Anesthesia Protocols

Standard Feline Protocol

Equine Protocol (Standing Sedation)

Equine Protocol (General Anesthesia)

Breed-Specific Safety Alerts

• Boxers: Acepromazine sensitivity — risk of profound, prolonged hypotension. Use alternative sedation (dexmedetomidine, butorphanol).
• Sighthounds (Greyhounds, Whippets, etc.): Prolonged recovery from thiopental and propofol due to low body fat. Dose-reduce propofol. Alfaxalone may be preferred.
• MDR1-Mutant Breeds (Collies, Aussies, Shelties, etc.): Exercise caution with acepromazine, butorphanol, and other P-glycoprotein substrates. Dose-reduce by 25-50% or substitute. Test MDR1 status when possible.
• Brachycephalics (Bulldogs, Pugs, Persians): High risk for upper-airway obstruction. Pre-oxygenate, have multiple endotracheal tube sizes ready, avoid heavy sedation, and delay extubation until strong swallow reflex.
• Giant breeds (Great Dane, Mastiff, Irish Wolfhound): Higher sensitivity to alpha-2 agonists. Increased bloat/GDV risk perioperatively. Position carefully to prevent myopathy/neuropathy.
• Pediatric (<12 weeks): Immature hepatic metabolism, limited glycogen reserves (hypoglycemia risk), higher body surface area (hypothermia risk). Reduce drug doses, minimize fasting, maintain body temperature aggressively.
• Geriatric: Reduced hepatic/renal clearance, cardiac reserve. Pre-anesthetic bloodwork mandatory. Reduce doses 25-50%.

Key Species Differences

Workflow

1. Confirm species, breed, age, weight, and ASA status (MANDATORY).
2. Review pre-anesthetic bloodwork (CBC, chemistry, coagulation if indicated).
3. Select premedication based on species, temperament, and procedure. Account for breed-specific contraindications.
4. Select induction agent and calculate dose. Titrate to effect.
5. Intubate and maintain on inhalant or injectable protocol. Monitor continuously (SpO2, ETCO2, ECG, BP, temperature).
6. Manage analgesia throughout: multimodal approach (opioid + NSAID + local block where possible).
7. Recovery monitoring until patient is extubated, normothermic, and ambulatory.

Limitations

• Anesthetic protocols must be individualized based on patient assessment; no single protocol suits all cases.
• Drug availability varies by country and institution. Not all agents are licensed in all jurisdictions.
• Equine anesthesia carries inherently higher risk than small animal; specialist involvement is recommended for complex cases.
• Dosing information is for reference only; always verify against current formulary (Plumb's) and patient-specific factors.
• This skill covers protocol selection. For safety monitoring, emergency management, and breed risk details, see anesthesia-safety.