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Medetomidine was given parenterally as a sedative and analgesic agent to 283 dogs. Mean doses varied from 17 micrograms/kg for x-ray examinations to 31 micrograms/kg for clinical examinations. An adequate analgesic effect was demonstrated at higher doses than produced sufficient sedation. Potent bradycardia was produced within 15 minutes post administration. No influence of breed, sex or age was found. Vomiting was observed in 8% of the cases. One dog died, showing chronic glomerulonephritis, myocardial necrosis and liver congestion at autopsy.
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PMID:Sedative and analgesic effects of medetomidine in dogs--an open clinical study. 257 Dec 67

The sedative effects of medetomidine at doses of 20 and 40 micrograms/kg im given alone or followed 16-18 min later by fentanyl (2 micrograms/kg iv) was investigated in 6 bitches of mixed breeds. The higher dose of medetomidine alone caused the greater degree of sedation, but two bitches were only lightly sedated with either dose. Side effects noted in some cases included apparent pain on injection, vomiting on induction of sedation, bradycardia, slowing of respiratory rate, cyanosis and muscular twitching. The intravenous injection of fentanyl caused a marked increase in depth of sedation in all animals, inducing a condition similar to neuroleptanaesthesia in which the eyes were rotated downward and the pedal reflex abolished. Slight twitching and sensitivity to sound occurred immediately after fentanyl injection, but this was transient. The cardiopulmonary effects of medetomidine (40 micrograms/kg im) followed 20 min later by either fentanyl (2 micrograms/kg iv) or a saline placebo were investigated in 4 beagle dogs. Medetomidine caused bradycardia, hypotension and reduced respiratory rate, inducing an intermittent respiratory pattern. The iv injection of fentanyl did not further alter the heart or respiratory rate or blood pressure. However there was a small but significant decrease in arterial oxygen tension and rise in arterial carbon dioxide tension. indicating some respiratory depression. We conclude that the use of intravenous fentanyl to dogs already sedated with medetomidine could prove useful in clinical cases where the initial sedation with medetomidine has proved inadequate.
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PMID:The use of medetomidine/fentanyl combinations in dogs. 257 Dec 71

Medetomidine is a sedative and analgesic drug intended for use in dogs and cats but it can also be successfully used in many other species. The effect of medetomidine is dose dependent at the recommended dose range (10-80 micrograms/kg for dogs and 50-150 micrograms/kg for cats). At doses higher than the recommended ones the strength of sedation does not increase, only the duration of the effect. From the cardiovascular changes induced with medetomidine, the profound bradycardia is most prominent. It can be transiently prevented with atropine or glycopyrrolate medication. An initial increase in arterial blood pressure followed by a longer lasting slightly hypotensive or normotensive period can be observed. Respiratory frequency tends to decrease but the changes stay within normal limits for resting animals. Vomiting may occur during the induction period of sedation. Occasional muscle jerks can be observed. Hypothermia has been reported in every animal sedated with medetomidine. Medetomidine can be used as preanaesthetic prior to ketamine, barbiturate and halothane anaesthesia.
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PMID:Introduction to the clinical pharmacology of medetomidine. 257 Dec 83

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.
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PMID:Clinical evaluation of medetomidine, a novel sedative and analgesic drug for dogs and cats. 269 57

The analgesic effects of fentanyl (4 micrograms/kg) and medetomidine (10 micrograms/kg) in 1 mL saline injected epidurally were measured in 15 cats. The response to an electrical cutaneous stimulus from a constant current generator was used as the index of analgesia. The stimulus was applied to a forelimb before epidural injection, and at 15, 30, 60, 90, 120, 180, 240, and 300 minutes post-injection (PI). The hindlimb was tested 5 minutes later. One mL saline only was used to control for volume of injection and saline. Medetomidine significantly increased the pain threshold for the hindlimb at 20 to 245 minutes PI compared with the preinjection level. Fentanyl significantly increased the pain threshold at 20 minutes PI only compared with preinjection levels. Medetomidine significantly increased the pain threshold of the forelimb at 15 to 120 minutes PI compared with the preinjection levels. Fentanyl did not significantly increase the pain threshold of the forelimb. Administration of medetomidine produced emesis in 12 of 15 cats in an average of 6.4 minutes PI (range, 3 to 11 minutes) and mild sedation in all cats. Injection of fentanyl produced no visible side effects in any of the cats.
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PMID:The analgesic effects of administering fentanyl or medetomidine in the lumbosacral epidural space of cats. 819 74

Medetomidine and fentanyl-droperidol (Innovar-vet) were assessed over a three hour period in 80 healthy dogs. Following physical examination, electrocardiogram (ECG), arterial blood sample analysis, and dynamometer pressure threshold (analgesia score), the dogs were randomly assigned to one of four treatments: Miv--medetomidine (750 micrograms/M2) administered intravenously (IV), Mim--medetomidine (1000 micrograms/M2) administered intramuscularly (IM), Iiv--Innovar-vet IV (0.05 mL/kg) or Iim--Innovar-vet IM (0.1 mL/kg). All assessments were carried out by a single individual unaware of the treatment used. Objective assessments included temperature, heart and respiratory rates, analgesia score, arterial blood gases, acid-base and lactate levels. Subjective evaluation included degree of sedation, response to various clinical procedures, noise responsiveness, posture, and the incidence of side effects. Onset and duration of effect were also recorded. The ECG strips were assessed for arrhythmias. Data was analyzed using a 3-way analysis of variance for continuous variables and a Chi-square analysis of frequencies. A p value < or = 0.05 was considered significant. Medetomidine-treated animals had a decreased respiratory rate, longer duration of analgesic effect, increased incidence of bradycardia, vomiting and twitching, were less noise responsive and shivered less throughout the study. An increased incidence of second degree heart block with Miv (15 min), a delayed onset and recovery with Mim and increased lactate levels following Iiv (15 min) were observed. No differences were found in other measurements and good to excellent chemical restraint was produced with all treatments in 65% or more cases.
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PMID:Comparison of medetomidine and fentanyl-droperidol in dogs: sedation, analgesia, arterial blood gases and lactate levels. 849 Aug 14

Medetomidine is a relatively new sedative analgesic in dogs and cats but some precautions are required when using it. It is a potent alpha 2-adrenoceptor agonist and stimulates receptors centrally to produce dose-dependent sedation and analgesia and receptors centrally and peripherally to cause marked bradycardia and decrease the cardiac output. While hypotension occurs frequently, higher doses of the sedative can raise the blood pressure due to an affect on peripheral receptors. Slowing of the respiratory rate is a frequent effect of medetomidine with some dogs showing signs of cyanosis. Other actions that follow medetomidine use are slowing of gastrointestinal motility, hypothermia, changes to endocrine function and, occasionally, vomiting and muscle twitching. The clinical use of medetomidine in dogs and cats is discussed. Recommended dose rates are presented along with precautions that should be taken when it is used alone for sedation, as an anaesthetic premedicant or in combination with ketamine, propofol or opioids. Hypoxaemia occurs frequently in dogs given medetomidine and propofol. The actions of medetomidine can be rapidly reversed with the specific alpha 2-adrenoceptor antagonist, atipamezole, which is an advantage because undesirable and sedative actions of medetomidine can be terminated.
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PMID:Medetomidine sedation in dogs and cats: a review of its pharmacology, antagonism and dose. 888 60

Medetomidine is a relatively new sedative analgesic drug that is approved for use in dogs in Canada. It is the most potent alpha2-adrenoreceptor available for clinical use in veterinary medicine and stimulates receptors centrally to produce dose-dependent sedation and analgesia. Significant dose sparing properties occur when medetomidine is combined with other anesthetic agents correlating with the high affinity of this drug to the alpha2-adrenoreceptor. Hypoventilation occurs with medetomidine sedation in dogs; however, respiratory depression becomes most significant when given in combination with other sedative or injectable agents. The typical negative cardiovascular effects produced with other alpha2-agonists (bradycardia, bradyarrhythmias, a reduction in cardiac output, hypertension +/- hypotension) are also produced with medetomidine, warranting precautions when it is used and necessitating appropriate patient selection (young, middle-aged healthy animals). While hypotension may occur, sedative doses of medetomidine typically raise the blood pressure, due to the effect on peripheral alpha2-adrenoreceptors. Anticholinergic premedication has been recommended with alpha2-agonists to prevent bradyarrhythmias and, potentially, the reduction in cardiac output produced by these agents; however, current research does not demonstrate a clear improvement in cardiovascular function. Negatively, the anticholinergic induced increase in heart rate potentiates the alpha2-agonist mediated hypertension and may increase myocardial oxygen tension, demand, and workload. Overall, reversal with the specific antagonist atipamezole is recommended when significant cardiorespiratory complications occur. Other physiological effects of medetomidine sedation include; vomiting, increased urine volumes, changes to endocrine function and uterine activity, decreased intestinal motility, decreased intraocular pressure and potentially hypothermia, muscle twitching, and cyanosis. Decreased doses of medetomidine, compared with the recommended label dose, should be considered in combination with other sedatives to enhance sedation and analgesia and lower the duration and potential severity of the negative cardiovascular side effects. The literature was searched in Pubmed, Medline, Agricola, CAB direct, and Biological Sciences.
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PMID:A review of the physiological effects of alpha2-agonists related to the clinical use of medetomidine in small animal practice. 1466 51