Serum Baclofen Concentrations in Four Dogs With Baclofen Toxicosis Treated With In-Series Carbon Hemoperfusion and Hemodialysis.

In-series carbon hemoperfusion and hemodialysis significantly accelerates baclofen elimination and may improve outcomes in severe canine toxicosis.

This case series reports serum baclofen concentrations before, during, and after in-series carbon hemoperfusion (cHP) and hemodialysis (HD) in four dogs presenting with severe baclofen toxicosis. Ingested doses ranged from 4–24 mg/kg, with extracorporeal therapy initiated a median of 7 hours post-ingestion. Treatment duration averaged 3 hours, processing a median of 1.3 L/kg of blood volume—approximately 15 times the estimated blood volume. Serum baclofen concentrations decreased by a median of 69% during cHP/HD. The extraction ratio was substantially higher for cHP (median 61%) compared to HD (median 4%), indicating that cHP is the primary driver of baclofen removal in this combined approach. The calculated half-life during cHP/HD was 1.9 hours, markedly shorter than the post-treatment endogenous half-life of 5.8 hours. The extracorporeal elimination constant was 2.8 times greater than the intrinsic elimination constant, confirming meaningful acceleration of drug clearance. Two dogs also required mechanical ventilation, reflecting the severity of neurological and respiratory compromise seen in baclofen toxicosis. These pharmacokinetic data support in-series cHP/HD as an effective extracorporeal technique for enhancing baclofen elimination in dogs with severe intoxication. The findings provide clinically useful quantitative benchmarks to guide decision-making when managing baclofen overdose in canine patients.

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