Antagonistic Effects of Atipamezole, Yohimbine and Prazosin on Medetomidine-Induced Diuresis in Healthy Cats

Murahata, Yusuke; Yamamoto, Asami; Miki, Yuya; Hikasa, Yoshiaki

doi:10.1292/jvms.13-0398

Cited by 5 publications

(3 citation statements)

References 23 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When it comes to managing Xylazine-induced hypotension and diuresis, many patients respond well to intravenous (IV) fluids alone, without the need for additional interventions [ 19 , 20 ]. Animal studies have demonstrated that Xylazine can cause diuresis, which can be reversed by Atipamezole and yohimbine [ 59 ].…”

Section: Reviewmentioning

confidence: 99%

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Ayub¹,

Parnia²,

Poddar³

et al. 2023

Cureus

View full text Add to dashboard Cite

Introduction and objectives: The opioid overdose epidemic is exacerbated by the emergence of Xylazine as an illicit drug adulterant. Xylazine, a veterinary sedative, can potentiate opioid effects while also causing toxic and potentially fatal side effects. This systematic review aims to assess the impact of Xylazine use and overdoses within the opioid epidemic context. Method: A systematic search was conducted following PRISMA guidelines to identify relevant case reports, and case series related to Xylazine use. A comprehensive literature search included databases like Web of Science, PubMed, Embase, and Google Scholar, utilizing keywords and Medical Subject Headings (MeSH) terms related to Xylazine. Thirty-four articles met the inclusion criteria for this review. Results: Intravenous (IV) administration was a common route for Xylazine use among various methods, including subcutaneous (SC), intramuscular (IM), and inhalation, with overall doses ranging from 40 mg to 4300 mg. The average dose in fatal cases was 1,200 mg, compared to 525 mg in non-fatal cases. Concurrent administration of other drugs, primarily opioids, occurred in 28 cases (47.5%). Intoxication was identified as a notable concern in 32 out of 34 studies, and treatments varied, with the majority experiencing positive outcomes. Withdrawal symptoms were documented in one case study, but the low number of cases with withdrawal symptoms may be attributed to factors such as a limited number of cases or individual variation. Naloxone was administered in eight cases (13.6%), and all patients recovered, although it should not be misconstrued as an antidote for Xylazine intoxication. Of the 59 cases, 21 (35.6%) resulted in fatal outcomes, with 17 involving Xylazine use in conjunction with other drugs. The IV route was a common factor in six out of the 21 fatal cases (28.6%). Conclusion: This review highlights the clinical challenges associated with Xylazine use and its co-administration with other substances, particularly opioids. Intoxication was identified as a major concern, and treatments varied across the studies, including supportive care, naloxone, and other medications. Further research is needed to explore the epidemiology and clinical implications of Xylazine use. Understanding the motivations and circumstances leading to Xylazine use, as well as its effects on users, is essential for developing effective psychosocial support and treatment interventions to address this public health crisis.

show abstract

Section: Reviewmentioning

confidence: 99%

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Ayub¹,

Parnia²,

Poddar³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…A dose ratio of 1:1 was used experimentally in healthy cats to assess the effects of different atipamezole doses on medetomidineinduced diuresis, but the authors do not comment on the sedative effects or antagonism thereof for this dose. 15 A recent paper assessed the haemodynamic effects of 'lowdose' intravenous atipamezole following dexmedetomidine infusion in anaesthetised cats, but the effects of 'low-dose' atipamezole on sedation reversal and recovery time were not assessed. 16 Concerns regarding the adverse effects of ketamine on recovery quality owing to its ability to induce dysphoria, excitation, ataxia and muscle hypertonus have previously been raised.…”

Section: Effects Of Atipamezole Dosage and Timing Of Administration Omentioning

confidence: 99%

Effects of atipamezole dosage and timing of administration on recovery time and quality in cats following injectable anaesthesia incorporating ketamine

Bruniges¹,

Yates

2019

Journal of Feline Medicine and Surgery

View full text Add to dashboard Cite

Objectives The aim of this study was to establish the optimum dosage and timing of administration of atipamezole in cats undergoing general anaesthesia incorporating ketamine to provide the shortest recovery possible without unacceptably compromising recovery quality. Methods In total, 128 healthy male cats (age range 2–108 months, weight range 0.56–5.22 kg) admitted for castration were randomly allocated to groups of 32. Anaesthesia was induced with 60 mg/m2 ketamine, 180 µg/m2 buprenorphine, 3 mg/m2 midazolam and 600 µg/m2 medetomidine intramuscularly (IM). Cats received 600 µg/m2 (groups 1ATI20 and 1ATI40) or 1.5 mg/m2 (groups 2.5ATI20 and 2.5ATI40) atipamezole IM either 20 (groups 1ATI20 and 2.5ATI20) or 40 mins (groups 1ATI40 and 2.5ATI40) after the ‘quad’. Preparation time, surgical time, auricular temperature, times to sternal recumbency and first standing, and recovery quality score were recorded. Data were analysed using ANOVA, Kruskal–Wallis, Mann–Whitney U-tests and χ2 tests. Statistical significance was deemed to be P ⩽0.05. Results Groups did not differ significantly in preparation or surgical time. Auricular temperature decreased significantly over time ( P <0.01) but did not differ between atipamezole treatment groups. Time to sternal recumbency in group 2.5ATI20 (52.9 ± 22.3 mins) was faster than group 1ATI20 (65.7 ± 24.7 mins) ( P ⩽0.05), but there were no significant differences between other groups. Time to first standing and recovery quality scores did not differ significantly between groups. Minimal adverse effects were seen. Conclusions and relevance Atipamezole administration after 20 mins did not reduce recovery time but neither was recovery quality adversely affected compared with when it was administered after 40 mins, following datasheet recommendations with concurrent ketamine administration. The results of this study also suggest that an atipamezole:medetomidine dose ratio of 2.5:1 is more effective than 1:1 in reducing recovery time, regardless of timing of administration, although this only reached statistical significance for time to sternal recumbency when atipamezole was administered after 20 mins.

show abstract

“…202 Prolonged confinement without opportunities for urination and defecation away from the enclosure can increase patient stress and discomfort. This problem may be exacerbated by perioperative administration of fluids and certain anesthetic agents such as α 2 -adrenoceptor agonists, 256,257 which can increase urine output. In addition, confinement inhibits elimination behavior in some patients.…”

Section: Return To Patient Housingmentioning

confidence: 99%

The Association of Shelter Veterinarians’ 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs

Griffin¹,

Bushby²,

McCobb³

et al. 2016

javma

View full text Add to dashboard Cite

As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASHstyle operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.

show abstract

Antagonistic Effects of Atipamezole, Yohimbine and Prazosin on Medetomidine-Induced Diuresis in Healthy Cats

Cited by 5 publications

References 23 publications

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Effects of atipamezole dosage and timing of administration on recovery time and quality in cats following injectable anaesthesia incorporating ketamine

The Association of Shelter Veterinarians’ 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs

Contact Info

Product

Resources

About