Summary of anaesthesia

• ACP

  Becoming less commonly used in the UK.

  No analgesia associated.

  No reversal

  Unpredictable sedation.

  Lower blood pressure.

  Comes in many formation.
• Alpha-2 agonists

  Medetomidine, dexmedetomidine, Xylazine, Detomidine and romfididine.

  Profound cardiorespiratory effects but this is dose dependant. Low doses can be beneficial for both sedation and analgesia with reduced cardiorespiratory effect.

  • Reduced cardiac output so contraindicated in compromised individuals.
  • Increased urine production (body’s glucose increases).
  • Analgesic
  • Produced miosis, reduces IOP and CBP but vomiting is possible.
• What reverses alpha-2 agonists?

  Atipamezole
• Benzodiazepines

  Midazolam, diazepam.

  Anxioltic, muscle relaxation, CVS stability but no analgesia. In healthy animals this can make them more excitable or have no effect. These drugs are reserved for compromised animals, ASA III-V
• What reverses benzodiazepines?

  Flumazenil
• Opioids

  Care with pure opioids in horses, this can slow their guts and can alter their gait.

  Used to provide pre-emptive and preventative analgesia but can also work synergistically with sedatives.

  Limited cardiovascular effects and the degree of sedation depends on the drug.
• Alfaxalone

  Can be given IM and can be combined with other drugs as part of a premed.

  Has minimal impact on the cardiovascular system.
• What is the anaesthesia protocol for fear aggressive patients?

  Ideally:

  • Alpha-2 + ketamine + opioid in combination IM

  Also think about handling, environment, equipment and pheromones. If possible, dispense medication for administration - Gabapentin, Trazadone
• What is the anaesthesia protocol for ASA I dogs?

  Alpha-2 + opioid
• What is the anaesthesia protocol for ASA II dogs?

  Combination depends on the disease:

  • Low dose ACP/alpha-2 and opioid usually tolerated.
  • Care with ACP in liver disease.
  • Care with alpha-2 in CVS disease.
• What are the pre-med options for healthy dogs?

  Opioid:

  • Methadone 10mg/ml - 0.1-0.5mg/kg IM/IV
  • Buprenorphine 0.3mg/ml - 0.01-0.03 mg/kg IM/IV
  • Butorphanol 10mg/ml - 0.1-0.4 mg/kg IM/IV

  Alpha-2:

  • Medetomidine 1mg/ml - 0.007-0.04mg/kg IM, 0.001-0.02mg/kg IV.
  • Dexmedetomidine 0.5mg/ml - 0.005-0.02mg/kg IM, 0.001-0.01mg/kg IV.
• What is the pre-med options for a fractious dog?

  Opioids:

  • Methadone 10mg/ml - 0.1-0.5mg/kg IM/IV
  • Buprenorphine 0.3mg/ml - 0.01-0.03 mg/kg IM/IV
  • Butorphanol 10mg/ml - 0.1-0.4 mg/kg IM/IV

  Alpha-2:

  • Medetomidine 1mg/ml - 0.007-0.04mg/kg IM, 0.001-0.02mg/kg IV.
  • Dexmedetomidine 0.5mg/ml - 0.005-0.02mg/kg IM, 0.001-0.01mg/kg IV.

  Ketamine 100mg/ml - 1-5mg/kg IM, 0.005-0.02mg/kg IV
• What is the pre-med options for sicker dogs?

  Opioid:

  • Methadone 10mg/ml - 0.1-.05mg/kg IM/IV
  • Butorphanol 10mg/ml - 0.1-0.4mg/kg IM/IV

  Midazolam 5mg/ml - 0.1-0.5 IM or IV

  Ketamine 100mg/ml - 1-5mg/ml IM, 0.005-0.005 mg/kg IV
• What is a healthy rabbit pre-med?

  Opioid:

  • Methadone 10mg/ml
  • Buprenorphine 0.3mg/ml
  • Butorphanol 10mg/ml

  Alpha-2:

  • Medetomidine 1mg/ml
  • Dexmedetomidine 0.5mg/ml

  Ketamine 100mg/ml
• Alpha-2 in a rabbit

  If using these in rabbits makes sure the atipamazole is already drawn up and ready as rabbits are good at hiding disease which may only present after the alpha-2 has been given. So having the reversal agent drawn up and ready can be life saving.
• Pre-medication in healthy cats?

  Opioid:

  • Methadone
  • Buprenorphine
  • Butorphanol

  +/- Alpha-2:

  • Medetomidine
  • Dexmedetomidine

  +/-ACP
• What is the pre-med in a spicy cat?

  Midazolam

  +/- opioid

  +/- Ketamine.
• What is the premedication for a sick cat?

  Opiod:

  • Methadone
  • Butorphanol

  +/- Alfaxalone

  +/- Midazolam