Equimidine

Give by slow intravenous injection. As this is a multi dose bottle the surface of the bung should be cleaned and disinfected prior to penetration of the bung with a sterile needle. The needle should be passed carefully into the bottle prior to withdrawal of the dose and then withdrawn carefully to avoid damage. (See also 4.5, above). Return bottle to cardboard carton after use.

The following procedure is recommended. Use two sterile needles, one to fill the syringe from the bottle and one to inject the patient. Once the required dose has been withdrawn from the vial, the syringe should be removed from the needle. A separate sterile needle should be inserted into the injection site and the syringe connected to it. The needles should be discarded.

Use alone for sedation

Dosage table

Use with butorphanol for sedation

Use only after reading all the information provided in section 4, Clinical Particulars.

Dosage 0.12 ml /100kg (12 mcg/kg detomidine hydrochloride) intravenously followed within 5 minutes by 25 mcg/kg butorphanol (e.g. 0.25 ml/100kg of a 10mg/ml solution) intravenously. Clinical experience has shown that 5 mg detomidine HCl (0.5 ml of the product) and 10 mg (e.g. 1 ml of a 10 mg/ml solution) of butorphanol affords effective and very safe sedation in horses above 200 kg bodyweight.

Warnings

Do not use combination in horses with a history of liver disease. The combination should not be used in pregnant mares or in animals suffering from colic.

Routine cardiac auscultation should be performed prior to use of this combination.

Do not use in horses with a pre-existing cardiac dysrhythmia or bradycardia.

Mild to severe ataxia may be encountered but clinical studies have shown that horses are unlikely to collapse. Normal precautions should be observed to prevent patient self-injury.

Use with ketamine (short duration anaesthesia)

Use only after reading all the information provided in section 4, Clinical Particulars. Ketamine should not be used as the sole anaesthetic agent in horses. It is important to adhere to the following procedures to obtain satisfactory surgical anaesthesia. Administer the product at a dose rate of 20 mcg/kg by slow intravenous injection.

Allow 5 minutes for the horse to become deeply sedated then administer ketamine at a dose rate of 2.2 mg/kg as an intravenous bolus. Onset of anaesthesia is gradual with the horse taking approximately 1 minute to become recumbent. (In large fit horses recumbency may take up to 3 minutes).

Anaesthesia will 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 ketamine injection. The period of surgical anaesthesia is about 10-15 minutes and if it is necessary to prolong anaesthesia, thiopentone sodium can be given as IV boluses of 1 mg/kg as required. Total doses of 5 mg/kg (5 x 1 mg/kg injections) have been given. Doses greater than this may reduce the quality of recovery. Thiopentone can also be given (as above) to deepen anaesthesia if needed.

The horse should be allowed to stand in its own time. Ataxia may be a problem if it stands prematurely and it should be encouraged to remain recumbent.

To facilitate handling and administration some horses have received acepromazine by intramuscular injection at a dose rate of 0.03 mg/kg at least 45 minutes prior to induction of anaesthesia.

Warnings

Allow sedation to develop. The two agents should never be co-administered in the same syringe.

It is recommended that feed is withdrawn for at least 12 hours prior to anaesthesia. Excitable horses can be poor subjects for anaesthesia. Considerate, quiet and careful handling during the administration of the agents is necessary so as to cause the minimum upset possible. If sedation with the product fails to occur then the procedure should be abandoned. In these circumstances ketamine must not be injected into the horse