Use of ketamine and xylazine anesthesia in dogs: A retrospective cohort study of 3,413 cases

ISMAR LUTVIKADIC; ALAN MAKSIMOVIC

doi:10.56093/ijans.v92i11.123310

Authors

ISMAR LUTVIKADIC University of Sarajevo, Veterinary Faculty, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0002-3768-3007
ALAN MAKSIMOVIC University of Sarajevo, Veterinary Faculty, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0002-4127-9445

https://doi.org/10.56093/ijans.v92i11.123310

Keywords:

Anesthesia, Dogs, Mortality rate, Ketamine, Xylazine

Abstract

The information regarding the risk of anesthesia-related death in veterinary medicine is scarce, and little is known about the mortality risk of specific anesthetics. The study conducted during 2019 at University of Sarajevo, Veterinary faculty, aimed to estimate the mortality risk of intermittent injectable ketamine-xylazine anesthesia in dogs and to investigate the potential relationship between mortality rate and anesthesiologists’ experience. Anesthetic records, where ketamine and xylazine combination was used for anesthesia induction and maintenance, were reviewed and divided into two groups: inexperienced (AN1) and experienced anesthesiologists (AN2). Inexperienced anesthesiologists were constantly supervised by experienced ones, whose corrective interventions were recorded. Overall detected mortality rate was 0.15%, with 0.18% and 0.11% in the AN1 and AN2 groups, respectively. A statistically significant difference was not found. Records of the AN1 group revealed interventions of experienced anesthesiologist in 92% of cases. Detected mortality rate was within the values previously established for inhalant anesthesia indicating high safety in usage of investigated protocol, if performed by experienced anesthesiologists. The high percentage of interventions of a senior anesthesiologist suggests that supervised upskilling of inexperienced anesthesiologists before their independent work could result in a better outcome.

Downloads

Download data is not yet available.

References

Abdel-Hady A A A, Abdelbasset K M and Soliman A S. 2017. Comparative experimental study on two designed intravenous anesthetic combinations in dogs. Excli Journal 16: 770–79.

Al-Rifai Z and Mulvey D. 2016. Principles of total intravenous anesthesia: Basic pharmacokinetics and model descriptions. BJA Education 16(3): 92–7. DOI: https://doi.org/10.1093/bjaceaccp/mkv021

Arbous M S, Grobbee D E, van Kleef J W V, de Lange J J, Spoormans H H A J M, Touw P, Werner F M and Meursing A E E. 2001. Mortality associated with anaesthesia: A qualitative analysis to identify risk factors. Anaesthesia 56: 1141–53. DOI: https://doi.org/10.1111/j.1365-2044.2001.02051.x

Bharati S J, Chowdhury T, Gupta N, Schaller B, Cappellani R B and Maguire D. 2014. Anaesthesia in underdeveloped world: Present scenario and future challenges. Nigerian Medical Journal 55(1): 1–8. DOI: https://doi.org/10.4103/0300-1652.128146

Biboulet P, Aubas P, Dubourdieu J, Rubenovitch J, Capdevila X and d’Athis F. 2001. Fatal and no fatal cardiac arrests related to anesthesia. Canadian Journal of Anaesthesia 48(4): 326–32. DOI: https://doi.org/10.1007/BF03014958

Bille C, Auvigne V, Libermann S, Bomassi E, Durieux P and Rattez E. 2012. Risk of anaesthetic mortality in dogs and cats: An observational cohort study of 3546 cases. Veterianry Anaesthesia and Analgesia 39(1): 59–68. DOI: https://doi.org/10.1111/j.1467-2995.2011.00686.x

Brodbelt D. 2009. Perioperative mortality in small animal anaesthesia. The Veterinary Journal 182: 152–61. DOI: https://doi.org/10.1016/j.tvjl.2008.06.011

Brodbelt D C, Blissitt K J, Hammond R A, Neath P J, Young L E, Pfeiffer D U and Wood J L N. 2008a. The risk of death: The confidential enquiry into perioperative small animal Fatalities (CEPSAF). Veterianry Anaesthesia and Analgesia 35(5): 365–73. DOI: https://doi.org/10.1111/j.1467-2995.2008.00397.x

Brodbelt D C, Hammond R A, Tuminaro D, Pfeiffer D U and Wood J L N. 2006. Risk factors for anaesthetic-related death in referred dogs. Veterinary Record 158: 563–4. DOI: https://doi.org/10.1136/vr.158.16.563

Brodbelt D C, Pfeifer D U, Young L and Wood J L N. 2008b. Risk factors for anesthetic-related death in dogs: results from the Confidential Enquiry into Perioperative Small Animal Fatalities (CEPSAF). Journal of American Veterinary Medical Association 233(7): 1096–104. DOI: https://doi.org/10.2460/javma.233.7.1096

Brown E N, Lydic R and Schiff N D. 2010. General Anesthesia, Sleep, and Coma. The New England Journal of Medicine 363: 2638–50. DOI: https://doi.org/10.1056/NEJMra0808281

Clarke K W and Hall L W. 1990. A survey of anaesthesia in small animal practice: AVA/BSAVA report. Journal of Veterinary Anaesthesia 1: 4–10. DOI: https://doi.org/10.1111/j.1467-2995.1990.tb00380.x

Cooper J B, Newbower R S and Kitz R J. 1984. An analysis of major errors and equipment failures in anesthesia management: Considerations for prevention and detection. Anesthesiology 60: 34–42. DOI: https://doi.org/10.1097/00000542-198401000-00008

DeLay J. 2016. Perianesthetic mortality in domestic animals: A retrospective study of postmortem lesions and review of autopsy procedures. Veterinary Pathology: 1–9. DOI: https://doi.org/10.1177/0300985816655853

Dyson D H, Maxie M G and Schnurr D. 1998. Morbidity and mortality associated with anesthetic management in small animal veterinary practice in Ontario. Journal of American Animal Hospital Association 34(4): 325–35. DOI: https://doi.org/10.5326/15473317-34-4-325

Gaynor J S, Dunlop C I, Wagner A E, Wertz E M, Golden A E and Demme W C. 1999. Complications and mortality associated with anesthesia in dogs and cats. Journal of American Animal Hospital Association 35: 13–17. DOI: https://doi.org/10.5326/15473317-35-1-13

Gil L and Redondo J I. 2013. Canine anaesthetic death in Spain: A multicenter prospective cohort study of 2012 cases. Veterinary Anaesthesia and Analgesia 40(6): e57–e67. DOI: https://doi.org/10.1111/vaa.12059

Hutt A and Hudetz A G. 2015. Editorial: General anesthesia: From theory to experiments. Front Systems Neuroscience 9: 105. DOI: https://doi.org/10.3389/fnsys.2015.00105

Hellebrekers L J, Sap R and Van Wandelen R M. 1990. Intramuscularly administered non-opiate anesthesia in dogs. A report on the use of ketamine/xylazine, tiletamine/ zolazepam, ketamine/midazolam and metomidine. Tijdschr Diergeneeskd 115(14): 661–69.

Hoffer I, Spivack J, Yaport M, Zerillo J, Reich D L, Wax D and DeMaria S. 2015. Association between anesthesiologist experience and mortality after orthotopic liver transplantation. Liver Transplantation 21(1): 89–95. DOI: https://doi.org/10.1002/lt.24014

Hosgood G and Scholl D T. 1998. Evaluation of age as a risk factor for perianesthetic morbidity and mortality in the dog. Journal of Veterinary Emergency and Critical Care 8(3): 222–36. DOI: https://doi.org/10.1111/j.1476-4431.1998.tb00128.x

Kennedy D and Norman C. 2005. What don’t we know? Science 309: 75. DOI: https://doi.org/10.1126/science.309.5731.75

Kim J, Heo J, Ji D and Kim M S.2015. Quantitative assessment of pupillary light reflex in normal and anesthetized dogs: a preliminary study. Journal of Veterinary Medicine Science 77(4): 475–78. DOI: https://doi.org/10.1292/jvms.14-0387

Lee A and Lum M E. 1996. Measuring anaesthetic outcomes. Anaesth Intensive Care 24: 685–93. DOI: https://doi.org/10.1177/0310057X9602400610

Maksimović A, Filipović S, Lutvikadić I, Brajenović N and Brčić-Karačonji I. 2019. Effect of morphine and tramadol on serum levels of lidocaine after epidural administration in dogs. Japanese Journal of Veterinary Research 67(4): 275–79.

Matthews N S, Mohn T J, Yang M, Spofford N, Marsh A, Faunt K, Lund E M and Lefebvre S L. 2017. Factors associated with anesthetic-related death in dogs and cats in primary care veterinary hospitals. JAVMA 250(6): 655–65. DOI: https://doi.org/10.2460/javma.250.6.655

Mezerová J, Snásil M and Němecek L. 1992. Use of xylazine and ketamine in the induction of halothane anesthesia in dogs. Veterinary Medicine (Praha) 37(4): 234–38.

Morris C, Perris A, Klein J and Mahoney P. 2009. Anaesthesia in haemodynamically compromised emergency patients: does ketamine represent the best choice of induction agent? Anaesthesia 64: 532–39. DOI: https://doi.org/10.1111/j.1365-2044.2008.05835.x

Morrison, J A, Spofford N, Yang M, Saito E, Lambert L and Faunt K. 2022. Development and implementation of veterinary anesthesia medical quality standards for primary care. Veterinary Anaesthesia and Analgesia 49(3): 233–42. DOI: https://doi.org/10.1016/j.vaa.2022.01.009

Naddaf H, Varzi H N, Sabiza S and Falah H. 2014. Effects of xylazine-ketamine anesthesia on plasma levels of cortisol and vital signs during laparotomy in dogs. Open Veterinary Journal 4(2): 85–89. DOI: https://doi.org/10.5455/OVJ.2014.v4.i2.p85

Newland M C, Ellis S J, Lydiatt C A, Peters K R, Tinker J H, Romberger D J, Ullrich F A and Anderson J R. 2002. Anesthetic-related cardiac arrest and its mortality: A report covering 72.959 anesthetics over 10 years from a US teaching hospital. Anesthesiology 97(1): 108–51. DOI: https://doi.org/10.1097/00000542-200207000-00016

Pignaton W, Braz J R C, Kusano P S, Módolo M P, de Carvalho L R, Braz M G and Braz L G. 2016. Perioperative and Anesthesia- Related Mortality an 8-year observational survey from a tertiary teaching hospital. Medicine 95(2): 1–6. DOI: https://doi.org/10.1097/MD.0000000000002208

Plumb D C. 2011. Xylazine HCl. Plumb’s Veterinary Drug Handbook, 7th ed., pp. 6308-32. PharmaVet Inc.

Posner L P and Burns P M. 2009. Injectable anesthetic agents. Veterinary Pharmacology and Therapeutics, 9th ed. , pp. 729- 834. (Eds) Riviere J E and Papich M G. Wiley-Blackwell.

Verma R, Mohan B, Attri J P, Chatrath V, Bala A and Singh M. 2015. Review article anesthesiologist: The silent force behind the scene. Anesthesia: Essays and Researches 9(3). DOI: https://doi.org/10.4103/0259-1162.159775

Walker I A, Bashford T, Fitzgerald J E and Wilson I H.2014. improving anesthesia safety in low-income regions of the World. Current Anesthesiology Report 4: 90–9. DOI: https://doi.org/10.1007/s40140-014-0056-7

Yosaitis J, Manley J, Johnson L and Plotkin J.2005. The role of the anesthesiologist as an integral member of the transplant team. HPB (Oxford) 7: 180–2. DOI: https://doi.org/10.1080/13651820510028927