Zoledronate is a medication that is used to treat high blood calcium levels caused by cancer and bone pain from osteosarcoma.
Zoledronate Helps with Bone Pain
Some of our cancer therapies are directed toward treating the side effects of cancer, rather than the cancer itself. Veterinarians use zoledronate for dogs suffering from bone pain.
Zoledronate is one of these medications. Used to treat osteoporosis in humans, in dogs it is usually used to treat hypercalcemia of malignancy (elevated blood calcium that can develop with cancer) and bone pain associated with osteosarcoma.1
Zoledronate is a member of a group of medications called bisphosphonates. Bisphosphonates inhibit bone destruction and weakening of the bone. Zoledronate may limit new blood vessels from growing into tumors (antiangiogenic) and may decrease the spread of certain cancer cells as well.1
Zoledronate is a human labeled injectable medication (Zoledronic acid) that is administered intravenously (IV).1 There is no veterinary labeled product available.1
Brand names for Zoledronate include:
How Does Zoledronate for Dogs Work
When bones weaken, they can be more easily damaged, sometimes they even fracture, and become painful. This is a problem for dogs with bone cancer, who experience a lot of pain from bone destruction.
Bisphosphonates like zoledronate act by inhibiting the action of osteoclasts (bone destroying cells). This action then inhibits the destruction of bone.1,2,3,4
In dogs, zoledronate is typically used in two cases:
- Hypercalcemia of malignancy is a serious consequence seen with some cancers. It causes elevated calcium levels that can cause organ (particularly renal) damage.2,3,4
- Zoledronate is used to help manage bone cancer. Bone pain from the destruction of bone by cancers like osteosarcoma, multiple myeloma or any other cancer that has spread to the bone cause bone destruction and bone pain.2,3,4 Zoledronate helps limit bone destruction.
When to Not Use Zoledronate for Dogs
Zoledronate is incompatible with the simultaneous intravenously (IV) administration of dantrolene, diazepam and phenytoin sodium.1
Dogs with kidney disease, hypocalcemia, or other health issues may not be candidates for zoledronate therapy.
How They Give Zoledronate to Dogs
Zoledronate must be administered at a veterinary facility, IV and with the benefit of an intravenous catheter.
The following tests may be performed prior to initiating zoledronate therapy and again periodically throughout the treatment period:1
- Kidney function
- Electrolytes –calcium (ionized and unionized), potassium, phosphorus and magnesium
- Complete blood count (CBC)
- Sometimes, Bone-specific alkaline phosphatase and urine N-telopeptide1
Since zoledronate is excreted through the kidneys you should be sure your dog remains well hydrated through the course of treatment.1
What If I Miss a Dose?
Consult with your veterinarian regarding recommendations should your appointment be rescheduled or if a dose is missed.
Storage and Handling
The storage and handling of this medication will be the responsibility of your dog’s veterinarian.
Zoledronate is considered a hazardous drug and precautions should be taken to prevent your exposure to urine, feces or vomit from your dog while they are being treated.
Use chemotherapy resistant gloves, put all waste in a plastic bag that can be sealed and for disposal.1 If your dog’s food bowls and toys are soiled, make sure to clean them thoroughly and separately.
Zoledronate Side Effects
Zoledronate causes infrequent side effects.4 In a study looking at 95 dogs receiving zoledronate 10 dogs demonstrated the following side effects:2
- Increased kidney function values (azotemia) or acute kidney damage2,3
- Injection site irritation2
Loss of appetite, fever and joint pain may also be appreciated post treatment.1 As always, report any changes in your pet’s condition to your dog’s veterinarian.
- Plumb DC. Zoledronate. Plumb’s Veterinary Drugs. https://app.plumbs.com/drug-monograph/vTu5mODx1yPROD. Updated September 2022. Accessed December, 2022.
- Brewer D, Macfarlane M, O’Connell E, Bacon N. Toxicity of zoledronic acid after intravenous administration: A retrospective study of 95 dogs. J Vet Intern Med. 2022; 36(1): 253- 258. doi:10.1111/jvim.16335
- Vidal S, Skorupski K, Wilcox J, et al. Retrospective evaluation of acute kidney injury after zoledronic acid administration to dogs with malignant osteolysis. Front. Vet. Sci., 02 July 2021 Sec. Comparative and Clinical Medicine
- Lopes M, Tosi G, McNaught K, et al. Retrospective assessment of tolerability and efficacy of zoledronate in the palliative treatment of cancer‐bearing dogs, Australian Veterinary Journal, 10.1111/avj.13218.
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