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Hello Nurse Kim,
Lorazepam can be used quite safely in dogs and cats to treat an assortment of ailments, including anxiety.
Typical dosings range from 0.5 mg up to 2 mg per pet every 4-8 hours as needed and/or to effect.
I would recommend for a dog this size to consider using the injectable drug Domitor ( detomidine) at lower end of dosing spectrum for a great level of sedation for radiographs and endoscopy.
With this combination, only the detomidine portion of the sedation needs to be reversed with AntiSedan in equal parts...the Lorazepam can wear off on it's own and ease recovery for the patient.
Your veterinarian can determine the specific drug dosages based on your pet's weight, anesthetic risk scale, and availability of drugs.
I hope that you found this information helpful.
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I encourage feedback and appreciate any type bonus!! Best wishes to you and your pet,
Dr . Jodi Lynn Smith
Well, if you are concerned that underlying aggression could be un-inhibited by sedation, than using a benzodiazepene sedative is NOT going to be a good option for you, as the same effect can occur with Lorazepam.
Domitor is COMPLETELY reversible. I have NEVER seen it not be reversed with the proper dosage of Antisedan given in the proper Intramuscular administration. Was ANY other premed used WITH the domitor that you can recall??? Acepromazine? Valium??? Butorphanol????
Perhaps the safest and BEST option for you would be to elect routine and simple induction with propofol or ketamine/valium for intubation and then transition her into Isoflurane anesthesia. An endoscope can be passed by the trach tube if upper airway assessment is needed. This way, you can be sure there is no delayed recovery period or prolonged sedative effects.
In a dog that large, you truly don't have alot of options for SAFE, EFFECTIVE, and REVERSIBLE sedation/anesthesia.
Please remember to PRESS ACCEPT so that I can be compensated for my time and professional recommendations concerning your pet. I encourage feedback and appreciate bonuses!! Best wishes to you and your pet,
Thank you for confirming that they did NOT reverse the domitor.....it is completely reversible.
The Acepromazine could have easily dorked her to the moon and back if the domitor was not reversed prior to discharge and if she had ANY degree of underlying heart, liver, or kidney disease that was subclinical at the time of sedation.
If aspiration is a worry, than simple chest films should be performed without sedation. A quick lateral chest view should suffice.
Please note that using Domitor and Acepromazine in a Giant Breed dog could potentially accelerate any UNDIAGNOSED cardiovascular irregularities. Meaning, if your pet had any degree of undiagnosed/subclinical heart disease, that using these medications without the proper monitoring, reversal, and recovery protocol could have precipitated an episode of congestive heart failure. It is pertinent that the determination of whether she has aspiration pneumonia or pulmonary edema 2' to congestive heart failure be made immediately, as the therapy is obviously going to be quite different between the two etiologies.
Metacam should never be used if underlying kidney disease is possible or if pre-operative bloodwork has not been done to verify renal status. Metacam can and does cause GI symptoms and can precipitate kidney failure if used without caution.
I think the place to start is to get your chest xrays done and see where to go from there. Oral antibiotics should be fine for her if she is not vomiting. She may also take Pepcid and Cerinia in capsule form for vomiting if needed once daily by mouth.
Your original question has been answered, the consult has now turned into something entirely different from the original question list price.
I wish you the best of luck with your pet.