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Table 2 Anesthesia for caval syndrome in dogs: emergency. Suggested agents that may be used

From: Anesthesia for the dog with heartworm disease: a brief, practical review

Pre-anesthesia

Premedication

Induction (titrate to effect)

Maintenance

Vasopressors

Inotropes

Diphenhydramine (2 mg/kg IM)

Maropitant (1 mg/kg IV)

Fentanyl (3–5 µg/kg IV, can be followed by a CRI of 5 µg/kg/h IV)

Midazolam (0.2 mg/kg IV)

Sevoflurane at a minimal concentration

Dopamine (2–5 µg/kg/min)

Dexamethaxone (0.2 mg/kg IV once if not on NSAIDs)

Butorphanol (0.2 mg/kg IV)

Propofol (2–4 mg/kg IV)

Isoflurane at a minimal concentration

Norepinephrine (0.1–0.5 µg/kg/min IV)

Place IV catheter and give crystalloid fluids (3–5 ml/kg/h IV)

Pre-oxygenate

Hydromorphone (0.1 mg/kg IV)

Etomidate (1–2 mg/kg IV, must be preceded by midazolam)

 

A positive inotrope Dobutamine (5–10 µg/kg/min IV to improve cardiac contractility)

May need FFP for clotting factors or pRBC for anemia, give via dedicated IV catheter

Decrease crystalloids to avoid volume overload

Methadone (0.1 mg/kg IV)

Alfaxalone (1–4 mg/kg IV)

Lidocaine (2 mg/kg IV can be followed by a CRI of 3 mg/kg/h IV)