Acepromazine (A) +

Opioid (one of the following):

Butorphanol (B) or

Buprenorphine (Bu) or

Methadone (Me)

0.03–0.05 mg/kg i.m. (A) +

0.2–0.4 mg/kg i.m. (B) or

20 μg/kg i.m. (Bu) or

0.2–0.5 mg/kg i.m. (Me)

Commonly used combination in adult dogs

In puppies, the acepromazine may predispose to prolonged recovery and hypothermia

Morphine does not have marketing authorization

Medetomidine (M) +

Opioid (one of the following):

Butorphanol (B) or

Buprenorphine (Bu) or

Methadone (Me)

10–20 μg/kg i.m. (M) +

0.2–0.4 mg/kg i.m. (B) or

20 μg/kg i.m. (Bu) or

0.1–0.2 mg/kg i.m. (Me)

Provides profound sedation

Medetomidine can be reversed with atipamezole

The medetomidine + methadone combination will necessitate reduced doses of induction agent a, such as:

• Propofol at 1 mg/kg i.v. or
• Alfaxalone at 0.5 mg/kg i.v. or
• Ketamine at 2 mg/kg i.m. or
• Mask induction with isoflurane

Midazolam (Mi) +

Methadone (Me)

0.3–0.4 mg/kg i.m. (Mi) +

0.2–0.5 mg/kg i.m. (Me)

Midazolam does not have marketing authorization

Dexmedetomidine (D) +

Opioid (one of the following):

Butorphanol (B) +

Buprenorphine (Bu) +

Methadone (Me)

125–375 μg/m2 i.m. (D) +

0.1–0.4 mg/kg i.m. (B) or

10–20 μg/kg i.m. (Bu) or

0.1–0.2 mg/kg i.m. (Me)

Provides profound sedation

Body surface area formula ensures accuracy of dosing across a range of sizes of dog

Dexmedetomidine can be reversed with atipamezole

The dexmedetomidine + methadone combination will necessitate reduced doses of induction agent a, such as:

• Propofol at 1 mg/kg i.v. or
• Alfaxalone at 0.5 mg/kg i.v. or
• Ketamine at 2 mg/kg i.m. or
• Mask induction with isoflurane

Midazolam/diazepam (Mi/D) +

Ketamine (K)

0.25–0.5 mg/kg i.m., i.v. (Mi/D) +

5–10 mg/kg i.m., i.v. (K)

Expect profound sedation/light general anaesthesia

Use lower doses i.v.