Vol. 20, No.

2 February 1998

CE Refereed Peer Review

New Drugs in
FOCAL POINT
★New anesthetics originally
Feline Anesthesia
developed to reduce
complications in human
Colorado State University
medicine can be used for
feline anesthesia. Khursheed Mama, BVSc, DVM

KEY FACTS
C
ats present special anesthetic challenges because of their size, tempera-
ment, and unique physiology. In addition, pharmacokinetic informa-
■ Medetomidine has greater tion and data on the cardiopulmonary and behavioral effects (Figure 1)
specificity for the α2-adrenergic of drugs used in the anesthetic management of cats are fairly limited. For this
receptor than does xylazine. reason, the use of anesthetic agents in cats has been based largely on extrapola-
tion from techniques used in humans and dogs.
■ Midazolam is a water-soluble Four recent studies from different geographic locations and practice situa-
benzodiazepine that can be tions have documented the incidence of perianesthetic complications in cats.1–4
painlessly injected into muscle. Incidence ranged from 1.3% to 10.4%; hypotension, arrhythmia, and apnea
were the most commonly observed complications.1–4 Reported mortality rates
■ Neither propofol nor a sedative varied from 0.06% to 0.43%.1–4 These data are especially sobering because the
dose of tiletamine–zolazepam reported anesthetic complications occurred primarily in young, healthy cats
provides analgesia. presented for routine, elective procedures (Figure 2).
The reported anesthetic mortality rate is significantly higher in cats than in
■ Etomidate reportedly has minimal humans (0.01%).5 The cause of the high incidence of complications is multi-
effects on cardiovascular or factorial and may be influenced by economics, underlying patient disease, sur-
respiratory function in cats. gical and anesthetic management techniques, perianesthetic support, and mon-
itoring. Improved anesthetic drug choices, dedicated patient support, and
■ Inhalant anesthetics cause vigilant monitoring of anesthetized patients will have a positive influence on
dose-dependent cardiovascular patient outcome.
and respiratory depression. In recent years, new anesthetic drugs have been developed in an effort to
minimize drug-induced complications. Although these drugs were developed
primarily for human anesthesia, they have applications in veterinary practice.
This article summarizes information on the use of new anesthetic drugs in fe-
line clinical practice (Table I) in an effort to help practitioners make informed
choices and improve the safety of feline anesthesia.

INJECTABLE ANESTHETICS
Injectable anesthetic drugs are used as sedatives as well as to induce and
maintain anesthesia in veterinary patients. In recent years, many new anesthet-
ic and adjuvant drugs have been developed. The following is a discussion of
five agents (medetomidine, midazolam, tiletamine–zolazepam, propofol, and
etomidate) that have applications in feline anesthesia.
Small Animal The Compendium February 1998

Medetomidine other injectable drug combi-

α 2 -Adrenergic agonists nations.8,9
(e.g., xylazine) are commonly Medetomidine use is re-
used in the anesthetic man- portedly associated with
agement of animals. Medeto- marked cardiovascular and
midine is a recently devel- respiratory depression. A con-
oped α2-adrenergic agonist sistent decrease in heart rate
that has a higher degree of (to approximately 50% of
specificity for this receptor preinjection values) is ob-
than does xylazine.6 Medeto- served after cats receive
midine can be administered medetomidine doses of 80 to
intramuscularly or intra- 100 µg/kg.6,9–12 Transient hy-
venously. It provides dose-de- pertension (resulting from
pendent sedation and analge- α2-mediated peripheral vaso-
sia in most species. Doses as Figure 1—A cat recovering from injectable anesthesia. constriction) followed by hy-
low as 10 µg/kg have been potension (to 40% below
used in cats to provide seda- presedation values) is com-
tion for short procedures.6 mon.6,11,12 Changes in blood
The reliability of sedation pressure may be further influ-
with these low doses is in- enced by concurrent admin-
creased with concurrent ad- istration of other drugs. 6
ministration of other seda- Dose-dependent respiratory
tive/analgesic drugs (e.g., depression and occasional
opioids). When medetomi- cyanosis are also reportedly
dine is used alone, higher dos- associated with medetomi-
es (up to 110 µg/kg) are sug- dine administration in cats.
gested, depending on the The incidence and severity of
nature of the procedure. 7 respiratory effects appear to
Doses above 80 µg/kg do not be greater when medetomi-
increase the intensity of seda- dine is administered with
tion or analgesia but do pro- Figure 2—A cat anesthetized with an injectable anesthetic for other drugs.6,7,9,12,13
long the duration of these ef- onychectomy (declawing). Because of potential car-
fects. 6 Standard doses of diovascular and respiratory
medetomidine (40 to 80 complications, the recom-
µg/kg) given as a preanesthetic markedly reduce the dose mended dose of medetomidine should be given only to
of anesthetic required for induction and maintenance of young, healthy patients. A lower dose should be used
general anesthesia. 6 for compromised patients. Careful monitoring even of
Although not approved by the U.S. Food and Drug Ad- healthy patients is recommended. Atipamezole, a high-
ministration (FDA) for use in cats (it is approved for use ly selective α2 antagonist, may be given to cats to re-
in dogs), medetomidine has been used extensively with ke- verse medetomidine-induced effects.10,13,14 In addition
tamine to provide anesthesia for elective procedures, much to the obvious benefits of reversing drug-induced seda-
as xylazine–ketamine combinations have been used. The tion in a busy practice, atipamezole may also be used to
time to lateral recumbency after an intramuscular injec- reverse medetomidine-induced side effects. Because ati-
tion of 80 µg/kg of medetomidine and either 5 or 7.5 pamezole will also reverse analgesia, the use of other
mg/kg of ketamine was approximately 4 minutes. Lateral analgesic drugs is highly recommended for an animal
recumbency lasted for 30 to 60 minutes after drug admin- recovering from a painful procedure.
istration, depending on the ketamine dose.8 In another
study, increasing the dose of ketamine from 2.5 to 10 Midazolam
mg/kg increased anesthetic duration from approximately Midazolam is the first clinically available water-solu-
36 minutes to 99 minutes.9 Although vomiting and occa- ble benzodiazepine. After midazolam is injected, the
sional muscle twitches were reported, medetomidine com- body’s pH changes the compound’s configuration,
binations reportedly provided better overall anesthetic making it highly soluble in lipids. These properties al-
conditions and a longer duration of anesthesia than did low for painless intramuscular administration and

α 2- A D R E N E R G I C A G O N I S T S ■ B E N Z O D I A Z E P I N E ■ P R E A N E S T H E T I C S E D A T I O N ■ A N A L G E S I A
 TABLE I
Agents Used for Feline Anesthesia
Approved
for
Use in
Drug Cats? Class Uses Dosage Comments
Injectable Agents

Medetomidine No α2-Adrenergic Preanesthetic Preanesthetic: 10–40 Can produce marked cardiovascular and respiratory
The Compendium February 1998

agonist or used in µg/kg IM or IV depression, especially if large IV doses are used

combination Induction: 20–60
with ketamine to µg/kg plus ketamine
induce anesthesia (5 or 7.5 mg/kg) IM
for elective or IV
procedures

Midazolam No Water-soluble Usually Sedation: 0.2 mg/kg Does not cause pain during IM injection; reliably absorbed
benzodiazepine administered plus ketamine (5–10 after IM injection; minimal adverse cardiovascular side
with ketamine mg/kg) IM effects; does not provide analgesia; can be reversed with
for sedation or to Induction: 0.2 flumazenil; behavioral changes are observed if midazolam is
induce anesthesia mg/kg plus administered alone
ketamine (5–10
mg/kg IV, 10–20
mg/kg IM)

Tiletamine– Yes Combined Heavy sedation Sedation: 1–3 Not recommended for cats with hypertrophic cardiac disease,
zolazepam formulation of a and/or induction mg/kg SC or IM raised intracranial pressure, or seizures; may have prolonged
dissociative agent of anesthesia in Induction: 5–7.5 action in patients with renal or hepatic disease; concurrent
(tiletamine) and a young, healthy mg/kg SC or IM, use of analgesic drugs is strongly suggested
benzodiazepine cats undergoing 1–3 mg/kg IV
(zolazepam) routine elective
procedures

Propofol No Alkylphenol Induction and Induction: 5–8 Repeated injections and short-term infusions have been used
sedative/hypnotic maintenance of mg/kg IV; 3–4 successfully in cats but may lead to prolonged recovery time
anesthesia mg/kg IV if a
benzodiazepine
is also used
Small Animal
Small Animal The Compendium February 1998

rapid, reliable onset of clini-

Indicated primarily for inducing anesthesia in a compromised

stabilized; side effects may be minimized by premedication or

if IV fluids are administered with the drug; can interfere with
cal signs (e.g., muscle relax-

cat when anesthesia cannot be postponed until the patient is

Produces respiratory arrest at a lower MAC multiple in cats

than in dogs; most likely to predispose the myocardium to
ation, postural changes, re-

Requires an agent-specific vaporizer; produces respiratory

catecholamine-induced arrhythmia; undergoes extensive

cumbency). In contrast,
diazepam causes pain on in-

(approximately 25%) biotransformation in humans

arrest at a lower MAC multiple in cats than in dogs
tramuscular injection and is
unreliably absorbed when
administered via that route.
Although not specifically
approved for use in cats,

Requires an agent-specific vaporizer

Requires an agent-specific vaporizer

Comments

midazolam offers potential

advantages for feline anes-
thetic practice, where the
intramuscular route is often
preferred.
In one study, dose-depen-
steroidogenesis

dent signs (e.g., ataxia, pos-

tural changes) attributable
to midazolam were ob-
served within 3 minutes of

All four volatile anesthetic agents produce a dose-dependent depression of respiration and myocardial function.
IM = intramuscular(ly), IV = intravenous(ly), MAC = minimum alveolar concentration, SC = subcutaneous(ly).
intramuscular injection in
awake, healthy cats.15 De-
spite apparent sedation,
diazepam (0.2–0.5
Induction: 0.5–2.0

however, two thirds of the

TABLE I (continued)

MAC = 2.58%

MAC = 9.79%
mg/kg IV plus

MAC = 1.6%

MAC = 1.1%

cats in the study were more

Dosage

difficult to restrain after

mg/kg IV)

drug administration; many

appeared intermittently agi-
tated or aroused. Appetite
also markedly increased
from baseline shortly after
maintenance of

maintenance of

maintenance of

maintenance of
Induction and

Induction and

Induction and

Induction and

drug administration.15 Simi-

Induction of
Uses

anesthesia

anesthesia

anesthesia

anesthesia

anesthesia

lar behavioral responses

have been associated with
diazepam in other domestic
species (e.g., dogs, hors-
es).16,17 Thus, on the basis of
Volatile anesthetic

Volatile anesthetic

Volatile anesthetic

Volatile anesthetic

these findings, the adminis-

tration of midazolam alone
Imidazole

to cats is not recommend-

Class

hypnotic

ed, although its concurrent

administration with other
drugs offers many advan-
tages.
Approved

Use in

In cats, midazolam (intra-

Cats?

Yes
No

No

No

No
for

venous or intramuscular) is
Inhalation Agentsa

usually administered with

ketamine. In addition to re-
ducing the amount of ket-
Sevoflurane
Etomidate

Desflurane

Halothane

amine needed to reach the

Isoflurane
Drug

same level of central ner-

vous system (CNS) depres-
a

sion, midazolam decreases

INTRAMUSCULAR INJECTION ■ APPETITE STIMULATION ■ BEHAVIOR MODIFICATION

Small Animal The Compendium February 1998

ketamine-induced muscle hypertonicity and convulsive and duration of action seem to be dose-related, al-
activity and ensures a smoother recovery from anesthesia. though individual variation has been reported.23 Re-
Intramuscular injection of 10 mg/kg of ketamine with cumbency is usually observed within 5 to 10 minutes
0.2 mg/kg of midazolam provided adequate sedation for of intramuscular administration of 3 to 15 mg/kg. Pro-
radiation therapy.18 Sedation lasts 30 to 40 minutes, and longed sedation and/or residual ataxia may last 2 to 4
complete recovery takes approximately 2 hours.18 Ke- hours after doses greater than 5 to 7.5 mg/kg.23,24 Exci-
tamine (11 and 22 mg/kg) and midazolam (0.22 mg/kg) tation occurs occasionally during induction and recov-
administered to 8- to 14-week-old kittens did not provide ery. If excitation does occur, a sedative or tranquilizer
adequate analgesia for ovariohysterectomy. However, (e.g., xylazine or acepromazine) is recommended to
anesthetic induction and recovery were generally smooth, prevent possible self-trauma and hyperthermia.
and anesthesia could be maintained successfully with an Depth of anesthesia is also dose-dependent. For ex-
inhalant anesthetic after intubation.19 Intravenous ke- ample, dental scaling and examination of the ocular
tamine doses as low as 3 mg/kg have been used success- fundus can be performed in cats that have received 5 or
fully to induce anesthesia in cats when midazolam was 7.5 mg/kg of tiletamine–zolazepam subcutaneously.23
used concurrently.20 However, even at doses as high as 15 mg/kg, a 30% re-
No cardiopulmonary side effects from midazolam in sponse rate to traction of the ovarian ligament was not-
cats have been reported, but this class of drugs is gener- ed during ovariohysterectomy.24 Tiletamine–zolazepam
ally reported to have minimal adverse effects. The hy- has no analgesic properties at sedative doses; therefore,
potension and arrhythmia associated with the rapid in- the concurrent use of analgesic drugs in surgical pa-
travenous administration of diazepam are attributable tients is strongly suggested.
to the propylene glycol base and not to the drug itself.21 Although intramuscular or subcutaneous use is more
No similar effects are reported for midazolam, which common, intravenous doses as low as 1 to 3 mg/kg are
has safely been used in cats with cardiovascular com- used to provide conditions suitable for intubation be-
promise. Respiration may, however, be depressed tem- fore inhalation anesthesia. The concurrent use of anti-
porarily after midazolam administration. Midazolam al- cholinergics is recommended because salivation caused
lows doses of concurrent analgesic and anesthetic by tiletamine–zolazepam may interfere with visualiza-
agents to be reduced, but it does not have any antinoci- tion of the larynx. Reflex pharyngeal activity is also
ceptive properties of its own and should not be used as commonly observed after tiletamine–zolazepam admin-
an analgesic. istration, but intubation is still easily achieved.25
Flumazenil, a benzodiazepine reversal agent, is cur- The indications and contraindications for tiletamine
rently available. A dose of 0.075 to 0.1 mg/kg has been use in cats are much the same as those suggested for ke-
suggested to reverse a benzodiazepine overdose.22 tamine. Both drugs are believed to maintain cardiovas-
cular function via indirect sympathetic actions. In cats
Tiletamine–Zolazepam that were lightly anesthetized with isoflurane, intra-
A 1:1 mixture of the dissociative drug tiletamine and venous administration of tiletamine–zolazepam resulted
the benzodiazepine zolazepam is commercially available in a transient decrease in peripheral vascular resistance
(Telazol®—Fort Dodge Laboratories). When reconsti- and myocardial contractility (and hence blood pres-
tuted as recommended on the label, the solution con- sure), which then recovered to above-baseline values.26
tains 50 mg/ml of each compound or 100 mg/ml of the Heart rate ranged from 150 to 252 beats/min, and
combination. The recommended dose is usually ex- pulse quality was good after subcutaneous administra-
pressed in terms of the combination of drugs. Tile- tion of tiletamine–zolazepam.23
tamine produces immobilization, as does ketamine— Dissociative drugs are not recommended for cats
but muscle rigidity and occasional seizure-like activity with hypertrophic cardiac disease because they can in-
can also occur. Zolazepam reduces the incidence of crease myocardial work. Hepatic or renal disease may
these side effects. When tiletamine and zolazepam are prolong the actions of tiletamine–zolazepam. Clinicians
used in combination, they produce dose-dependent may wish to avoid using dissociative drugs in patients
CNS depression. with these disorders. If the drugs are used in patients
Tiletamine–zolazepam is approved for use in cats; in- with hepatic or renal disease, the dose should be re-
tramuscular or subcutaneous doses of 3 to 15 mg/kg duced and the veterinarian should be alert for potential
have been recommended. These small volumes can be complications. Dose-dependent respiratory depression
administered easily, and the response to injection is is reportedly associated with intravenous administration
generally minimal. In one report, 63% of cats showed of tiletamine–zolazepam and with concurrent adminis-
no response during subcutaneous injection.23 The onset tration of other anesthetic drugs.23–26

BENZODIAZEPINE ■ DISSOCIATIVE DRUGS ■ CARDIOVASCULAR EFFECTS ■ ANALGESIA

The Compendium February 1998 Small Animal

Propofol help reduce the magnitude

Propofol is an alkylphenol of cardiovascular depres-
with sedative/hypnotic ef- sion, which is reportedly
fects similar to those of thio- similar to or greater than
barbiturates. However, un- that observed with thiopen-
like thiobarbiturates (which tal. Arterial hypotension is
may cause transient arousal the effect most commonly
when administered intra- reported and is primarily a
venously), propofol can be result of a decrease in sys-
given by slow intravenous temic vascular resistance,30
administration to produce although negative inotropic
dose-dependent CNS de- effects have also been re-
pression. In addition, al- ported.31,32 Arterial hypoten-
though some animals react sion is minimized by slow
to propofol administration Figure 3—An intubated cat breathing oxygen from a nonre- administration of propofol
(human patients report a breathing anesthetic circuit after propofol induction and and the prior administra-
burning sensation), perivas- maintenance for removal of a tracheal foreign body. tion of fluids. Respiratory
cular injection is not report- depression, which is com-
ed to cause a local inflam- monly reported after propo-
matory reaction. fol administration, is also
After a single intravenous minimized by slow adminis-
dose, blood (and brain) con- tration.
centrations of propofol fall Although propofol’s prima-
off very rapidly. This is ry use in veterinary medicine
manifested clinically as an is anesthesia induction, addi-
extremely short duration of tional bolus doses or infu-
action (less than 10 min- sions may be administered to
utes); the primary use of this prolong anesthetic duration
drug in veterinary medicine without significant effect on
is to induce anesthesia be- recovery time. Recovery is re-
fore maintenance with other ported to be rapid, smooth,
anesthetic drugs. Propofol is and excitement-free in humans
also suitable for short-term Figure 4—A cat anesthetized with propofol to facilitate up- and domestic species.30,33,34
per-airway examination. This cat has an oral mass that ob-
restraint during painless pro- Because of these characteris-
structed visualization of the larynx.
cedures, such as radiography, tics, propofol is frequently
upper-airway examination used for outpatient proce-
(Figures 3 and 4), and su- dures in human medicine
ture removal. The drug has no direct analgesic proper- and may have similar applications in veterinary practice.
ties; therefore, analgesics are suggested when propofol is The rapid, smooth, excitement-free recovery from propo-
used for more invasive or painful procedures. fol is attributed to rapid redistribution and metabolism at
Although the FDA has not approved propofol for use hepatic (and possibly extrahepatic) sites.
in cats, doses of 5 to 8 mg/kg have reportedly been Although repeated injections and short-term infu-
used to induce anesthesia in cats. Premedication with sions have been used successfully in cats,27 they have re-
clinically used doses of acepromazine (e.g., 0.04 (Fig- portedly led to prolonged recovery.35 The prolonged re-
27
ures 3 and 4). mg/kg in one study ) and/or opioids is covery probably results from the limited ability of cats
shown to have no effect on the propofol dose required to metabolize propofol to its glucuronide conjugates.36
27–29
for anesthetic induction in cats. Clinically, concur- Heinz-body anemia, general malaise, anorexia, and di-
rent administration of a benzodiazepine (e.g., diazepam arrhea are been reported after sequential daily adminis-
[0.2 to 0.5 mg/kg]) does reduce the induction dose of tration of propofol to cats.35
propofol to 3 to 4 mg/kg. Because propofol is still rela-
tively expensive, the reduced dose can have some prac- Etomidate
tical economic implications. The hypnotic etomidate, which is an imidazole, has
Reducing the anesthetic induction dose could also been used as an anesthetic in humans since the 1960s.

SEDATIVE/HYPNOTIC ■ SHORT-TERM IV ANESTHETIC RECOVERY ■ HYPOTENSION ■ IMIDAZOLE

The Compendium February 1998 Small Animal

Because it is expensive and few veterinarians are famil- contrast, halothane reportedly undergoes extensive bio-
iar with it, etomidate is not extensively used in veteri- transformation in humans.41,42
nary medicine. It does, however, offer certain advan- The minimum alveolar concentration (MAC) of an
tages when used appropriately in cats. anesthetic agent is the end-tidal concentration that pro-
Etomidate’s primary clinical application is in com- duces no response in 50% of the patients exposed to a
promised cats when anesthesia cannot be postponed painful stimulus (e.g., a clamp applied to the base of
until the patient is stabilized. The drug reportedly has the tail). The MAC for desflurane, sevoflurane, isoflu-
minimal effects on cardiovascular or respiratory func- rane, and halothane in cats has been determined. Des-
tion in humans and cats.37,38 Feline patients with car- flurane (with a MAC of 9.79%) is the least potent, fol-
diac disease (e.g., hypertrophic cardiomyopathy) have lowed by sevoflurane (2.58%), isoflurane (1.6%), and
been safely anesthetized with a combination of etomi- halothane (1.1%). 42–45 Anesthetic doses can be ex-
date (0.5 to 2.0 mg/kg) and diazepam (0.2 to 0.5 pressed in multiples of MAC to permit comparisons
mg/kg). among the four anesthetic agents.
Before administering etomidate, the veterinarian All four of these volatile anesthetic agents produce a
must consider certain unique properties of the drug. dose-dependent depression of myocardial function.
Etomidate is currently available as a solution in propy- However, at 1.3 MAC, desflurane caused less depres-
lene glycol, which renders it extremely hyperosmolar, sion of cardiac index in cats than did similar doses of
causing possible pain on injection as well as hemolysis. halothane or isoflurane.45 Heart rate and blood pres-
These effects may be minimized if intravenous fluids sure, however, were comparable.46 With the exception
are administered with the drug. Side effects seen after of a possible increase in heart rate, the cardiovascular
etomidate administration, including occasional myo- effects of sevoflurane are similar to those of isoflurane
clonus, are reduced with premedication.39 Etomidate at equipotent concentrations.41 Halothane is the most
can interfere with steroidogenesis or cortisol synthesis likely to predispose the myocardium to catecholamine-
for as long as 6 hours in cats that receive a single intra- induced arrhythmia41,47; no significant differences in
venous induction dose.40 In animals that are dependent this regard are noted among desflurane, sevoflurane,
on corticosteroids, administration of a physiologic dose and isoflurane.
of dexamethasone or any other short-acting glucocorti- Inhalant anesthetics reportedly produce dose-depen-
coid is suggested. dent respiratory depression. However, studies of the use
of halothane, desflurane, sevoflurane, and isoflurane in
cats indicate little depression in respiratory rate, even at
INHALANT ANESTHETICS
high anesthetic doses.44–46 However, a dose-related in-
Many veterinary surgeons prefer to use inhalation
crease in the partial pressure of carbon dioxide in arteri-
anesthesia. This technique enables the anesthetist to de-
al blood (PaCO2) implies a reduction in alveolar ventila-
liver anesthetics precisely and to change the delivered
tion with increasing dose.41 Desflurane and halothane
anesthetic concentration rapidly. This route of adminis- produce respiratory arrest at a lower MAC multiple in
tration also facilitates oxygen administration and venti- cats than in dogs.44,45
latory support. Many inhalant anesthetics and delivery Both desflurane and sevoflurane must be used in
systems have been used in veterinary anesthesia.41,42 agent-specific vaporizers. The desflurane vaporizer is
Halothane and isoflurane are currently the volatile used much like other anesthetic vaporizers, but its in-
anesthetics that are most widely used in veterinary ternal structure is different (e.g., it requires electricity).
anesthesia. Some veterinary practices also use nitrous The additional cost of using these newer anesthetic
oxide, which is a gas. Although these agents offer many agents must be weighed against the potential benefits in
benefits in the anesthetic management of patients, the routine feline anesthetic practice.
search for the ideal inhalant anesthetic continues.
Sevoflurane and desflurane, two agents that recently CONCLUSION
became available, have several potential advantages over Despite the recent availability of new drugs for use in
existing agents. They have significantly lower blood/gas the anesthetic management of feline patients, there is
partition coefficients or solubilities than halothane or still no ideal agent. This emphasizes the need for mak-
isoflurane. This translates to faster induction and recov- ing informed choices when selecting drugs, supporting
ery, which may offer some advantage.41,42 Also, sevoflu- patients during the anesthetic period, and monitoring
rane and desflurane (like isoflurane) undergo minimal patients for potential complications. To ensure a favor-
biotransformation in humans; the potential for the for- able outcome, the intensity of anesthetic case manage-
mation of toxic metabolites is therefore reduced. In ment must be suited to a patient’s anesthetic risk.

CARDIOVASCULAR FUNCTION ■ DRUG METABOLISM ■ MINIMUM ALVEOLAR CONCENTRATION

Small Animal The Compendium February 1998

ACKNOWLEDGMENT dogs given diazepam and diazepam–ketamine. Am J Vet Res

The author thanks Kayomee Daroovalla for her assis- 47:795–798, 1986.
tance in preparing this manuscript. 17. Muir WW, Sams RA, Huffman RH, Noonan JS: Pharmaco-
dynamic and pharmacokinetic properties of diazepam in
horses. Am J Vet Res 43:1756–1762, 1982.
18. Chambers JP, Dobson JM: A midazolam and ketamine
About the Author combination as a sedative in cats. J Assoc Vet Anesth 16:
Dr. Mama is affiliated with the Department of Clinical Sci- 53–54, 1989.
ences, College of Veterinary Medicine and Biomedical 19. Faggella AM, Aronsohn ΜG: Anesthetic techniques for neu-
Sciences, Colorado State University, Fort Collins, Col- tering 6- to 14-week-old kittens. JAVMA 202(1):56–62,
orado. She is a Diplomate of the American College of 1993.
Veterinary Anesthesiologists. 20. Ilkiw JE, Suter CM, McNeal D, et al: The effect of intra-
venous administration of variable dose midazolam after
fixed-dose ketamine in healthy awake cats. J Vet Pharmacol
Ther 19:217–224, 1996.
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