Can medetomidine be used as part of a premed for brachycephalic dog breeds? What if they are aggressive/difficult to handle?

RE: Can medetomidine be used as part of a premed for brachycephalic dog breeds? What if they are aggressive/difficult to handle?

Carl Bradbrook — Wed, 29 Apr 2020 14:18:59 GMT

I agree with both Dan and Jo. I routinely use dexmedetomidine in combination with an opioid in our brachycephalic patients, unless there are any underlying cardiac problems that would suggest against it use. Wherever possible I use it IV so we can be with the patient once administered, and as mentioned proceed immediately to induction of anaesthesia and intubation if any concerns arise. I do use it IM, but again would have the patient continuously observed following administration.

Dose wise I use 2 - 4 mcg/kg IV and 3-5 mcg/kg IM, and do give low doses (1 mcg/kg IV) in recovery if needed to ensure this is smooth, and again ensure the patient is monitored continuously and we have all kit ready to re-induce anaesthesia/intubate if needed.

RE: Can medetomidine be used as part of a premed for brachycephalic dog breeds? What if they are aggressive/difficult to handle?

Jo Murrell — Tue, 28 Apr 2020 15:23:07 GMT

I agree with Dan - as long as there are no cardiac issues i preferentially use dexmedetomidine with methadone in BOAS dogs for surgery - usually i go for a 3-5 µg/kg dexmed IV with methadone to get good sedation. If you already have IV access then should severe respiratory obstruction occur then you can rapidly proceed to induction of anaesthesia and intubation. Constant monitoring is key - particularly after IM administration.

RE: Can medetomidine be used as part of a premed for brachycephalic dog breeds? What if they are aggressive/difficult to handle?

Dan Holden — Tue, 28 Apr 2020 15:13:53 GMT

I routinely use medetomidine in conjunction with an opioid for premeds in these breeds for BOAS surgery or for unrelated procedures, especially if they are difficult to handle. Its overwhelming advantage is atipamezole - reversal allows the patient to regain control of its airway rapidly post-anaesthesia. It could be added to other premed protocols in very small doses. The crucial thing with these cases is that they are under constant observation from the time of premedication to the time they leave the premises, with equipment & drugs for a hasty intubation always at hand.