A Knowledge Summary published last month, discusses whether benzodiazepines (e.g. diazepam, midazolam) are more effective than methocarbamol in relaxing muscles and reducing tremors, in dogs with metaldehyde intoxication. The piece critically reviewed the five retrospective case series available in the literature, involving cases treated mainly with benzodiazepines, a few of which had methocarbamol.
The Summary concludes that there is not enough evidence to establish whether benzodiazepines or methocarbamol is better for the control of muscle tremors during metaldehyde intoxication. Further study is needed to provide information of the efficacy of both treatments.
It has been suggested in previous literature that methocarbamol is very successful in reducing muscle tremors during this intoxication; however, the availability of methocarbamol is limited in the UK. Due to the anticonvulsant activity and broader availability of benzodiazepines, as well as their multiple administration routes and rapid action via IV route, benzodiazepines are the preferred choice of many vets for the initiation of treatment for metaldehyde intoxication. The author stresses that in all cases of intoxication, all points of care should be taken into consideration when decision-making on medication choice.