Guidelines

Guidelines on Anesthesia and Analgesia in Cats

Unit for Laboratory Animal Medicine
Aug 15, 2016 12:00 am

This document has been designed by ULAM veterinary personnel as a guideline for sedation, anesthesia, and analgesia of laboratory cats. This is not intended to be an all-inclusive tutorial on drug combinations that can be used in cats. The following guidelines are also general recommendations and consequently do not include reference to specific research-associated concerns.

All surgical procedures, anesthetics, analgesics, antibiotics or other medications used on animals must be approved by the IACUC, described in the animal use protocol and performed by personnel listed on the protocol and appropriately trained for the surgical procedure. Any techniques or drug protocols deviating from this document must be justified and approved in the IACUC protocol prior to application.

  • Responsibility

    1. Principal Investigator: Responsible to ensure appropriate anesthesia and/or analgesia is provided for all cats undergoing potentially painful procedures, including survival surgery, unless otherwise indicated in the relevant approved protocol.
  • Definitions

    1. Anesthesia: Temporarily induces loss of sensation with or without loss of consciousness.
    2. Analgesia: Provides pain relief without loss of consciousness.
    3. IM: Intramuscular
    4. IV: Intravenous
    5. SC: Subcutaneous
    6. Sedation: A mild degree of central depression in which the patient is awake but calm. This is inadequate for surgery.
  • Procedures

    1. Prior to Anesthetic/Analgesic/Sedative Event

    1. Handling and Restraint
      Cats respond most favorably to quiet and gentle but firm handling over brief periods of time.
      1. Gradual acclimation to handling and restraint techniques over 1-2 weeks can facilitate positive human-feline interactions and alleviate excess anxiety when cats are handled for research or veterinary purposes.
      2. To avoid excess anxiety in the pre- and post- anesthetic periods, the environment should be devoid of extraneous noise, including loud talking and laughing.
      3. The amount and duration of manual restraint should be kept to the minimum required to accomplish the necessary procedure.
      4. To minimize the time required for restraint, equipment and reagents should be ready for use prior to handling the animal.
      5. Pre-anesthetic doses of sedatives or tranquilizing agents are often used to facilitate immobilization or anesthetic induction, and to reduce anxiety.
    2. Fasting
      1. Healthy, adult cats should receive no food for 8 - 12 hours prior to sedation or anesthesia in order to reduce the risk of regurgitation and aspiration.
      2. Overnight fasting is recommended for procedures scheduled earlier in the day.
      3. Kittens less than 10 weeks old or those weighing less than 2 kg should not be fasted longer than 1 to 2 hours due to an increased risk of severe hypoglycemia.
      4. Cats should be allowed free access to water until sedatives or pre-anesthetic medications are administered.
    3. Ocular lubrication such as Paralube® must be used to prevent corneal drying during anesthesia or sedation.

    2. Normal Monitoring Parameters

    1. More information on anesthetic/sedation monitoring requirements can found in Anesthesia and Sedation Monitoring Guidelines.
    2. The goal of monitoring should be to maintain normal cardiac function, respiratory function, and body temperature. Understanding the basic physiologic effects of the anesthetics used is paramount to correctly interpreting monitoring parameters. More information on anesthetic and sedative effects on physiologic parameters can be found in Anesthesia and Analgesia Drug Descriptions
    3. Table 1: Physiologic Data of Cats

         

         Temperature   

        Heart Rate   
         (Beats per minute)   

         Respiratory Rate   
         (Breaths per minute)   

         Blood Pressure (mmHg)   

         Without sedation   
         or anesthesia   

         100.5 - 102.5 F   
         (38.1 - 39.2 C)   

         120 - 140 at rest   

         16 - 40 at rest   

         90 - 160 Systolic   
         50 - 90 Diastolic   
         90 - 100 Mean Arterial Pressure (MAP)   

         With sedation   
         or anesthesia   

         T > 98 F   
         (>37 C)   

         >100   

         10 - 20   

         70 - 90 Mean Arterial Pressure (MAP)   

    3. Physiologic Support

    1. Hypothermia
      1. An external heat source should be provided during the entire anesthetic and recovery period to prevent hypothermia. For examples of approved external heat supplementation products, refer to Anesthesia and Sedation Monitoring Guidelines.
    2. Endotracheal Intubation
      1. Placement of an endotracheal tube is recommended for most general anesthesia protocols. Endotracheal tubes with an inflatable cuff are preferred. Tubes with an outer diameter of 3.0mm to 3.5mm are typically adequate for most adult cats.
        1. The laryngeal mask airway (e.g. v-gel®) is a supraglottic device that is a suitable alternative for intubation in cats. For more information and training regarding this method of intubation, please contact the ULAM Training Core.
      2. Intubation may be difficult in cats due to the frequent occurrence of laryngospasms. Repeated, unsuccessful attempts at endotracheal intubation may result in trauma and swelling of the airway.
      3. To facilitate intubation, 2% lidocaine (0.1ml) can be topically applied to the laryngeal folds using a syringe at least one minute prior to intubation (NOTE: Local anesthetic sprays containing benzocaine have been reported to induce methemoglobinemia in cats and should be avoided).
      4. Once intubated, the ET cuff should be inflated to a light seal. Over-inflation of the cuff should be avoided to prevent trauma and secondary complications to the trachea.
      5. Contact the ULAM Training Core (ULAM-trainingcore@umich.edu or 734-763-8039) to set up a time to learn how to correctly and safely perform endotracheal intubation in the cat.
    3. Vascular Access and Fluid Support
      1. The placement of indwelling catheter(s) is advised. The cephalic vein of the forelimb or the medial saphenous vein of the hind limb are common sites for IV catheter placement.
      2. Intravenous fluids (e.g. Normosol or Lactated Ringers) should be supplied at a rate of 5-10 ml/kg/hr for an adult cat undergoing a procedure of 30 minutes or more. More information on appropriate fluid rates can be found in Guidelines on the Performance of Surgery in Non-Rodent Mammals.

    4. Recovery

    1. More information on required monitoring parameters during post-operative recovery can be found in Guidelines on the Performance of Surgery in Non-Rodent Mammals and Anesthesia and Sedation Monitoring Guidelines.
    2. Recover animals in clean kennels or transport cages. Animals must be fully recovered prior to return to their housing location.
    3. Food and water should be withheld until the animal is fully recovered and ambulating normally.
      1. Kittens less than 10 weeks old or weighing less than 2 kg should be fed small amounts within two hours of anesthesia to prevent hypoglycemia.
    4. Supplemental heat should be provided and rectal temperature periodically monitored until cats are fully awake.
    5. The endotracheal tube may be removed when active swallowing efforts are noted.
      1. Never leave a cat unattended with an endotracheal tube in place and ensure that the cuff is completely deflated prior to movement or extubation.

    5. Sedatives

    1. Detailed information on all approved anesthetics and sedatives can be found in Anesthesia and Analgesia Drug Descriptions.
    2. All sedatives should be administered prior to the intended procedure based on the time to effect, which is generally 15-20 minutes for IM administration. Duration of action for sedative-analgesic combinations for use in minor procedures is generally 15-60 minutes depending upon combination used.
    3. Contact ULAM Veterinary Staff (ULAM-vets@umich.edu or 734-936-1696) with questions regarding specific applications (i.e. kittens <10 weeks of age), drugs or medications. 
    4. Table 2: Sedation Dosage Information

         Drug   

         Dosage and Route a   

         Notesa   

         Dexmedetomidine   

         Up to 40 up/kg   
         IM   

      • Light to moderate sedation with mild to moderate analgesia; dose should be titrated to the response of the patient.   
      • Appropriate for minor procedures such as restraint, radiographs, bandage changes, etc.   
      • Reverse with atipamazole at the same volume as dexmedetomidine (SC, IM, IV).   

         Acepromazine   
         + Butorphanol   

         0.1 mg/kg   
         + 0.2 - 0.4 mg/kg   
         IM, IV   

      • Moderate sedation combination, with moderate analgesia.   
      • Useful for painful or fractious animals.   
      • Use lower dose range for IV.   

         Dexmedetomidine   
         + Butorphanol   

         Up to 20 ug/kg   
         + 0.2 - 0.4 mg/kg   
         IM, IV   

      • Moderate sedation combination, with moderate analgesia.   
      • Useful for painful or fractious animals.   
      • Reverse dexmedetomidine portion with atipamezole IM at the same volume as dexmedetomidine.   
      • Use lower dose range for IV.   

         Ketamine   
         + Dexmedetomidine   
         + Butorphanol   

         2.2 - 6.6 mg/kg   
         + 0.011 - 0.033 mg/kg   
         + 0.22 - 0.66 mg/kg   
         IM   

      • Deep sedation with moderate analgesia at high end of dose range.   
      • Appropriate for minor surgical procedures such as wound management, castration, laceration repair.   
      • Also useful for injectable anesthetics (see Procedures section 6.b).
      • Reverse dexmedetomidine portion with atipamezole IM at the same volume as dexmedetomidine.   
      a Intramuscular (IM), Intravenous (IV), Subcutaneous (SC)

    6. Anesthetics

    1. Anticholinergics
      1. May be administered prior to or in conjunction with alpha-2 agonists (e.g., xylazine or dexmedetomidine) or opioids to counteract bradycardia and hyper salivation. Contact the ULAM Veterinary Staff (ULAM-vets@umich.edu or 734-936-1696) for recommendations regarding appropriate use of these drugs. 
      2. Table 3: Anticholinergics Dosage Information

           Drug   

           Dosage and Route a   

           Notes a   

           Atropine   

           0.02 - 0.04 mg/kg   
           IM, IV, SC   

        • Onset 10 - 15 minutes after SC/IM injection.   
        • Duration: 45 - 60 minutes   
        • Use lower IV doses to avoid tachycardia.   

           Glycopyrrolate   

           0.005 - 0.01 mg/kg   
           IM, IV, SC   

        • Duration of action up to 4 hours.   
        • Does not cross blood brain barrier.   
        • Less tachycardia compared to atropine.   
        • Not for emergency use.   
        a Intramuscular (IM), Intravenous (IV), Subcutaneous (SC)
    1. Injectable Anesthetic
      1. Supplemental oxygen should be provided for all injectable anesthetic protocols. Consider intubation for any animals undergoing anesthesia to allow for airway control and administration of oxygen or inhalant anesthetic.
      2. If, for minor procedures, isoflurane is not utilized, in combinations involving ketamine, anesthesia can be prolonged by supplementing with ketamine only. 
      3. Table 4: Injectable Anesthetic Dosage Information

           Drug   

           Dosage and Route a   

           Notes a   

           Propofol   

           3 - 6 mg/kg.   
           IV   

        • For anesthetic induction only.   
        • Utilize slow bolus dosing (over 60 seconds) to effect.   
        • Repeat administration past 3 consecutive days not recommended; associated with Heinz body anemia.   
        • Caution: Apnea possible with rapid injection, intubate and assist in breathing if this occurs.   

           Ketamine   
           + Midazolam   

           5 - 10 mg/kg   
           + 0.2 - 0.4 mg/kg   
           IM, IV   

        • Induction protocol.   
        • Use lower dose range for IV.   

           Ketamine   
           + Dexmedetomidine   
           + Butorphanol   

           2.2 - 6.6 mg/kg   
           + 0.011 - 0.033 mg/kg   
           + 0.22 - 0.66 mg/kg   
           IM, IV   

        • "Kitty Magic" induction protocol.   
        • Can reverse upon recovery with ½ volume atipamezole IM.   
        • Use lower dose range for IV.   

           Ketamine   
           + Dexmedetomidine   
           + Hydromorphone   

           5 mg/kg   
           + 0.01 mg/kg   
           + 0.1 mg/kg   
           IM   

        • Provides injectable anesthesia for procedures lasting 45 - 60 minutes.   
        • Can also be used as induction protocol.   
        • Can reverse upon recovery with ½ volume atipamezole IM.   
        a Intramuscular (IM), Intravenous (IV)
    1. Inhalation Anesthetics 
      1. Table 5: Inhalation Anesthetic Dosage Information

           Drug   

           Dosage   

           Notes   

           Isoflurane   

           To effect.  Typically:   
           3 - 5% induction   
           0.1 - 3% maintenance   

        • Dose dependent cardiac and respiratory depression.   
        • Calibrated vaporizer and passive or active scavenging use required.
        • Sedation should be used in conjunction with mask or chamber induction to avoid injury and minimize breath holding.   

           Sevoflurane   

           To effect. Typically:   
           7 - 9% for induction   
           0.1 - 6% for maintenance   

        • Preferred for mask or chamber inductions.   
        • Dose dependent cardiac and respiratory depression.   
        • Calibrated vaporizer and passive or active scavenging use required.   

    7. Neuromuscular Blocking Agents (NMBA)

    1. Extreme care must be taken to ensure that a proper level of anesthesia and analgesia is achieved prior to administering a neuromuscular blocking agent.
    2. Neuromuscular blocking agents require special monitoring procedures which are detailed in Anesthesia and Sedation Monitoring Guidelines.
    3. Concurrent positive pressure ventilation is required. Reversal of NMBAs with neostigmine and glycopyrrolate is possible under specific conditions. Consult the ULAM veterinarians for instructions on NMBA reversal. 
    4. Table 6: Neuromuscular Blocking Agent Dosage Information

         Drug   

         Dosage and Route a   

         Duration   

         Notes   

         Atracurium   

         0.2 mg/kg IV   
         Re-dose w/ 0.1 mg/kg IV   

         20 - 35 minutes   

      • Give a tenth of this dose initially (priming dose), followed 4 - 6 minutes later with the remaining does.   

         Pancuronium   

         0.044 - 0.11 mg/kg IV   

         30 - 45 minutes   

      • 0.044 mg/kg if repeat bolus needed.   
      • May increase heart rate.   
      a Intravenous (IV)

    8. Local Anesthetics

    1. Appropriate for minimally invasive procedures such as skin biopsy, or as a supplement to sedation, anesthesia and analgesia. 
    2. Table 7: Local Anesthetic Dosage Information 

         Drug   

         Dosage and Route a   

         Onset and Duration   

         Notes a   

         Lidocaine   
         1 - 2%   

         2 mg/kg   
         SC infiltration or local nerve block   

         Onset: 5 - 10 minutes   
         Duration: 1 - 2 hours   

      • Mix 0.9ml lidocaine, 0.1 ml of sodium bicarbonate and 2.0 ml sterile water to reduce sting of injection in awake patients.   

         Bupivacaine   
         0.25 - 0.5%   

         0.5 - 1 mg/kg   
         SC infiltration or local nerve block   

         Onset: 20 - 30 minutes   
         Duration: 4 - 8 hours   

      • Cardio-toxic: aspirate prior to injection, do not give IV.   
      • Can be diluted with saline to increase volume.   
      NOTE: Addition of 1:200,000 epinephrine delays absorption and prolongs local anesthesia
      a Intramuscular (IM), Intravenous (IV), Subcutaneous (SC)

    9. Analgesics

    1. Signs of Pain in Cats
      May include, but are not limited to, the following:
      1. Quiet, lethargic, reluctant to move
      2. Purring
      3. Salivation
      4. Decreased appetite
      5. Rough hair coat
      6. Hunched posture
      7. Abnormal vocalization
      8. Abnormal gait
      9. Guarding, licking, chewing or scratching a painful area
      10. Social isolation
      11. Abnormal aggression
      12. Increased resting respiratory rate or effort (e.g. >40 bpm)
      13. Increased resting heart rate (e.g. >220 bpm)
    2. For an example of a visual scoring system from Colorado State University see Appendix A.
    3. Prevention and Management of Pain
      Prevention of pain by administering analgesics prior to anesthetic recovery is more effective than treatment after signs have developed. Several analgesics are available.
      1. Very low doses of dexmedetomidine (IV) or acepromazine (IV) titrated to effect, or in combination with an opioid, are very useful for treating post-operative agitation or dysphoria. Please contact the ULAM veterinarians for these recommendations.
      2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) - Acetaminophen is toxic to cats and its use is contraindicated. In addition, aspirin has delayed metabolism and should be avoided in cats. Robenacoxib is a newly approved NSAID that can be safely administered for 3 consecutive days.
      3. Please contact the ULAM veterinarians for additional analgesia therapy options such as local anesthesia blocks, epidurals, or intra-articular injections.
    4. Preemptive Analgesia
      1. Particularly opiates like buprenorphine, can reduce the dose of anesthetics required for surgical anesthesia and increase the respiratory depression associated with anesthetics.
      2. When preemptive analgesia is used, consider reducing the dose of anesthetic (whether inhalant or injectable) to the low end of the recommended range.
      3. Anesthetic depth must be carefully monitored and drug doses may need to be titrated to maintain appropriate levels.
      4. With new projects, sexes, or anesthetic analgesic combinations, assess a subset of animals before expanding to use in a larger cohort.
      5. Opioid side effects
        1. Cats administered opioids may show an increase in compulsive or stereotypic behaviors such as purring, grooming, or kneading their paws. Higher doses do not correlate with greater sedation and may produce CNS excitation or agitation.
        2. CNS excitation can be mitigated by using lower doses in combination with a sedative such as acepromazine, diazepam, or midazolam. The use of opioids (particularly hydromorphone) has been associated with transient hyperthermia in cats.
        3. Rectal temperatures should be monitored until cats are fully recovered for identification and appropriate treatment of hyperthermia (see Procedures section 11.c). 
           
    5. Table 8: NSAID and Opioid Dosage Information

         Drug   

         Dosage and Routea   

         Duration of Effect   

         Notesa   

         NSAIDs   

         

         Carprofen   

         1 - 4 mg/kg SC x 1 dose   

         24 hours   

      • One-time administration; caution advised   

         Ketoprofen   

         2 mg/kg SC   

         24 hours   

      • Limit dosing to a maximum of 5 consecutive days; caution advised   

         Meloxicam   

         0.3 mg/kg SC x 1 dose   

         24 hours   

      • One-time injection; caution advised.   
      • Contact ULAM veterinarians for recommendations regarding oral meloxicam dosing   

         Robenacoxib   
         (Onsior®)   

         2.5 - 6 kg BW:   
         1 whole tablet PO (6 mg)   

         6.1 - 12 kg BW:   
         2 whole tablets PO (12 mg)   

         2 mg/kg SC   

         24 hours   
         

         24 hours   
         

         24 hours   

      • Recommended for a maximum of 1 dose per day for up to 3 days.   
      • Cannot be accurately dosed in cats <2.5kg.   
      • May be given with a small amount of food. Tablets should not be broken.   
      • Subcutaneous (SC) injection can be interchanged with oral tablets.   

         Opioids   

         

         Buprenorphine   

         0.01 - 0.04 mg/kg   
         IM, IV, OTM*, SC**   

         6 - 8 hours   

      • Re-dose as needed every 6 - 8 hours.   
      • Dose at the high end of the range for more severe pain.   

             * OTM (oral transmucosal) administration has been shown to provide similar analgesic   
             efficacy to IM and IV routes.   

             **Evidence has shown that SC administration does not reliably reach therapeutic plasma   
             levels, IM or IV route recommended for treatment of acute pain.   

         Fentanyl   
         Transdermal   
         Patch   

         12.5 ug/hr patch   

         72 - 96 hours   

      • Fentanyl delivery from the patch is highly variable.   
      • Side effects may include inappetance, agitation sedation and increased body temperature.   
      • Apply 24 hrs prior to intended procedure.   

         Hydromorphone   

         0.05 - 0.1 mg/kg   
         SC, IM, IV   

         2 - 6 hours   

      • Transient hyperthermia, reverse w/ naloxone (0.01 - 0.04 mg/kg IM, IV, SC as needed)   

         Oxymorphone   

         0.025 - 0.1 mg/kg   
         SC, IV, IM   

         2 - 6 hours   

      • Reverse w/ naloxone (0.01 - 0.04 mg/kg IM, IV, SC as needed)   

         Tramadol   

         1 - 2 mg/kg   
         PO   

         12 - 24 hours   

      • Dose 2 - 4 times per day.   
      • Toxicity risk when combined with SSRI or Tricyclic Antidepressants.   
       aIntramuscular (IM), Intravenous (IV), Subcutaneous (SC), Oral Transmucosal (OTM)

    10. Emergency Resuscitation

    1. In the event of an anesthetic crisis, turn anesthetic gases off and contact a ULAM veterinarian at 734-936-1696 immediately.
    2. Reverse anesthetic agents, if appropriate.
    3. Use the following guidelines to support the animal until the veterinarian arrives:
      • A - Ensure a patent Airway: Place a cuffed endotracheal tube or confirm patency of tube already in place.
      • B - Assist in Breathing if necessary: Turn anesthetic gases off and ventilate with pure oxygen. A rapid ventilation rate (> 20 breaths per minute) is recommended to remove carbon dioxide, prevent acidosis, and decrease cerebral pressure.
      • C - Provide Cardiovascular Support as indicated: This can include rapid chest compressions (30-40% of lateral dimension; 80-120/minute) with the animal in lateral recumbency, and rapid infusion of intravenous crystalloid fluids (50-60 ml/kg bolus) to support perfusion.

    11. Reversal Agents

    Reversal agents are not required with sedation or anesthetic protocols, but can be useful to reduce prolonged recovery times or in the event of anesthetic complications. Analgesic effects are also reversed with the use of reversal agents, and pain management should be modified accordingly.

    1. Atipamezole (Antisedan ®) is used extra-label for reversal of the sedative and analgesic effects of dexmedetomidine in cats.
      1. The dose volume of atipamezole is the same as the preceding dose volume of dexmedetomidine, given IM.
      2. Atipamezole can also be used extra-label to reverse xylazine sedation, at a dose of 0.025-0.050 mg/kg IM.
    2. Naloxone is used extra-label for opioid reversal in the event of respiratory depression.
      1. A dose of 0.01 - 0.04 mg/kg IV, IM, or SC has duration of action of 45-90 minutes, and may need to be re-dosed if the duration of action of the opioid given is longer than 90 minutes.
    3. Naloxone is also used extra-label for adjunctive treatment of post-anesthetic hyperthermia in cats, when temperatures exceed 41.1°C; 106°F.
      1. A dose of 0.01 mg/kg IM or SC has been shown to return temperatures to normal <30 minutes.
  • Appendix A: Feline Acute Pain Scale

  • References

    1. Baumans V, Coke C, Green J, Moreau E, Peterson-Kane E, Reinhardt A, Reinhardt V, Van Loo P eds. Making Lives Easier for Animals in Research Labs, Animal Welfare Institute, Washington, DC, 2007.
    2. Bednarski R, Grimm K, Harvey R, Lukasik VM, Penn WS, Sargent B, and Spelts K (2011) AAHA Anesthesia Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association: November/December 2011, Vol. 47, No. 6, pp. 377-385.
    3. Flecknell P, Laboratory Animal Anesthesia, Second Edition, Academic Press, Ltd., London 1996
    4. Flecknell P, Waterman-Pearson eds. Pain Management in Animals, WB Saunders. London England, 2000.
    5. Fox JG, Anderson LC, Loew FM, Quimby FW eds. Laboratory Animal Medicine 2nd Ed. Academic Press, London England, 2002.
    6. Gaynor J, Muir W, Handbook of Veterinary Pain Management, Mosby, St. Louis Missouri, 2002.
    7. Hellyer, PW, SR Uhrig, and NG Robinson. "Feline Acute Pain Scale." Anesthesia Pain Management. Colorado State University, 2006. Web. 1 June 2016. http://csu-cvmbs.colostate.edu/Documents/anesthesia-pain-management-pain-score-feline.pdf
    8. Hrapkiewicz K, Medina L, Holmes D, Clinical Laboratory Animal Medicine 2nd ed. Iowa Sate University Press, Ames, Iowa, 1998.
    9. Kohn DF. 1997. Anesthesia and analgesia in laboratory animals. San Diego: Academic Press.
    10. Muir WW, Hubbel JAE, eds. Handbook of Veterinary Anesthesia, CV Mosby Co. St Louis, MO, 1989.
    11. Plumb D, Veterinary Drug Handbook, 8th Ed., Iowa State University Press, Ames Iowa, 2015.
    12. Posner LP, Pavuk AA, Rokshar JL, Carter JE, Levine JF. Effects of opioids and anesthetic drugs on body temperature in cats. Vet Anaesth Analg. 2010;37(1):35-43.
    13. Proceedings of the 34th World Small Animal Veterinary Congress, IVIS, 2009. http://www.ivis.org/proceedings/wsava/2009/lecture2/9.pdf?LA=1
    14. Recognition and Alleviation of Pain and Distress in Laboratory Animals, national Academy Press, Washington, DC, 1992.
    15. Selmi AL, Mendes GM, Lins BT, Figueiredo JP, Barbudo-Selmi GR. Evaluation of the sedative and cardiorespiratory effects of dexmedetomidine, dexmedetomidine-butorphanol, and dexmedetomidine-ketamine in cats. J Am Vet Med Assoc. 2003;222(1):37-41.
    16. Thurmon JC, Tranquilli WJ, Benson GJ, eds. Lumb and Jones' Veterinary Anesthesia, Third Edition, William and Wilkins, Baltimore, MD, 1996.
    17. Veterinary Information Network. North American companion animal formulary 6th Ed. North American Compendiums, 2004. http://www.vin.com/Members/Drug/NACA.plx
    18. Veterinary Anesthesia and Analgesia Support Group. http://www.vasg.org
Species: Cats
Questions?

If you have questions or comments about this document, contact ULAM Veterinary Staff (ULAM-vets@umich.edu or 734-936-1696).

The ULAM Training Core (ULAM-trainingcore@umich.edu or 734-763-8039) can be contacted to provide training in techniques at no charge.

For any concerns regarding animal health after work hours or on holidays/weekends, contact DPS (3-1131) who will contact the on-call veterinarian.