To view this site you must be a
veterinarian surgeon or nurse.
Are you a Veterinary Surgeon or Veterinary Nurse?


Peri-anaesthetic management of the gastric dilation and volvulus (GDV) patient

The emergency presentation of a GDV is often a stressful situation for the veterinary team, and is a scenario were good preparation and an appropriate period for patient stabilisation are vital to a successful outcome. The anaesthetic risk in these cases is particularly high, with most graded on the American Society of Anesthesiologists (ASA) scale as 5(E) on presentation. Appropriate patient stabilisation may reduce this risk to ASA 3(E), and lead to a better patient outcome (please see this article and downloadable chart on Achieving Safer Anaesthesia with ASA). Previous literature has suggested blood lactate at presentation may be a predictor of survival, based on the degree of gastric ischaemia/necrosis, but recent work has shown serial blood lactate measurement to be more useful for guiding treatment and discussing prognosis, rather than a single result.

This brief review will focus on considerations for anaesthesia, analgesia and patient stabilisation following presentation to the clinic.


The patient with GDV is very likely to present with multiple clinical derangements that require urgent investigation prior to anaesthesia. These considerations include;

  • Abdominal pain
  • Abdominal/gastric distension
    • Cranial displacement of diaphragm
    • Regurgitation and reflux risk
  • Hypovolaemia/hypovolaemic shock
    • Reduced venous return and cardiac output, arterial hypotension, tachycardia, congested and tacky mucous membranes
  • Cardiac arrhythmias
  • Hypoventilation
    • Panting (increased respiratory rate and reduced tidal volume due to gastric distension and diaphragm displacement)
  • Electrolyte and metabolic disturbances

Pre-anaesthesia preparation

On presentation a full physical examination will provide the clinician with information on patient status and the degree of cardiovascular compromise present. Particular attention should be paid to examination of the cardiovascular system, including heart/pulse rate, arterial blood pressure and electrocardiography (ECG) and the gastrointestinal system. During placement of intravenous access blood may be drawn for biochemical and haematological analysis, including electrolytes and where possible lactate and blood gases.

Analgesia should be provided following baseline patient data collection. A full mu agonist opioid, such as methadone is most appropriate for administration at this time, may be given IV and has a quick onset time.  

Patient stabilisation should continue with administration of fluid therapy, Hartmanns/ Lactated Ringers solution is an appropriate selection (see fluid therapy section for further details). Regular monitoring of the cardiovascular system should be performed to assess patient response to fluid therapy.  Following analgesia administration and during initial fluid therapy, further diagnostics may be possible, including abdominal radiography to confirm GD or GDV, followed by gastric decompression. Orogastric intubation may be possible in certain patients, otherwise percutaneous decompression may be performed. Gastric decompression is an important procedure to reduce the risk of cardiovascular collapse during induction of anaesthesia. Continuous monitoring of ECG is useful to detect the presence of any ventricular arrhythmias that are common with this disease presentation. Recent evidence has suggested that the early use of a lidocaine IV bolus followed by infusion (2mg/kg followed by 50mcg/kg/min) is beneficial, in terms of reduced occurrence of cardiac arrhythmias, risk of acute kidney injury and hospitalisation time. Commencement of a lidocaine infusion may therefore be considered following initial triage and should be continued throughout the peri-operative period. Close monitoring should be paid for any early signs of toxicity, including nausea and tremors.

Blood work

Pre-anaesthetic blood work should be used to further assess patient status, focusing on the incidence of haemoconcentration (PCV and TS), acid-base status (such as evidence of acidaemia), hyperlactataemia and other indicators of reduced tissue perfusion, electrolyte abnormalities that may require correction and indicators of organ dysfunction, e.g. acute kidney injury, using markers such as creatinine and BUN.

Fluid therapy and cardiovascular support

Crystalloid fluid therapy should form the basis of initial resuscitative efforts. The aim being to restore circulating volume, tissue perfusion and oxygen delivery. Volume requirements should be based on patient response to fluid resuscitation. Bolus dosing should be based on 10-20ml/kg aliquots administered over 10-20 minutes, followed by patient reassessment. A positive response should indicate the patient is fluid responsive, and a further bolus should therefore be administered. If no further response is noted, then this may indicate that vasopressor administration is required. Noradrenaline is likely to be the most appropriate vasopressor to select at this time. It should be titrated to effect, has a rapid onset and following discontinuation a rapid termination of effect. Small, incremental dose increases are recommended to avoid significant vasoconstriction which may result in profound vasoconstriction and a significant bradycardia/bradyarrhythmia. Restoration of a more normal heart rate and adequate arterial blood pressure are indicators that volume and vessel tone are more normal and the patient is more stable to proceed to induction of anaesthesia.

Protocol selection

Anaesthesia agent selection should be based on those most appropriate for the patient, but also those most familiar to the clinician. As already eluded to, induction of anaesthesia should be postponed until the patient’s cardiovascular status is considered stable enough to manage the stress associated with it. 

Further PREMEDICATION may not be required in addition to the earlier administered of methadone in the compromised patient. 

INDUCTION of anaesthesia should be achieved with an IV agent. Alfaxalone is an excellent choice in this clinical scenario, with evidence in the literature to support its safety profile and use. In a 2011 study it was shown to be a suitable alternative when compared to a potent opioid and benzodiazepine combination for induction of anaesthesia in sick dogs (ASA 3-5) (please see this summary of the 2011 article by Psatha et al examining the use of alfaxalone in high risk patients). The use of a co-induction protocol with a benzodiazepine may allow for a reduction in the dose required of the IV induction agent and also improve conditions associated with tracheal intubation. The cardiorespiratory depressant effects of the IV induction agents are dose related and therefore can be minimised if the agent is injected slowly to allow for sufficient circulation time for its full effect (please see the Alfaxan User Guide). Care should be exercised to minimise the risk of regurgitation of gastric contents, therefore ensuring the airway is secured prior to allowing the head to be placed below the level of the abdomen. 

MAINTENANCE of anaesthesia using an inhalational agent (isoflurane or sevoflurane) is most common allowing the appropriate adjustment of vaporiser setting according to depth of anaesthesia. The main adverse effects observed with the inhalational agents are respiratory depression and vasodilation, resulting in hypoventilation and hypotension, both of which are dose dependent (see intra-operative analgesia below). Significant hypoventilation, resulting in hypercapnia (end-tidal CO2 values greater than 55-60mmHg) will require implementation of supportive ventilation, either intermittent manual ventilation or positive pressure ventilation, if available.

Intra-operative analgesia

Good provision of intra-operative analgesia is essential, with the aim to reduce inhalational anaesthesia requirements and therefore adverse effects such as vasodilation and hypoventilation. Non-steroidal anti-inflammatory drugs (NSAIDS) should be avoided until the patient is considered stable and recovering well in the post-operative period. Options for analgesia during laparotomy for GDV correction include:

  • Opioid analgesia
    • Bolus dosing of e.g. methadone (0.1-0.2mg/kg) or fentanyl (1-2mcg/kg)
    • Continuous infusion of e.g. fentanyl (5-10mcg/kg/hr)
  • Lidocaine
    • This may be continued during the peri-anaesthesia period (25-50mcg/kg/min)
  • Paracetamol (acetaminophen)
    • 10mg/kg IV q8-12 hours
  • Ketamine
    • Continuous infusion following a loading dose (0.2mg/kg IV bolus; 5-10mcg/kg/min)
  • Epidural anaesthesia
    • May be considered but caution is advised, particularly in the patient with signs consistent with sepsis or septic shock

Monitoring during anaesthesia

Continuous monitoring of patient status is an important aspect of patient safety during any anaesthetic. The use of multiple modalities of monitoring equipment will be extremely useful during anaesthesia and should focus on the considerations discussed. Monitoring of arterial blood pressure, pulse oximetry, ECG, body temperature and capnography and ETCO2 will provide invaluable information to ensure appropriate provision of analgesia, fluid therapy and depth of anaesthesia. If invasive blood pressure monitoring is available this will provide further information, allowing assessment of real time changes, as well as for blood gas sampling. Please see: The Big Chill; Nuances of CV Monitoring; Capnography I; and Capnography II for additional information.

Patient monitoring during anaesthesia should be focused on:

Fluid therapy

Current recommendations suggest an initial rate of 4-5ml/kg/h in healthy dogs during anaesthesia, tailored to the individual. The patient with GDV is definitely a case where additional fluid therapy is required, and initial crystalloid rates during anaesthesia are more likely to be around 10ml/kg/h, allowing then for adjustment as needed. Although the use of colloids has reduced in recent years, there are likely to be situations, particularly with large breed dogs or those non-septic patients that are non-responsive to crystalloid therapy where colloids may be considered. Both vasopressor and inotropic support may be required during anaesthesia to maintain vascular tone and cardiac contractility.


The recovery period is just as important as any other part of anaesthesia. Careful monitoring should aim to address a number of points:

  • Continuous monitoring until the patient has their trachea extubated and can maintain sternal recumbency
  • Regular monitoring until body temperature is over 37oC
  • Monitoring of ECG and arterial blood pressure are useful to detect any arrhythmias, and any subsequent effect on arterial blood pressure
  • The bladder should be checked before the patient regains consciousness and emptied if required
  • Pain should be assessed on a regular basis and analgesia provided as required. Methadone as required is likely to form the back bone of post-operative analgesia, along with continuation of a lidocaine infusion and the use of IV paracetamol (please see Practical Acute Pain Assessment).
  • Fluid therapy should be continued with an appropriate type and rate dependent on patient status
  • Continued monitoring of biochemical status may be indicated, to ensure normality of acid-base status, electrolytes and to assess any organ dysfunction
  • Continuation of vasopressor support may be indicated in the early recovery phase
  • Nutritional status should be carefully assessed


Careful physical examination, identification of patient factors and consideration of anaesthetic risks will ensure good patient safety. Good preparation and planning, prior to induction of anaesthesia are key to a successful outcome in the patient with GDV.

Article by
Carl Bradbrook

RCVS and EBVS® European Specialist in Veterinary Anaesthesia and Analgesia.

Carl graduated from the University of Liverpool in 2002 and after a few years in mixed practice undertook a residency in anaesthesia and intensive care at The Royal Veterinary College. He has worked in both private and university specialist centres and most recently worked as an independent anaesthesia consultant. 

Carl is an RCVS Recognised Specialist and a European Veterinary Specialist and is currently President of the Association of Veterinary Anaesthetists. Carl joined Anderson Moores Veterinary Specialists in October 2018. In 2020 he was awarded Fellowship of the Royal College of Veterinary Surgeons. His main areas of interest are the use of regional local anaesthetic techniques, monitoring of ventilation and neuroanaesthesia.

Originally published: Tuesday, 15th October 2019


Further reading

Bruchim, Y., Itay, S., Shira, B.-H., Kelmer, E., Sigal, Y., Itamar, A., & Gilad, S. (2012). Evaluation of lidocaine treatment on frequency of cardiac arrhythmias, acute kidney injury, and hospitalization time in dogs with gastric dilatation volvulus. Journal of Veterinary Emergency and Critical Care, 22(4), 419–427.

Green, T. I., Tonozzi, C. C., Kirby, R., & Rudloff, E. (2011). Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus: 84 dogs (2003-2007). Journal of Veterinary Emergency and Critical Care, 21(1), 36–44.

Psatha, E., Alibhai, H.I.K., Jimenez-Lozano, A., Armitage-Chan, E., & Brodbelt, D.C. (2011). Clinical efficacy and cardiorespiratory effects of Alfaxalone, or diazepam/fentanyl for induction of anaesthesia in dogs that are a poor anaesthetic risk. Veterinary Anaesthesia and Analgesia, 38, 24-36.

Keep reading... More news items that may interest you.

Caesarean Sections. Part 1: Physiology of the Pregnant Patient

In this first of four parts discussing anaesthesia for the Caesarean section we examine the anaesthesia-relevant physiological changes that occur during pregnancy.

Read On...

Paper summaries: IM alfaxalone in dogs

To complement the main editorial by Matt Gurney we examine some of the publications referenced in his article on the intramuscular use of alfaxalone in dogs

Read On...

Intramuscular use of alfaxalone in dogs: Why? When? How?

Alfaxalone (Alfaxan Multidose) is regularly administered intravenous induction agent in dogs, but what are the options if we cannot immediately gain venous access and need to sedate the dog? Matt Gurney, President of the European College of Veterinary Anaesthesia and Analgesia, considers the current literature and discusses why, when and how alfaxalone may be administered to the dog intramuscularly.

Read On...

Intramuscular use of alfaxalone in cats: Why? When? How?

We are all aware that occasionally it is necessary to administer sadation, and even general anaesthesia, to cats via the intramuscular route. In this article Matt Gurney, RCVS and European specialist in Veterinary Anaesthesia and Analgesia, discusses some useful protocols for the IM administration of alfaxalone in cats, and describes when and why this drug may prove valuable.

Read On...

Paper summaries: IM alfaxalone in cats

To complement the main editorial by Matt Gurney we examine some of the publications referenced in his article on the intramuscular use of alfaxalone in cats

Read On...

Anaesthetic recovery: How can we minimise complications?

Anaesthetic recovery is a high risk period for complications and death (Brodbelt et al, 2008). In this article Courtney Scales DipVN NCert(Anaesth) RVN discusses how we can reduce the potential risks and improve the recovery experience for our patients.

Read On...

Paper summary: Nebulised adrenaline in the postoperative management of brachycephalic obstructive airway syndrome in a Pug

Laryngeal oedema is a potentially life-threatening complication of invasive BOAS surgery. In this case study by Ellis and Leece (2017) the use of nebulised adrenaline to successfully manage this condition is described.

Read On...

Reducing anaesthetic risk in the perioperative period – a team approach

Sadly, complications can occur during the peri-anaesthetic period with potentially detrimental effects on the patient. In this article Lou Northway, VNCertECC NCert(Anaesth) RVN, examines the most common causes of adverse peri-anaesthetic events and the steps that can be taken to reduce their incidence.

Read On...

Paper summary: Effects of hypothermia on recovery from general anaesthesia in the dog.

This paper by Pottie et al (2007) examines the effects of hypothermia on recovery from general anaesthesia in the dog.

Read On...

How can we calm and sedate the uncooperative kitty?

Uncooperative, aggressive or stressed cats are commonly encountered in the veterinary clinic. This article examines the aims for calming these patients, the importance of planning and considers selected sedative protocols.

Read On...

Paper summary: Intramuscular butorphanol/alfaxalone combination for sedation of cats prior to echocardiography

The sedation of cats prior to cardiac examination requires a drug protocol that has minimal effects on the cardiovascular system. This study examined a combination of butorphanol and alfaxalone administered intramuscularly on echocardiographic assessment and on cardiovascular function.

Read On...

Anaesthesia: where can we maximise efficiency and save time?

Improving efficiency and “saving time” are key to increasing throughput in busy clinical practice, especially when the normal working environment has been disrupted, where there is an increased demand for services, or when surgical lists become overloaded. This article provides potential solutions for some common bottlenecks and inefficiencies during the anaesthetic process.

Read On...

Paper summary: The effect of propofol or alfaxalone on post-induction heart rate in healthy dogs

The maintenance of heart rate and cardiac output are essential to ensure adequate organ perfusion. This study by Okushima et al examined the effects of alfaxalone versus propofol on heart rate at the time of induction of anaesthesia.

Read On...

Paper summary: Effect of intravenous dose escalation with alfaxalone and propofol on the occurrence of apnoea in dogs.

Apnoea following induction of anaesthesia can result in both morbidity and mortality if not identified early and managed successfully. In this 2012 article by Keates and Whittem alfaxalone and propofol were administered to dogs at 1x, 2x, 5x, 10x and 20x multiples of the labelled dose to determine the incidence of apnoea and the respiratory safety profile of each drug.

Read On...

Intravenous induction of anaesthesia in dogs, cats and pet rabbits.

In this article Karen Heskin, Veterinary Technical Manager for Jurox UK, and Carl Bradbrook, RCVS & European Veterinary Anaesthesia and Analgesia Specialist and President of the Association of Veterinary Anaesthetists, discuss the three most commonly used intravenous induction agents for cats, dogs and pet rabbits in the UK. To complement this discussion we have created three useful summaries to download as quick reference guides for your clinical personnel.

Read On...

ASA Classification and Patient Safety Checklists

As clinics and hospitals reduce routine treatments and move towards critical and emergency care during the COVID-19 crisis, to complement our previously published articles on ASA classification and the use of checklists in anaesthesia, we have created this short slide presentation to act as a useful summary.

Read On...

Paper summary: Proportion of litters of purebred dogs born by Caesarean section.

It is recognised that brachycephalic dog breeds are more likely to experience dystocia and require Caesarean section. This study examined the influence of breed on the incidence of interventional surgery.

Read On...

Caesarean section. Part 1: Physiology relevant to anaesthesia.

In this first of four parts discussing anaesthesia for the Caesarean section we examine the anaesthesia-relevant physiological changes that occur during pregnancy.

Read On...

Under Pressure: Practical blood pressure assessment and management.

The monitoring of blood pressure under anaesthesia is critical for patient care. In this article Claire Roberts, RVN and owner of SynergyCPD, examines the physiology, monitoring and management of blood pressure in anaesthetised patients.

Read On...

Cardiovascular stability with Alfaxan Multidose

Cardiovascular stability is a major feature of Alfaxan Multidose. In this article we examine the benefits for your patients and the supporting evidence.

Read On...

Paper summary: Effect of lingual swab placement on pulse oximetery readings

This study by Mair et al (2016) examined what effect the placement of swabs of different thicknesses and colour would have on pulse oximetry readings.

Read On...

Practical pulse oximetry for the Veterinary Nurse

Pulse oximetry is one of the most commonly performed monitoring procedures in veterinary anaesthesia. In this article Courtney Scales, RVN and owner of Anursethesia discusses the why and how we use pulse oximeters, the advantages and pitfalls, and how to manage abnormal readings.

Read On...

Paper summary: Comparison of direct and oscillometric blood pressure assessment using a veterinary specific device

Blood pressure management requires accurate monitoring. In this summary of an article by Acierna et al (2013) we compare a veterinary specific oscillometric device to direct blood pressure measurement.

Read On...

Having their best interests at HEART: Coronary collateral circulation in the rabbit, stress & the effects of alpha-2 agonists, phenothiazines and volatiles.

How extensive is the coronary collateral circulation in the rabbit and what are the effects of stress and drugs on the heart of this species?

Read On...

Co-induction of anaesthesia. Is there a clear advantage?

In this article Matt Gurney, RCVS/ECVS specialist in Veterinary Anaesthesia and Analgesia, examines whether co-induction techniques are advantageous.

Read On...

What are the benefits of slow administration of alfaxalone and does co-induction with alfaxalone/midazolam have any benefits in healthy dogs?

In this summary of a study by Miller et al (2019) we examine if there are any benefits to an alfaxalone/midazolam induction over alfaxalone alone in the healthy dog.

Read On...

Paper summary: Clinical efficacy and cardiorespiratory effects of alfaxalone, or diazepam/fentanyl for induction of anaesthesia in dogs that are a poor anaesthetic risk.

In this summary of a paper by Psatha et al (2011) we examine the clinical benefits of alfaxalone in high-risk patients when compared to the induction protocol of diazepam + fentanyl.

Read On...

Getting to the HEART of the matter - considerations for anaesthetising the cardiac patient.

In this article Miranda discusses the challenges of anaesthetising patients with cardiac disease and how protocols can be modified to accommodate these patients.

Read On...

Paper summary: How does buprenorphine compare to butorphanol for postoperative analgesia in cats?

A prospective multi-centre clinical trial comparing buprenorphine vs butorphanol for postoperative analgesia in cats.

Read On...

Paper summary: Analgesic effects of maxillary and inferior alveolar nerve blocks in cats undergoing dental extractions.

With dental surgery one of the most commonly performed procedures in small animal practice, what benefits do dental nerve blocks provide in cats?

Read On...

What should we consider when anaesthetising patients, including geriatrics, for dental procedures?

What should we consider when anaesthetising both adult and senior patients admitted for dental treatment?

Read On...

Checklist for geriatric dental anaesthesia

This article summarises and combines "Anaesthesia for the geriatric patient" and "What should we consider when anaesthetising patients, including geriatrics, for dental procedures?" into a single checklist for anaesthesia for the geriatric dental patient. A downloadable summary is also available by following the link.

Read On...

How do we recognise, assess and treat chronic pain in companion animals?

In this article Ian Self, Associate Professor in Veterinary Anaesthesia and Analgesia, School of Veterinary Medicine and Science, Nottingham, reflects on the recognition, assessment and management options for chronic pain in companion animals

Read On...

The physiology of acute and chronic pain.

In this article, which accompanies " How do we recognise, assess and treat chronic pain in companion animals?", Ian Self describes the physiology of acute and chronic pain

Read On...

What should we consider when anaesthetising the geriatric patient?

With an increasing number of anaesthetics being performed in older pets is there anything we should be aware of or do differently? In this article Carl Bradbrook examines the management of anaesthesia in geriatrics..

Read On...

Paper summary: What effect does does rapid, high volume fluid therapy have on cardiovascular function?

In this summary of a paper by Valverde (2012) we examine the effects of high-volume, rapid fluid therapy on cardiovascular function and hematological values during isoflurane-induced hypotension in healthy dogs.

Read On...

Paper summary: Pre-anaesthetic screening of geriatric dogs

In this summary of a paper by Joubert (2007) we examine the value of pre-anaesthetic screening in geriatric dogs and how the results influence the anaesthetic process.

Read On...

Anaesthesia for Canine Cushing's disease: What should we assess and what should we monitor?

Cushing's disease (hyperadrenocorticism) is relatively common in the dog and this article discusses the appropriate pre-anaesthetic assessment we should perform and why careful monitoring is essential.

Read On...

Paper summary: How frequently are intravenous catheters removed as a result of complications due to bacterial contamination?

In this summary of a paper by Ramos (2018) we examine the incidence of bacterial colonisation of intravenous catheters removed as a result of cannula complication

Read On...

What's the Point? Peripheral Intravenous Cannulation.

Peripheral venous cannulation is a common invasive procedure in small animals, but what are the best-practice insertion techniques and what can we do to avoid complications?

Read On...

Rabbit Anaesthesia – Understanding Your Patient.

How does the anatomy, physiology, behaviour and response to drugs affect your decision making when anaesthetising the rabbit patient?

Read On...

Paper summary: Heated intravenous fluids alone fail to prevent hypothermia in cats under general anaesthesia.

In this summary of a paper by Jourdan et al (2017) we examine the common practice of warming intravenous fluids and the effect on patient temperature.

Read On...

​Considerations for anaesthesia of the brachycephalic dog.

In this article Matt Gurney discusses the induction of anaesthesia and intubation of the brachycephalic patient.

Read On...

Watch the induction and intubation of a brachycephalic.

Induction of anaesthesia and intubation of a brachycephalic dog with Matt Gurney.

Read On...

Paper summary: The effect of omeprazole on oesophageal pH in dogs during anaesthesia

This summary of a publication by Panti et al., examines the effect of orally administered omeprazole on gastro-oesophageal reflux in the anaesthetised dog.

Read On...

How does a syringe driver benefit your patients?

Syringe drivers are becoming increasingly commonplace in modern veterinary practice and are a useful tool for multiple applications. This article looks at the science behind constant rate infusions and the basics of syringe driver use.

Read On...

Paper summary: Pet owner opinions about anaesthesia, pain and surgery in small animals

In this paper we explore perceptions and opinions of Canadian pet owners about anaesthesia, pain and surgery in small animals.

Read On...

Achieving Safer Anaesthesia with ASA and Joanne Michou MA VetMB DipECVAA MRCVS

How can a Veterinary version of the ASA Physical Status Classification help you achieve safer anaesthesia? To find out how watch our webinar.

Read On...

Paper summary: ASA classification and risk of anaesthetic related death in dogs and cats.

This scientific paper assessed whether the American Society of Anesthesiologists (ASA) Physical Status Classification correlated with the risk of anaesthetic death in dogs and cats.

Read On...

New! Methadyne, Our New Methadone Now Available

This is our third product launch this year, and the latest addition to our anaesthesia and analgesia portfolio, Methadyne, contains 10mg/ml methadone as its active ingredient. It can be administered for analgesia of moderate to severe pain in dogs and cats, to provide neuroleptanalgesia, and as part of a patient’s premedication protocol prior to general anaesthesia.

Read On...

A retrospective comparison of two analgesic strategies after uncomplicated tibial plateau levelling osteotomy in dogs.

In this review we summarise a publication by Bini (2018) examining two protocols for the administration of methadone following TPLO surgery in dogs.

Read On...

Practical Acute Pain Assessment

In this summary of acute pain assessment, Carl Bradbrook examines why we should be monitoring patients for pain and looks at the commonly used scoring systems.

Read On...

Alfaxan for the maintenance of anaesthesia: Peer reviewed clinical papers.

In this article we have identified the key clinical peer reviewed papers to support the use of Alfaxan for maintenance of Anaesthesia in Cats and Dogs.

Read On...

TIVA or not? (Total intravenous anaesthesia).

In this article the Jurox UK Technical Team discuss the use of intravenous agents to maintain anaesthesia in the dog and cat.

Read On...

Benzodiazepines - can they help reduce anaesthesia related side effects?

In part 4 of this series on premedicant agents we examine the pros and cons of benzodiazepines.

Read On...

Paper summary: Effect of benzodiazepines on the dose of alfaxalone needed for endotracheal intubation in healthy dogs

This paper examined whether a benzodiazepine, administered as a co-induction agent with alfaxalone, improved endotracheal intubation, and reduced the dose of alfaxalone, in the dog

Read On...

Putting methadone in its place in your pain management.

In this article we examine why methadone could be considered the analgesic of choice for many of our patients and understand its importance in modern veterinary medicine. The article includes a link to a downloadable summary sheet.

Read On...

Food for Thought: Pre-anaesthetic Fasting

In this article Karen examines why we fast our canine and feline patients prior to anaesthesia and what the current recommendations are. Karen also investigates why rabbits are different and should not be starved before anaesthesia.

Read On...

​Purr-fecting Pain Management

In this article summary we examine which of the two opioids, buprenorphine or butorphanol, provides the most appropriate analgesia following ovariohysterectomy in the cat.

Read On...

Perspectives on Premeds - Phenothiazines: from Mental Health to Premedication

In this article from the Perspectives on Premeds series, Karen takes us through the properties and uses of phenothiazines in modern veterinary practice.

Read On...

Methadone with Acepromazine - when is enough, enough?

This study looks at the effects of three methadone doses combined with acepromazine on sedation and some cardiopulmonary variables in dogs.

Read On...

AceSedate®, Our New Acepromazine, Available Now.

We have extended our anaesthesia and analgesia portfolio with the launch of AceSedate®. Containing the tried and trusted, long-acting sedative agent acepromazine as its active ingredient, AceSedate can be used for the premedication, sedation and tranquilisation of cats and dogs.

Read On...

Time: is 30 minutes long enough?

This recent study examined whether the application of EMLA cream, for 30 or 60 minutes, would be a useful tool to improve patient compliance prior to intravenous cannula placement in the veterinary clinical practice setting.

Read On...

Caesarean Section Survival Guide. Part 2: Anaesthetic Protocol Selection & Peri-operative Considerations.

In this second instalment of the 2-part article, we explore premedication, induction, maintenance & monitoring, recovery and analgesia for the Caesarean section patient.

Read On...

Buprenorphine: it’s not all static in rabbits

Opioids are well known for causing gastrointestinal stasis in mammalian species. This recent paper examined the effects of a single high dose of buprenorphine on the rabbit gastrointestinal tract using non-invasive imaging techniques.

Read On...

Caesarean Section Survival Guide. Part 1: Physiology & Pre-anaesthetic Considerations.

In the first instalment of this 2-part review Karen examines the physiological changes that occur during pregnancy and how those adjustments can affect the selection of anaesthetic protocols for the increasingly common Caesarean section.

Read On...

No leeway for the spay: A comparison between methadone and buprenorphine for perioperative analgesia in dogs undergoing ovariohysterectomy.

This recent paper compares post-operative pain scores and requirement for rescue analgesia following premedication with methadone or buprenorphine, in combination with acepromazine or medetomidine, in 80 bitches undergoing ovariohysterectomy.

Read On...

Cardiac arrest - the human factor

Cardiac arrest in dogs and cats is, thankfully, relatively rare. However, when it does happen it can have devastating consequences for the animal, owner and the veterinary team. This study examined the common causalities leading up to a cardiac arrest with the aim of changing protocols to improve outcomes.

Read On...

Are you Using Safety Checklists in your Practice?

In this article, Carl focuses on the benefits of introducing a safety checklist in practice to reduce patient morbidity, mortality and to improve communication between members of the veterinary team. The article contains links to the AVA safety checklist as well as a link to a customisable list that you can adapt to your practice needs. 

Read On...

The Big Chill - Temperature Management in Sedated and Anaesthetised Patients

The effects of hypothermia are very far reaching throughout the peri-anaesthetic process. In this article, James takes us through the interesting mechanisms of body cooling and warming, the clinical relevance of hypothermia and what we can do to prevent it.

Read On...

Keeping the Finger on the Pulse -  Nuances in CV Monitoring

All patients are exposed to the risks associated with general anaesthesia. Continuously monitoring anaesthetised patients maximises patients safety and wellbeing. In this article, Dan takes us through the common monitoring techniques that provide information about the cardiovascular status of your patient. 

Read On...

Effect of Maropitant on Isoflurane Requirements & Postoperative Nausea & Vomiting

Despite being widely recognized in humans, postoperative nausea and vomiting (PONV), and the role of maropitant in reducing inhalational anaesthetic requirements have been poorly documented in dogs. This recent study evaluates PONV and isoflurane requirements after maropitant administration during routine ovariectomy in bitches.

Read On...

New! Alfaxan® Multidose Now Available

We are happy to announce we have enhanced our anaesthesia and analgesia portfolio with the introduction of Alfaxan®Multidose for dogs, cats and pet rabbits.

Read On...

Sevoflurane requirement in dogs premedicated with medetomidine and butorphanol

Little information is available about the effect that different doses of medetomidine and butorphanol may have when using sevoflurane for maintenance of anaesthesia in dogs. This recent study evaluates heart rate and median sevoflurane concentration required at different dose rates.

Read On...

Capnography II - What happened to the elephants? A summary of abnormal traces

In this second article of the capnography series, James provides a guide to a few of the most common traces that you will encounter during surgery. Scroll to the end of the article to download a printable capnography cheatsheet. 

Read On...

Pain, what a Pain! (Part 2) – Practical Tips On How To Perform Dental Nerve Blocks In Companion Animal Practice

In this second article of the Pain, what a Pain! series, Dan takes us through the LRA techniques associated with dental and oral surgery. In this article, you will find practical tips and pictures on common dental nerve blocks as well as safety concerns to consider.

Read On...

​Peri-anaesthetic mortality and nonfatal gastrointestinal complications in pet rabbits

This recent retrospective study looks at the cases of 185 pet rabbits admitted for sedation or general anaesthetic and evaluates the incidence and risk factors contributing to peri-anaesthetic mortality and gastrointestinal complications.

Read On...

Pain, what a Pain! How Locoregional Anaesthesia can Improve the Outcome and Welfare of Veterinary Patients (Part 1)

In this first article out of a series of two, Dan takes us through an introduction and practical tips for appropriate local anaesthesia delivery. Find out why these anaesthesia techniques, that are well recognised in human medicine, have seen an increase in popularity in veterinary medicine over the recent years

Read On...

Perspectives on Premeds – Opioids

Perspectives on Premeds is a series of articles touching on different pharmacological, physiological and clinical aspects of pre-anaesthetic medication. This second article aims to provide a refresher on opioids.

Read On...

Effects of Dexmedetomidine with Different Opioid Combinations in Dogs

Read the highlights of a recently published research paper that evaluates cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone and in combination with morphine, methadone, meperidine, butorphanol, nalbuphine and tramadol. 

Read On...

Preoxygenation Study Highlights

This study evaluates the effectiveness of two methods of preoxygenation in healthy yet sedated dogs and the impact of these methods on time taken to reach a predetermined haemoglobin desaturation point (haemoglobin saturation (SpO2) of 90%) during an experimentally induced period of apnoea.

Read On...

Capnography – Not Just a Load of Hot Air

Capnography is the measurement of inhaled and exhaled carbon dioxide (CO2) concentration. The graphical illustration of CO2 within respired gases versus times is known as the capnogram.

Read On...

Perspectives on Premeds – Alpha-2 Agonists

Perspectives on Premeds is a series of articles touching on different pharmacological, physiological and clinical aspects of pre-anaesthetic medication. This first article aims to provide a refresher on α2 agonists.

Read On...

Alfaxan - now licensed for use in pet rabbits

Jurox Animal Health is delighted to announce that Alfaxan is now licensed for cats, dogs and pet rabbits. This is an exciting advance and could change the way rabbits are anaesthetised in the U.K.

Read On...
Repeatable. Reliable. Relax.