Premed and prep workshop

Question 1

How long should you fast a rabbit for prior to an ovariohysterectomy?

Answer 1

Don’t fast it

Question 2

What is the approximate death rate in healthy dogs following anaesthesia (e.g. CEPSAF study)?

Answer 2

1 in 600

Question 3

In which patients is routine pre-anaesthetic blood testing warranted?

Answer 3

In patients requiring preanaesthetic stabilisation
In geriatric patients
In patients undergoing invasive surgery, with a high risk of haemorrhage

Question 4

Which dog breed is prone to regurgitation during anaesthesia?

Answer 4

Brachycephalics

Question 5

Which dog breeds are prone to opioid induced dysphoria?

Answer 5

Alaskan breeds
Labrador Reterievers

Question 6

Which dog breeds can suffer from a gene mutation leading to sensitivity of some anaesthetic drugs and ivermectin?

Answer 6

Collies

Question 7

If a collie had a MDR1 gene mutation, which anaesthetic drug would they be sensitive to?

Answer 7

penothiazines, morphine, macrocyclic lactones
e.g., Acepromazine

Question 8

Which opioid is a full mu opioid receptor agonist (MOR), NMDA receptor antagonist, and affects noradrenaline re-uptake and is an excellent analgesic?

Answer 8

Methadone

Question 9

Which sedation/premedication drugs are available as oral gels for horses?

Answer 9

Acepromazine
Detomidine

Question 10

What drugs can be used to antagonise a methadone overdose?

Answer 10

Naloxone
Butorphanol

Question 11

Which combination(s) of drugs would be suitable for premedication of a healthy young working cocker spaniel prior to GA for exploring a swelling on the dorsum of the paw assumed to be caused by a grass seed.

Answer 11

Medetomidine and methadone (potent analgesia and good sedation, for an ASA 1 dog)
Acepromazine and buprenorphine

Question 12

Which combination would be suitable for sedation/premedication of an 8 year old Labrador which has been hit by a car 2 hours ago. The plan is to anaesthetise the dog for radiography and fracture stabilisation. The dog has been bleeding from an open fracture of the humerus. The dog is whimpering and tachycardic, but an IV cephalic cannula was placed with little resentment.

Answer 12

Methadone

Question 13

What premedication would you like to use in a 4kg cat, that is a bit spicy, and uncooperative. The cat has been limping for 3 days after having disappeared for a week, and you want to radiograph the pelvis and hindlimbs.

Answer 13

Dexmedetomidine and methadone
Medetomidine and buprenorphine

Question 14

Rocky is a 7 year old Boxer with a mast cell tumour on his flank that need removal. Rocky has mitral valve regurgitation and is on pimobendan twice a day. You auscultate his heart and indeed you hear a IV/V left sided murmur, and the owners report he’s slowing down on his walks, but is otherwise ok. What do you do?

Answer 14

Administer methadone and antihistamine
Administer low dose acepromazine and methadone

Question 15

Which sedative drug is contraindicated in breeding stallions?

Answer 15

Acepromazine

Question 16

You have decided to administer medetomidine and methadone IM to the (hyperactive) working cocker as a premed. The dose you decide to use is 0.3mg/kg methadone and 10mcg/kg medetomidine. The dog weighs 12 kg. The medetomidine is 1mg/ml and the methadone is 10mg/ml. What volume of drugs are you going to draw up?

Answer 16

0.12ml medetomidine and 0.36ml methadone

Question 17

A cocker spaniel stays in over night, the IV cannula is bandaged in. Overnight he manages to remove the foot bandage and chew out his stitches from his wound. In the morning you decide to re-anaesthetise him this time using an IV route for the premed. You decide to use 0.005mg/kg dexmedetomidine and 0.02mg/kg buprenorphine. Calculate how much dexmedetomdine and buprenorphine to draw up. Buprenorphine comes in vials 0.3mg/ml and dexmedetomidine is 0.5mg/ml. (12kg dog)

Answer 17

0.12ml dexmedetomidine and 0.8ml buprenorphine

Question 18

You wish to sedate a 550kg horse IM with acepromazine and butorphanol for cannula placement before GA.
You decide to use 0.05mg/kg acepromazine (10mg/ml) and 0.02mg/kg butorphanol (10mg/ml). Calculate the volumes to draw up

Answer 18

2.75ml ACP and 1.1ml butorphanol

Question 19

Moth is a 4 year old siamese recently diagnosed with hyperthyroidism. Moth does not travel well, and is very fearful in the consult room. The owners have started oral medication for moth, but Moth needs monthly blood tests. Suggest drugs the owners can give orally to moth before she travels.

Answer 19

Trazodone
Gabapentin

Question 20

Kai is an uncooperative XL Bully of approx 50kg with a bite history that requires sedation prior to anaesthesia for removal of a grass seed that he has inhaled as he has a sudden onset sneezing of blood tinged fluid. The dog is muzzled and the owner can restrain him for a short period of time for an IM injection. What would you like to inject the dog with?

Answer 20

Dexmedetomidine, ketamine, butorphanol and acepromazine