Anesthesia Protocols Quick Reference
Pre-med, induction, maintenance & reversal for dogs and cats
Pre-Anesthetic Checklist
- History & physical exam
- CBC & chemistry (age/ASA appropriate)
- Cardiac auscultation
- IV catheter placed & patent
- Fasting confirmed (8–12 hrs)
- Anesthetic machine check
- Emergency drugs drawn & labeled
- ET tube + stylet ready
- Warming system available
- Fluid pump / drip set primed
- ASA status assigned
- Owner consent signed
Pre-Medication Combinations
| Combination | Dog Dose | Cat Dose | Route | Notes |
|---|---|---|---|---|
| Hydromorphone + Acepromazine | 0.05–0.1 + 0.01–0.03 mg/kg | 0.05–0.1 + 0.01–0.03 mg/kg | IM | Good sedation; ace: avoid in brachy / cardiac |
| Hydromorphone + Midazolam | 0.05–0.1 + 0.2 mg/kg | 0.05–0.1 + 0.2 mg/kg | IM/IV | Reversible; good for cardiac / geriatric |
| Butorphanol + Dexmedetomidine | 0.2–0.4 + 2–5 mcg/kg | 0.2–0.4 + 5–10 mcg/kg | IM | Profound sedation; reverse dex with atipamezole |
| Buprenorphine + Acepromazine | 0.02–0.03 + 0.01–0.03 mg/kg | 0.02–0.03 + 0.01–0.03 mg/kg | IM | Longer onset; good for mild-moderate pain |
| Ketamine + Dexmedetomidine + Butorphanol | 3–5 + 2–5 + 0.2 mg/kg | 3–5 + 5–10 + 0.2 mg/kg | IM | "Kitty magic" / "Dog magic"; heavy sedation |
| Methadone + Acepromazine | 0.3–0.5 + 0.01–0.03 mg/kg | 0.3–0.5 + 0.01–0.03 mg/kg | IM | Full mu agonist; excellent analgesia |
Induction Agents
| Agent | Dog Dose | Cat Dose | Route | Notes |
|---|---|---|---|---|
| Propofol | 4–6 mg/kg | 4–8 mg/kg | IV | Titrate to effect; apneic → pre-oxygenate |
| Alfaxalone | 2–3 mg/kg | 2–5 mg/kg | IV/IM | Minimal CV effects; rapid recovery |
| Etomidate | 1–2 mg/kg | 1–2 mg/kg | IV | Cardiac sparing; painful / myoclonus |
| Ketamine + Diazepam | 5–7 + 0.25 mg/kg | 5–7 + 0.25 mg/kg | IV | Dissociative + benzodiazepine; IM possible |
| Tiletamine-Zolazepam | 3–6 mg/kg | 3–6 mg/kg | IV/IM | Telazol; prolonged recovery at higher doses |
Maintenance Options
Isoflurane
- MAC: Dog 1.28%, Cat 1.63%
- Induction: 3–5%
- Maintenance: 1.5–3%
- Less arrhythmogenic than halothane
Sevoflurane
- MAC: Dog 2.36%, Cat 2.58%
- Induction: 5–8%
- Maintenance: 2.5–4.5%
- Rapid onset/offset; low solubility
Total IV Anesthesia (TIVA)
- Propofol CRI: 0.1–0.4 mg/kg/min
- Alfaxalone CRI: 0.07–0.1 mg/kg/min
- Requires supplemental O₂
- Good for MH-susceptible breeds
Reversal Agents
| Agent | Dose | Route | Reverses | Notes |
|---|---|---|---|---|
| Atipamezole | 0.05–0.1 mg/kg (5× dex dose) | IM | Dexmedetomidine | Equal vol to dexmedetomidine IM |
| Flumazenil | 0.02 mg/kg | IV | Midazolam / Diazepam | Short-acting; may need repeat |
| Naloxone | 0.02–0.04 mg/kg | IV/IM | Opioids | Titrate; reverse analgesia too |
| Nalbuphine | 0.02–0.04 mg/kg | IV/IM | Opioid side effects (partial) | Preserves some analgesia |
Pain Scale Quick Reference
Glasgow Composite Measure (CMPS)
- Score 0–3: Mild / acceptable
- Score 4–6: Moderate — intervene
- Score ≥7: Severe — urgent analgesia
- Validated for dogs post-surgery
Colorado State University (CSU)
- Acute Pain Scale: 0–24 (dog), 0–20 (cat)
- Score <4: Acceptable
- Score ≥5: Analgesic intervention
- Includes psychologic / behavioral scoring
Feline Grimace Scale (FGS)
- Ear position, orbital tightening
- Muzzle tension, whisker position
- Head position
- Score 0–2 per feature; total ≥4 = pain
General Analgesic Ladder
- Step 1: Local / regional block
- Step 2: NSAID (if no CI)
- Step 3: Opioid (full or partial μ-agonist)
- Step 4: Multimodal + adjuvants
Disclaimer: This card is for educational reference only. Always verify drug concentrations, patient-specific factors, and protocols against current references and institutional guidelines.