ketamine analgesia dose

RE: ketamine analgesia dose

Gillian Mostyn — Wed, 25 Nov 2015 16:07:30 GMT

For anyone who is interested....dog is AOK now.

Who'd a thowt it!

RE: ketamine analgesia dose

Gillian Mostyn — Thu, 19 Nov 2015 23:03:35 GMT

Even biopsied 3 different sites to make sure I found any neoplasia!

(Fingers belong to nurse....she scrubbed in to help me exteriorise but didn't bother with gloves cos at that point I was assuming PTS!)

RE: ketamine analgesia dose

Joyce Whitehead — Thu, 19 Nov 2015 22:55:35 GMT

Yes I'd have put money on that being cancerous too...

I'm glad he is doing well thoug, fingers crossed.

RE: ketamine analgesia dose

Gillian Mostyn — Thu, 19 Nov 2015 20:41:19 GMT

Well, this is one occasion when I'm glad to be completely wrong.

I was convinced it was neoplastic. I was wrong. Histopath - acute necrotising pancreatitis. I had told the owner this was a vague possibility - hence why I offered biopsy and 24hrs....but I seriously thought it was pointless. Just goes to show....

What would everyone else have thought of this:

It was completely solid and was so friable, the large split happened simply as I lifted it gently from the abdomen! The photo doesn't do it justice really, especially the colour - all shades of black and green. I've had a few cases of acute pancreatitis before, and one of necrotising pancreatitis that went to exlap with biopsy and did really well, but I've never seen anything like this before. Apparently seen more in cockers, like this one.

I'm posting this because I nearly PTS this dog on the table, yet it is eating, drinking and doing remarkably well today, considering the day he had yesterday.

Truely gobsmacked. Happy clients tho. So far... everyone is aware that it might all go wrong yet.....

RE: ketamine analgesia dose

Julian Earl — Thu, 19 Nov 2015 10:24:41 GMT

loke Michael says above, I believe the dose is 1ml per 100kg.for unresponsive pain.

RE: ketamine analgesia dose

Gillian Mostyn — Wed, 18 Nov 2015 17:54:22 GMT

Mariette, thanks but you're right, the biopsy is long done!

I've done a few pancreatic biopsies...not had any major complications. However, usually euthanased when they look as bad as this one.....

RE: ketamine analgesia dose

mariette asselbergs — Wed, 18 Nov 2015 16:58:03 GMT

[quote user="Gillian Mostyn"]

Appreciate some info:

I have admitted a dog with V and abdo pain this morning that ex lap revealed a large and horrible looking pancreas. Likely to be neoplastic but owner wants biopsy (!!). Am now wanting a good analgesia regime for him till we get results back. Currently on methadone/metacam - did I read somewhere that you can give ketamine as a bolus for analgesia in dogs?? Ta

[/quote]

Gilian, you have probably already done it, but there is this re-assuring article in JSAP 2015 (56):

Pancreatic surgical biopsy in 24 dogs and 19 cats: postoperative complications and clinical relevance of histological findings

K. M. Pratschke*, J. Ryan†, A. McAlinden† and G. McLauchlan* *School of Veterinary Medicine, College of Medicine, University of Glasgow, Glasgow G61 1QH †University College Dublin Veterinary Hospital, University College Dublin, Belfield, Dublin 4, Ireland

OBJECTIVE: To assess the immediate postoperative complications associated with pancreatic biopsy in dogs and cats and review the clinical relevance of biopsy findings.

METHODS: Retrospective review of clinical records from two referral institutions for cases undergoing pancreatic biopsy between 2000 and 2013.

RESULTS: Twenty-four dogs and 19 cats that had surgical pancreatic biopsy had sufficient detail in their clinical records and fulfilled the inclusion criteria. Postoperative complications were seen in 10 cases of which 5 were suggestive of post-surgical pancreatitis. Two patients were euthanased within 10 days of surgery because of the underlying disease; neither suffered postoperative complications. Pancreatic pathology was found in 19 cases, 7 cases showed no change other than benign pancreatic nodular hyperplasia, and no abnormalities were seen in 18 cases.

CLINICAL SIGNIFICANCE: Complications may be encountered following surgical pancreatic biopsy, although the risk should be minimal with good surgical technique. Pancreatic biopsy may provide a useful contribution to case management but it is not clear whether a negative pancreatic biopsy should be used to rule out pancreatic disease. Dogs were more likely to have no significant pathology found on pancreatic biopsy than cats, where chronic pancreatitis was the most common finding.

Hope it went well

Mariette

RE: ketamine analgesia dose

Hannah Wynne Richards — Wed, 18 Nov 2015 16:32:58 GMT

Until you added the bit about the prelim diagnostics, I was thinking you were a bit young to be a dinovet!

Wynne

RE: ketamine analgesia dose

Gillian Mostyn — Wed, 18 Nov 2015 15:06:12 GMT

Much appreciated. He's actually just eaten (wasn't going to feed him but tried to get at another dog's food so enthusiastically that we gave him some) so seems pretty comfortable at the moment. Amazingly. Will keep the ketamine on standby....

RE: ketamine analgesia dose

Michael Woodhouse — Wed, 18 Nov 2015 14:22:51 GMT

We use 0.1ml/10kg ketamine, 0.5ml/10kg Comfortan IM and repeat as needed.

The ketamine seems to make a massive difference. Never gone down the infusion line.

RE: ketamine analgesia dose

David Mills — Wed, 18 Nov 2015 14:06:36 GMT

0.05-0.1mls per 10kg loading dose iv. Then 0.35mls per 500ml fluids running at 2M. Combine with pure opioid in bag 1.25mls per 500ml (methadone fine used this way). Also cerenia some visceral analgesic properties.

RE: ketamine analgesia dose

Gillian Mostyn — Wed, 18 Nov 2015 14:02:19 GMT

Thank you both!

(p.s. reread my post and its sounds like I went from painful abdo straight to ex lap! There were bloods, xray and ultrasounds in there too!!)

RE: ketamine analgesia dose

Andrew Kent — Wed, 18 Nov 2015 13:30:00 GMT

Hi Gillian,

I use a lot of lidocaine infusions along with opioids with severe pancreatitis cases and find it quite effective. Then go to full MLK type infusions if more is needed.

Andy

RE: ketamine analgesia dose

Mark Hedberg — Wed, 18 Nov 2015 13:27:59 GMT

According to BSAVA 8th ed formulary, you can use 200-500 microgram per kilogram loading dose of ketamine, followed by 2-5 micrograms per kilogram per hour. Your mileage may vary.