sedation options in old dog...

Re: sedation options in old dog...

Matt Gurney — Sat, 21 Aug 2010 12:02:20 GMT

I would go for ace 0.01mg/kg and butorphanol 0.2mg/kg IM. Dose for lean weight and leave for 45 mins for maximum effect. Buprenorphine doesn't give as much sedation as butorphanol. This is usually enough to take the edge off the dog so you can place an IV catheter. You can then always top up IV with either butorphanol 0.2mg/kg or midazolam 0.2mg/kg. Don't be afraid of using a little propofol or alfaxalone and placing an ETT to give you more control. Obviously supplemental oxygen. There are plenty of options other than medetomidine, which is not the best choice in a dog where you are unsure of its cardiovascular status. If it is hypothyroid its contractility may be reduced anyway but even more so by any dose of alpha 2. (But somehow dogs with cardio disease -even DCM- survive medetomidine!) Don't forget that atipamezole antagonises the sedative action of medetomidine but not all of the cardio effects so is not the convenient 'bale-out' it is perceived to be - plus the atipamezole won't do anything whilst the medetomidine is bound to the receptors.

Re: sedation options in old dog...

Michael Woodhouse — Mon, 16 Aug 2010 18:45:18 GMT

[quote user="Amanda Magrath"]

...anyone have any suggestions for a good sedative protocol for an aggressive, nervous, 10 year old, morbidly obese and possibly hypothyroid Labrador?! This is needed to do an FNA and obtain a blood sample!

[/quote]

An 'ACP sandwich' at home will easily get you the blood - I had an almost identical case today. ~30kg lab that's nice everywhere but the vets where she goes mad. 50mg ACP an hour before surgery and I took the blood in the car with the little old lady holding the head from the front seat.

I have always found it better to sedate these dogs at home rather than when they are stressed at the surgery. Even if you need to top up with a little medetomedine/butorphanol. You can always reverse the medetomidine if you get really worried.

Re: sedation options in old dog...

Bob Russell — Mon, 16 Aug 2010 13:31:08 GMT

I find half dose torbugesic/medetor works well enough to do most minor procedures and never had safety concerns - you can always add to it if necessary but for things like this never needed to. A muzzle for absolute safety if a real toad.

We make sure there is O2 available if necessary but cannot recall any need for it (makes me feel more confident I suppose).

Re: sedation options in old dog...

Utlendigur — Mon, 16 Aug 2010 13:15:45 GMT

I find 0.01ml/kg of acp + 0.01ml/kg butorphanol works well - good sedation with minimal cardiovascular effects

Re: sedation options in old dog...

Mark Holmes — Mon, 16 Aug 2010 11:56:07 GMT

I would concur with the medetomidine/Butorphanol combination, I use alot of it and so far (he says caressing a piece of wood) I have never lost anything on it. I makes a great premed and sedation. I don't use it in dogs with marked cardiac disease unless I have no option (aggression and/or excessive loopiness) but even then I haven't had problems.

I have certainly lost animals throught the stress of handling and frequently point this out to younger vets who are pinning an animal down because they are nervous about sedation.

Re: sedation options in old dog...

Martin Atkinson — Mon, 16 Aug 2010 10:34:16 GMT

I wouldn't have any problems with using buprenorphine or butorphanol and medetomidine combination but I would probably go easy on the latter and initially only use the dose for its estimated lean weight, you can always give it a bit more later.