Risk of hemolytic anemia with intravenous administration of famotidine to hospitalized cats

BACKGROUND: Famotidine administered IV has been associated anecdotally with hemolysis in cats, and some veterinarians recommend using injectable famotidine only by the subcutaneous (SC) route for cats. However, the actual risk of such a reaction is not known. HYPOTHESIS: We hypothesized that famotidine, when given IV slowly, would not be associated with a clinically significant drop in packed cell volume (PCV) in hospitalized cats. ANIMALS: One hundred and forty-two hospitalized cats. METHODS: A retrospective medical record review was performed for hospitalized cats prescribed famotidine IV (n = 56), famotidine SC (n = 48), or no famotidine (n = 38) at a veterinary medical teaching hospital over the period from January 2004 through December 2006. RESULTS: Baseline signalment, observation times, and famotidine dosage (in treated cats) were similar among groups. Median baseline PCVs were significantly lower in the IV (31.5%) and SC (32.0%) groups compared with the control group (35.0%; P= .04). The median percent drop in PCV (3-4%), however, was no different in cats that received famotidine by either route compared with the control group (P= .90), and no cats in either famotidine group were observed to have any clinical signs of hemolysis. CONCLUSIONS AND CLINICAL IMPORTANCE: We conclude from this retrospective study that famotidine IV was given to 56 hospitalized cats without evidence of hemolysis, and that the IV route appeared safe when famotidine was administered over 5 minutes. We could not document a safety advantage of SC versus IV administration in this group of cats.