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MEDICINE II

Administration of Intravenous Anesthetics


to Horses Immediately After Maximal Exercise

John A. E. Hubbell, DVM, MS; Kenneth W. Hinchcliff, BVSc, PhD;


L. Michael Schmall, DVM, MS; William W. Muir, DVM, PhD;
James T. Robertson, DVM; and Richard A. Sams, PhD

Horses can be safely anesthetized immediately after maximal exercise with standard doses of
intravenous anesthetic drugs if full sedation is achieved before drug administration. Two anesthetic
drug regimens (diazepam and ketamine; tiletamine and zolazepam) produced a good quality of
anesthesia. Authors’ address: Dept. of Veterinary Clinical Sciences, The College of Veterinary
Medicine, The Ohio State University, 601 Tharp St., Columbus, OH 43210. r 1998 AAEP.

1. Introduction administration of twice the standard dose of seda-


A critical factor in treating horses immediately after tives.7 This project was designed to determine the
injuries is the difficulty in managing an excited, effectiveness of four commonly used intravenous
stressed, and exhausted horse. Occasionally, anes- anesthetic techniques in horses sedated with a com-
thesia must be induced immediately to prevent bination of xylazine and acepromazine immediately
exacerbation of the injury or to allow for a complete after maximal exercise.
examination. Intravenous anesthesia in unstressed
horses is associated with cardiovascular depression 2. Materials and Methods
and imbalances of ventilation and perfusion that can Six Thoroughbred horses were used. The horses
produce tissue hypoxia and ischemia.1–5 Intrave- were entered into an exercise program on a treadmill
nous anesthesia in exhausted horses may be more designed to establish and maintain a level of fitness
difficult because of the excitement and metabolic similar to that maintained in Thoroughbred horses
derangements that occur after exercise. Another in race training. At the end of 6 weeks the horses
concern is the potential for exacerbation of the were tested to establish their individual maximum
delayed return to pre-exercise physical status that oxygen utilization (VO2 max). The treadmill speed
occurs when movement is restricted or sedatives are that caused the horse to exercise at 120% of its VO2
administered.6,7 To our knowledge, neither the effec- max was used during simulated races. At 14-day
tiveness nor the cardiorespiratory effects of intrave- intervals, the horses were instrumented for the
nous anesthetic agents in horses recuperating from collection of arterial and venous blood gases and the
maximal exercise have been reported. measurement of cardiopulmonary and metabolic in-
We have shown that sedation can be attained in dices. The horses were exercised at 120% of their
horses after maximal exercise by the intravenous VO2 max until fatigued or for a maximum of 2 min.

NOTES

242 1998 9 Vol. 44 9 AAEP PROCEEDINGS


MEDICINE II

Fatigue was defined as the inability to maintain 4. Discussion


position on the treadmill despite vigorous oral encour- Anesthesia was successfully induced in horses se-
agement. Measurements were made prior to exer- dated with xylazine–acepromazine immediately af-
cise and 1, 10, 20, 30, 45, 60, and 90 min after ter maximal exercise. Based on the ease of
exercise. Xylazine (2.2 mg/kg IV) and aceproma- administration, quality of anesthesia, and degree of
zine (0.04 mg/kg IV) were administered 2 min after cardiorespiratory depression, ketamine–diazepam
the end of exercise. Five minutes after the end of and tiletamine–zolazepam appear to be the most
exercise, one of four intravenous anesthetic protocols suitable drug combinations. The quality and dura-
was administered: (1) ketamine (2.2 mg/kg), (2) tion of anesthesia were not good when ketamine was
diazepam (0.1 mg/kg) and ketamine (2.2 mg/kg), (3) used alone. Guaifenesin–thiopental was cumber-
premixed tiletamine and zolazepam (1 mg/kg), and some to administer and produced more cardiovascu-
(4) guaifenesin (50 mg/kg) and thiopental (5 mg/kg). lar depression.
Each horse received each of the drug combinations Although increased doses of sedative drugs are
and the order was randomized. Time to lateral required during the recuperative period from maxi-
recumbency, time to the return to sternal recum- mal exercise,7 only standard doses of intravenous
bency, time to standing, and the number of attempts anesthetic agents were required to induce anesthe-
to stand were recorded. The quality of sedation, sia in this study. The differences in dose require-
induction, anesthesia (10, 20, and 30 min), and ments are probably the result of the decreases in
recovery were scored by three independent observers neuroexcitatory substances and cardiac output pro-
using visual analog scales. Data were analyzed by duced by prior sedative administration. The amount
using a two-way analysis of variance with appropri- of cardiovascular and respiratory depression pro-
ate posttests. The level of significance was set at duced in these horses was similar to that in previous
p , 0.05. reports of resting horses.1–5
3. Results This research was supported by a grant from the
Times (in seconds) from the beginning of drug admin- Grayson-Jockey Club Research Foundation.
istration to lateral recumbency were as follows:
ketamine, 83.7 6 8.7; ketamine–diazepam, 61.2 6 References
4.1; tiletamine–zolazepam, 55.7 6 4.0; and guaifen- 1. Muir WW, Skarda RT, Milne DW. Evaluation of xylazine and
esin–thiopental, 72.3 6 4.8. Times (in minutes) to ketamine hydrochloride for anesthesia in horses. Am J Vet
the resumption of sternal recumbency were as fol- Res 1977;38:195–201.
lows: ketamine, 25.2 6 6.3; ketamine–diazepam, 2. Hubbell JAE, Bednarski RM, Muir WW. Xylazine and tilet-
40.4 6 6.3; tiletamine–zolazepam, 50.4 6 6.2; and amine-zolazepam anesthesia in horses. Am J Vet Res 1989;50:
737–742.
guaifenesin–thiopental, 63.4 6 8.6. Times (in min-
3. Muir WW, Skarda RT, Sheehan W, et al. Evaluation of
utes) to standing were as follows: ketamine, 29.2 6 thiamylal, guiafenesin, and ketamine hydrochloride combina-
8.4; ketamine–diazepam, 46.2 6 7.9; tiletamine– tions administered prior to halothane anesthesia in horses. J
zolazepam, 53.1 6 6.8; and guaifenesin–thiopental, Equine Med Surg 1979;3:178–184.
67.8 6 7.8. The quality of induction and the quality 4. Muir WW, Sams RA, Huffman RH, et al. Pharmacodynamic
of anesthesia were inadequate with ketamine alone and pharmacokinetic properties of diazepam in horses. Am J
but good to excellent with the other techniques. Vet Res 1982;43:1756–1762.
The quality of recovery was best with ketamine– 5. Hubbell JAE, Muir WW, and Sams RA. Guaifenesin: cardio-
diazepam, followed by guaifenesin–thiopental, tilet- pulmonary effects and plasma concentrations in horses. Am J
amine–zolazepam, and ketamine. The percentage Vet Res 1980;41:1751–1755.
6. Hubbell JAE, Hinchcliff KW, Muir WW, et al. Cardiorespira-
of horses standing on the first attempt were as
tory and metabolic effects of walking, standing, and standing
follows: ketamine, 50%; ketamine–diazepam, 83%; with a splint during the recuperative period from maximal
tiletamine–zolazepam, 50%; and guaifenesin–thio- exercise in horses. Am J Vet Res 1997;58:1003–1009.
pental, 66%. Cardiorespiratory changes were simi- 7. Hubbell JAE, Hinchcliff KW, Schmall LM, et al. Sedative
lar for all techniques, with the exception of arterial administration to horses immediately after maximal exercise:
blood pressures, which were significantly lower in determination of drug and dose, in Proceedings. 43rd Annu
the guiafenesin–thiopental group. Conv Am Assoc Equine Practnr 1997;279–282.

AAEP PROCEEDINGS 9 Vol. 44 / 1998 243

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