Introduction-Constant-rate-infusion (CRI) of lidocaine is increasingly used in rabbits for the treatment of abdominal pain. Currently, lidocaine intoxication has not been reported in pet rabbits. Methods-We searched the medical record database of an academic institution from 7/18/1974 to 10/29/2023 with the keywords “lidocaine” and “overdose”, filtering for lagomorphs. Results-Records of two rabbits were retrieved. Both rabbits received a CRI of lidocaine as part of their treatment plan. Errors in set up of these CRIs lead to delivery of lidocaine at a higher rate than intended. One rabbit received 2% lidocaine at a dose of 1000 mcg/kg/min for 30 minutes. The rabbit was noted to be trembling, arrythmic and tachycardic. The rabbit received an intravenous bolus of 1.5 ml/kg of 20% lipid emulsion, followed by a CRI at 15 ml/kg/hour, until a total of 12 ml/kg of lipid emulsion were administered. The rabbit clinical signs regressed. The other rabbit received 5000 mcg/kg/min of 2% lidocaine for 30 minutes. The rabbit developed opisthotonous followed by seizures. The rabbit received a bolus of midazolam, oxygen by flow-by, followed by 20% lipid emulsion. This rabbit developed pulmonary edema likely as consequence of the emulsion. The rabbit was administered furosemide at 2 mg/kg subcutaneously every 4 hours. Both rabbits recovered and were discharged from the hospital. Conclusions-Lidocaine administered ten and fifty times the high end of the dosing range (100 mcg/kg/min) for half an hour resulted in severe cardiac and neurological signs, respectively. In these two cases, treatment was successful in resolving the clinical signs.
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