Wednesday, November 13, 2013

1164. ANAESTHESIA IN THE DWARF HAMSTER - Zoletil & Gas Mask
















THE SURGICAL PATIENT


 
 
 
ZOLETIL
 
Zoletil(R) is a combination of a dissociative anesthetic agent, tiletamine hypochloride, and a tranquilizer, zolazepam hypochloride.
 
 
 

Zoletil(R) is a combination of a dissociative anesthetic agent, tiletamine hypochloride, and a tranquilizer, zolazepam hypochloride.


Zoletil(R) has now been available for more than 10 years in Europe, Latin America, Asia, and in the Pacific area.

Zoletil(R) is very comfortable to use thanks to:

A HIGH THERAPEUTIC INDEX
In dogs:
  • Average dosage: 5-7 mg/kg
  • Lethal dosage: 100 mg/kg
In cats:
  • Average dosage: 7-10 mg/kg
  • Lethal dosage: 220 mg/kg



LIMITED SIDE EFFECTS
  • No cardiorespiratory depression
  • No epileptic effect
  • Transient decrease of body temperature
  • No hepatic or renal toxicity
  • Laryngeal, palpebral, and pharyngeal reflexes are maintained
  • Can be used on pregnant bitches and queens



EFFECTIVENESS
  • Fast onset of action: within 1 minute by IV route, 3-5 minutes by IM route
  • Good anesthetic effect
  • Instantaneous muscle relaxation
  • Immediate superficial analgesia
  • Smooth awakening: between 30 minutes to 2 hours



MULTI PURPOSE
Zoletil(R) is a very convenient injectable anesthetic agent:
The following indicative guidelines will illustrate how Zoletil(R) can be used in a variety of procedures in cats and dogs, ranging from restraint to orthopedic surgery.


General advice
Food
It is advisable to withhold food for 12 hours before injection of Zoletil(R).

Body temperature
Body temperature should be monitored Animals should be protected from body heat loss.

Eyes
The eyes normally remain open with the pupils dilated. The use of an ophthalmic ointment is advisable to protect the cornea from desiccation.

Dosage
Do not exceed the maximum safe dose of 72 mg/kg of bodyweight in cats.

Recovery
Recovery time depends on doses, injection route, general status of the patient.
Smooth recovery in cats.
For an optimum recovery, the patient should be kept away from loud noises and bright lights.


Storage
Non-reconstituted product should be used within 2 years. Once reconstituted, Zoletil(R) can be kept 8 days at 4°C (over 90% efficacy maintained).

Warning
Factors affecting response to immobilizing medicines include:

  • age, sex, reproduction status
  • general nutritional status (obesity)
  • concomitant diseases

Doses are given according to the species and the type of procedure used.

Doses are flexible taking into account the status of the subject.

Doses should be reduced in geriatric and debilitated patients.
Sedation
Zoletil(R) is indicated for minor procedures such as immobilization and handling, diagnostic examination and restraint:
  • Allows a good quality sedation
  • Onset of action is quick:3-5 minutes

RECOMMENDED PROTOCOL

  • Zoletil(R) 5 mg/kg

Biopsies/wound cleaning
Zoletil(R) is very convenient to use for minor surgeries such as biopsies, wound cleaning, suturing:
  • Short duration anesthesia is possible
  • Easy to administer by IM route
  • Highly safe for the patient
  • Does not lower blood pressure

RECOMMENDED PROTOCOL

  • Premedication: 15 minutes before induction glycopyrrolate (0.01 mg/kg IM or SC) or atropine (0.05 mg/kg SC)
  • Induction: Zoletil(R) 5-7 mg/kg IM

Dental procedures

Sedation may not always be enough to operate and a short duration anesthesia is then required.

Zoletil(R) allows comfort of use:

  • Preserves the laryngeal reflex so there is no need for intubation
  • Easy to use
  • Allows muscle relaxation, needed because procedures often need a mouth large open

RECOMMENDED PROTOCOL

For orthodontics/short procedures (20 minutes)

  • Premedication: 15 minutes before induction atropine (0.05 mg/kg SC) to reduce salivation
  • Induction: : Zoletil(R) 10 mg/kg IM

For dental care/long procedures (40 minutes)

  • Premedication: 15 minutes before induction atropine (0.05 mg/kg SC) to reduce salivation
  • Induction: Zoletil(R) 15 mg/kg IM

Urinary surgery

The health status of the patient is usually critical when brought for an urinary surgery. The use of a very safe anesthetic agent is therefore required.

Zoletil(R) is an anesthetic agent of choice for urology procedures:

  • Highly safe for this type of patient:
    Tiletamine has no direct effect on kidney functions, so it avoids bradycardia and hypovolemia
  • Allows muscle relaxation and sedation
  • A maintenance protocol is possible
    Zoletil(R)
    has no cumulative toxicity so it can be re-injected

RECOMMENDED PROTOCOL

  • Renal checkup
  • Premedication:15 minutes before induction atropine (0.05 mg/kg SC)
  • Induction: Zoletil(R) 5 mg/kg IM
  • Maintenance: Inhalation anesthesia or Zoletil(R) (2-3 mg/kg IM) if needed
  • Fluid therapy necessary during anesthesia and post surgery

Male cat neutering

Zoletil(R) is very convenient to use in this type of routine surgery:

  • Short duration anesthesia is possible
  • Easy to administer by IM route
  • Highly safe for the patient

RECOMMENDED PROTOCOL

  • Premedication: 15 minutes before induction glycopyrrolate (0.01 mg/kg IM or SC) or atropine (0.05 mg/kg SC)
  • Induction: Zoletil(R) 7 mg/kg IM

Caesarian sections

As anesthetics pass trough the placental barrier and can have an impact on kittens, an optimal anesthesia should be:

  • a short duration one
  • with a short lap between induction and delivery
  • with a flexible dose regime
  • cause only a mild respiratory depression in kittens

Zoletil(R) is an anesthetic agent of choice for these procedures:

  • Highly safe for the mother and kittens:
    Zolazepam has no depressant effect on the respiratory system,
    Tiletamine does not lower arterial pressure
  • Allows a quick awakening of the mother without hypothermia

RECOMMENDED PROTOCOL

  • Premedication: 30 minutes before induction glycopyrrolate (0.01 mg/kg IM or SC) doesn't pass through the placental barrier
  • Induction: Zoletil(R) 7-10 mg/kg IM
  • Perfusion: Ringer lactate (5 mL/kg per hour)
  • Place animal in supine position as late as possible (light inclination on the side preferable)
  • Mask oxygenation or intubation
  • Once newborns are delivered, anesthesia of the mother can be deepen
  • Care to newborns:
    • If respiratory depression: doxapram + oxygen therapy
    • If bradycardia: atropine 0.04 mg/kg IM
    • If mother in state of chock: keep placenta for it will provide a blood supplement to newborns

Female cat ovariectomy

Zoletil(R) is an anesthetic agent of choice for this type of procedures as it is very convenient to use:

  • Easy to administer by IM
  • Highly safe anesthetic agent for the patient
  • A maintenance protocol is possible, if surgical procedure is to be extended (e.g. pregnancy or metritis)
    Zoletil(R) has no cumulative toxicity so it can be re-injected

RECOMMENDED PROTOCOL

  • Premedication: 15 minutes before induction glycopyrrolate (0.01 mg/kg IM or SC) or atropine (0.05 mg/kg SC)
  • Induction: Zoletil(R) 7-10 mg/kg IM
  • Maintenance:Zoletil(R) 2.5 mg/kg IM if needed

Bone surgery

Intramedullary fixation

When inhalation anesthesia is not possible, Zoletil(R) can be indicated for long procedures:
  • Brings an efficient and safe approach to performing basic bone surgery anesthesia
    Zoletil(R) has no cumulative toxicity
    Zolazepam is quickly eliminated
  • An instantaneous muscle relaxation is observed

RECOMMENDED PROTOCOL

  • Premedication: 15 minutes before induction glycopyrrolate (0.01 mg/kg IM or SC) or atropine (0.05 mg/kg SC)
  • Induction: Zoletil(R) 10-15 mg/kg IM
  • Maintenance: Zoletil(R) 5-7 mg/kg IM
  • Note: As Zoletil(R) shows mild analgesic effects, adequate management of pain should be performed (NSAIDs, opioids)
 
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Zoletil 50 Rx


G: Per vial w/ powder: Tiletamine HCl 125 mg, zolazepam base 125 mg. Per solvent vial: Sterilized water for inj 5 mL, reconstituted soln 50 mg/mL.
A: Zoletil 50 is a general injectable anesthetic agent. Tiletamine is a dissociative anesthetic agent. Zola­ze­pam is a sedative, an anxiolytic and a muscle relaxant. It enhances the tiletamine depression of the CNS. It also prevents seizures due to tiletamine and improves both muscle relaxation and recovery from anesthesia. Zoletil 50 produces a state of unconsciousness that has been referred to as dissociative because it appears to selectively interrupt association pathways to the brain. Depen­ding on the animal species, analgesia persists after the anesthetic effect has subsided. Pharyngeal and laryngeal reflexes remain intact. Cranial nerves and spinal reflexes remain intact. Consequently, the animal’s eyes remain open and the animal can swallow, move its tongue, chew, blink its eyelids and move its limbs during the anesthesia. The actions of Zoletil 50 can be summarized as follows: Catalepsy: Rapid, w/out agitation, followed by muscular relaxation. Analgesia: Immediate super­ficial analgesia, moderate visceral analgesia. Sur­gi­cal anesthesia: With muscular relaxation, persist­ence of laryngeal, pharyngeal and palpebral reflexes, no depression of respiratory center, possibi­lity of salivation.
I: Induction of anesthesia prior to inhalants or as a sole anesthetic agent for a wide variety of diagnosis and short duration surgical procedures of minor severity in cats, dogs and many wild and exotic animals.
D: Premedication – Atropine sulfate: Dogs- 0.1 mg/kg by SC, 15 mins before inj of Zoletil. Cats – 0.05 mg/kg by SC, 15 mins before inj of Zoletil. Induction – Mix extemporaneously the contents of the powder vial w/ the solvent. By IM – Loss of righting reflex in 3-6 mins. By IV – Loss of righting reflex on <1 10-15="" 100="" 10="" 30="" 5="" 7-10="" 7.5="" 72="" additional="" and="" anesthesia:="" be="" both="" bw.="" bw="" by="" can="" cats-="" cats="" cumulative="" dogs-="" dogs="" dosage="" dose="" doses="" ed.="" effect="" examination:="" examination="" exceed="" has="" im="" in="" initial="" injected="" iv="" kg="" lethal="" maximal="" mg="" min.="" minor="" no="" not="" of="" reinject="" safe="" shld="" short="" should="" species="" strong="" surgery:="" surgery="" that="" the="" to="" total="" varies="" w=""> non-domestic animals
. Duration of anesthesia: 20-60 mins according to dosage. Recovery: Analgesia has a longer duration than surgical anesthesia. Return to normal is progressive (2-6 hrs) and quiet, provid­ed that noise and light are avoided. Recovery can be longer in case of overdosing in fat or old animals. CI: Refer to product literature for further informa­tion.
P: Salivation is occasionally observed and can be controlled by administration of anticholinergic drugs, such as atropine, before anesthesia. Re­duce dose when other anesthetic agents are used.
Pr: Vial 10 mL + 1 solvent (5 mL) per box.
VR-2831 2012-04-03 125 mg/125 mg
 
 
 


 
REFERENCES
http://www.slideshare.net/kkrimetz/rat-anesthesia












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