Acepromazine, a prelude to the vet

Tags

acepromazine, sedatives, socialization, vet

Bowdu has a vet appointment today for his annual blood draw to check his thyroid levels. Since he has proven to be so unmanageable during these routine visits, we got a mild sedative to administer beforehand.

This is the drug information provided to us by the vet:

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Pharmaceutical: Acepromazine 25 mg
Dosage: Give 1 tablet orally two hours prior to next visit for sedation
Indications for Use: Your veterinarian has prescribed this drug as a sedative or as a preanesthetic agent.
Side effects: It may cause low blood pressure and low heart rate in all species. This drug in rare cases can cause discolored urine. GI effects are possible side effects of this medication. Intramuscular injections may cause pain. The response to this drug is variable among individual animals. If your animal is overly sedated or not affected at the dose described discontinue use and contact the veterinarian.

* Notify your veterinarian if your animal has ever had any seizures prior to the administration of this drug. This medication can cause animals with a pre existing seizure tendency to have seizures while on this medication. Animals with pre existing heart, liver or kidney disease should be given this drug with caution.

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The prescription included three pills so we would have some extra on hand, perhaps for a future, unexpected emergency. We could have test-dosed Bowdu just to observe how he would react, as we’ve never tried pre-sedating him before. But we didn’t.

Anticipating the worst makes for clever strategy: either I prove myself right, or I create ample space for relief. I am prepared to have him injected with even heavier sedatives just to complete the blood draw, as has usually been the case. Meanwhile, I’m hoping the Ace will take some of the fight out of him, so it’ll be easier to get in there with a muzzle or any necessary needles.

Or he may be so disoriented, the intended sedative effect will backfire. From Mike Richards, DVM via Vetinfo.com:

Many dogs seem to be able to will themselves to overcome its effects, at least temporarily. This makes it less than ideal as a drug for dealing with aggressive or fearful dogs but there have not been better alternatives for medicating prior to the visit. It works often enough that many vets will try this approach first. We do this when we think it has a chance of helping make an office visit go easier. We just remember to continue to be very careful when examining the dog.

From Terry Kelley CVT, CPDT at Fearfuldogs.com:

Research has shown these drugs [Acepromazine and Chlorpromazine] functions primarily as chemical restraints without affecting the animal’s emotional behavior. While under the effect of Ace, the animal still has a very strong fear, anxiety, avoidance or arousal response, but it does not physically display these reactions and is less able to react. The dog or cat appears calm and relaxed but mentally is lucid and still having an intense emotional reaction to its surroundings. Ace is a dissociative agent and prevents the patient from understanding his environment in a logical manner. So, the actual fear level of the animal is increased. Compounding the situation, the animal is being restrained and it makes a negative association with the entire experience.

[…]

Side effects of Ace include (but are not limited to): increased noise sensitivity and startle response, decreased respiration, bradycardia leading to cardiovascular collapse (dogs and cats), hypotension, erratic thermoregulation leading to hypothermia or hyperthermia, a decrease in seizure thresholds, muscle spasms, excitation and sudden aggression (break-through response), absent pulse, unconsciousness. The duration of Ace also varies in each individual, thus making the fearful or aggressive patient even more unpredictable. Note: Ace should never be used as a tranquilizer for animals traveling due to the erratic thermoregulation effects (inability to control body temperature in cold or hot conditions).

Though the information given by the latter source is much more detailed, it mentions a lot that was not posed as a risk in more general articles. Their emphasis is on behavioral modification rather than a chemical band-aid, an approach which I’m more inclined to strive for. So these words of caution are definitely in my mind as I try to focus on making this a good experience.

We’ve been dropping in for the hell of a hypo-allergenic cookie (Science Diet, blechgk, but a novelty to the Bows nonetheless) several times over the past couple weeks. I keep telling them “It’s the cooookie place!” but they tend to wise up the moment we’re in for a real visit. High value cheesy treats and hot dogs will be on hand. I will be surprised if this manages to work.

I have a pretty pessimistic attitude about Bowdu’s behavior at the vet, even though it’s all our own damn fault. We never did much to actively make the vet a positive experience for him, we just trusted his resilience and ability to bounce back — until he hit his adolescent months. Then suddenly, he decided he no longer wanted any of his orifices violated, he was going to snap and scream, and he was going to get away with it.

We live with the mistakes that we made in Bowdu’s upbringing and training, accepting the wisdom accumulated from trial and error (and I’ll be the first to admit to the abundance of error). But if I could hit the reset button, this is one of the critical things that I would try to change. We could have done a lot more to create positive associations with the vet from puppyhood, but the DD and I both let our deep-seated distrust of doctors and hospitals get in the way. So now, not only are vet visits psychologically stressful for Bowdu, there’s the physiological stress of medication, as well as the extra fees for the pharmaceutical crutches that help us get the job done.

21 September 2011

Atta boy, Ace Face.

FOLLOWUP: Ace Face, Recap