title: Adverse extrapyramidal effects in four horse given fluphenazine decanoate.
abstract: METHODS
  4 racehorses were examined because of markedly abnormal behavior following administration of fluphenazine decanoate.
  
  
  RESULTS
  Clinical signs included restlessness, agitation, profuse sweating, hypermetria, aimless circling, intense pawing and striking with the thoracic limbs, and rhythmic swinging of the head and neck alternating with episodes of severe stupor. Fluphenazine was detected in serum or plasma from all 4 horses. The dose of fluphenazine decanoate administered to 3 of the 4 horses was within the range (25 to 50 mg) routinely administered to adult humans.
  
  
  RESULTS
  In 2 horses, there was no response to IV administration of diphenhydramine hydrochloride, but the abnormal behavior in these 2 horses appeared to resolve following administration of benztropine mesylate, and both horses returned to racing. The other 2 horses responded to diphenhydramine administration. One returned to racing. The other was euthanized because of severe neurologic signs, respiratory failure, and acute renal failure.
  
  
  CONCLUSIONS
  Findings indicate that adverse extrapyramidal effects may occur in horses given fluphenazine decanoate. These effects appear to be unpredictable and may be severe and life threatening. Use of fluphenazine decanoate as an anxiolytic in performance horses is not permitted in many racing and horse show jurisdictions, and analytic procedures are now available to detect the presence of fluphenazine in serum or plasma.
authors.affiliation: Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
authors.forename: John D
authors.initials: JD
authors.lastname: Baird
authors.forename: Luis G
authors.initials: LG
authors.lastname: Arroyo
authors.forename: Modest
authors.initials: M
authors.lastname: Vengust
authors.forename: M Kimberly J
authors.initials: MK
authors.lastname: McGurrin
authors.forename: Alexander
authors.initials: A
authors.lastname: Rodriguez-Palacios
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Kenney
authors.forename: Manickam
authors.initials: M
authors.lastname: Aravagiri
authors.forename: George A
authors.initials: GA
authors.lastname: Maylin
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001522:Behavior, Animal / Q000187:drug effects; D001590:Benztropine / Q000627:therapeutic use; D004155:Diphenhydramine / Q000627:therapeutic use; D005116:Extrapyramidal Tracts / Q000187:drug effects*; D017809:Fatal Outcome; D005260:Female; D005476:Fluphenazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006734:Horse Diseases / Q000139:chemically induced*; D006736:Horses; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001590:Benztropine; D004155:Diphenhydramine; C011825:fluphenazine depot; D005476:Fluphenazine