Sedation for ultrasound

Re: Sedation for ultrasound

Christopher Saul — Thu, 02 May 2013 22:22:41 GMT

I think it's more an IV vs IM thing, I really reckon you can get em quite flat if you give em low doses IV.

I concede that 0.1ml/10Kg might be insufficient for the more aggressive patients when given IM, and I would also concede that IME you would need to use the IV route to get decent sedation out of 0.05ml/10Kg ( I wouldn't use that dose IM)

Re: Sedation for ultrasound

David Mills — Thu, 02 May 2013 22:02:54 GMT

This may just be a general practice vs referral thing. Unless things are unusually quiet, IME those doses are just far too low- there are no facilities or time for waiting for torb to have an effect or even having that quiet a room. Personally I would prefer to get the dose high enough at the first attempt as topping up Dom is arguably more dangerous than a higher initial dose. Given that the cv effects plateau after 5mcg/kg I really don't see the issue in using a higher initial dose.

Re: Sedation for ultrasound

Christopher Saul — Thu, 02 May 2013 21:03:14 GMT

I'm with Andy on the 0.05ml/10Kg of domitor, though to be fair that would be my IV dose. My IM dose would be 0.1ml/10Kg.....

Re: Sedation for ultrasound

Andrew Kent — Thu, 02 May 2013 19:53:08 GMT

[quote user="David Mills"]

[quote user="Andrew Kent"]It depends what you are doing, for a standard ultrasound you really don't need doses nearly that high.[/quote]

[quote user="Sandra Patzner"] a very nervous and thus snappy Border Collie.[/quote]

Good luck with your hands, and any sort of decent ultrasound for that matter.

[/quote] Our imaging department are very happy with that sedation and they are the first to complain if the patients are not sedated enough. You might be surprised with the response to lower doses, just needs a calm environment even for a nervous dog. If necessary give the butorphanol first and give it time to work before giving the medetomidine. The most you would need in a dog is 10mcg/kg.

Re: Sedation for ultrasound

David Mills — Thu, 02 May 2013 19:39:32 GMT

[quote user="Andrew Kent"]It depends what you are doing, for a standard ultrasound you really don't need doses nearly that high.[/quote]

[quote user="Sandra Patzner"] a very nervous and thus snappy Border Collie.[/quote]

Good luck with your hands, and any sort of decent ultrasound for that matter.

Re: Sedation for ultrasound

Andrew Kent — Thu, 02 May 2013 19:09:52 GMT

It depends what you are doing, for a standard ultrasound you really don't need doses nearly that high. I give dogs 0.05ml per 10kg of medetomidine and 0.3ml per 10kg of butorphanol IM. rarely need more. (Surgeons tend to use higher doses :-p)

I give cats a bit more (0.01 mg/kg)

if doing biopsies then would give more analgesia - buprenorphine or methadone plus higher dose of Dom.

Re: Sedation for ultrasound

David Mills — Thu, 02 May 2013 18:35:41 GMT

If IV possible, 0.1ml dom per 10kg, 0.2ml torb per 10kg.

If IM, 0.25ml/10kg dom, 0.3ml torb per 10kg.

Neither contraindicated in liver disease. but dom is biotransformed in the liver, so may take longer (if hepatic dysfunction present not just enzyme changes) to process - would reverse iv atipam.

I would not use diazepam by any route if liver disease or chance of liver disease present. It can also markedly unmask aggression in nervous dogs.

Re: Sedation for ultrasound

Rob Loxley — Thu, 02 May 2013 18:16:49 GMT

[quote user="Sandra Patzner"]Any suggestions ?[/quote]

Are you planning to tru-cut it?

Re: Sedation for ultrasound

mariette asselbergs — Thu, 02 May 2013 17:41:13 GMT

Medetomidfine and butorphanol at lowest dose should be safe and quickly reversible. If it is just anxiety you might tri rectal diazepam. The Ultrasound environment in itself seems to be quite calming on most animals in my experience.

Mariette