{"id":2902,"date":"2017-08-07T11:21:00","date_gmt":"2017-08-07T11:21:00","guid":{"rendered":"https:\/\/az.research.umich.edu\/animalcare\/document\/guidelines-anesthesia-and-analgesia-dogs\/"},"modified":"2025-02-17T15:37:01","modified_gmt":"2025-02-17T15:37:01","slug":"guidelines-anesthesia-and-analgesia-dogs","status":"publish","type":"document","link":"https:\/\/az.research.umich.edu\/animalcare\/guidelines\/guidelines-anesthesia-and-analgesia-dogs\/","title":{"rendered":"Guidelines on Anesthesia and Analgesia in Dogs"},"template":"","categories":[8],"tags":[],"content-type":[39],"topic":[34],"update-type":[],"class_list":["post-2902","document","type-document","status-publish","hentry","category-dogs","content-type-guidelines","topic-anesthesia-and-analgesia"],"acf":{"use_legacy_editor":true,"updated_date":"2024-08-23 00:00:00","update_notice":true,"author":"Unit for Laboratory Animal Medicine","summary":"This document has been designed by the ULAM veterinary staff as a guideline for sedation<\/a>, anesthesia<\/a>, and analgesia<\/a> of laboratory canines. This is not intended to be an inclusive tutorial on all possible drug combinations that can be used in canines. The following guidelines are also general recommendations and consequently do not include reference to specific research associated concerns.\r\n\r\nAll surgical procedures, anesthetics, analgesics, antibiotics or other medications used on animals must be approved by the IACUC<\/a>, described in the animal use protocol, 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.","button_links":null,"related_content":[2985,2973,2913,2915,2890],"legacy_path":"guidelines-anesthesia-and-analgesia-dogs","legacy_node_id":47,"legacy_related_nids":"137, 123, 58, 60, 35, 1048","legacy_content_section":[{"legacy_section_type":"heading","legacy_heading":"Responsibility","legacy_subheading":"","legacy_section_text":"","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area","legacy_heading":"","legacy_subheading":"","legacy_section_text":"
    \r\n \t
  1. Principal Investigator:<\/strong>\u00a0Responsible to ensure appropriate anesthesia and\/or analgesia is provided for all canines undergoing potentially painful procedures, including survival surgery, unless otherwise indicated in the relevant approved protocol.<\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"heading","legacy_heading":"Glossary Definitions","legacy_subheading":"","legacy_section_text":"","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"glossary_terms","legacy_heading":"","legacy_subheading":"","legacy_section_text":"","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":[2405,2404,2393,2446,2503,2519,2583,2609,2690],"legacy_glossary_nids":"1072, 1071, 1060, 1115, 1172, 1189, 1255, 1284, 1371","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"heading","legacy_heading":"Procedures","legacy_subheading":"","legacy_section_text":"","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"1. Prior to Anesthetic\/Analgesic\/Sedative Event","legacy_section_text":"
      \r\n \t
    1. Handling and Restraint\r\n
        \r\n \t
      1. To avoid excessive anxiety in the pre- and post- anesthetic periods, provide an environment devoid of extraneous noise, including loud talking.<\/li>\r\n \t
      2. The amount of restraint and its duration should be kept to the minimum required to accomplish the necessary procedure.<\/li>\r\n \t
      3. To reduce the time of restraint, equipment and reagents should be ready to use prior to handling the animal.<\/li>\r\n \t
      4. Pre-anesthetic doses of sedative\/tranquilizer agents are often used to facilitate immobilization and to reduce anxiety.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
      5. Pre-anesthetic Fasting\r\n
          \r\n \t
        1. Withhold food for at least 8 hours but no longer than 24 hours prior to sedation or anesthesia in order to reduce the risk of regurgitation and aspiration.\r\n
            \r\n \t
          1. Fasting periods for greater than 24 hours related to specialized procedures (ie. gastrointestinal procedures) should be described in the protocol.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
          2. Do not withhold water prior to anesthesia or sedation.<\/li>\r\n \t
          3. For neonatal or unhealthy animals, special care is required. Consult a ULAM Faculty Veterinarian prior to fasting these animals\u200b.<\/em><\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
          4. Apply sterile non-medicated ophthalmic ointment to the eyes to prevent corneal drying during anesthesia or sedation.<\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"2. Routes of Administration","legacy_section_text":"
              \r\n \t
            1. More detailed information regarding injection techniques and maximum quantities safely administered to dogs can be found in\u00a0Guidelines on Administration of Substances to Laboratory Animals<\/a>.<\/em><\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"3. Normal Monitoring Parameters","legacy_section_text":"
                \r\n \t
              1. More information on anesthetic\/sedation monitoring requirements can found in\u00a0Anesthesia and Sedation Monitoring Guidelines<\/a><\/em>.<\/li>\r\n \t
              2. The goal of monitoring should be to maintain normal cardiac function, respiratory function, and body temperature, and an appropriate depth of anesthesia. 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\u00a0Anesthesia and Analgesia Drug Descriptions<\/a>.<\/em>\r\n
                  \r\n \t
                1. Without anesthesia<\/a>\r\n
                    \r\n \t
                  1. Temperature = 100 - 102.5\u00a0o<\/sup>F; 38 \u2013 39\u00a0o<\/sup>C<\/li>\r\n \t
                  2. Heart Rate (beats\/min) = 70-180<\/li>\r\n \t
                  3. Respiratory Rate (breaths\/min) = 20-40 resting<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                  4. With anesthesia\r\n
                      \r\n \t
                    1. Temperature = >98\u00a0o<\/sup>F; >37\u00a0o<\/sup>C<\/li>\r\n \t
                    2. Heart Rate (beats\/min) = 60-80<\/li>\r\n \t
                    3. Respiratory Rate (breaths\/min) = 10-12<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                    4. Pulse:<\/strong>\u00a0Strong and regular (a lingual-tongue artery can be palpated if necessary)<\/li>\r\n \t
                    5. Blood pressure<\/strong>: Systolic blood pressure >90 mm Hg and mean >70 mm Hg<\/li>\r\n \t
                    6. Capillary refill time:<\/strong>\u00a0<2s<\/li>\r\n \t
                    7. Mucous membranes:<\/strong>\u00a0pink not pale, white, or blue<\/li>\r\n<\/ol>\r\n<\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"4. Physiologic Support","legacy_section_text":"
                        \r\n \t
                      1. Hypothermia\r\n
                          \r\n \t
                        1. An external heat source should be provided during the entire anesthetic and recovery period. For examples of approved external heat supplementation products, please refer to the\u00a0Anesthesia and Sedation Monitoring Guidelines<\/a><\/em>.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                        2. Fluids\r\n
                            \r\n \t
                          1. Providing fluid support during anesthesia is important particularly if a procedure lasts one-half hour or more. More information on appropriate fluid rates can be found in\u00a0Guidelines on the Performance of Surgery in Non-Rodent Mammals<\/a>.<\/em><\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                          2. Vascular Access\r\n
                              \r\n \t
                            1. The placement of an indwelling catheter is advised. Cephalic, lateral saphenous, and jugular veins are readily accessible in dogs for intravenous administration of drugs and fluids.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                            2. Endotracheal Intubation\r\n
                                \r\n \t
                              1. Dogs are easily intubated with the use of a laryngoscope.<\/li>\r\n \t
                              2. Endotracheal tube sizes for 25-kg dogs are between 7.5 and 9 mm OD; for a 50-kg dog, sizes range from 10 to 15 mm OD. It is important to have several sizes available and ready with appropriate ties when attempting intubation.<\/li>\r\n \t
                              3. Application of sterile surgical lubricant to the tip of the endotracheal tube will help facilitate intubation. Inflate the cuff just enough to stop gas leakage (approximately 20 cm H2<\/sub>O). Over-inflation of the endotracheal tube cuff can damage the trachea.<\/li>\r\n<\/ol>\r\n<\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"5. Recovery","legacy_section_text":"
                                  \r\n \t
                                1. More information on required monitoring parameters during post-operative recovery can be found in\u00a0Guidelines on the Performance of Surgery in Non-Rodent Mammals<\/a>.<\/em><\/li>\r\n \t
                                2. Recover animals in clean kennels or transport cages.\r\n
                                    \r\n \t
                                  1. Ideally, animals will be recovered in the surgery area so they can be appropriately monitored throughout the post-operative period.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                                  2. If a large number of surgeries are being conducted at one time, animals may be housed together following anesthesia and prior to full recovery if they are continually observed. This is to ensure that more alert animals do not injure non-responsive cage mates.<\/li>\r\n \t
                                  3. Nutritional support should be withheld until the animal is fully recovered and ambulating normally.<\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"6. Sedation Protocols","legacy_section_text":"
                                      \r\n \t
                                    1. Detailed information on all approved anesthetics and sedatives can be found in\u00a0Anesthesia and Analgesia Drug Descriptions<\/a><\/em>.<\/li>\r\n \t
                                    2. All premedicants and sedatives should be administered 15-20 minutes prior to restraint or induction. Duration of action for sedative-analgesic combinations for use in minor procedures is generally 15-60 minutes depending upon combination used.<\/li>\r\n \t
                                    3. The following drug combinations are for use with minor procedures or as premedicants prior to anesthetic induction.\r\n
                                        \r\n \t
                                      1. For dose ranges listed as IV<\/a>, IM<\/a>, and SC<\/a>, use lower end of the range for IV administration.\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
                                        Sedation +\/- Analgesia<\/strong><\/th>\r\nDrug or Combination<\/strong><\/th>\r\nDosage<\/strong><\/th>\r\nRoute<\/strong><\/th>\r\n<\/tr>\r\n
                                        Mild to moderate sedation<\/em><\/td>\r\nAcepromazine<\/td>\r\n0.02 - 0.5 mg\/kg\r\n0.3 - 0.125 mg\/kg<\/td>\r\nIV\r\nIM \/ SC<\/td>\r\n<\/tr>\r\n
                                        Dexmedetomidine<\/td>\r\n2 - 10\u00a0\u00b5g\/kg<\/td>\r\nSQ<\/a> \/ IM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Midazolam<\/td>\r\n0.2 - 0.4 mg\/kg<\/td>\r\nIM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Mild to moderate sedation<\/em>\r\nMild analgesia<\/em><\/td>\r\nAcepromazine + Butorphanol<\/td>\r\n0.005 - 0.05 mg\/kg\r\n+ 0.1 - 0.4 mg\/kg<\/td>\r\n\u00a0IV \/ SQ \/ IM<\/td>\r\n<\/tr>\r\n
                                        Midazolam + Butorphanol<\/td>\r\n0.10 - 0.20 mg\/kg\r\n+ 0.1 - 0.40 mg\/kg<\/td>\r\nIM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Mild to moderate sedation<\/em>\r\nModerate analgesia<\/em><\/td>\r\nAcepromazine + Buprenorphinea<\/sup><\/strong><\/td>\r\n0.02 - 0.05 mg\/kg\r\n+ 0.01 - 0.02 mg\/kg<\/td>\r\nSQ \/ IM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Midazolam + Buprenorphinea<\/sup><\/strong><\/td>\r\n0.10 - 0.20 mg\/kg\r\n+ 0.01 - 0.02 mg\/kg<\/td>\r\nSQ \/ IM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Moderate sedation<\/em>\r\nModerate to strong analgesia<\/em><\/td>\r\nAcepromazine + Hydromorphone or<\/strong> Morphine or<\/strong> Oxymorphone or<\/strong> Fentanyl<\/td>\r\n0.010 - 0.060 mg\/kg\r\n+ 0.10 - 0.20 mg\/kg or<\/strong>\r\n0.50 - 1.0 mg\/kg or<\/strong>\r\n0.05 - 0.10 mg\/kg or<\/strong>\r\n0.005 - 0.010 mg\/kg<\/td>\r\nSQ \/ IM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Midazolam + Hydromorphone or<\/strong>\r\nMorphine or<\/strong>\r\nOxymorphone or<\/strong>\r\nFentanyl<\/td>\r\n0.10 - 0.20 mg\/kg\r\n+ 0.10 - 0.20 mg\/kg or<\/strong>\r\n0.50 - 1.0 mg\/kg or<\/strong>\r\n0.05 - 0.10 mg\/kg or<\/strong>\r\n0.005 - 0.010 mg\/kg<\/td>\r\nIM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Dexmedetomidine + Buprenorphinea<\/sup><\/strong><\/td>\r\n2 - 10 \u00b5g\/kg\r\n+ 0.01 - 0.02 mg\/kg<\/td>\r\nSQ \/ IM<\/td>\r\n<\/tr>\r\n
                                        Profound sedation<\/em>\r\nStrong analgesia<\/em><\/td>\r\nDexmedetomidine\u00a0 + Hydromorphone or<\/strong>\r\nMorphine or<\/strong>\r\nOxymorphone or<\/strong>\r\nFentanyl<\/td>\r\n2 - 10 \u00b5g\/kg\r\n+ 0.10 - 0.20 mg\/kg or<\/strong>\r\n0.50 - 1.0 mg\/kg or<\/strong>\r\n0.05 - 0.10 mg\/kg or<\/strong>\r\n0.005 - 0.010 mg\/kg<\/td>\r\nIM \/ IV<\/td>\r\n<\/tr>\r\n
                                        Tiletamine + Zolazepam (Telazol\u00ae)<\/td>\r\n6 - 13 mg\/kg<\/td>\r\nSQ \/ IM<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

                                        a<\/sup><\/strong>Pre-emptive analgesia<\/a>, particularly\u00a0opioids<\/a>\u00a0like buprenorphine, can reduce the dose of anesthetics required for surgical anesthesia and increase the respiratory depression associated with anesthetics. When preemptive analgesia is used, consider reducing the dose of anesthetic (whether inhalant or injectable) to the low end of the recommended range. Anesthetic depth must be carefully monitored and drug doses may need to be titrated to maintain appropriate levels. With new projects, sexes, strains or anesthetic analgesic combinations, assess a subset of animals before expanding to use in a larger cohort.<\/em><\/p>\r\n<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t

                                      2. Anticholinergics are\/may be used to treat and\/or prevent anesthetic and preanesthetic bradycardia, decrease\u00a0airway and salivary secretions, dilate the pupil, block vagally mediated reflexes, and block the effects of\r\nparasympathomimetic drugs.\r\n
                                          \r\n \t
                                        1. Atropine 0.02-0.04 mg\/kg SC, IM, or IV<\/li>\r\n \t
                                        2. Glycopyrrolate 0.01 - 0.02 mg\/kg SC or IM<\/li>\r\n<\/ol>\r\n<\/li>\r\n<\/ol>","legacy_media_position":"","legacy_media_file":"","legacy_media_url":"","legacy_glossary_term":"","legacy_glossary_nids":"","legacy_resource":"","legacy_resource_nids":"","legacy_buttons":null},{"legacy_section_type":"text_area_with_subheading","legacy_heading":"","legacy_subheading":"7. Anesthetic Protocols","legacy_section_text":"
                                            \r\n \t
                                          1. For dose ranges listed as IV<\/a>, IM<\/a>, and SC<\/a>, use lower end of the range for IV administration.<\/li>\r\n \t
                                          2. Anticholinergics\r\n
                                              \r\n \t
                                            1. Atropine 0.02-0.04 mg\/kg SC, IM, or IV<\/li>\r\n \t
                                            2. Glycopyrrolate 0.01 - 0.02 mg\/kg SC or IM<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t
                                            3. Injectable Anesthetic Induction Agents Used in Dogs\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
                                              Drug<\/strong><\/th>\r\nDose and Route<\/strong><\/th>\r\nNotes<\/strong><\/th>\r\n<\/tr>\r\n<\/thead>\r\n
                                              Ketamine + Midazolam<\/td>\r\n5 mg\/kg (K)\r\n+ 0.28 mg\/kg (M) IV or IM<\/td>\r\n\r\n
                                                \r\n \t
                                              • May be mixed in same syringe.<\/li>\r\n \t
                                              • Ketamine may sting with IM application.<\/li>\r\n \t
                                              • For IV administration, administer midazolam first, then titrate ketamine to effect.<\/li>\r\n \t
                                              • Average duration 10 - 20 minutes.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
                                              Ketamine + Diazepam<\/td>\r\n5 mg\/kg (K) IV or IM\r\n+ 0.25 mg\/kg (D) IV<\/td>\r\n\r\n
                                                \r\n \t
                                              • Diazepam can only be given IV.<\/li>\r\n \t
                                              • Ketamine can be given IM or IV (stinging may occur IM).<\/li>\r\n \t
                                              • For IV administration, administer diazepam first, then titrate ketamine to effect.<\/li>\r\n \t
                                              • Average duration 10 - 20 minutes.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
                                              Ketamine\r\n+ Dexmedetomidine\r\n+ Opioid\r\n\"Doggie Magic\"<\/td>\r\n1 - 3 mg\/kg (K)\r\n+ 2 - 10 \u00b5g\/kg (D)\r\n+ an opioid such as\r\nbutorphanol 0.1 - 0.2 mg\/kg or<\/strong>\r\nbuprenorphine 0.005 - 0.01 mg\/kg or<\/strong>\r\nhydromorphone 0.05 - 0.2 mg\/kg\r\nIV or IM<\/td>\r\n\r\n
                                              Tiletamine + Zolazepam (Telazol\u00ae)<\/td>\r\n2 mg\/kg IV or<\/strong>\r\n5 mg\/kg IM<\/td>\r\n\r\n
                                                \r\n \t
                                              • Good for fractious dogs, but rough recovery.<\/li>\r\n \t
                                              • Average duration 10 - 30 minutes.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
                                              Propofol<\/td>\r\n4 - 6 mg\/kg IV in unmedicated animals\r\n\r\n1 - 4 mg\/kg IV in premedicated\/sedated animals<\/td>\r\n\r\n
                                              Alfaxalone<\/td>\r\n1 - 4 mg\/kg IV<\/td>\r\n\r\n