Beware of what Anesthetic your Vet gives your dog.

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carolyn dewrance
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Beware of what Anesthetic your Vet gives your dog.

Post by carolyn dewrance »

Last night after a week of battling to keep my maltese alive, she passed away, Last Friday, she had 3 teeth removed, and came home in a sleepy state, which I took as normal, but 3 days later she was still sleeping, so back to the Vet who said it was possibly the affects of the Anesthetic, and that it would ware off. Well it did ware off Last night she died. Some of the older members of this site will remember Roxie, and how she was a mother to litters of puppies and kittens that had no mother of their own. She was a very special little girl and I would like to warn all of you the danger of using this Anesthetic on any dog or cat.
Please read and if possible save for future refrence.

For Animal Use Only List 5206
PropoFlo™
propofol
Anesthetic Injection. Fliptop vial. Each mL contains 10 mg propofol. Emulsion for intravenous use in dogs. Shake Well Before Use.
CAUTION:
Federal law restricts this drug to use by or on the order of a licensed
veterinarian.
DESCRIPTION:
PropoFlo™ Injection is a sterile, nonpyrogenic emulsion containing 10
mg/mL of propofol suitable for intravenous administration. Propofol is
chemically described as 2, 6-diisopropylphenol and has a molecular
weight of 178.27. Propofol is very slightly soluble in water and is therefore
formulated as a white, oil-in-water emulsion. In addition to the active
component, propofol, the formulation also contains soybean oil (100
mg/mL), glycerol (22.5 mg/mL), and egg lecithin (12 mg/mL), with sodium
hydroxide to adjust the pH. The propofol emulsion is isotonic and has a
pH of 7-8.5.
CLINICAL PHARMACOLOGY:
Propofol injection is an intravenous sedative hypnotic agent for use in the
induction and maintenance of anesthesia. Intravenous injection of
propofol in the dog is followed by extensive metabolism of propofol in the
liver to inactive conjugates which are excreted in the urine. Elimination
from the central compartment occurs rapidly, with an initial elimination
phase of less than 10 minutes1. Induction of anesthesia will usually be
observed within 75-120 seconds after the beginning of propofol
administration. The duration of anesthesia following the recommended
induction doses averages 6.7 minutes in premedicated and
unpremedicated animals. Recommended maintenance doses for
anesthesia in unpremedicated animals, animals premedicated with
acepromazine, and animals premedicated with a combination of agents
results in anesthesia lasting an average of 3.68, 3.80 and 5.43 minutes,
respectively, after each maintenance dose. Recovery from propofol is
rapid; full standing recovery is generally observed within 20 minutes. The
u s e o f c e r t a i n premedicant combinat ions (e.g.,
acepromazine/oxymorphone) may result in prolonged recovery. Recovery
may be delayed in Sighthounds. Propofol has been used in association
with atropine, glycopyrrolate, acepromazine, xylazine, oxymorphone,
halothane and isoflurane. No pharmacological incompatibility has been
observed.
INDICATIONS:
Propofol is an anesthetic injection for use in dogs as follows:
1. For induction of anesthesia.
2. For maintenance of general anesthesia for up to 20 minutes.
3. For induction of general anesthesia where maintenance is provided by
inhalant anesthetics.
DOSAGE AND ADMINISTRATION:
Shake the vial thoroughly before opening. Parenteral drug products
should be inspected visually for particulate matter and discoloration prior
to administration, whenever solution and container permit. Propofol is a
white stable emulsion; do not use if there is evidence of separation of the
phases. Propofol contains no antimicrobial preservatives. Strict
aseptic techniques must always be maintained during handling
since the vehicle is capable of supporting the rapid growth of
microorganisms. Failure to follow aseptic handling procedures may
result in microbial contamination causing fever, infection/sepsis,
and/or other life-threatening illness. Do not use if contamination is
suspected. Once propofol has been opened, vial contents should be
drawn into sterile syringes; each syringe should be prepared for
single patient use only. Unused product should be discarded within
6 hours. The emulsion should not be mixed with other therapeutic agents
prior to administration. Administer by intravenous injection only.
INDUCTION OF GENERAL ANESTHESIA:
For induction, propofol injection should be titrated against the response of
the patient over 30-60 seconds or until clinical signs show the onset of
anesthesia. Rapid injection of propofol (<5 seconds) may be associated
with an increased incidence of apnea2. The average propofol induction
dose rates for healthy dogs given propofol alone, or when propofol is
preceded by a premedicant, are indicated in the table below. This table is
for guidance only. The dose and rate should be based upon patient
response.
Induction Dosage Guidelines
Preanesthetic Propofol Induction Dose Propofol Rate of Administration
mg/kg Seconds mg/kg/min mL/kg/min
None 5.5 40-60 5.5-8.3 0.55-0.83
Acepromazine 3.7 30-50 4.4-7.4 0.44-0.74
Acepromazine / Oxymorphone 2.6 30-50 3.1-5.2 0.31-0.52
Propofol doses and rates for the above premedicants were based upon
the following average dosages. These doses may be lower than the label
directions for their use as a single medication
3,4.
Dose (mg/kg) Routes
Acepromazine 0.060 IM, SC, IV
Oxymorphone 0.090 IM, SC, IV
Xylazine 0.33 IM, SC
The use of these drugs as preanesthetics markedly reduces propofol
requirements. As with other sedative hypnotic agents, the amount of
opioid and/or α-2 agonist premedication will influence the response of the
patient to an induction dose of propofol. In the presence of premedication,
the dose of propofol may be reduced with increasing age of the animal.
The dose of propofol should always be titrated against the response of
the patient. During induction, additional low doses of propofol, similar to
those used for maintenance with propofol, may be administered to
facilitate intubation or the transition to inhalant maintenance anesthesia.
MAINTENANCE OF GENERAL ANESTHESIA:
A. Intermittent Propofol Injections:
Anesthesia can be maintained by administering propofol in intermittent IV
injections. Clinical response will be determined by the amount and the
frequency of maintenance injections. The following table is provided for
guidance:
Maintenance Dosage Guidelines
Preanesthetic Propofol Maintenance Dose Rate of Administration
mg/kg Seconds mg/kg/min
mL/kg/min
None 2.2 10-30 4.4-13.2 0.44-1.32
Acepromazine 1.6 10-30 3.2-9.6 0.32-0.96
Acepromazine / Oxymorphone 1.8 10-30 3.6-10.8 0.36-1.08
Repeated maintenance doses of propofol do not result in increased
recovery times or dosing intervals, indicating that the anesthetic effects of
propofol are not cumulative.
B. Maintenance by Inhalant Anesthetics:
Due to the rapid metabolism of propofol, additional low doses of propofol,
similar to those used for maintenance with propofol, may be required to
complete the transition to inhalant maintenance anesthesia. Clinical trials
using propofol have shown that it may be necessary to use a higher initial
concentration of the inhalant anesthetic halothane than is usually required
following induction using barbiturate anesthetics, due to rapid recovery
from propofol5.
OVERDOSAGE:
Rapid administration or accidental overdosage of propofol may cause
cardiopulmonary depression. Respiratory arrest (apnea) may be
observed. In cases of respiratory depression, stop drug administration,
establish a patent airway, and initiate assisted or controlled ventilation
with pure oxygen. Cardiovascular depression should be treated with
plasma expanders, pressor agents, antiarrhythmic agents or other
techniques as appropriate for the observed abnormality.
WARNINGS:
Rapid single or repeat bolus administration may cause undesirable
cardiorespiratory depression including hypotension, apnea and oxygen
desaturation.
When using propofol, patients should be continuously monitored
and facilities for the maintenance of a patent airway, artificial
ventilation, and oxygen supplementation must be immediately
available.
SIDE EFFECTS:
The primary side effect of propofol is respiratory depression as evidenced
by tachypnea and apnea. Tachypnea and apnea were observed in 43 and
26% of the cases in the clinical trial, respectively. All cases of apnea
resumed normal breathing spontaneously, or responded satisfactorily to
oxygen supplementation and/or controlled ventilation. Other transient side
effects are observed infrequently or rarely:
Respiratory: labored breathing
Cardiovascular: hypotension, bradycardia, tachycardia, membrane
cyanosis, arrhythmias
Musculoskeletal: fasciculations, tenseness, paddling, movements
Central Nervous System: excitation, opisthotonus, seizures, excessive
depression
Gastrointestinal: emesis, retching, salivation
PRECAUTIONS:
1. Propofol contains no antimicrobial preservatives. Strict aseptic
techniques must always be maintained during handling since the vehicle
is capable of supporting the rapid growth of microorganisms. Failure to
follow aseptic handling procedures may result in microbial contamination
causing fever, infection/sepsis, and/or other life-threatening illness. Do
not use if contamination is suspected. Once propofol has been opened,
vial contents should be drawn into sterile syringes; each syringe should
be prepared for single patient use only. Unused product should be
discarded within 6 hours.
2. Anesthesia effects: Careful monitoring of the patient is necessary when
using propofol as a maintenance anesthetic due to the possibility of rapid
arousal. Apnea may occur following maintenance doses of propofol.
Following induction, additional propofol may be needed to complete the
transition to inhalant maintenance anesthesia due to rapid recovery from
propofol. Doses administered during the transition to inhalant anesthesia
may result in apnea. Propofol has also been used during inhalant
maintenance anesthesia to increase anesthetic depth. Propofol used
during inhalant maintenance may result in apnea.
3. Physiological effects: Mild hypotension may occur during propofol
anesthesia.
4. Premedicants: Premedicants may increase the anesthesia or sedative
effect of propofol and result in more pronounced changes in systolic,
diastolic and mean arterial blood pressures.
5. Breeding animals: The use of propofol in pregnant and breeding dogs
has not been evaluated. Propofol crosses the placenta and, as with other
general anesthetic agents, the administration of propofol may be
associated with neonatal depression.
6. Neonates: Propofol has not been evaluated in dogs less than 10 weeks
of age.
7. Compromised or debilitated dogs: Doses may need adjustment for
geriatric or debilitated patients. The administration of propofol to patients
with renal failure and/or hepatic failure has not been evaluated. As with
other anesthetic agents, caution should be exercised in dogs with cardiac,
respiratory, renal or hepatic impairment, or in hypovolemic or debilitated
dogs. Geriatric dogs may require less propofol for induction of anesthesia
(see Dosage and Administration).
8. Sighthounds: Propofol induction and maintenance produced
satisfactory anesthesia and recoveries in sighthounds. In the clinical
study, a total of 27 sighthounds were induced with propofol, 6 of which
were maintained on propofol. Induction doses were similar in sighthounds
compared to other animals, however, recoveries were delayed.
9. Cardiac arrhythmias: In one study, propofol increased myocardial
sensitivity to the development of epinephrine-induced ventricular
arrhythmias in a manner similar to other anesthetics6. In the clinical study,
transient ventricular arrhythmias associated with propofol were observed
in 2 of 145 animals induced and maintained on propofol.
10. Concurrent medication: No significant adverse interactions with
commonly used drugs have been observed.
11. Perivascular administration: Perivascular administration does not
produce local tissue reaction.
CONTRAINDICATIONS:
Propofol injection is contraindicated in dogs with a known hypersensitivity
to propofol or its components, or when general anesthesia or sedation are
contraindicated.
HUMAN USER SAFETY:
Not for human use. Keep out of the reach of children.
Rare cases of self-administration have been reported, including fatalities.
Propofol should be managed to prevent the risk of diversion, through
such measures as restriction of access and the use of drug accountability
procedures appropriate to the clinical setting. Exercise caution to avoid
accidental self-injection. Overdose is likely to cause cardiorespiratory
depression (such as hypotension, bradycardia and/or apnea). Remove
the individual from the source of exposure and seek medical attention.
Respiratory depression should be treated by artificial ventilation and
oxygen. Hypersensitivity reactions to propofol, including anaphylaxis, may
occur in some individuals who are also allergic to muscle relaxants7.
Avoid inhalation and direct contact of this product with skin, eyes, and
clothes. In case of contact, eyes and skin should be liberally flushed with
water for 15 minutes. Consult a physician if irritation persists. The
Material Safety Data Sheet (MSDS) contains more detailed occupational
safety information. For customer service, adverse effects reporting,
and/or a copy of the MSDS, call (888) 299-7416.
STORAGE:
Propofol undergoes oxidative degradation in the presence of oxygen and
is therefore packaged under nitrogen to eliminate this degradation path.
Store between 4 and 22°C (40-72°F). Do not store below 4°C (40°F).
Protect from light. Shake well before use.
HOW SUPPLIED:
PropoFlo™ is supplied in cartons of five-5 mL (50 mg per vial) or five-20
mL (200 mg per vial) vials containing 10 mg propofol per mL.
REFERENCES:
1. Detailed information on the pharmacokinetics and metabolism of
propofol can be obtained from Abbott Laboratories.
2. Smith, J.A., J.S. Gaynor, R.M. Bednarski and W.W. Muir. Adverse
effects of administration of propofol with various preanesthetic regimens
in dogs. JAVMA. 202:1111-1115 (1993).
3. Plumb, D.C. ed. Veterinary Drug Handbook, Second Edition. Iowa
State University Press, Ames, IA (1995).
4. Detailed information on the preanesthetic doses used with propofol in
clinical studies is available in the Freedom of Information (FOI) Summary
or can be obtained from Abbott Laboratories.
5. Muir, W.W., J.A.E. Hubbell, R.T. Skarda, and R.M. Bednarski.
Handbook of Veterinary Medicine, Second Edition. Mosby-Year Book,
Inc. (1995).
6. Kamibayashi, T., Y. Hayashi, K. Sumikawa, A. Yamatodani, K.
Kawabata and I. Yoshiya. Enhancement by propofol of epinephrineinduced
arrhythmias in dogs. Anesthesiology 75:1035-1040 (1991).
7. Laxenaire, M.C., E. Mata-Bermejo, D.A. Moneret-Vautrin and J.L.
Gueant. Life-threatening anaphylactoid reactions to propofol (Diprivan®).
Anesthesiology 77:275-280 (1992).
©Abbott 2005 • Printed in USA
1342071A R896 NADA 141-098, Approved by FDA
TEXT TAKEN FROM PACKAGE INSERT EN-0772/R4; January 2005
Manufactured for: Abbott Laboratories, North Chicago, IL 60064, USA
Carolyn Dewrance
4 Fernwood Close
Richwood
Cape Town 7441

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Nita F.
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by Nita F. »

Carolyn,

Please accept my condolences for your loss of Roxie. She was a very special lady. And thanks for sharing the anesthesia information.

Nita
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by VIOLET315 »

i'm so sorry for the loss of your pet. isn't this the same drug they think killed michael jackson
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carolyn dewrance
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by carolyn dewrance »

Yes I believe it is, so it shows you just how powerful it is, regardless what the Vets or doctors say about it. Roxie did not deserve to go like this and neither did Michael.
Carolyn Dewrance
4 Fernwood Close
Richwood
Cape Town 7441

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Deanski
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by Deanski »

I feel your pain.. Back in 2007, I dropped off Gizmo to get groomed. They used a tranq on him as he got upset by others doing the grooming. Now, he's been fully under for 3 major surgerys prior. Never had issues with this tranq before of any obvious signs of stress.

He came out of being tranq'd, then vomited and collapsed. He never came around after this and passed away.

NEVER use a "reversable" type tranq on a Chow. Only use specific gas or limited anesthtics when having any major surgery.

ALWAYS have a screening done, check with breeder if others in the litter had issues.

Chows have a terrible time while under and do not react well. Always seek experienced help prior.

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Re: Beware of what Anesthetic your Vet gives your dog.

Post by heweijun8 »

We are adopting a Chow Pup from a rescue, and they said they would neuter him before adoption but we read that neutering or spaying a dog too early before they have reached full growth can result in various health concerns. We may try to negotiate to neuter him once he is full grown and of course provide proof, to the shelter once he has been neutered. We were previously aware that the sometimes vets over medicate chows which sometimes results in death, but upon reading this, we were wondering what should we ask my vet before we neuter our chow?
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carolyn dewrance
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by carolyn dewrance »

I don't think any animal should be nutered before they are at least a year old, and if you have not female animals in your yard and the yard is propley fenced off from your neighbours then he should be allright.
Have you ever owned a chow before, or is this a x chow you are getting, more important is that the animal is checked for hip dysplasia, elbow dysplasia and any eye problems. How old is the pup? you should only adopt a puppy at the age of 12 weeks. Check with your vet, and ask him if he can examin the puppy before you take it home. Good luck
Carolyn Dewrance
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heweijun8
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by heweijun8 »

carolyn dewrance wrote:I don't think any animal should be nutered before they are at least a year old, and if you have not female animals in your yard and the yard is propley fenced off from your neighbours then he should be allright.
Have you ever owned a chow before, or is this a x chow you are getting, more important is that the animal is checked for hip dysplasia, elbow dysplasia and any eye problems. How old is the pup? you should only adopt a puppy at the age of 12 weeks. Check with your vet, and ask him if he can examin the puppy before you take it home. Good luck
To my knowledge they are pure bred chows w/o papers because they are rescue. They are 12 weeks old right now but we will probably take them home within the next couple weeks. As for the hip and elbow dysplasia and eye problems I have no idea, I'll have to bring them to the vet first. Also I agree with the neutering / spaying, we spayed our Shiba inu at around 1 year. I am just uncertain of whether or not it is the type of anesthetic that vets use that can kill a chow or the dosage or both. From what I have researched it seems that it is usually the vets over dosing the chow because they are afraid of them.
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by heweijun8 »

UPDATE: We spoke with the shelter and we are adopting this boy, once we pass home inspection. The pups are being spayed / neutered right now, unfortunately I don't believe they should this early but what can you do. Hopefully feeding a good raw diet and regular exercise will overlook the possible complications that may or may not occur due to early neutering. However I still would like to know more about the anesthetic thing, just in case for future. I will also be calling around the vets in my area to see if they have experience with Chows.
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by karylle »

I'm sure Roxie will always be remembered. My condolences. Thanks for your information about the anesthetic.
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Re: Beware of what Anesthetic your Vet gives your dog.

Post by Grab »

Propofol is actually a pretty safe injectable sedative. I used it on my late Chow for both of his eye surgeries because he had an issue with an anesthetic before (and since we weren't sure if it was the anesthetic or the injectable sedative that was the issue, we were playing it safe). It's always coupled with iv fluids and it is very quick acting...so you use a very small amount and have a small leeway before they start waking up. It is also able to be used just the one day..you have to throw it out, once opened, after a specific number of hours. It's a great drug to use on older animals, as it does exit the system pretty quickly.

Unfortunately, any person or animal can have a reaction to any anesthetic (or any drug for that matter). It's tragic, but senseless to blame a medication.

Michael Jackson did die from use of this drug, but because he was using it as a sleep aid and with no monitoring. INjectable sedatives are not sleeping pills and shouldn't be used as such. In order for him to stay sleeping all night, he was obviously using a far higher dose than would have been called for.
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