Sedative action of the α2-agonist medetomidine in cats

Medetomidine, a novel alpha 2-agonist drug intended for small animal sedation, was injected intramuscularly at dose rates of 0.02, 0.06 and 0.18 mg/kg. Xylazine (3.0 mg/kg) and saline were used for comparison. The five treatments were tested in a Latin square design in five cats. Treatments differed significantly in three-way analysis of variance, medetomidine inducing an increase in drowsiness with a corresponding decrease in both aroused waking and sleep determined by polygraphical criteria. The duration of effect was dose-dependent. The effect of 0.18 mg/kg medetomidine was comparable to 3.0 mg/kg of xylazine. The drugs also induced bradycardia.     

Duration of nonresponse to noxious stimulation after intramuscular administration of butorphanol, medetomidine, or a butorphanol-medetomidine combination during isoflurane administration in dogs

OBJECTIVE: To assess duration of actions of butorphanol, medetomidine, and a butorphanol-medetomidine combination in dogs given subanesthetic doses of isoflurane (ISO). ANIMALS: 6 healthy dogs. PROCEDURE: Minimum alveolar concentration (MAC) values for ISO were determined. for each dog. Subsequently, 4 treatments were administered to each dog (saline [0.9% NaCl] solution, butorphanol [0.2 mg/kg of body weight], medetomidine [5.0 microg/kg], and a combination of butorphanol [0.2 mg/kg] and medetomidine [5.0 microg/kg]). All treatments were administered IM to dogs concurrent with isoflurane; treatment order was determined, using a randomized crossover design. Treatments were given at 7-day intervals. After mask induction with ISO and instrumentation with a rectal temperature probe, end-tidal CO2 and anesthetic gas concentrations were analyzed. End-tidal ISO concentration was reduced to 90% MAC for each dog. A tail clamp was applied 15 minutes later. After a positive response, 1 of the treatments was administered. Response to application of the tail clamp was assessed at 15-minute intervals until a positive response again was detected. RESULTS: Duration of nonresponse after administration of saline solution, butorphanol, medetomidine, and butorphanol-medetomidine (mean +/- SD) was 0.0+/-0.0, 1.5+/-1.5, 2.63+/-0.49, and 5.58+/-2.28 hours, respectively. Medetomidine effects were evident significantly longer than those for saline solution, whereas effects for butorphanol-medetomidine were evident significantly longer than for each agent administered alone. CONCLUSION AND CLINICAL RELEVANCE: During ISO-induced anesthesia, administration of medetomidine, but not butorphanol, provides longer and more consistent analgesia than does saline solution, and the combination of butorphanol-medetomidine appears superior to the use of medetomidine or butorphanol alone.     

Influence of medetomidine on stress-related neurohormonal and metabolic effects caused by butorphanol, fentanyl, and ketamine administration in dogs

OBJECTIVE: To examine stress-related neurohormonal and metabolic effects of butorphanol, fentanyl, and ketamine administration alone and in combination with medetomidine in dogs. ANIMALS: 10 Beagles. PROCEDURE: 5 dogs received either butorphanol (0.1 mg/kg), fentanyl (0.01 mg/kg), or ketamine (10 mg/kg) IM in a crossover design. Another 5 dogs received either medetomidine (0.02 mg/kg) and butorphanol (0.1 mg/kg), medetomidine and fentanyl (0.01 mg/kg), medetomidine and ketamine (10 mg/kg), or medetomidine and saline (0.9% NaCI) solution (0.1 mL/kg) in a similar design. Blood samples were obtained for 6 hours following the treatments. Norepinephrine, epinephrine, cortisol, glucose, insulin, and nonesterified fatty acid concentrations were determined in plasma. RESULTS: Administration of butorphanol, fentanyl, and ketamine caused neurohormonal and metabolic changes similar to stress, including increased plasma epinephrine, cortisol, and glucose concentrations. The hyperglycemic effect of butorphanol was not significant. Ketamine caused increased norepinephrine concentration. Epinephrine concentration was correlated with glucose concentration in the butorphanol and fentanyl groups but not in the ketamine groups, suggesting an important difference between the mechanisms of the hyperglycemic effects of these drugs. Medetomidine prevented most of these effects except for hyperglycemia. Plasma glucose concentrations were lower in the combined sedation groups than in the medetomidine-saline solution group. CONCLUSIONS AND CLINICAL RELEVANCE: Opioids or ketamine used alone may cause changes in stress-related biochemical variables in plasma. Medetomidine prevented or blunted these changes. Combined sedation provided better hormonal and metabolic stability than either component alone. We recommend using medetomidine-butorphanol or medetomidine-ketamine combinations for sedation or anesthesia of systemically healthy dogs.     

Medetomidine, levo-methadone and diazepam as premedication for lumbosacral epidural anaesthesia in dogs

The effect of medetomidine (40 μg/ kg) together with levo-methadone (0.5 mg/kg) was evaluated in dogs as a sedative and analgesic premedication followed by a lumbosacral epidural block with mepivacaine 2% or bupi-vacaine 0.5% (0.3–0.5 ml/10cm crown-rump length). When sedation became insufficient in the course of surgery, additional diazepam (0.1–0.2 mg/kg) was administered. Only in 43% of the dogs could surgery be performed without additional sedation. Medetomidine and levo-methadone influenced the cardio-respiratory system markedly. Hypoxaemia as well as hypercarbia were evident. Diazepam had no additional effect on these respiratory changes. After surgery 19 dogs were given atipamezole, 18 received atipamezole and naloxone while 17 received no antagonists. In 10 out of the 19 dogs receiving only atipamezole, fits of excitability were seen, but those receiving atipamezole and naloxone had a quiet recovery.     

Comparison of the sedative effects of medetomidine and xylazine in horses.

The sedative effects in horses of the new alpha 2 agonist medetomidine were compared with those of xylazine. Four ponies and one horse were treated on separate occasions with two doses of medetomidine (5 micrograms/kg bodyweight and 10 micrograms/kg bodyweight) and with one dose of xylazine (1 mg/kg bodyweight) given by intravenous injection. Medetomidine at 10 micrograms/kg was similar to 1 mg/kg xylazine in its sedative effect but produced more severe and more prolonged ataxia, and one animal fell over during the study. Medetomidine at 5 micrograms/kg produced less sedation but a similar degree of ataxia to 1 mg/kg xylazine.     

Sedative effects of medetomidine in pigs.

Sedative effects of medetomidine, a potent selective and specific alpha 2-adrenoceptor agonist, were evaluated in pigs using 5 different doses (30, 50, 80, 100 and 150 micrograms/kg of body weight) and compared with those of xylazine (2 mg/kg). Atropine (25 micrograms/kg) was mixed with both drugs to prevent severe bradycardia. All drugs were administered intramuscularly. Medetomidine at a dosage of 30 micrograms/kg produced more potent sedation than xylazine. The depth of sedation induced by medetomidine was dose dependent within the range from 30 to 80 micrograms/kg. At 100 or 150 micrograms/kg, the depth of sedation was mostly the similar level to that at 80 micrograms/kg but the duration was prolonged. The degree of muscle relaxation produced by medetomidine also seemed to be dose dependent from 30 to 80 micrograms/kg and was stronger than that produced by xylazine. An increase in the duration of muscle relaxation was dose dependent up to 150 micrograms/kg. No analgesic effect was produced by xylazine, however moderate analgesia was obtained by medetomidine. There were no marked changes in heart rate and respiratory rate during the observation period in pigs of any groups, however mild hypothermia after the administration of both drugs was observed. From these results, medetomidine has a significant and dose-dependent sedative effects which are much more potent than that of xylazine, and a combination of 80 micrograms/kg of medetomidine and 25 micrograms/kg of atropine is suitable for sedation with lateral recumbency and moderate muscle relaxation without notable side effects in pigs.     

The effects of medetomidine and xylazine on gastrointestinal motility and gastrin release in the dog

The effect of medetomidine, a potent and highly selective α₂-adrenoceptor agonist, on the motility of the gastric antrum, duodenum, mid-jejunum and ileum was investigated in ten dogs. Its effect on the release of gastrin was also determined. Administration of medetomidine intramuscularly (i.m.) at a dose of 40 μg/kg inhibited the motility of the gastric antrum, duodenum, mid-jejunum and ileum significantly, in comparison to administration of xylazine intramuscularly at a dose of 2.0 mg/kg. The release of gastrin was also significantly decreased in dogs receiving medetomidine. It was found to inhibit the motility in the gastric antrum and duodenum longer than in the mid-jejunum and ileum, presumably by acting specifically on α₂-adrenoceptors, likely at the peripheral level. Medetomidine also inhibited the gastric contraction associated with gastrin secretion.     

Effects of a medetomidine-midazolam-butorphanol combination on renal cortical, intestinal and muscle microvascular blood flow in isoflurane anaesthetized dogs: a laser Doppler study

Objective To obtain renal cortical, ileal, colonic and skeletal muscle microvascular blood flow measurements in dogs using the laser Doppler technique and to characterize the effects of medetomidine‐midazolam‐butorphanol combination on these flows. Study Design Prospective randomized experimental study. Animals Fourteen clinically normal beagles (two groups of seven), aged 1–4 years and weighing 13.2 ± 1.8 kg. Methods All dogs were anaesthetized with 1.7% end‐tidal isoflurane in oxygen. In the treatment group, after instrumentation and when anaesthesia was considered stable, medetomidine (1 mg m^?2 body surface area (BSA)) was administered intramuscularly (time 0). Midazolam (1 mg kg^?1) and butorphanol (0.1 mg kg^?1) were administered intravenously 20 minutes later. Atipamezole (2.5 mg m^?2 BSA) was administered intramuscularly 60 minutes after medetomidine. In the control group, saline (0.5, 2.5 and 0.25 mL) was administered at the corresponding times. Heart rate, systolic, diastolic and mean arterial pressures, body temperature, renal cortical, ileal, colonic and skeletal muscle microvascular blood flows were measured before time 0, and 5, 15, 25, 40, 60, 65, 70 and 90 minutes thereafter. Results Heart rate, ileal and skeletal muscle blood flows decreased in the treatment group, while no changes were observed in the control group. Conclusions Laser Doppler flowmetry allowed the measurement of microvascular blood flow in different organs. The medetomidine‐midazolam‐butorphanol combination decreases intestinal and skeletal muscle microvascular blood flows, while renal cortical blood flow is maintained. Clinical relevance Medetomidine‐midazolam‐butorphanol combination can be used to induce a short duration anaesthesia in dogs, but it will induce cardiovascular depression. This depression appears to be accompanied by a redistribution of blood flow.     

Cardiovascular effects of medetomidine, detomidine and xylazine in horses

The cardiovascular effects of medetomidine, detomidine, and xylazine in horses were studied. Fifteen horses, whose right carotid arteries had previously been surgically raised to a subcutaneous position during general anesthesia were used. Five horses each were given the following 8 treatments: an intravenous injection of 4 doses of medetomidine (3, 5, 7.5, and 10 microg/kg), 3 doses of detomidine (10, 20, and 40 microg/kg), and one dose of xylazine (1 mg/kg). Heart rate decreased, but not statistically significant. Atrio-ventricular block was observed following all treatments and prolonged with detomidine. Cardiac index (CI) and stroke volume (SV) were decreased with all treatments. The CI decreased to about 50% of baseline values for 5 min after 7.5 and 10 microg/kg medetomidine and 1 mg/kg xylazine, for 20 min after 20 microg/kg detomidine, and for 50 min after 40 microg/kg detomidine. All treatments produced an initial hypertension within 2 min of drug administration followed by a significant decrease in arterial blood pressure (ABP) in horses administered 3 to 7.5 microg/kg medetomidine and 1 mg/kg xylazine. Hypertension was significantly prolonged in 20 and 40 microg/kg detomidine. The hypotensive phase was not observed in 10 microg/kg medetomidine or detomidine. The changes in ABP were associated with an increase in peripheral vascular resistance. Respiratory rate was decreased for 40 to 120 min in 5, 7.5, and 10 microg/kg medetomidine and detomidine. The partial pressure of arterial oxygen decreased significantly in 10 microg/kg medetomidine and detomidine, while the partial pressure of arterial carbon dioxide did not change significantly. Medetomidine induced dose-dependent cardiovascular depression similar to detomidine. The cardiovascular effects of medetomidine and xylazine were not as prolonged as that of detomidine. KEY WORDS: cardiovascular effect, detomidine, equine, medetomidine, xylazine.     

Cardiopulmonary assessment of medetomidine, ketamine, and butorphanol anesthesia in captive Thomson's gazelles (Gazella thomsoni).

This investigation evaluated the cardiopulmonary effects of medetomidine, ketamine, and butorphanol anesthesia in captive juvenile Thomson's gazelles (Gazella thomsoni). Butorphanol was incorporated to reduce the dose of medetomidine necessary for immobilization and minimize medetomidine-induced adverse cardiovascular side effects. Medetomidine 40.1 +/- 3.6 microg/kg, ketamine 4.9 +/- 0.6 mg/kg, and butorphanol 0.40 +/- 0.04 mg/kg were administered intramuscularly by hand injection to nine gazelles. Times to initial effect and recumbency were within 8 min postinjection. Cardiopulmonary status was monitored every 5 min by measuring heart rate, respiratory rate, indirect blood pressure, end-tidal CO2, and indirect oxygen-hemoglobin saturation by pulse oximetry. Venous blood gases were collected every 15 min postinjection. Oxygen saturations less than 90% in three gazelles suggested hypoxemia. Subsequent immobilized gazelles were supplemented with intranasal oxygen throughout the anesthetic period. Sustained bradycardia (<60 beats per minute, as compared with anesthetized domestic calves, sheep, and goats) was noted in eight of nine gazelles. Heart and respiratory rates and rectal temperatures decreased slightly, whereas systolic, mean, and diastolic blood pressure values were consistent over the anesthetic period. Mild elevations in end tidal CO2 and PCO2 suggested hypoventilation. Local lidocaine blocks were necessary to perform castrations in all seven of the gazelles undergoing the procedure. Return to sternal recumbency occurred within 7 min and return to standing occurred within 12 min after reversal with atipamezole (0.2 +/- 0.03 mg/kg) and naloxone (0.02 +/- 0.001 mg/kg). Medetomidine, ketamine, and butorphanol can be used to safely anesthetize Thomson's gazelles for routine, noninvasive procedures. More invasive procedures, such as castration, can be readily performed with the additional use of local anesthetics.     

USE OF MEDETOMIDINE AS A PREANAESTHETIC IN BIRDS

Medetomidine, an α₂-adrenoceptor agonist, was used to balance ketamine anaesthesia in birds. Twenty zebra doves weighing 40 to 60 g were equally divided into 2 groups. Group 1 was used to evaluate the effects of 100 mg/kg of 5% ketamine and of 0.1 mg/kg of 0.005% medetomidine in combination with 100 mg/kg of 5% ketamine. Group 2 was used to study the effects of 200 mg/kg of 5% ketamine and of 30 mg/kg of 1% pentobarbital. All injections were made intramuscularly. Medetomidine-ketamine combination provided better analgesia, deeper anaesthesia, and smoother recovery with less wing flapping than with ketamine alone. The anaesthetic effect of the combination was comparable to that of pentobarbital but recovery was smoother. The selection of preanesthetic and anaesthetic medications is one of the problems associated with avian surgery. Medetomidine is a new sedative compound whose effect is mediated via the stimulation of the central α₂-adrenoceptors. It provides analgesic and sedative or anaesthetic effects in dogs and cats (Vähä, 1989) and sedative effect in zebra doves (Cherdchanpipat et al., 1989). This study was designed to evaluate the effect of medetomidine in combination with ketamine, the anaesthetic of choice for a number of avian species. The combination effect was compared with the effect of ketamine given alone, and with the effect of pentobarbital, the anaesthetic used successfully for decades by a number of practitioners.     

Combined paravertebral plexus block and parasacral sciatic block in healthy dogs

ObjectiveTo evaluate the effectiveness of paravertebral lumbar plexus block combined with parasacral sciatic block to anesthetize one hind limb in awake dogs.Study designRandomized, controlled, blinded experimental study.AnimalsEight healthy mongrel dogs weighing 12.4 ± 4.5 kg and aged 7 ± 2.33 years.MethodsAfter sedation with medetomidine, dogs received B1: bupivacaine 0.25%, 0.2 mL kg^?1, B2: bupivacaine 0.5%, 0.2 mL kg^?1, B3: bupivacaine 0.25% 0.4 mL kg^?1, P1: NaCl 0.2 mL kg^?1, P2: NaCl 0.4 mL kg^?1. The lumbosacral plexus was blocked through a paravertebral block of the fourth, fifth and sixth lumbar nerves combined with a parasacral block. The relevant nerves were located using a nerve stimulator and injections of each treatment were administered. Degree and durations of sensory blockade were determined through the response to a Halsted clamp pressure on the skin innervated by the saphenous/femoral and lateral cutaneous femoral nerves (lumbar dermatomes) and by the peroneal and tibial nerves. The degree and duration of motor blockade was assessed evaluating the ability to walk normally and proprioception.ResultsP1 and P2 treatments did not show any grade of sensory or motor blockade. The B2 treatment produced a higher degree of sensory blockade compared to B1 and B3 for both lumbar and sciatic dermatomes. There was no significant difference in the degree of sensory blockade comparing B1 to B3. The B2 treatment had greater motor blockade compared to B1 and B3. The duration of sensory and motor blockade was longer in B2 compared to B1 and B3.Conclusion and clinical relevanceWhen the nerve stimulator is used to perform the lumbosacral plexus block, the concentration of the bupivacaine has a more important role than the volume to produce a more solid and longer block.     

Comparison of the clinical utility of medetomidine/ketamine and xylazine/ketamine combinations for the ovariectomy of cats

A controlled trial was conducted to assess suitability of combinations of medetomidine and ketamine for the ovariectomy of cats, to investigate the possible side effects, and to compare medetomidine/ketamine with a combination of xylazine and ketamine. Three hundred and thirty-seven cats were submitted to surgery; 100 were anaesthetised with 80 micrograms/kg medetomidine and 5 mg/kg ketamine, 137 with 80 micrograms/kg medetomidine and 7.5 mg/kg ketamine, and 100 were anaesthetised with 1 mg/kg xylazine and 10 mg/kg ketamine. The combinations were injected intramuscularly in the same syringe. The anaesthesia provided by the medetomidine/ketamine combinations was characterised by good muscle relaxation, good analgesia and minimal side effects. The only difference between the two doses of ketamine was the length of the period of anaesthesia. The advantages of the medetomidine/ketamine combination in comparison with xylazine/ketamine were the need for a lower dose of ketamine, a longer duration of action and better analgesia. Similar side effects were observed with both medetomidine/ketamine and xylazine/ketamine combinations.     

Anesthetic effects of ketamine or isoflurane induction prior to isoflurane anesthesia in medetomidine-premedicated dogs

Dogs were given medetomidine (10 microg/kg body weight, intramuscularly) followed in 10 minutes by either ketamine (4 mg/kg body weight, intravenously) or isoflurane mask induction and maintained on isoflurane for 30 minutes. Medetomidine induced lateral recumbency in all dogs. Endotracheal intubation was faster and smoother when dogs were given ketamine than when induced with isoflurane. Analgesia was excellent in all groups. Respiratory depression was more profound when dogs were given ketamine. Recovery quality was smooth and similar among all groups. Medetomidine-premedicated dogs could be induced with either ketamine or isoflurane and maintained on 1.3% isoflurane to achieve good analgesia with smooth recovery from anesthesia.     

A comparative study of medetomidine/ketamine and xylazine/ketamine anaesthesia in dogs

The anaesthetic and physiological effects of a combination of 40 micrograms medetomidine with 2.5 ketamine, 5.0 or 7.5 mg/kg administered intramuscularly were compared with the effects of a combination of 1 mg/kg xylazine and 15 mg/kg ketamine. All the combinations rapidly induced an anaesthetic state that permitted endotracheal intubation, with the absence of the pedal reflex and with good muscle relaxation, and induced bradycardia that was less pronounced as the dose of ketamine was increased. All the combinations produced a decrease in respiratory rate. Increasing the dose of ketamine combined with medetomidine resulted in a very significant prolongation of the duration of anaesthesia, the duration of muscle relaxation and the arousal time. The duration of the anaesthetic effects of 40 micrograms/kg medetomidine with 5 mg/kg ketamine was comparable to that provided by the recommended xylazine/ketamine combination but the period of muscle relaxation was significantly longer. The recovery from medetomidine/ketamine took longer than recovery from xylazine/ketamine but there were fewer side effects.     

Nerve Stimulator–Guided Sciatic-Femoral Block in Pet Rabbits (Oryctolagus cuniculus) Undergoing Hind Limb Surgery: A Case Series

This article describes the clinical applicability of a nerve stimulator–guided technique, previously described in dogs, to block the sciatic and the femoral nerves in 4 pet rabbits (Oryctolagus cuniculus) undergoing hind limb surgeries. Preanesthetic intramuscular doses of medetomidine (0.08 mg/kg), ketamine (15 mg/kg), and buprenorphine (0.03 mg/kg) were administered to the rabbit patients. The rabbits were intubated and general anesthesia was maintained using isoflurane in oxygen. The sciatic-femoral nerve block was performed with 2% lidocaine at a volume of 0.05 mL/kg/nerve. Sciatic-femoral block was feasible in rabbits, and the motoric responses following electrical stimulation of both nerves were consistent with those reported in dogs after successful nerve location. Iatrogenic complications, namely nerve damage and local anesthetic toxicity, did not occur. Based on these results, the authors conclude that the sciatic-femoral nerve block described in dogs can be safely performed in rabbits. Clinical trials are required to assess the analgesic efficacy of the combined sciatic-femoral nerve block in rabbits as a part of multimodal pain management.     

Sedative and analgesic effects of medetomidine in dogs

The sedative and analgesic effects of medetomidine were studied in 18 laboratory beagles in a randomized cross-over study which was carried out in a double-blind fashion. Xylazine was included as a positive control and placebo as a negative control. Medetomidine was used at doses of 10, 30, 90 and 180 micrograms/kg i.m. compared to a dose of 2.2 mg/kg xylazine i.m. Parameters closely related to sedation were used to measure the degree of sedation. These were a posture variable (including evaluation of the dog's posture without external disturbance and resistance when laid recumbent) and a relaxation variable (including relaxation of the jaws, upper eyelids and anal sphincter). The first signs of sedation were recorded 1.5-3.5 min after administration of both drugs. The dogs sat down at 0.6-2.6 min post-injection and became prone at 1.9-5.9 min. Medetomidine dose-dependently affected the posture of the dogs and the relaxation variable--the higher the dose, the stronger and longer lasting the effect recorded. The sedative effect of xylazine was comparable to a medetomidine dose of 30 micrograms/kg. The analgesic effect was assessed as changes in the response to superficial pain induced by electrical stimuli. The response threshold increased significantly with both drugs and the effect of medetomidine was dose-dependent. The effects of the doses of 30 micrograms/kg medetomidine and 2.2 mg/kg xylazine did not differ significantly. In summary, medetomidine possessed an excellent sedative effect associated with analgesia in dogs.     

Neurohormonal and metabolic effects of medetomidine compared with xylazine in beagle dogs

This study was aimed to investigate and compare the effects of medetomidine and xylazine on the blood level of some stress-related neurohormonal and metabolic variables in clinically normal dogs, especially focusing on time and dose relations of the effects. A total of 9 beagle dogs were used for 9 groups, which were treated with physiological saline solution (control), 10, 20, 40, and 80 μg/kg medetomidine, and 1, 2, 4, and 8 mg/kg xylazine, intramuscularly. Blood samples were taken at 10 times during 24 h from a central venous catheter. Plasma norepinephrine, epinephrine, cortisol, glucose, insulin, glucagon, and non-esterified fatty acid concentrations were determined. Both medetomidine and xylazine similarly and dose-dependently inhibited norepinephrine release and lipolysis. Medetomidine suppressed epinephrine release dose-dependently with greater potency than xylazine. Xylazine also tended to decrease epinephrine levels dose-dependently. The cortisol and glucagon levels did not change significantly in any treatment group. Both drugs suppressed insulin secretion with similar potency. Both medetomidine and xylazine increased glucose levels. The hyperglycemic effect of medetomidine, in contrast with xylazine, was not dose-dependent at the tested dosages. The results suggested that the effect of medetomidine on glucose metabolism may not be due only to α₂-adrenoceptor-mediated actions.     

Clinical evaluation of medetomidine, a novel sedative and analgesic drug for dogs and cats

Medetomidine, a potent alpha 2-adrenoceptor agonist, was investigated in open, multicenter clinical trials with patients of various canine and feline breeds (1736 dogs and 678 cats). The purpose of the study was to find an optimal dose of medetomidine for sedation and analgesia in clinical practice and to study how well the intended procedure could be performed under the influence of the drug. The mean dose (i.m.) of medetomidine used for examinations, clinical procedures and minor surgical interventions was 40 micrograms/kg, and for radiography 30 micrograms/kg. In cats the dose was 80-110 micrograms/kg. On the doses chosen, almost all animals were recumbent and 72% of the dogs and 85% of the cats were in a slight anaesthetic stage, unable to rise. The evaluation of the overall suitability of medetomidine (% of cases) in different indications was "very satisfactory" or "satisfactory" in 95% of dogs and 81-96% of cats. Side effects reported were limited almost exclusively to vomiting and muscle jerking in dogs (12% and 0.5% of the cases) and to vomiting in cats (65%). Medetomidine seems to suffice for pharmacological restraint of dogs and cats. The concomitant use of medetomidine (80-100 micrograms/kg) and ketamine (7 mg/kg) in cats (n = 295) provided a good anaesthesia (20-40 min). The recovery was smooth. The present study shows that medetomidine provides an effective level of sedation and analgesia for clinical use.     

Perioperative stress response in the dog: effect of pre-emptive administration of medetomidine

OBJECTIVE: To determine the effect of medetomidine on the stress response induced by ovariohysterectomy in isoflurane-anesthetized dogs. STUDY DESIGN: Prospective randomized study. ANIMALS: Twelve healthy adult female purpose-bred dogs, weighing 16.8 to 25 kg. METHODS: Two treatments were randomly administered to each of twelve dogs at weekly intervals: (1) Saline injected IM followed in 15 minutes by isoflurane anesthesia (ISO) induced by mask and maintained at an end-tidal concentration of 1.8% for 60 minutes; and (2) Medetomidine, 15 ug/lkg IM followed in 15 minutes by isoflurane anesthesia (ISO&MED) induced by mask and maintained at an end-tidal concentration of 1.0% for 60 minutes. One week after completion of these two treatments, all dogs were ovariohysterectomized. six receiving each treatment (SURG and SURG&MED). Central venous blood samples (10 mL) were obtained immediately before medetomidine or saline (baseline) and at 30, 75, and 195 minutes and 24 hours after administration of medetomidine or saline in ISO and ISO&MED. In SURG and SURG&MED, samples were obtained immediately prior to injection of medetomidine or saline (baseline) and at 30 (before skin incision), 45 (after severence of the ovarian ligament), 75 (after skin closure), 105 (30 minutes after skin closure, dog recovered and in sternal recumbency), 135, 195, 375 minutes, and 24 hours after the initial sample. Samples were analyzed for epinephrine, norepinephrine, adrenocorticotrophic hormone (ACTH), cortisol, insulin, and glucose. Data were analyzed by analysis of variance and where significant differences were found, a least significant difference test was applied. RESULTS: Premedication with medetomidine prevented or delayed the stress response induced by ovariohysterectomy in isoflurane-anesthetized dogs. CONCLUSIONS: The stress response induced by ovariohysterectomy, although significant, is of short duration. Medetomidine safely and effectively reduced surgically-induced stress responses. CLINICAL RELEVANCE: Surgically induced stress responses can be obtunded or prevented by administration of medetomidine.