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Topic:Sedation
Sedation in horses involves the administration of pharmacological agents to induce a state of calmness, relaxation, or sleepiness. This practice is commonly employed to facilitate veterinary procedures, diagnostic imaging, or transportation by reducing stress and movement in the animal. The primary sedatives used in equine medicine include alpha-2 adrenergic agonists, such as xylazine and detomidine, and opioids, like butorphanol. These agents act on the central nervous system to achieve the desired sedative effects. The choice of sedative and its dosage depend on various factors, including the horse's age, weight, health status, and the procedure's nature. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, efficacy, and safety considerations of sedation in equine practice.
Anesthetic Recovery Following a Midazolam-Containing Co-Induction Protocol in Horses Undergoing Total Intravenous Anesthesia. Anesthetic recovery is a critical phase in horses under field conditions, and induction protocols may influence recovery quality during total intravenous anesthesia. Objective: To compare two anesthetic induction protocols, one including midazolam and the other based solely on xylazine and ketamine, regarding anesthetic induction and recovery quality, total recovery time, and attempts to achieve standing in horses undergoing total intravenous anesthesia. Methods: Twelve healthy male horses older than 2 years were randomly assigned to XC (xylazine 1 mg/kg and ketamine 2 mg/kg) or XCM (xylazine ...
Diagnostic and Therapeutic Standing Needle Arthroscopy of the Distal Interphalangeal Joint in 36 Horses. The objective of this study is to describe the technique, complications, and outcomes of standing needle arthroscopy of the distal interphalangeal joint (DIPJ) in horses. Unassigned: This is a retrospective study. Unassigned: Five cadaver forelimbs; 36 client-owned horses. Unassigned: A 1.9-mm needle arthroscope was used to evaluate the DIPJ in cadaver limbs and clinical cases. Horses underwent diagnostic and/or therapeutic arthroscopy under standing sedation and local anaesthesia. Data collected included signalment, diagnostic imaging findings, intraoperative findings, complications, and outc...
Limb position, not exercise or sedation, affects power Doppler neovascularization detection in equine superficial digital flexor tendon core lesions. To determine the effect of limb position, exercise, and sedation on neovascularization detectability with the use of power Doppler ultrasonography (PDU) in superficial digital flexor tendon core lesions of the equine forelimb. Unassigned: 9 Thoroughbred horses with superficial digital flexor tendon core tendinopathies were assessed with PDU before lesion induction (week 0) and 12 weeks after lesion induction, with 5 horses in the study period ranging from January to April 2024 and 4 horses from January to April 2025. During weeks 0 and 12, ultrasound examinations were performed 24 hours apart,...
Semi-extensive management system drives lower prevalence of equine orodental disorders. The prevalence of orodental disorders in horses kept under different management systems is lacking. More detailed knowledge is needed to support targeted therapeutic and prophylactic approaches, as these conditions play a crucial role in maintaining equine health and welfare. This study aimed to compare the prevalence of orodental disorders in horses raised, kept, and fed under extensive, semi-extensive, or intensive management systems. Unassigned: Sixty-nine clinically healthy adult crossbred horses with no history of dental treatment were examined, with 23 horses included in each study group...
Comparison of xylazine-ketamine-guaifenesin and xylazine-tiletamine-zolazepam protocols for constant rate infusion anesthesia in horses undergoing field castration. The common use of "triple drip" (xylazine, ketamine, and guaifenesin; XKG) is a popular protocol for constant rate infusion (CRI) in equine practice. However, due to restrictions on ketamine and guaifenesin in many countries, tiletamine-zolazepam (TZ) could serve as an alternative. To date, there have been limited studies evaluating the use of xylazine in combination with TZ (XTZ) administered via CRI to maintain surgical anesthesia in equine field practice. Objective: To compare the effectiveness and safety of XTZ infusion with the classical XKG protocol for field anesthesia. Methods: Twelve ...
USE OF GUAIFENESIN-KETAMINE-XYLAZINE INFUSION FOR MAINTENANCE OF ANESTHESIA IN CAPTIVE PREZEWALSKI HORSES (EQUUS FERUS PRZEWALSKI ): A CASE SERIES. This case series documents the use of triple drip, a combination of IV guaifenesin, ketamine, and xylazine (GKX) to extend the length of anesthesia in zoo-owned Przewalski horses (). In three separate procedures involving two different animals, GKX was used to prolong and deepen the plane of anesthesia for 90 to 120 min beyond an initial induction dart containing ketamine, butorphanol, azaperone, and medetomidine. The depth of anesthesia was sufficient to permit surgical excision of SC abscesses and other procedures. Throughout the anesthetic events, the horses breathed spontaneously and maint...
Fatalities within seven days after equine standing sedation: A prospective, multicentre study. Information regarding mortality associated with standing procedures in horses is sparse. Objective: To report data from >12,000 standing sedations. Methods: Confidential, observational, prospective, multicentre, cohort study. Methods: We collected records of horses/ponies undergoing standing sedation for surgery or advanced diagnostic imaging using at least one top-up or controlled rate infusion (CRI). Procedures were either NON-COLIC or COLIC. Outcome at seven days was recorded as (i) ALIVE, (ii) EUTHANASIA or (iii) DEAD. Data were collected with a portable document format (PDF) questionn...
Single-dose intravenous α2-agonists do not acutely alter anti-inflammatory bioactive protein profiles but reduce interleukin-8 in equine autologous protein solution and platelet-rich plasma. Determine the acute effects of xylazine and detomidine on concentrations of selected growth factors, cytokines, and α2-macroglobulin (A2M) in platelet-rich plasma (PRP) and autologous protein solution (APS) and the long-term effects of these sedatives on serum A2M. We hypothesized that sedative administration would decrease concentrations of all bioactive proteins in PRP and APS acutely and A2M in serum for 6 days following sedative administration. Unassigned: 6 horses were randomized to receive IV xylazine (200 mg) or detomidine (10 mg). Blood was collected before and 5 minutes after sedativ...
The Early Ophthalmic Effects of Vatinoxan in Healthy Detomidine-Sedated Horses. To evaluate the short-term ophthalmic effects of vatinoxan, a peripherally selective alpha2-adrenoceptor antagonist, in detomidine-sedated horses. Methods: Seven healthy horses without ophthalmic disease in a randomized, masked, two-period crossover study design, with a ≥ 7-day rest period. Methods: After a bilateral palpebral block (lidocaine 40 mg) and baseline data collection, horses received intravenous detomidine (20 μg/kg [DET]) or DET with vatinoxan (200 μg/kg [DET-VAT]). Intraocular pressure (IOP) was measured from the left eye while tear production (Schirmer tear test -1; ...
Ovum pick-up in mares: Evidence review and best practice recommendations using a modified GRADE approach. Ovum pick-up (OPU) is a procedure that is now performed in mares worldwide to harvest oocytes for in vitro embryo production. There is a lack of consensus surrounding best practices for various procedural elements of the technique and recently there has been an increasing focus on the welfare aspects of the procedure. Our objective was to summarize current practice and to develop guidelines for OPU in the mare, using a modified GRADE approach to optimize efficiency and mare welfare. Published evidence on various aspects of the procedure was compiled, and to supplement the relative lack of publ...
Case Report: Oral and topical chronic administration of THC-rich and CBD-rich cannabis oil as palliative care in a rescued horse with open wound, sarcoid and chronic pain. Cannabinoid-based therapies have shown analgesic, anti-inflammatory, and wound-healing potential across veterinary species; however, clinical data on long-term use of THC-rich formulations in horses remain scarce. This case report describes the use of combined oral and topical THC-rich and CBD-rich full-spectrum cannabis oils as part of a palliative care strategy in a rescued horse with severe chronic disease. A senior mixed-breed gelding was rescued with a large, chronic ulcerative lesion of the left hind limb, severe malnutrition, non-weight-bearing lameness (AAEP grade 5/5), and refractory ...
Use of computer-assisted tomography for diagnosis and standing surgical reduction of progressive ethmoidal hematoma in a mare. Progressive ethmoidal hematoma (PEH) is a rare, nonneoplastic mass occurring in the sinonasal passages of horses. An 11-year-old, pregnant Thoroughbred mare was presented with a history of intermittent nasal discharge and stertorous respiration. On examination, radiography revealed increased opacity in the sinus and nasal cavities and endoscopy identified a mass emerging from the left ethmoidal turbinate. Computed tomography (CT) showed the range and origin of the mass, indicative of PEH. A standing frontonasal flap was made under sedation, following temporary tracheostomy to secure the airway...
A Surgical Technique for Removal of Setaria digitata From the Anterior Chamber Under Standing Sedation: Outcomes in 12 Horses. To describe a rapid surgical technique for removal of the intraocular nematode Setaria digitata from the anterior chamber of horses under standing sedation and to report clinical outcomes. Methods: Twelve client-owned horses (2021-2026) presented with a motile intracameral worm. Methods: All surgeries were performed under field conditions using standing sedation (xylazine 1.1 mg kg and butorphanol 0.1 mg kg IV), regional nerve blocks (lidocaine 2%), and topical anesthesia (proparacaine). A 2.8 mm uniplanar oblique (~45°) corneal incision was created ventrolaterally approximately 2â€...
The effect of romifidine on endoscopic grading of laryngeal function in horses. To our knowledge, the effect of sedation with romifidine on the grading of laryngeal function in horses has not been studied. Our objective was to examine the effects of romifidine on the grading of laryngeal function and the cross-sectional area of the rima glottis (CSARG). Methods: Ten horses underwent three endoscopic examinations of the larynx: once while unsedated (group R1), once after being sedated with romifidine (0.04Â mg/kg intravenously; group R2) and once again, while still sedated, after receiving a repeat dose of romifidine (0.08Â mg/kg intravenously, total dose; group R3). The r...
Effects of vatinoxan in horses sedated with detomidine and butorphanol for gastroscopy: a randomized clinical study. The peripheral alpha2-adrenoceptor antagonist vatinoxan attenuated the side effects of alpha2-adrenergic sedatives in experimental studies in horses. This clinical study investigated the effects of vatinoxan in horses sedated for gastroscopy with detomidine and butorphanol. Client-owned horses were randomly allocated to receive one of the following two intravenous treatments: detomidine hydrochloride (HCl) (12μg/kg) + butorphanol tartrate (12μg/kg) (DB; n=11) or DB + vatinoxan HCl (200μg/kg) (DBV; n=11). Borborygmi score and heart rate were recorded by auscultation. Sedation level was evalu...
Standing NanoNeedle Arthroscopy of the Distal Interphalangeal Joint for Removal of Osteochondral Fragments of Distal P2 and the Extensor Process in a Horse. In horses, standing arthroscopy offers a valuable alternative to general anesthesia for the reduction of anesthetic-associated risks, and provides improved visualization in joints where access is facilitated by weightbearing. These techniques are particularly advantageous for patients with increased anesthetic risk or financial limitations. To the authors' knowledge, the removal of osteochondral fragments from the distal interphalangeal joint in a standing, sedated horse using small-diameter arthroscopic equipment has not been previously reported. Methods: A 7-year-old American Quarter Horse-T...
Behavioral and cardiorespiratory effects of a medetomidine and tramadol combination in horses. The use of combinations of sedative and analgesic drugs during standing procedures in horses is necessary to provide reliable sedation with minimal ataxia and reduced responses to surgical or other stimuli in horses. Objective: This study assessed the behavioral and cardiorespiratory effects of medetomidine (M) administered with and without tramadol (T) in horses. Methods: Eight horses were sedated intravenously with M (5 µg/kg) alone or with T (2 mg/kg) in a arandomized, blind, two-way crossover trial. Behavioral responses, including head height above the ground (HHAG), postural instability ...
A single pneumatic tourniquet is superior to wide rubber tourniquets for saphenous intravenous regional limb perfusion with amikacin in standing, sedated horses. To establish whether tourniquet type and number influence synovial fluid amikacin concentrations of the tarsocrural joint (TCJ) or metatarsophalangeal joint (MTPJ) after standing saphenous IV regional limb perfusion (IVRLP) with 2 g of amikacin. Unassigned: 8 healthy adult horses underwent 4 saphenous IVRLP protocols with amikacin, differing in tourniquet type (pneumatic vs wide rubber) and number (1 placed mid-gaskin vs 1 placed mid-gaskin and 1 mid-metatarsus) in a randomized, crossover design. Amikacin concentrations were measured in serum and synovial fluid of the TCJ and MTPJ at 15 and 30...
Pharmacokinetics of 2 mg/kg Bupivacaine in a Rectus Abdominis Sheath Block in Horses. Administering large volumes of bupivacaine in the rectus abdominis sheath (RAS) block in horses could cause local anesthetic toxicity. This study aimed to evaluate the pharmacokinetics of 2 mg/kg bupivacaine in RAS blocks and the associated toxicity risk. Six healthy adult horses were sedated with xylazine and received an ultrasound-guided bilateral 2-point RAS block. Plasma samples were collected at baseline and from 5 min to 24 h after the block and analyzed using liquid chromatography-tandem mass spectrometry. A noncompartmental analysis was performed to determine the maximum concentr...
Imaging of the equine abdomen using point of care ultrasound (POCUS): Effects of sedation on intestinal motility in horses. Point of care ultrasonographic (POCUS) assessment of the equine abdomen is now readily available to the equine practitioner using hand-held ultrasound transducers. Commonly used medications may alter the sonographic appearance or function of the small intestine, caecum or colon. Objective: To demonstrate qualitative and quantitative effects of xylazine sedation on intestinal motility of healthy horses using hand-held, wi-fi ultrasound transducers and validate POCUS methodology by determination of intra- and interobserver agreement. Methods: Double-blind cross-over study of eight healthy horses...
Ultrasound-guided intralesional tendon and ligament injections in the horse. To describe principles of ultrasound-guided injection techniques for intralesional delivery of regenerative orthobiologics into equine tendon and ligament core lesions. Unassigned: A university-owned horse and equine cadaver forelimbs. Unassigned: A reproducible protocol for ultrasound-guided injection is demonstrated with the superficial digital flexor tendon used as an example. Following diagnosis of the lesion, the horse should be sedated and the affected limb desensitized with perineural anesthesia. The lesion is identified ultrasonographically in transverse and longitudinal planes, marked...
Synthesis and Characterization of Deuterated Detomidine for Use in Equine Medication Regulation. Detomidine, 5-[(2,3-dimethylphenyl)methyl]-1H-imidazole, is a tranquilizer/sedative/analgesic widely used in equine medicine and regulated by several different analyte concentrations of detomidine and its hydroxydetomidine and carboxydetomidine metabolites in plasma and urine. Accurate regulatory quantitation of detomidine at low picogram/mL concentrations requires the availability of a stable isotope internal standard of detomidine; however, to the best of our knowledge, no certified deuterated internal standard of detomidine is commercially available and its synthesis has not been reported. ...
Plasma and Urinary Elimination Profiles of Medetomidine Metabolites in Horses for the Purpose of Doping and Medication Control. Medetomidine, an α₂-adrenergic agonist, is widely used as a sedative in horses. While its pharmacological effects are established, limited data exist on elimination of its metabolites, 3'-hydroxy medetomidine (HMD) and 3'-carboxy medetomidine (CMD), which are of regulatory interest. HMD is currently targeted in plasma and urine under International Screening Limits (ISLs) established by the International Federation of Horseracing Authorities (IFHA). In this study, seven Thoroughbreds received 6.3 μg/kg of medetomidine intravenously. Blood and urine were collected for 96 h and analyzed b...
Investigating the effect of surface cryotherapy on equine patient compliance to infraorbital nerve block placement. To investigate the effect of applying ice to the skin overlying the infraorbital canal on the compliance of healthy adult horses to infraorbital nerve block placement during standing sedation. Methods: Blinded, randomized crossover trial. Methods: Thirty healthy adult horses [16 ± 3.9 years old (mean ± standard deviation), weighing 594 ± 63 kilograms (kg)]. Methods: Each horse acted as its own control with a minimum of 7 days between treatments. Horses were sedated using detomidine hydrochloride, and sedation level was evaluated using a published simple descriptive scale. Horses were random...
Utility of dynamic preload indices of hypovolemia in isoflurane-anesthetized horses. To evaluate the utility of the dynamic indices, systolic pressure variation (SPV%), pulse pressure variation (PPV%) and plethysmographic variability index (PVI%) during induced hypovolemia, and to determine their correlation with cardiac output (CO) in anesthetized horses. Methods: Prospective experimental study. Methods: A group of eight healthy adult research horses. Methods: After sedation with intravenous (IV) xylazine, anesthesia was induced with IV ketamine and diazepam and maintained with constant-dose isoflurane delivered in 100% oxygen. Horses were positioned in dorsal recumbency, par...
Comparison of two doses of lidocaine constant rate infusion on cardiopulmonary function and recovery in isoflurane-anesthetized horses. To compare cardiopulmonary variables and recovery scores in isoflurane-anesthetized horses undergoing arthroscopy using two different intravenous (IV) lidocaine constant rate infusions (CRIs; 50 or 100 μg kg minute) under intermittent positive pressure ventilation (IPPV) or spontaneous ventilation (SV). Methods: Prospective, randomized, clinical study. Methods: A group of 30 client-owned horses, 8-156 months old (range), with body masses of 280-550 kg. Methods: Anesthesia protocol consisted of xylazine, ketamine and diazepam, and maintenance with isoflurane and a CRI of dexmedetomidine. All g...
Pharmacopuncture with low-dose dexmedetomidine and saline aquapuncture at acupoint Governing Vessel 24 provides sedation in healthy adult horses. To evaluate sedation in horses following pharmacopuncture with dexmedetomidine at acupoint Governing Vessel 24 (GV-24) compared to aquapuncture at GV-24 or an equivalent dose of dexmedetomidine administered via IV or SC routes. Unassigned: 10 adult mares received 4 treatments in a blinded, randomized, crossover design: (1) dexmedetomidine administered at GV-24 (DexmedGV24; 1 μg/kg); (2) saline administered at GV-24 (SalineGV24; 1.5 mL); (3) dexmedetomidine administered SC on the lateral neck (DexmedSC; 1 μg/kg); or (4) dexmedetomidine administered IV (DexmedIV; 1 μg/kg). Sedation scores (fa...
Exposure to Subcutaneously Administered Butorphanol in Horses Pre-Treated With Detomidine or Detomidine-Vatinoxan. The aim of the study was to determine the exposure to subcutaneously administered butorphanol in horses pre-treated with intravenous (IV) detomidine, with or without vatinoxan, a peripherally selective alpha-adrenoceptor antagonist. Five healthy, adult horses received three IV treatments 7 days apart, in a randomized, cross-over design: detomidine 20 μg/kg (DET-B), detomidine 20 μg/kg with vatinoxan 200 μg/kg (DETVAT-B) and saline (S-B), all followed by 0.1 mg/kg of butorphanol administered subcutaneously 30 min later. Venous samples were collected between 10 and 270 min after...
How to perform a venogram of the equine foot. The objective of this video is to demonstrate a reliable technique for obtaining diagnostic venogram images of the equine foot. Venogram studies are indicated to assess vascular contrast filling of the equine digit, primarily in cases of laminitis. Unassigned: A healthy university-owned horse was used for demonstration purposes. The protocol was approved by the Virginia Polytechnic Institute and State University IACUC. Unassigned: The horse's shoes are removed, and the foot is cleaned of debris. The horse is sedated and a medial and lateral abaxial nerve block performed. The pastern is clipped...
Effect of a Constant Rate Infusion of Ketamine on a Variable Rate Infusion of Xylazine in Standing Horses Undergoing Ventriculocordectomy and Laryngoplasty. Standing sedation in horses provides immobilization and analgesia for surgery while avoiding the high risks of general anesthesia. Ketamine at subanesthetic doses may enhance sedation and reduce xylazine requirements, but evidence in clinical settings is limited. In a randomized blinded trial, we evaluated whether adding a low-dose ketamine infusion could reduce the xylazine dose required for effective sedation during standing ventriculocordectomy and laryngoplasty. Fifty-one horses were randomly assigned to sedation with xylazine alone (SX group) or xylazine plus ketamine (KX group) in a cont...
