talmud, learned treatises on minute points of ritual and
ceremonial, discussions on the benedictory formulas that are
appropriate to each occasion of life: on rising in the morning, or lying
down at night, on eating, washing, on being married, on hearing
thunder, and a myriad other profound trivialities—such was the stuff
that their studies were made of. And whilst Norman and Saxon, Celt
and Dane were being welded into one English people, Israel
remained a race distinct in face, speech, domestic economy,
deportment, diet of the body and diet of the soul.
The singularity of the Jews’ habits, their usury, the wealth
accumulated thereby, and the ostentatious display of it, must from
the very first have evoked among the English feelings of distrust and
jealousy, dislike and contempt, such as at a later period inspired a
genial poet to pronounce that “Hell is without light where they sing
lamentations.” But during the first century of their residence in the
country they seem to have suffered from no active manifestation of
these feelings. William the Conqueror favoured them, and William
Rufus actually farmed out vacant bishoprics to them.
1087–1100
The latter prince’s easy tolerance of Judaism is
denounced by the monkish historians in many quaint tales, which,
though meant to throw light on William’s irreligion, also serve to
illustrate his sense of humour. At one time a Jew, whose son had
been lured to Christianity, went to the King, and, by means of
prayers and a present of sixty marks, prevailed upon him to lend his
assistance in recovering the strayed lamb. The King did his utmost to
carry out his part of the contract, but, on finding the youth obdurate,
told the father that inasmuch as he had failed he was not entitled to
the present; but inasmuch as he had conscientiously striven to
succeed, he deserved to be paid for his trouble, and he kept thirty
marks. On another occasion William summoned some Christian
theologians and some learned Rabbis to his presence, and, telling
them that he was anxious to embrace that doctrine which upon
comparison should be found to have truth on its side, he set them
disputing for his own entertainment.
The King’s good-natured attitude was even shared by his
antagonists. St. Anselm, the Norman Archbishop of Canterbury, for
example, and other eminent ecclesiastics, in their efforts to convert
the Jews, did not overstep the limits of argument; at times of peril
churches and monasteries afforded an asylum to the effects and to
the families of Jews; no attempt was made to poison the relations,
such as they were, between the two elements; and there are
instances of Jews helping the monks with prayers and otherwise in
their efforts to resist the encroachments of Archbishops, and even of
Jews drinking with Gentiles.
Meanwhile, the Continent was undergoing the spiritual travail
which resulted in the tremendous explosion of the Crusades.
England, as a member of the Catholic family of nations, and in many
ways under Continental influence, could not long remain deaf to the
cry which rang throughout Christendom. The unsettled condition of
the country under the first three Norman kings, and the convulsions
to which it fell a prey under the fourth, had hitherto prevented
England from responding to the Pope’s call in an adequate manner;
but the religious fever was infectious, and on reaching England it
translated any vague sentimental dislike of the Jews that may have
existed into an open and determined hostility, which led to deeds of
violence such as had already disgraced the Continent.
The atrocious charge of sacrificing Christian children and using
their blood in their mysterious Passover rites, or in medicine, is now
for the first time heard under the definite form which has since
become familiar; and the English town of Norwich seems to be
entitled to the unenviable credit of its birth. The populace of that city
was one day, in 1144, horrified by the rumour that the Jews had
kidnapped and murdered a boy, named William, for the purpose of
obtaining his blood. A renegade Jew brought forth the libel, and the
local bishop adopted it. The sheriff considered the evidence
insufficient, and refused to sanction a trial before the Bishop’s Court.
But the people, encouraged by the clergy, took the law into their own
hands, and, despite the sheriff’s efforts to protect the Jews, many of
the latter were slaughtered, while the rest fled in fear for their lives.
1155–1189 Within the next thirty-four years the same blood-
accusation recurred at Gloucester and Bury St.
65
Edmunds, and led to a similar catastrophe. But during the reign of
Henry II. anti-Jewish feeling, with the last exception, was firmly
checked. That King, renowned in history as “the greatest prince of
his time for wisdom, virtue, and abilities,” followed in the footsteps of
William the Conqueror and William Rufus, and, in the opinion of the
monastic chroniclers, sullied his otherwise stainless character by the
favour which he showed to the Jews. He delivered them from the
jurisdiction of the ecclesiastical courts and granted to them the
privilege of settling their disputes in their own Beth Din, or Religious
Tribunal, and of burying their dead outside the cities in which they
dwelt. Henceforward the Jews were to be regarded as the King’s
own chattels, and to enjoy the protection of the King’s officers, as
they did in Germany, and on the same terms.
Royal favours, of course, are never granted without an
equivalent. The wealth of the Jews, being moveable and
concentrated in few hands, was much more accessible to the King
than that of his Christian subjects. They were, accordingly, made to
pay more than the latter. When, in 1187, Henry levied a contribution,
he received from the Jews alone nearly one-half of the whole
amount, they contributing one-fourth of their property (£60,000),
while the Christians one-tenth (£70,000). But, though the King’s
Exchequer was the richer for the King’s clemency, the Jews enjoyed
the right to live and grow wealthy. England was not a loser by this
toleration of the children of Israel. Their ready money, despite the
high rates of interest at which it was lent, supplied a powerful
stimulus to industry and to architecture. Many a castle and cathedral
owed their existence to Jewish capital. And not only the means of
erection but also models for imitation were due to the Jews, who by
their example taught the rude English burgesses the superiority of a
stone house over a mud hovel, as is shown by the buildings at Bury
St. Edmunds and Lincoln which still bear the name of “Jews’
houses.” Indeed, in this and subsequent reigns we hear marvellous
tales of Jewish opulence and magnificence, such as that of Abraham
fil Rabbi, Jurnet of Norwich, and Aaron of Lincoln, and even of
unwelcomed proselytes to Judaism. Both these blessings, however,
material prosperity and religious popularity, proved curses in
disguise to their possessors. The riches of the Jew could not but
rouse the cupidity of mediaeval barons, and his dissent the bigotry of
mediaeval priests. Moreover, it would have been contrary to all the
laws of probability and human nature had the Jews been left
unmolested much longer in a land where the crusading spirit was
abroad, where the popular hatred of the Jew had been recently
fanned by abominable calumny and by royal favour, and where the
civil authority was so frequently set at naught by feudal lawlessness.
Last and most ominous sign, the Jews by an Act, passed in 1181,
were forbidden to keep or bear arms.
1189 Where prejudice is, pretexts for persecution are not
wanting. A favourable opportunity for the expression of
public feeling was offered by the coronation of Richard Coeur de
Lion. Richard was the first English King who took up the cross
against the infidels, and his reign was appropriately inaugurated by
an anti-Jewish demonstration. The Jews were by royal edict
forbidden to show their unchristian countenances in the Abbey
during the ceremony. But some of them, armed with rich gifts from
their people to the King, presumed to take up their station outside
the Church. The street was thronged with the servants and retainers
of the barons and knights who assisted at the coronation, as well as
by a miscellaneous mob, drawn thither by curiosity. The foreign
faces of the Jews were soon detected by the fanatical crowd, in
holiday mood, and were at once made the marks of insult and riot.
The wretches tried to escape; the populace pursued them; and one
at least was obliged to save his life by baptism. Later in the day a
rumour got abroad that the King had ordered a general slaughter of
the Jews. The alleged command found many persons only too ready
to carry it out. All the Jews that happened to be out of doors were cut
to pieces, without remorse and without resistance, while those who
had wisely remained at home were attacked by the zealous and
greedy crowd, who broke into their houses, murdered the inmates,
plundered their effects, and ended by setting fire to the Jewry. The
riotous and avaricious instincts of the populace once roused, the
havoc spread far and wide, and the city of London soon became a
scene of pillage and rapine, in which no invidious distinction was
made between Christian and infidel, but all were impartially robbed
who were worth robbing. The King’s endeavours to bring these
atrocities home to the guilty resulted in the discovery that the
punishment would involve so great a number that, after having
hanged three offenders, he was forced to desist. The very magnitude
of the crime saved its authors.
Nor did the excitement terminate in the capital. The good news
of the massacre of the Jews travelled to the provinces, and
everywhere found the field ready to receive the seed. All the
principal towns in England swarmed at that time with Crusaders
preparing for their expedition. The sight of these warriors stirred the
martial and religious spirit of the people, and, when they started the
campaign against the Crescent by falling upon the native Jews, they
found numerous and enthusiastic auxiliaries among the burgesses,
the priests, and the impoverished gentlemen. Indeed, how could any
one refuse to help in the destruction of God’s enemies, who in many
cases also happened to be the assailants’ creditors? In York the
immediate excuse for an attack was a certain Joceus, who, being
forcibly baptized in London on the day of Richard’s coronation, on
his return home renounced the creed thrust upon him and thereby
earned the odium of apostasy. Accompanied by a number of his co-
religionists the hunted man sought refuge with all his treasures in the
castle. The mob, incited by a fanatical Canon and led by the
castellan, laid siege to the castle. The Jews had recourse to
desperate measures. Some of them, acting on the heroic advice of a
Rabbi, killed their own wives and children, flung the corpses from the
battlements upon the besieging crowd, and then prepared to consign
the castle and themselves to the flames. The others capitulated, and
were massacred by the mob, at the instigation of a gentleman deeply
indebted to them. Then the crowd, headed by the landed proprietors
of the neighbourhood, all of whom owed money to the Jews,
hastened to the Cathedral, where the bonds were kept, and burnt
them on the altar, under the benedictions of the priests.
Like deeds were perpetrated at Norwich, Bury St. Edmunds,
Lynn, Lincoln, Colchester, and Stamford, and in all these places, as
in London, the King’s officers found themselves powerless to prevent
or punish. Richard, however, could not afford to have his Jews
butchered or driven out of the country. He, therefore, issued a
charter, confirming to the wealthiest among them the privileges
which they had enjoyed under his predecessors: the privilege of
owning land, of bequeathing and inheriting money-debts, of moving
to and fro in the country without let or hindrance, and of exemption
from all tolls. In return for his protection, the King claimed a closer
supervision of their property and profits. His Treasury was to know
how much they had, and how much they made. Staffs of Jewish and
Christian clerks, appointed in various parts of the country, were to
witness their deeds, enter them into a special register, and see that
three copies were made of every bond: one to be placed into the
hands of a magistrate, another into those of some respectable
private citizen, and a third to be left with the Jew. Debts due to the
Jews were really due to the King, and might not be compounded or
cancelled without his consent. Disputes between Jews were to be
settled at the royal Courts, and, in a word, a severe and vigilant eye
was to be kept on the Israelites and their money-bags.
1199–1216 John, Richard’s miserable successor, whose reign
brought nothing but ruin to himself and shame on his
country, found it expedient to continue towards the Jews the lucrative
generosity initiated by better men. The oppression of the Jews was a
monopoly of the crown, and John made it quite plain that he would
not tolerate any rivals. He invested Jacob of London with the dignity
of Chief Rabbi over all the Jewish congregations throughout England
and styled him his “dear, dear friend,” warning his subjects that any
insult or injury offered to him would be regarded by the King as an
insult to himself. He extended to the whole colony the favours and
immunities granted to a privileged few by Richard, and, like him,
accompanied this act of grace with an even more rigorous control of
their affairs. The Jews had to pay dearly even for this limited and
precarious protection. The sole difference between the treatment of
them on the part of the King and that meted out to them by his
subjects was that the latter despoiled them spasmodically, the former
systematically. It was no longer a question of occasional
contributions, such as the £60,000 wrung from them by Henry II.,
and like impositions levied to defray the expenses of Richard’s
Crusade, but a steady and unsparing bleeding: tallages, inheritance
duties and a heavy percentage on all loan transactions, in addition to
confiscations and general fines, or fines for breaches of the law, with
which the King would now and again diversify the monotony of
normal brigandage. The procedure was perfectly immoral and yet
perfectly legal. The King’s treasury was replenished out of the
pockets of men who were as absolutely his as his own palaces, and
whom he could sell or mortgage as any other property, according to
his convenience. Even the King’s commissioners—Jews deputed to
collect the tallage—had power to seize the wives and children of
their own co-religionists. It is computed that at this period the Jews
contributed about one-twelfth of the whole royal revenue.
1210 But John’s cruelty was boundless as his
meanness. Not content with ordinary measures of
extortion, he suddenly ordered all the Jews—men, women and
children—to be imprisoned and forced to yield all they possessed.
Thus by one fell swoop were snatched from them the fruits of a life’s
laborious accumulation, and many were brought to the verge of
starvation. Men and women, until yesterday opulent, were seen
begging from door to door in the day time, and at night prowling
about the purlieus of the city like homeless and hungry curs. Those
who were suspected of being the owners of hidden treasure were
tortured until they confessed, and, in the case of a Jew of Bristol, at
least, a tooth a day was found an efficient test of a Jew’s
squeezability. Grinder after grinder was drawn from his jaw in
horrible agony, till the victim, after having lost several teeth, paid the
10,000 marks demanded of him. By such a fiscal policy the King’s
protégés were made to feel the full weight of royal favour. But even
this condition of serfdom and occasional torture was preferable to
the lot that was in store for them in the future. John, whatever his
own standard of humanity might have been, when the citizens of

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BSAVA Small Animal Formulary 10th

edition Part A Canine and Feline Fergus

BSAVA Small Animal Formulary 10th edition Part B Exotic

BSAVA Manual of Canine and Feline Fracture Repair and

Canine and feline geriatric oncology : honoring the

Atlas of Canine and Feline Urinalysis 1st Edition

Canine and Feline Behavior for Veterinary Technicians

Canine and Feline Cytology: A Color Atlas and

Small animal anesthesia and pain management: a color

Small Animal Dermatology: A Color Atlas and Therapeutic

Drug listings and monographs 1

Appendix I: general information

Appendix II: protocols

Index sorted by therapeutic class 476

Daniel Batchelor BVSc PhD DSAM DipECVIM-CA MRCVS

Nick Bexfield BVetMed PhD DSAM DipECVIM-CA PGDipMEdSci PGCHE

Daniel L. Chan DVM DipACVECC DipECVECC DipACVN FHEA MRCVS

Heidi Featherstone BVetMed DVOphthal DipECVO MRCVS

Polly Frowde MA VetMB DipECVIM-CA MRCVS

Jenny Helm BVMS CertSAM DipECVIM-CA FHEA MRCVS

Hannah Hodgkiss-Geere BVM&S MSc PhD DipECVIM-CA FHEA MRCVS

Andrew Kent BVSc DipECVIM-CA MRCVS

David Killick BVetMed PgCELTHE PhD CertSAM DipECVIM-CA(Onc)

Hilary Jackson BVM&S DVD DipACVD DipECVD MRCVS

Jo Murrell BVSc(Hons) PhD DipECVAA MRCVS

Catherine Stalin MA VetMB DipECVN FHEA MRCVS

Andrew Tanner BSc(Hons)

Angelika von Heimendahl MScAg BVM DipECAR MScVet (Cons) MRCVS

James Warland MA VetMB Dip-ECVIM-CA MRCVS

Sue Paterson MA VetMB DVD DipECVD FRCVS

• Drug interactions. A listing of those interactions which may be

AVM-GSL: Authorized veterinary medicine – general sales list. This

NFA-VPS: Non-food animal medicine – veterinarian, pharmacist,

POM-VPS: Prescription-only medicine – veterinarian, pharmacist,

POM-V: Prescription-only medicine – veterinarian. These medicines

CD: Controlled Drug. A substance controlled by the Misuse of Drugs

on the Schedule to The Misuse of Drugs Regulations 2001 (as

Schedule 2: Includes etorphine, ketamine, morphine, methadone,

Schedule 3: Includes buprenorphine, tramadol, the barbiturates (e.g.

Schedule 4: Includes most of the benzodiazepines except

Schedule 5: Includes preparations (such as several codeine

The prescribing cascade

■ A veterinary medicine not authorized in the UK, but

authorized in another EU member state for use in any

A product licensed A product licensed

A UK human licensed product

A product prepared extemporaneously by a

A veterinary medicine A human medicine can

‘Off-label’ use of medicines

unfamiliar drugs, consider pharmaceutical and pharmacological

Drug storage and dispensing

All medicines should be labelled. The label should include:

In order to comply with the current Veterinary Medicines Regulations,

Health and safety in dispensing

Many prescribers and users of medicines are not aware of the

Examples of drugs known or suspected to be human carcinogens

(c) or teratogens (t):

• ACE inhibitors (t), e.g. benazepril, enalapril, ramipril

Note that most carcinogens are also likely to be teratogens.

may lead to unopposed beta activity, thereby causing vasodilation

• Melting corneal ulcers: 1 drop of the ophthalmic solution q1–4h

Actinomycin-D see Dactinomycin A

arrhythmias, dry mouth and cold extremities. Repeated injections

B Drug interactions: Toxicity may occur if used with other

Drug listings and monographs 1

Index sorted by therapeutic class 476