calculation

Re: calculation

BTCC Fan RVN — Wed, 06 Mar 2013 22:09:41 GMT

Thank you everybody for the information!

And yes dont worry i NEVER decide what medication animals need that is upto to the vet. Just find it a bit confusing when different vets ask for the same medication and i calculate for them to check and they say i have done it wrong becasue i have used the calculation of the other vet!

No matter what in the end, i ALWAYS ask the vet to check before i do anything.

Re: calculation

Steph Worsley — Wed, 06 Mar 2013 13:59:18 GMT

I echo everything the others have said...all case and vet dependant.

I have a general standard IV protocol for sedation for imaging (usually 1-1 1/2 hrs xray and ultrasound) which is 0.005mg/kg medotomidine and 0.2mg/kg butorphanol

However this can vary greatly depending on the patient I am sedating and the exact procedures being undertaken, our ortho team have a different protocol again as do soft tissue and oncology!

medotomidine is USUALLY 1mg/ml and butorphanol is USUALLY 10mg/ml

Sorry but best advice is speak to the vet you are sedating/premedding for as at the end of the day it is them prescribing the medication not you!!!!

Re: calculation

Sophie Bedford RVN CertVNECC — Wed, 06 Mar 2013 09:54:47 GMT

We use different dose rates depending on what we're giving it to - so rabbits will have a different dose to cats etc. Again, in our practice like you it does differ depending on the vet doing the operation as some prefer less rather than a higher dose. I would suggest you have in practice both dose rates and you draw it up depending on which vet is doing the operation.

Even if a dose range is available you can't force a vet to use something they're not happy with so I'd check with each operating vet before drawing up.

Re: calculation

Siobhan Steven — Wed, 06 Mar 2013 08:59:55 GMT

Because concentrations of drugs can be different we quote our doses in mg/kg or ug/kg. Though you have mentioned the generic names of the drugs, which helps if these are the brands you use.

So to save confusion, Medetomidine has a wide dose range, and we use 5-15ug/kg IM and titrate these dose to slightly lower if given IV, so the killer Rotti who would get 15ug/kg IM may get 8-10ug/kg IV if someone was to miraculously get a catheter in!

Butorphanol is given at 0.1-0.5mg/kg IV or 0.2-0.8mg/kg IM

Ketamine at 5-10mg/kg IM lower dose IV.

You can get a beautiful sedation for the evil creature by combining these drugs, but use Butorphanol in this context for non invasive procedures, radiography and ultrasound for example, for invasive procedures replace the Butorphanol with 0.5mg/kg Methadone IM (0.2-0.3 mg/kg IV).

If the patient is just a little anxious we would usually use around 6-8ug/kg IM Medetomidine and 0.5mg/kg IM Methadone, for a desexing and that should facilitate catheter placement for induction. (Assuming the patient has no cardiac issues etc, all our patients are assessed on a case by case basis and we are lucky enough to be have a big selection of drugs to tailor our plan.)

Hope this helps, it seems like the DVM's you work with are comfortable with the doses they use, and as there are dose 'ranges' they are not doing anything 'wrong' but you can vary the dose for each individual for the desired affect.

Re: calculation

Lee484 — Wed, 06 Mar 2013 08:16:47 GMT

Hi,

I'm not going to be much help because in most places, it depends on the vet. Each practice will probably have a different 'set' dosage.

For example, one of my vets does:

Domitor - 0.04mls/kg

Torb - 0.01mls/kg

These are given IM, then 5-10mins later

Ketamine - 0.02mls/kg given IV

With this dosage you can reverse the Domitor straight away, no waiting 45mins, this was given to us by an anaesthetist at the RVC.

My other vet prefers the Fort Dodge dosage chart, which I don't have on me, but its a higher dose than the above, all given IM and reversed after 45mins.

Hope that helps a little bit.