Hedgehogs (Erinaceus europaeus)

Hedgehogs (Erinaceus europaeus)

Table of doses for hedgehogs

Drug	Dose	Comments
Anaesthetics: Gaseous anaesthesia can be used in all species and in most it is the preferred method
Alfaxalone	2-6 mg/kg i.m. In combination with dexmedetomidine for sedation: Alfaxalone (2 mg/kg) + dexmedetomidine (0.05 mg/kg) i.m. a In combination with midazolam for deep sedation to light anaesthesia: Alfaxalone (3-5mg/kg) + midazolam (1mg/kg) deep s.c.	Reverse dexmedetomidine with atipamezole (see below) Higher doses of alfaxalone will induce light anaesthesia. Midazolam can be reversed with flumazenil 0.05 mg/kg s.c.
Diazepam	Sedation: 0.5-2 mg/kg i.m. b,c Anticonvulsant: 3 mg/kg i.m. b In combination with ketamine for anaesthesia: Diazepam (0.5—2 mg/kg) + ketamine (5-20 mg/kg) i.m. d
Ketamine	10-20 mg/kg i.m. b,c In combination with diazepam for anaesthesia see above c In combination with medetomidine for anaesthesia: Ketamine (5 mg/kg) + medetomidine (0.1 mg/kg) i.m.d	Sole agent – variable effects; prolonged recovery seen in some cases
Medetomidine	0.05-0.1 mg/kg i.m. for light sedation; 0.2 mg/kg i.m. for deep sedation b,d In combination with ketamine for anaesthesia see above c	Variable effects; prolonged recovery seen in some cases Reverse with atipamezole (see below)
Atipamezole	0.25—0.5 mg/kg i.m., s.c. (equivalent to 5x dose (mg/kg) medetomidine or 10x dose (mg/kg) dexmedetomidine used) a,b,c Note: Doses up to 1 mg/kg i.m. are quoted by some authors for use in European hedgehogs d	Reversal of medetomidine: 5 times the medetomidine dose (i.e. equal volume of the 5 mg/ml atipamezole solution) Reversal of dexmedetomidine: 10 times the dexmedetomidine dose (0.5 mg/ml solution) (i.e. equal volume of the 5 mg/ml atipamezole solution when 0.5 mg/ml solution of dexmedetomidine is used)
Analgesics
Buprenorphine	0.02-0.05 mg/kg i.m., s.c. q6-8h b	For moderate/severe pain (e.g. traumatic injuries and postoperative analgesia)
Butorphanol	0.2-0.4 mg/kg i.m., s.c. q6-8h b
Carprofen	5-10 mg/kg s.c. q24h; p.o. q12h b	Anti-inflammatory: the usual considerations for the careful use of NSAIDs in dehydrated, hypovolaemic or hypertensive animals, as well as those with underlying gastrointestinal disease, should be observed
Meloxicam	0.5 mg/kg s.c., p.o. q24h b
Antibiotics Antibiotic use (both appropriate and inappropriate) imposes a powerful selection pressure on bacteria and is the primary driver of antibiotic resistance. Eliminating unnecessary use in people and animals is, therefore, essential to safeguard this invaluable resource. The reader is referred to the Guidelines for responsible antibiotic use for further information
Ampicillin	20-30 mg/kg s.c., p.o. q12h b	Broad-spectrum bactericidal Not recommended or use with caution
Amoxicillin/clavulanate (co-amoxiclav)	30-50 mg/kg i.m., s.c., p.o. q12h b	Broad-spectrum bactericidal Useful for infections of the respiratory tract, skin and soft tissues (including abscesses)
Amoxicillin LA	50-150 mg/kg s.c. q24h or q48h b	Useful first choice broad-spectrum bactericidal administered every 48 hours for most infections (e.g. for secondary bacterial pneumonia associated with lungworm) Higher doses (up to 150 mg/kg) and increased frequency (q24h) may, anecdotally, be effective for more severe infections
Cefalexin	25 mg/kg p.o. q8h c 30 mg/kg i.m., s.c., p.o. q12-24h b	Anecdotally, dosing q24h may be effective for most soft tissue infections, but more severe infections (e.g. abscesses and pyoderma) require more frequent dosing
Clindamycin	10-20 mg/kg p.o. q12h b	For anaerobic infections (e.g. abscesses, wound infections and dental infections) May also be useful for infections involving the bones and joints
Enrofloxacin	10-20 mg/kg i.m., s.c., p.o. q12h b	Fluroquinolones should ideally be reserved for infections where culture and sensitivity testing predict a clinical response and use of first- and second- line antimicrobials would not be considered effective Avoid use in young growing animals as potentially causes abnormalities of the cartilage
Marbofloxacin	8-10 mg/kg s.c. q24h b
Metronidazole	20-40 mg/kg p.o. q12h b	For anaerobic infections
Oxytetracycline	50 mg/kg i.m., s.c., p.o. q12h b	Broad-spectrum bacteriostatic
Antifungals
Enilconazole	0.2% dilution applied topically every 3 days for 4-6 applications b	Topical antifungal treatment for ringworm applied as a wash or spray May be used as a sole agent in mild cases and concurrently with systemic antifungals in severe cases After treatment, keep hedgehogs warm to prevent hypothermia, especially in small juveniles
Itraconazole	10-15 mg/kg p.o. q12h b,e	Parenteral antifungal treatment for ringworm Treat for 2-4 weeks and then re-sample
Terbinafine	50-100 mg/kg p.o. q12h or q24h b,e	Parenteral antifungal treatment for ringworm Treat for 2-4 weeks and then re-sample Calculated dosing frequency is q12h but, anecdotally, it is as effective when administered q24h (especially in larger animals)
Antiparasiticides
Amitraz	1: 400 dilution applied topically to skin as a wash every 7 days; generally 3-6 applications are required b	For treatment of mites (Caparinia, Demodex, Sarcoptes ) Essential to change bedding and clean out cage during treatment Repeat examination of skin scrapes are needed to monitor effect
Cypermethrin	Topical spray applied sparingly to affected skin b	Pyrethroid insecticide combined with F10 in a spray Useful for treating myiasis and as a fly repellent
Cyromazine	Topical application to wet the affected area b	Insect growth inhibitor useful for preventing hatching and development of blowfly larvae Can be used in combination with an insecticide to kill existing maggots Easy to apply, especially between the spines, if used as a spray, be aware of the cooling affect – do not use in hypothermic animals
Febendazole	100 mg/kg p.o. q24h for 5 days b	Useful as an in-feed treatment against nematodes and may have some effect on cestodes
Fipronil	0.25% spray used sparingly b 7.5-15 mg/kg spot-on application b	Useful for treating fleas and ticks Always ensure good ventilation during and after treatment Be aware of the cooling affect – do not use in hypothermic animals
Ivermectin (injectable)	0.5-3.0 mg/kg s.c. b	Good activity against most parasites: lower doses typically used for ectoparasites; higher doses used by some practitioners for treatment of lungworm species Repeat treatment every 7-10 days if necessary
Ivermectin (topical)	0.2-0.5 mg/kg spot-on application b	Useful for treating ectoparasites (e.g. fleas, ticks and mites) Repeat treatment after 10 days
Levamisole	27 mg/kg s.c. q48h b	Dosing regimen: 3 injections given at 48-hour intervals (other regimens can be used) Traditionally used for lungworm but drug availability is a problem, so has largely been replaced by ivermectin
Mebendazole	50-100 mg/kg p.o. q24h for 5 days b	Useful for treating nematodes and cestodes
Permethrin	Light topical application of powder to skin b 250-350 mg/kg spot-on application b	Useful for treating fleas, ticks and myiasis
Praziquantel	10-20 mg/kg i.m., s.c., p.o. once b 30 mg/kg spot-on application b	Useful for treating cestodes and trematodes
Pyrethrum	Light topical application of powder to the skin b	Useful for treating ectoparasites (especially fleas) Use very sparingly
Sulfadimidine	200 mg/kg s.c. q24h for 3 days b	Useful for treating coccidiosis
Sulfadoxine/trimethoprim	50 mg/kg i.m., s.c. q24h for 5 days b
Toltrazuril	25-50 mg/kg p.o.; repeat if necessary
Miscellaneous
Bromhexine	1 pinch of powder p.o. q12h (3 mg/kg q24h) b	Mucolytic Aids expectoration of mucus in parasitic bronchopneumonia
Clenbuterol	1 pinch of granules p.o. q12h b	Bronchodilator Relieves bronchospasm and assists mucociliary clearance in respiratory disease
Dexamethasone	1-5 mg/kg i.v., i.m., s.c. b	Corticosteroid: lower doses are anti-inflammatory; higher doses may be useful in treating parasitic bronchopneumonia Use with caution in wild animals

NSAID(s) = non-steroidal anti-inflammatory drugs

References and further reading

a Bellini L, Pagani G, Mollo A et al. (2019) Evaluation of alfaxalone and dexmedetomidine for intramuscular restraint in European hedgehogs (Erinaceus europaeus). Veterinary Record 185 (5), 145.

b Bexton S (2016) Hedgehogs. BSAVA Manual of Wildlife Casualties, 2nd edition, ed. E Mullineaux and E Keeble, pp. 117-136. BSAVA Publications, Gloucester.

c Carpenter JW (2013) Exotic Animal Formulary, 4th edition. Elsevier, Oxford.

d Carpenter JW (2022) Exotic Animal Formulary, 6th edition. Elsevier, Oxford.

e Bexton S and Nelson H (2016) Comparison of two systemic antifungal agents, itraconazole and terbinafine, for the treatment of dermatophytosis in European hedgehogs (Erinaceus europaeus). Veterinary Dermatology 27 (6), 500-e133.

Useful websites

https://www.bsavalibrary.com/

https://bvajournals.onlinelibrary.wiley.com/

https://www.britishhedgehogs.org.uk