Has anybody experienced lack of efficiency with Medetor recently?

RE: Has anybody experienced lack of efficiency with Medetor recently?

Michael Woodhouse — Wed, 05 Sep 2018 23:32:05 GMT

We use lots of medetomidine and butorphanol and use 90%+ is given sub cut and it works quickly and predictably. Will use higher doses IV for things like radiography.

RE: Has anybody experienced lack of efficiency with Medetor recently?

Lindsey Edwards — Wed, 05 Sep 2018 19:31:13 GMT

I give medetomidine combinations IV in most cases but not for fractious or small dogs with bendy legs such as extreme jack russels/shih tzus unless IV fluid catheter already in place. Effect is definitely quicker but don't find it more predictable than (careful) IM - not fat depots/sub cut.

Sounds a little counterintuitive to bypass stress by muzzling and wrestling with a pet for a must get IV! A quiet, dark induction area without other dogs/cats/stimuli may also help after IM admin! I have used a covered crate just off induction/theatre area or get someone to sit with patient if anxious but not aggressive

RE: Has anybody experienced lack of efficiency with Medetor recently?

Cool — Wed, 05 Sep 2018 10:25:48 GMT

Well, I get a muzzle on and i give it IV. it is only in very few cases(and i mean very few) that I have not been able to give it IV. In those cases where I am not able to give it IV, i use the higher end of the dose range IM and it still works. Giving IV works much faster in my experience

RE: Has anybody experienced lack of efficiency with Medetor recently?

Martin Atkinson — Wed, 05 Sep 2018 10:19:40 GMT

[quote user="Adebowale Ajao"]In stressed animals i now give the medetomidine and butorphanol combination IV and i have never had any issues irrespective of the brand of medetomidine or butorphanol used.[/quote]Isn't part of the reason we use the IM route because of the challenge in getting IV in a very stressed or aggressive animal?

RE: Has anybody experienced lack of efficiency with Medetor recently?

Cool — Wed, 05 Sep 2018 10:11:33 GMT

It could be a dodgy bottle indeed but one thing I know that can affect the efficacy of alpha2 adrenoceptor agonists is significant excitement or stress prior to administration of the sedative. It is easy to tell if a dog is excited but stress in cats is not as obvious. I will consider removing the cats from a noisy kennel area/ward immediately after administration of the drug. I have only experienced inefficiency in a very stressed dog once and I gave the medication IM. In stressed animals i now give the medetomidine and butorphanol combination IV and i have never had any issues irrespective of the brand of medetomidine or butorphanol used.

RE: Has anybody experienced lack of efficiency with Medetor recently?

Martin Atkinson — Tue, 04 Sep 2018 16:30:56 GMT

[quote user="Peter Faulkner"]I have noticed is you have to be as accurate as possible when measuring out the Torbugesic (we use Dolorex) as even a tiny error on the proportion of one to the other and there's hardly any sedation at all. [/quote]You can take your coat off Pete! We have traditionally used butorphanol as the opiate with medetomidine and found it to be very predictable. Under pressure from my nurses I've change my dinovet ways and they've started using buprenorphine, or another opioid, and found there is a marked reduction and variation in sedative effect for the same dose rate. This is fine for a GA for a placcid animal but not ideal for a fractious cat. So if they are being sedated rather than for just a premed and/or if is not expected to be painful, we will revert to butorphanol. Of course there is a variation in effect depending how accurate the injector is when giving these IM as well so there may be operator error to take into consideration.

RE: Has anybody experienced lack of efficiency with Medetor recently?

Peter Faulkner — Mon, 03 Sep 2018 18:18:30 GMT

[quote user="villagevet"]

[quote user="Peter Faulkner"]a tiny error on the proportion of one to the other and there's hardly any sedation at all[/quote]

I use a range of doses/ratios depending on the degree of sedation/pre-medication I require and cannot say that the 'wrong' one doesn't work. I'd be more worried a 'one-size fis all' dose would be potentially overdosing on effect and risk such as for x-rays/ear exams etc in an other wise compliant patient or increasing risk of adverse events under anaesthesia if induced afterwards?[/quote]

It was just an observation.

I'll get my coat. :)

RE: Has anybody experienced lack of efficiency with Medetor recently?

David Mills — Fri, 31 Aug 2018 20:04:35 GMT

[quote user="Peter Faulkner"]

We use Sedator without any efficiency problems. This probably doesn't apply to you, but one thing I have noticed is you have to be as accurate as possible when measuring out the Torbugesic (we use Dolorex) as even a tiny error on the proportion of one to the other and there's hardly any sedation at all. I used to know why, but its lost in the mists of time now. :)

[/quote]

I've never found this and use both like water. There is an additive effect of both but there's no interaction as such, they work in completely different ways. I suspect most of what is being seen is intrafat dosing? Or perivenous.

[quote user="Sammy82"]Just in the last 2 weeks we are experiencing problems with Domitor not being as efficient. Tripled cats needed masked to be able to intubate, emaciated 3kg cat hardly being hardly touched by 0.1ml im.... Just wondering if it's just this one bottle or if there might be a dodgy batch. Has anybody experienced similar recently?[/quote]

Report it as a SLE (suspected lack of efficacy) via VMD website.

I've had a few dodgy bottles over the years, manufacturers normally give you a few free, just make sure not from same batch if poss. I've always suspected its due to local factors though E. G. Being left in the sun, incorrect storage in factory, wholesalers etc etc. Some want you to send the bottle back so they can check.

RE: Has anybody experienced lack of efficiency with Medetor recently?

Robin Grimmer — Fri, 31 Aug 2018 18:09:25 GMT

Efficacy not efficiency.

RE: Has anybody experienced lack of efficiency with Medetor recently?

Lindsey Edwards — Fri, 31 Aug 2018 17:56:20 GMT

[quote user="Peter Faulkner"]a tiny error on the proportion of one to the other and there's hardly any sedation at all[/quote]

RE: Has anybody experienced lack of efficiency with Medetor recently?

Peter Faulkner — Fri, 31 Aug 2018 09:31:18 GMT

RE: Has anybody experienced lack of efficiency with Medetor recently?

Sammy82 — Fri, 31 Aug 2018 08:34:12 GMT

It's the original. Didn't even get a chance to check if problem started with opening of new bottle as I only work part time. Need to investigate an question all the other vets.

RE: Has anybody experienced lack of efficiency with Medetor recently?

James Dunne — Fri, 31 Aug 2018 07:51:33 GMT

Some of the generics of this drug do not seem to be nearly as effective as the original one. We use medetomidine frequently for part of anaesthesia combinations for cats [+ketamine/opiate] and for sedation of dogs for radiographs [+butorphanol] and depending on which one has been purchased by the practice based on the 'best deal', we see very variable efficacy.

RE: Has anybody experienced lack of efficiency with Medetor recently?

Liz Barton — Thu, 30 Aug 2018 20:44:02 GMT

We had a dodgy bottle with reduced efficacy several years back - nothing recent, but we've changed to Sedator. Contact the manufacturers (Vetoquinol for Domitor) and consider VMD adverse reaction report (I believe lack of efficacy counts as adverse reaction).