It should be noted that dosage and routes of administration vary widely between species.
Dogs intramuscular use,
Cats: intramuscular, intravenous or subcutaneous use,
Horses: intravenous use only.
To ensure a correct dosage, bodyweight should be determined as accurately as possible.
The cap may be safely punctured up to 20 times.
DOG - XYLAZINE/KETAMINE
Dosage and administration: Administer xylazine at a dose rate of 1 mg xylazine/kg by intramuscular injection. Immediately administer the product at a dose rate of 15 mg ketamine/kg (equivalent to 1.5 ml/10 kg bodyweight) by intramuscular injection.
Effect: Dogs become recumbent in approximately 3 minutes and lose their pedal reflex in approximately 7 minutes. Duration of anaesthesia is approximately 24 minutes, the pedal reflex returning about 31 minutes following administration of the product.
Xylazine and Ketamine Canine Anaesthesia – (IM) |
Weight of Dog in kg | *Xylazine (2% sol.) - ml | **Ketamine (100 mg/ml) - ml |
1 | 0.05 | 0.15 |
3 | 0.15 | 0.45 |
5 | 0.25 | 0.75 |
10 | 0.50 | 1.50 |
15 | 0.75 | 2.25 |
20 | 1.00 | 3.00 |
25 | 1.25 | 3.75 |
30 | 1.50 | 4.50 |
40 | 2.00 | 6.00 |
* Based on a dose rate of 1 mg xylazine/kg bodyweight ** Based on a dose rate of 15 mg ketamine/kg bodyweight |
DOG - MEDETOMIDINE/KETAMINE
Dosage and administration: Administer medetomidine at a dose rate of 40 µg medetomidine/kg and the product at a dose rate of 5.0-7.5 mg ketamine/kg bodyweight (equivalent to 0.5-0.75 ml/10 kg), depending on duration of anaesthesia required, by intramuscular injection.
Effect: Loss of pedal reflex occurs approximately 11 minutes following injection at 5 mg/kg and 7 minutes following injection at 7.5 mg/kg. Duration of anaesthesia is approximately 30 and 50 minutes respectively.
Medetomidine and Ketamine Canine Anaesthesia – (IM) Dosage chart for 5 mg ketamine/kg (duration of anaesthesia approximately 30 minutes) |
Weight of Dog in kg | *Medetomidine (1 mg/ml) - ml | **Ketamine (100 mg/ml) - ml |
1 | 0.04 | 0.05 |
3 | 0.12 | 0.15 |
5 | 0.20 | 0.25 |
10 | 0.40 | 0.50 |
15 | 0.60 | 0.75 |
20 | 0.80 | 1.00 |
25 | 1.00 | 1.25 |
30 | 1.20 | 1.50 |
40 | 1.60 | 2.00 |
DO NOT REVERSE WITH ATIPAMEZOLE |
* Based on a dose rate of 40 µg medetomidine/kg bodyweight ** Based on a dose rate of 5 mg ketamine/kg bodyweight |
Medetomidine and Ketamine Canine Anaesthesia – (IM) Dosage chart for 7.5 mg ketamine/kg (duration of anaesthesia approximately 50 minutes) |
Weight of Dog in kg | *Medetomidine (1 mg/ml) - ml | **Ketamine (100 mg/ml) - ml |
1 | 0.04 | 0.08 |
3 | 0.12 | 0.23 |
5 | 0.20 | 0.38 |
10 | 0.40 | 0.75 |
15 | 0.60 | 1.13 |
20 | 0.80 | 1.50 |
25 | 1.00 | 1.88 |
30 | 1.20 | 2.25 |
40 | 1.60 | 3.00 |
DO NOT REVERSE WITH ATIPAMEZOLE |
* Based on a dose rate of 40 µg medetomidine/kg bodyweight ** Based on a dose rate of 7.5 mg ketamine/kg bodyweight |
DOG - BUTORPHANOL/MEDETOMIDINE/KETAMINE
Dosage and administration: Administer butorphanol at a dose rate of 0.1 mg/kg and medetomidine at a dose rate of 25 µg/kg by intramuscular injection. Ketamine injection should be administered 15 minutes following administration of butorphanol and medetomidine at a dose rate of 5 mg ketamine/kg (equivalent to 0.5 ml/10 kg bodyweight) by intramuscular injection.
Effect: Following administration of butorphanol and medetomidine, dogs become recumbent in approximately 6 minutes and lose their pedal reflex in approximately 14 minutes. The pedal reflex returns approximately 53 minutes following administration of ketamine. Sternal recumbency is attained approximately 35 minutes later followed by standing a further 36 minutes later.
Butorphanol, medetomidine, and Ketamine Canine Anaesthesia - (IM) |
Weight of Dog in kg | *Butorphanol (10 mg/ml) - ml | **Medetomidine (1 mg/ml) - ml |
1 | 0.01 | 0.03 |
3 | 0.03 | 0.08 |
5 | 0.05 | 0.13 |
10 | 0.10 | 0.25 |
15 | 0.15 | 0.38 |
20 | 0.20 | 0.50 |
25 | 0.25 | 0.63 |
30 | 0.30 | 0.75 |
40 | 0.40 | 1.00 |
ADMINISTER BUTORPHANOL AND MEDETOMIDINE BY INTRAMUSCULAR INJECTION AT THE ABOVE DOSE RATES WAIT 15 MINUTES BEFORE ADMINISTERING KETAMINE BY IM INJECTION AT THE DOSE RATES BELOW |
Weight of Dog in kg | ***Ketamine (100 mg/ml) - ml |
1 | 0.05 |
3 | 0.15 |
5 | 0.25 |
10 | 0.50 |
15 | 0.75 |
20 | 1.00 |
25 | 1.25 |
30 | 1.50 |
40 | 2.00 |
DO NOT REVERSE WITH ATIPAMEZOLE |
* Based on a dose rate of 0.1 mg butorphanol/kg bodyweight ** Based on a dose rate of 25 µg medetomidine/kg bodyweight *** Based on a dose rate of 5 mg ketamine/kg bodyweight |
CAT – KETAMINE AS A SOLE AGENT
Mono-anaesthetic use of ketamine is possible, but to avoid undesired psycomotoric effects combined anaesthesia is recommended.
Dosage and administration: The product on its own may be used by intravenous or subcutaneous injection, but intramuscular injection is the recommended route. The dose is 11-33 mg ketamine/kg depending on the degree of restraint or surgical interference that is intended.
Ketamine as a sole agent in cats – (IM, IV, SC) |
Weight of Cat in kg | MINOR RESTRAINT: *Ketamine (100 mg/ml) - ml | MAJOR SURGERY: *Ketamine (100 mg/ml) - ml |
1.5 | 0.16 | 0.49 |
2 | 0.22 | 0.66 |
2.5 | 0.27 | 0.82 |
3 | 0.33 | 0.99 |
3.5 | 0.38 | 1.15 |
4 | 0.44 | 1.32 |
4.5 | 0.49 | 1.48 |
5 | 0.55 | 1.65 |
* Based on a dose rate of 11 mg ketamine/kg bodyweight, suitable for minor restraint ** Based on a dose rate of 33 mg ketamine/kg bodyweight, suitable for minor surgery and restraint of fractious cats |
Effect: Duration of anaesthesia with the product is 20-40 minutes and recovery takes place over a 1-4 hour period.
For major surgery, ketamine should be used in conjunction with supplemental sedatives or anaesthetics. Dosage varies from 1.25-22 mg/kg (0.06-1.1 ml/5 kg) depending on the combination and route of administration used.
Vomiting is unlikely to occur when ketamine is used alone, however, cats should be starved for several hours prior to anaesthesia where possible.
Acepromazine pre-medication with ketamine as a sole agent: Acepromazine can be administered by intramuscular injection, as premedication. Endotracheal intubation can be achieved during ketamine anaesthesia. Inhalation anaesthesia may be maintained by suitable combinations of methoxyflurane, halothane, nitrous oxide and oxygen.
CAT - XYLAZINE/KETAMINE
Dosage and administration: Administer xylazine at a dose rate of 1.1 mg xylazine/kg (corresponding to 0.28 ml/5 kg bodyweight of xylazine 2% solution). Wait 20 minutes and then administer the product at a dose rate of 22 mg ketamine/kg bodyweight (equivalent to 1.1 ml/5 kg), by intramuscular injection.
Effect: Xylazine may induce vomiting up to 20 minutes after administration. Onset of anaesthesia after intramuscular injection of ketamine takes 3-6 minutes. A xylazine/ketamine combination produces a deeper anaesthesia with more pronounced respiratory and cardiac effects and a longer recovery period than acepromazine/ketamine combinations.
Xylazine and Ketamine Feline Anaesthesia – (IM) |
Weight of Cat in kg | *Xylazine (2% soln) - ml | WAIT | **Ketamine (100 mg/ml) - ml |
1.5 | 0.08 | 20 MINUTES | 0.33 |
2 | 0.11 | 0.44 |
2.5 | 0.14 | 0.55 |
3 | 0.17 | 0.66 |
3.5 | 0.19 | 0.77 |
4 | 0.22 | 0.88 |
4.5 | 0.25 | 0.99 |
5 | 0.28 | 1.10 |
* Based on a dose rate of 1.1 mg xylazine/kg bodyweight **Based on a dose rate of 22 mg ketamine/kg bodyweight |
CAT - MEDETOMIDINE/KETAMINE
Dosage and administration:
a) Intramuscular
Administer medetomidine at a dose rate of 80 µg medetomidine/kg by intramuscular injection. This should be followed immediately by the intramuscular injection of the product at a dose rate of 2.5 mg up to a maximum of 7.5 mg ketamine/kg bodyweight (equivalent to 0.12-0.38 ml/5 kg).
Medetomidine and Ketamine Feline Anaesthesia – (IM) |
Weight of Cat in kg | *Medetomidine (1 mg/ml) - ml | *Ketamine (100 mg/ml) - ml |
1.5 | 0.12 | 0.08 |
2 | 0.16 | 0.10 |
2.5 | 0.20 | 0.13 |
3 | 0.24 | 0.15 |
3.5 | 0.28 | 0.18 |
4 | 0.32 | 0.20 |
4.5 | 0.36 | 0.23 |
5 | 0.40 | 0.25 |
* Based on a dose rate of 80 µg medetomidine/kg bodyweight ** Based on a dose rate of 5 mg ketamine/kg bodyweight |
b) Intravenous
Medetomidine and the product may be also administered by intravenous injection at the following dose rates; 40 µg medetomidine/kg and 1.25 mg ketamine/kg.
Medetomidine and Ketamine Feline Anaesthesia – (IV) |
Weight of Cat in kg | *Medetomidine (1 mg/ml) - ml | *Ketamine (100 mg/ml) - ml |
1.5 | 0.06 | 0.02 |
2 | 0.08 | 0.03 |
2.5 | 0.10 | 0.03 |
3 | 0.12 | 0.04 |
3.5 | 0.14 | 0.05 |
4 | 0.16 | 0.05 |
4.5 | 0.18 | 0.06 |
5 | 0.20 | 0.06 |
* Based on a dose rate of 40 µg medetomidine/kg bodyweight ** Based on a dose rate of 1.25 mg ketamine/kg bodyweight |
Effects: Onset of anaesthesia is 3-4 minutes (following IM). The duration of surgical anaesthesia varies between 30-60 minutes and is related to the dose of the product used. If required, anaesthesia may be prolonged with halothane and oxygen with or without nitrous oxide.
Atropine is not normally necessary when using a medetomidine/ketamine combination.
Clinical experience has shown that when ketamine and medetomidine have been used intravenously in cats and the need for anaesthesia has passed administration of 100 µg atipamezole/kg by intramuscular injection results in recovery to sternal recumbency in approximately 10 minutes and to standing in approximately 14 minutes.
CAT - BUTORPHANOL/MEDETOMIDINE/KETAMINE
Dosage and administration:
a) Intramuscular
Administer butorphanol at a dose rate of 0.4 mg/kg, medetomidine at a dose rate of 80 µg/kg and the product at a dose rate of 5 mg ketamine/kg bodyweight (equivalent to 0.25 ml/5 kg) by intramuscular injection.
Butorphanol, medetomidine, and Ketamine Feline Anaesthesia - (IM) |
Weight of Cat in kg | *Butorphanol (10 mg/ml) - ml | **Medetomidine (1 mg/ml) - ml | ***Ketamine (100 mg/ml) - ml |
1.5 | 0.06 | 0.12 | 0.08 |
2 | 0.08 | 0.16 | 0.10 |
2.5 | 0.10 | 0.20 | 0.13 |
3 | 0.12 | 0.24 | 0.15 |
3.5 | 0.14 | 0.28 | 0.18 |
4 | 0.16 | 0.32 | 0.20 |
4.5 | 0.18 | 0.36 | 0.23 |
5 | 0.20 | 0.40 | 0.25 |
* Based on a dose rate of 0.4 mg butorphanol/kg bodyweight ** Based on a dose rate of 80 µg medetomidine/kg bodyweight *** Based on a dose rate of 5 mg ketamine/kg bodyweight |
b) Intravenous
Administer butorphanol at a dose rate of 0.1 mg/kg, medetomidine at a dose rate of 40 µg/kg and the product, depending on depth of anaesthesia required, at a dose rate of 1.25-2.5 mg ketamine/kg bodyweight (equivalent to 0.06- 0.13 ml/5kg) by intravenous injection.
Butorphanol, medetomidine, and Ketamine Feline Anaesthesia - (IV) Dosage chart for 2.5 mg ketamine/kg (duration of anaesthesia approximately 28 minutes). |
Weight of Cat in kg | *Butorphanol (10 mg/ml) - ml | **Medetomidine (1 mg/ml) - ml | ***Ketamine (100 mg/ml) - ml |
1.5 | 0.02 | 0.06 | 0.04 |
2 | 0.02 | 0.08 | 0.05 |
2.5 | 0.03 | 0.10 | 0.06 |
3 | 0.03 | 0.12 | 0.08 |
3.5 | 0.04 | 0.14 | 0.09 |
4 | 0.04 | 0.16 | 0.10 |
4.5 | 0.05 | 0.18 | 0.11 |
5 | 0.05 | 0.20 | 0.13 |
* Based on a dose rate of 0.1 mg butorphanol/kg bodyweight ** Based on a dose rate of 40 µg medetomidine/kg bodyweight *** Based on a dose rate of 2.5 mg ketamine/kg bodyweight |
Effects: Cats become recumbent in 2-3 minutes following intramuscular injection. Loss of pedal reflex occurs 3 minutes post injection. At 45 minutes post induction, reversal with 200 µg atipamezole/kg results in return of pedal reflex 2 minutes later, sternal recumbency 6 minutes later and standing 31 minutes later. The approximate time scales following intravenous administration are provided in the following table.
Approximate time scales when using the triple combination intravenously.
Product *Dose mg/kg | Time to recumbency | Time to loss of pedal reflex | Time to return of pedal reflex | Time to sternal recumbency | Time to standing |
1.25 | 32 secs | 62 secs | 26 mins | 54 mins | 74 mins |
2.50 | 22 secs | 39 secs | 28 mins | 62 mins | 83 mins |
* In conjunction with butorphanol at 0.1 mg/kg and medetomidine at 40 µg/kg |
Clinical experience has shown that reversal, at any stage, with 100 µg atipamezole/kg results in return of the pedal reflex 4 minutes later, sternal recumbency 7 minutes later and standing 18 minutes later.
HORSE
When using a total intravenous technique and for safe and effective use of a top-up regime, the use of an intravenous catheter is strongly advised.
Excitable horses are sometimes poor subjects for anaesthesia. To achieve the best results, it is important the horses are not stressed before the anaesthetic and that the whole procedure, from induction to recovery, should take place in quiet and calm surroundings. For horses that are stressed before the procedure, the use of acepromazine 45 minutes prior to administration of either detomidine or romifidine facilitates handling and placement of an intravenous catheter.
If the horse fails to become sedated following the injection of xylazine, detomidine or romifidine, then ketamine should not be injected and the anaesthetic procedure should be abandoned. The situation should be assessed to establish why the horse failed to respond, and then the environment and/or the drugs should be adjusted as necessary, before trying again the following day.
During castration it has been noted that the use of lidocaine between the testicles eliminates the possible response to ligation of the testicular cord and minimises the number of top-ups required.
HORSE - XYLAZINE/KETAMINE
Dosage and administration: Xylazine should be administered by slow intravenous injection at a dose rate of 1.1 mg xylazine/kg. The product should be administered within 5 minutes of xylazine as an intravenous bolus at a dose rate of 2.2 mg ketamine/kg bodyweight (equivalent to 2.2 ml/100 kg).
Effects: The horse should appear sedated by 2 minutes post injection of xylazine. Induction and recumbency take 1-2 minutes. Muscle jerking may occur in the first minutes, but this usually subsides. Anaesthesia is variable in duration, lasting between 10-30 minutes, but usually less than 20 minutes. Horses invariably stand 25-45 minutes after induction.
Recovery is generally quiet, but may occur suddenly. Therefore it is important that only short duration interferences are attempted, or that arrangements to prolong anaesthesia are made. For longer periods of anaesthesia, intubation and maintenance by inhalation anaesthesia can be used.
Xylazine and Ketamine Equine Anaesthesia – (IV) |
Weight of Horse in kg | +*Xylazine (10% soln) - ml | WAIT | **Ketamine (100 mg/ml) - ml |
50 | 0.60 | 2 MINUTES | 1.10 |
100 | 1.10 | 2.20 |
150 | 1.70 | 3.30 |
200 | 2.20 | 4.40 |
250 | 2.80 | 5.50 |
300 | 3.30 | 6.60 |
400 | 4.40 | 8.80 |
500 | 5.50 | 11.00 |
600 | 6.60 | 13.20 |
+ Administer xylazine, wait 2 minutes before administering ketamine * Based on a dose rate of 1.1 mg xylazine/kg bodyweight ** Based on a dose rate of 2.2 mg ketamine/kg bodyweight |
HORSE - DETOMIDINE/KETAMINE
Dosage and administration: Detomidine should be administered by intravenous injection at a dose rate of 20 µg/kg. Allow five minutes for the horse to become deeply sedated then administer the product at a dose rate of 2.2 mg ketamine/kg bodyweight (equivalent to 2.2 ml/100 kg) as an intravenous bolus.
Effect: Onset of anaesthesia is gradual; most horses take approximately 1 minute to become recumbent. Large, fit horses may take up to 3 minutes for recumbency. Anaesthesia will continue to deepen for a further 1-2 minutes and during this time the horse should be left quietly.
Horses regain sternal recumbency approximately 20 minutes after administration of the product surgical anaesthesia lasts for approximately 10-15 minutes.
Maintenance of surgical anaesthesia
Should it become necessary to prolong anaesthesia, either of the following regimes may be used:
i) Thiopental sodium
Thiopental sodium may be administered intravenously to prolong anaesthesia.
ii) Detomidine/Ketamine
Administer 10 µg detomidine/kg (50% the initial premedication dose) by intravenous injection, followed immediately by 1.1 mg ketamine/kg (50% the initial induction dose) by intravenous injection. This will provide approximately 10 minutes additional surgical anaesthesia, which can be repeated at regular 10 minute intervals (up to 5 times) without compromising recovery.
Detomidine and Ketamine Equine Anaesthesia – (IV) Premedication and Induction of Anaesthesia |
Weight of Horse in kg | *Detomidine (10 mg/ml) - ml | WAIT | **Ketamine (100 mg/ml) - ml |
50 | 0.10 | 5 MINUTES | 1.10 |
100 | 0.20 | 2.20 |
150 | 0.30 | 3.30 |
200 | 0.40 | 4.40 |
250 | 0.50 | 5.50 |
300 | 0.60 | 6.60 |
400 | 0.80 | 8.80 |
500 | 1.00 | 11.00 |
600 | 1.20 | 13.20 |
Induction – administer detomidine IV, wait 5 minutes before administering ketamine IV * Based on a dose rate of 20 µg detomidine/kg bodyweight ** Based on a dose rate of 2.2 mg ketamine/kg bodyweight |
Top-up (Maintenance) dose at 10 minute intervals |
Weight of Horse in kg | ~Detomidine (10 mg/ml) - ml | ~~Ketamine (100 mg/ml) - ml |
50 | 0.05 | 0.55 |
100 | 0.10 | 1.10 |
150 | 0.15 | 1.65 |
200 | 0.20 | 2.20 |
250 | 0.25 | 2.75 |
300 | 0.30 | 3.30 |
400 | 0.40 | 4.40 |
500 | 0.50 | 5.50 |
600 | 0.60 | 6.60 |
Maintenance - administer detomidine IV, immediately followed by ketamine IV ~ Based on a dose rate of 10 µg detomidine/kg bodyweight ~~ Based on a dose rate of 1.1 mg ketamine/kg bodyweight |
HORSE - ROMIFIDINE/KETAMINE
Dosage and administration: Administer romifidine by intravenous injection at a dose rate of 100 µg romifidine/kg. The horse should appear sedated by 5-10 minutes after injection. At this stage administer the product at a dose rate of 2.2 mg ketamine/kg (equivalent to 2.2 ml/100kg) as an intravenous bolus. Sedation should be apparent before the induction of anaesthesia.
Maintenance of surgical anaesthesia
Should it become necessary to prolong anaesthesia, either of the following regimes may be used:
i) Thiopental sodium
Thiopental sodium may be administered intravenously to prolong anaesthesia.
ii) Romifidine/Ketamine
Depending on depth and duration of anaesthesia required, administer romifidine intravenously within the dose range of 25-50 µg/kg bodyweight (25-50% of the initial premedication dose) followed immediately by ketamine intravenously at a dose rate of 1.1 mg/kg bodyweight (50% of the initial induction dose). Each top-up lasts approximately 8-10 minutes and can be repeated at regular 8-10 minute intervals (up to 5 times) without compromising recovery.
Romifidine and Ketamine Equine Anaesthesia – (IV) Premedication and Induction of Anaesthesia |
Weight of Horse in kg | *Romifidine (10 mg/ml) - ml | WAIT | **Ketamine (100 mg/ml) - ml |
50 | 0.50 | 5-10 MINUTES | 1.10 |
100 | 1.00 | 2.20 |
150 | 1.50 | 3.30 |
200 | 2.00 | 4.40 |
250 | 2.50 | 5.50 |
300 | 3.00 | 6.60 |
400 | 4.00 | 8.80 |
500 | 5.00 | 11.00 |
600 | 6.00 | 13.20 |
Induction - administer romifidine IV, wait 5-10 minutes before administering ketamine IV * Based on a dose rate of 100 µg romifidine/kg bodyweight ** Based on a dose rate of 2.2 mg ketamine/kg bodyweight |
Top-up (Maintenance) dose at 8-10 minute intervals |
Weight of Horse in kg | ~Romifidine (10 mg/ml) - ml | ~~Ketamine (100 mg/ml) - ml |
50 | 0.25 | 0.55 |
100 | 0.50 | 1.10 |
150 | 0.27 | 1.65 |
200 | 1.00 | 2.20 |
250 | 1.25 | 2.75 |
300 | 1.50 | 3.30 |
400 | 2.00 | 4.40 |
500 | 2.50 | 5.50 |
600 | 3.00 | 6.60 |
Maintenance – administer romifidine IV, immediately followed by ketamine IV ~ Based on a dose rate of 50 µg romifidine/kg bodyweight ~~ Based on a dose rate of 1.1 mg ketamine/kg bodyweight |