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    Difficult Dogs IVAPM

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    Rani Jeyaraman
    This document provides guidelines for sedating difficult dogs. It recommends using drug combinations for safety and effectiveness. The safest and most effective combinations are medetomidine combined with an opioid for profound sedation and analgesia, or acepromazine combined with an opioid for variable but good sedation. Safety precautions include having adequate staff, equipment, drugs, and the ability to decline dangerous patients.

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    Difficult Dogs IVAPM

    Uploaded by

    Rani Jeyaraman
    34 views15 pages
    This document provides guidelines for sedating difficult dogs. It recommends using drug combinations for safety and effectiveness. The safest and most effective combinations are medetomidine combined with an opioid for profound sedation and analgesia, or acepromazine combined with an opioid for variable but good sedation. Safety precautions include having adequate staff, equipment, drugs, and the ability to decline dangerous patients.

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    This document provides guidelines for sedating difficult dogs. It recommends using drug combinations for safety and effectiveness. The safest and most effective combinations are medetomidine combined with an opioid for profound sedation and analgesia, or acepromazine combined with an opioid for variable but good sedation. Safety precautions include having adequate staff, equipment, drugs, and the ability to decline dangerous patients.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    34 views15 pages

    Difficult Dogs IVAPM

    Uploaded by

    Rani Jeyaraman
    This document provides guidelines for sedating difficult dogs. It recommends using drug combinations for safety and effectiveness. The safest and most effective combinations are medetomidine combined with an opioid for profound sedation and analgesia, or acepromazine combined with an opioid for variable but good sedation. Safety precautions include having adequate staff, equipment, drugs, and the ability to decline dangerous patients.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 15

    SEDATION OF

    DIFFICULT
    DOGS
    General Rules of Thumb
    (How to Keep Your Thumbs)
     Ability to decline patients
     Muzzled before arrival if dangerous
     Set aside adequate time
     Charge for your time
    Safety First!
     Health of pet vs. intact vet
     Liability (owner injury)
     Liability (patient injury)
     Adequate staff
     Adequate equipment
     Adequate drugs
    Oral Sedation
     http://www.vasg.org/oral_sedation_for_diffic
    ult_dogs.htm
     Usually inadequate (easily overridden)
     False sense of security
     Keep your health insurance up-to-date if
    using this method routinely
    Oral Sedation (continued)
     Acepromazine: 0.5-2.0 mg/kg
     Diazepam: 1.0-2.0 mg/kg (disinhibition)
     Alprazolam: 0.1-0.5 mg/kg (disinhibition)
     Combinations:
     Telazol 10-20 mg/kg w/ Acepromazine 2
    mg/kg: given in a “meatball” at home;
    profound sedation, long recovery
    Oral Sedation (continued)
     Acepromazine 1-2 mg/kg w/ Diazepam 0.5-
    1.0 mg/kg
     Phenobarbital 2.5 mg/kg w/ Diazepam 0.5-
    1.0 mg/kg
    Injectable Sedation
     Better when combinations of drugs are
    used
     Opioids form the basis of most
    combinations (neuroleptanalgesia)
     Unless anesthetized, any dog can bite
     Unless anesthetized, any dog can bite
    Opioids– Which one and why?
     Nalbuphine: 0.4 mg/kg; very inexpensive,
    not controlled, variable sedation
     Butorphanol: 0.2 mg/kg; moderately
    expensive, C IV, mild to moderate sedation
     Buprenorphine: 0.010-0.020 mg/kg;
    expensive, C III, usually not recommended
    due to minimal sedative qualities
    Opioids (continued)
     Mu agonists– very inexpensive, C II, more
    side effects (bradycardia, vomiting, etc.)
     Morphine: 0.5-1.0 mg/kg IM (if used IV, give
    very slowly to minimize histamine release)
     Hydromorphone: 0.1-0.2 mg/kg IM, IV
     Fentanyl: 0.005-0.010 mg/kg IM, IV
    Medetomidine/Opioid (Domitor)
     Profound sedation, good analgesia
     Rare catecholamine override
     Moderately expensive
     Side effects include bradycardia, initial
    hypertension
     Avoid if cardiac disease, organ failure
     Add anticholinergic if brachycephalic or
    vagal stimulation anticipated
    Medetomidine/Opioid (cont.)
     Medetomidine dose: 0.005-0.040 mg/kg IM
    or IV (low end if IV)
     Increasing dose increases duration and
    degree of sedation
     Can add induction agent (watch doses!) if
    sedation insufficient
     Reversible with atipamezole (Antisedan)
    Acepromazine/Opioid
     Variable sedation (usually good)
     Side effects include hypotension,
    hypothermia, rare collapse (Boxers)
     Very inexpensive
     Reasonably safe with cardiac disease
    (caution with forward failure)
     Acepromazine dose: 0.01-0.1 mg/kg IM, IV
     Long duration, irreversible
    Benzodiazepine/Opioid
     Midazolam preferred for IM use
     Variable sedation (better in geriatric or
    compromised patients)
     Fewest CV effects
     Variable expense (midazolam>diazepam)
     Benzo dose: 0.1-0.4 mg/kg IM, IV
     Short duration; reversible with flumazenil
    Telazol (tiletamine/zolazepam)
     Dissociative/benzodiazepine (anesthetic)
     Can be used alone (better with opioid)
     Expensive; minimal analgesia alone
     Short duration anesthesia, long, rough
    recovery (tiletamine>zolazepam duration)
     Caution with CV, organ disease
     5-10 mg/kg IM; 2-5 mg/kg IV
    SUMMARY

    •Better living through


    chemistry
    •Domitor is your
    friend
    •Safety, safety,
    safety

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