Veterinary Anesthesia & Analgesia Support Group
Practical Information for the Compassionate Veterinary Practitioner
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  Oral Sedation For Difficult Patients
  Angela Dyer-Corso
  April, 2004
As veterinarians, all too often we are called upon to vaccinate, examine, or otherwise deal with dogs who are aggressive, fearful, poorly trained, not properly socialized, or all of the above. Many veterinarians seek information to adequately sedate these dogs with oral medications prior to their appointments. Various medications have been tried with limited success. It is important to remember that with many tranquilizers, the drugs help the patient to be tranquil or calm when all is well, but have no sedative effect when the animal is stimulated. Most veterinarians would recommend skipping oral sedatives and going right to injectable medications as they have a more predictable response. Use care, have the owner muzzle the dog at home, and warn the client of all the risks associated with sedating an aggressive dog (including death). Here are some options for oral medications if you find yourself in need of this information.

  1. Acepromazine – doses in Plumb range from 0.55 to 2.2 mg/kg orally. Its use as a sole oral sedative is questionable at best. It is poorly absorbed when given with food. Many vets have found this to be an unreliable sedative. Many dogs appear sedated, but can easily overcome their sedation with any stimulus, leading to unpredictable behavior. Or, even worse, leading to a false sense of security on the part of the staff or veterinarians with the inevitable consequence of injury.
  1. Diazepam – Can be dosed up to 2.2 mg/kg orally. It is important to remember that it can have a disinhibitory effect on certain patients. Removing what little inhibition the patient may have to bite you is less than ideal.
  1. Pentobarbital – doses up to 60mg/kg (pre-euthanasia) have been used effectively1
  1. Alprazolam (Xanax) – Published dose in Plumb is 0.1mg/kg for anxiety. Anecdotally, some veterinarians are giving this at 0.5mg/kg up to 8mg total dose for oral sedation in the extreme case.
  1. Telazol & Acepromazine – one paper1 advocated the use of telazol powder at 20mg/kg mixed in food. This combination had predictable, heavy sedation when combined with 2.2mg/kg acepromazine PO. Keep in mind that 7 of 8 dogs were sternally recumbent and reluctant to stand. 6 of 8 dogs were laterally recumbent and unable to maintain sternal recumbency. The patient may need to be kept in the hospital until able to ambulate.
    • One of our members has used telazol at 10 mg/kg (using the injectable solution) with acepromazine at 2.2 mg/kg and found a very attractive, balanced level of restraint with sternal recumbency in an otherwise insanely wild 25 kg canine. This patient was able to ambulate within 5 hours of the medication’s administration.
  1. Other Combinations: Several other combinations have also been described:
    • Acepromazine 1.25mg/kg + Diazepam 0.5mg/kg
    • Butorphenol + Diazepam
    • Phenobarbital 2 to 2.5 mg/kg BID + Diazepam 0.5 to 1mg/kg BID - TID


    Page References:
    1 Comparison of five regimens for oral administration of medication to induce sedation in dogs prior to euthanasia. Ramsay EC, Wetzel RW. J Am Vet Med Assoc. 1998 Jul 15;213(2):240-2. Erratum in: J Am Vet Med Assoc 1998 Oct 15;213(8):1170.
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