Desmopressin (DDAVP): veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

DDAVP, Minirin, Desmotabs, Desmopressin acetate

Species with doses

Dogs and Cats

Routes

Ocular, PO, SC

Last reviewed

1 October 2026

Indications

• Central diabetes insipidus — diagnosis (response trial) and maintenance therapy
• Von Willebrand disease type 1 — pre-surgical/bleeding prophylaxis (boosts vWF release)
• Mild haemophilia A / uraemic platelet dysfunction bleeding (adjunct)

Desmopressin (DDAVP) dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Central diabetes insipidus (conjunctival): Plumb’s p.361: 1–4 drops once or twice daily (Nichols; Behrend); one drop twice daily controls most dogs (Rijnberk 2005). Papich 5e: 2–4 drops (≈2 µg) q12–24h intranasally or in the eye, or 0.5–2 µg per dog IV/SC. Use the 0.1 mg/mL product — NOT the 1.5 mg/mL nasal spray.
• Central diabetes insipidus (oral tablets): Papich 5e: 0.05–0.1 µg/kg q12h (up to 0.1–0.2 µg/kg), or 0.1 mg per dog three times daily then twice daily. Plumb’s p.361: ½–1 of a 0.1 or 0.2 mg tablet q8h as a 5–7-day diagnostic trial (Nelson 2002).
• Von Willebrand disease (pre-op): Papich 5e: 1 µg/kg SC, or diluted in 20 mL saline IV over 10 min. Plumb’s p.361: 1 µg/kg SC 30 min pre-op (Brooks 2003); 1–4 µg/kg SC, effect in 30 min lasting about 2 h (Carr & Panciera). Not effective for type 2 or 3 vWD; have transfusion available. (The previous row stored 1e-06 mg/kg — 1000× too small.)

Cats

• Central diabetes insipidus: Plumb’s p.361: 1–2 drops conjunctival once or twice daily (Bruyette 1991); 1–4 drops (Nichols 2000); oral 25–50 µg per cat (¼–½ of a 100 µg tablet) q12h (Aroch 2005).

Contraindications

Type 2B (and some type 3) von Willebrand disease (can worsen thrombocytopenia/bleeding). Hyponatraemia or conditions risking water intoxication. Cardiac disease where fluid retention is dangerous. Nephrogenic (rather than central) diabetes insipidus — it will not work. Known hypersensitivity.

Species-specific warnings

Cats: Effective for feline central DI; use small drop volumes and monitor for over-treatment (water retention).

Adverse effects

• Water retention / hyponatraemia / water intoxication if free-water intake is not managed
• Local irritation (conjunctival/nasal routes)
• Tachyphylaxis of the vWF effect on repeated dosing within days
• Rare: restlessness, mild abdominal discomfort

Drug interactions

• Drugs causing fluid retention / SIADH-type effects: additive hyponatraemia risk
• NSAIDs: enhance antidiuresis (water retention)
• Glucocorticoids: may reduce antidiuretic effect
• Other vWF-affecting drugs: relevant around surgery

Pregnancy and lactation

Used in human pregnancy for DI with care; veterinary data limited — use if clearly indicated and monitor sodium/water balance.

Monitoring

• Water intake / urine output and urine specific gravity (DI control)
• Serum sodium (hyponatraemia), especially early and if on IV fluids
• Buccal mucosal bleeding time / surgical haemostasis (vWD use)
• Body weight and demeanour (water intoxication signs)

Toxicity and overdose

The principal hazard is water intoxication/hyponatraemia (lethargy, vomiting, ataxia, seizures, coma) from excessive antidiuresis with unrestricted water intake — most likely with overdose or in patients given IV fluids. Otherwise very well tolerated.

Management: Stop the drug and restrict water; manage hyponatraemia carefully (avoid over-rapid correction — risk of osmotic demyelination). Mild cases self-correct as the effect wanes; severe symptomatic hyponatraemia needs cautious, monitored correction and seizure control.

Clinical pearls

• The conjunctival drop is the classic, practical route for canine central DI — titrate drops to abolish the polyuria
• For von Willebrand disease, give ~30 min before surgery — but the effect is brief and diminishes with repeated doses (tachyphylaxis), so it is a one-shot tool, not maintenance therapy
• It only works in CENTRAL DI — nephrogenic DI will not respond (useful diagnostically)
• Watch sodium/water balance: the danger is water intoxication, particularly if the patient also receives IV fluids
• Refrigerate the injectable/nasal solution to preserve potency

Mechanism of action

Selective agonist at renal V2 vasopressin receptors, increasing aquaporin-2 water-channel insertion in collecting-duct cells so water is reabsorbed and urine is concentrated (antidiuresis). V2 stimulation on vascular endothelium also triggers release of stored von Willebrand factor and factor VIII, transiently raising plasma levels to improve primary haemostasis. The molecule is engineered to maximise V2 (antidiuretic) over V1 (vasopressor) activity.

Formulations and products

• Intranasal/ophthalmic solution 100 mcg/mL (0.01 %)
• Injection 4 mcg/mL
• 0.1 mg / 0.2 mg tablet
• Nasal spray 10 mcg/spray
• Minirin — 0.1 / 0.2 mg tablet; 10 mcg/spray nasal; 4 mcg/mL injection, Tablet / nasal spray / injection (human-label)
• Desmopressin (DDAVP) — 100 mcg/mL nasal/ophthalmic; 4 mcg/mL injection, Nasal solution / injection (human-label)

Storage

Injection and nasal/ophthalmic solution: REFRIGERATE (2–8 °C); some products stable short-term at room temperature — follow label. Tablets: 15–25 °C, protect from light/moisture.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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Frequently asked questions