Sedative effects of intramuscular alfaxalone-methadone-midazolam versus ketamine-methadone-midazolam in cats.

OBJECTIVE

To assess depth and quality of sedation and the ability to place an intravenous catheter in cats after intramuscular (IM) injection with alfaxalone-methadone-midazolam (AMM) or ketamine-methadone-midazolam (KMM).

STUDY DESIGN

Blinded randomized clinical trial.

ANIMALS

A group of 46 healthy Domestic Short Hair cats.

METHODS

Cats were randomly assigned to be administered IM methadone 0.3 mg kg and midazolam 0.3 mg kg with either alfaxalone 2 mg kg (AMM group, n = 23) or ketamine 3 mg kg (KMM group, n = 23). Before IM injection, a temperament score was assigned. The reaction to injection was scored. After 15 minutes, the depth of sedation was scored using a simple descriptive scale (SDS) and multidimensional sedation score. Success or failure to place an intravenous catheter at first attempt was recorded; p < 0.05.

RESULTS

Cats in the AMM group had a significantly higher median temperament score (p = 0.026). Behavioural reaction to injection with AMM was significantly less compared with KMM (p = 0.016). Median sedation scores were significantly higher in the AMM group than in the KMM group: SDS 4 (0-4) versus 2 (0-4), p = 0.01, respectively; multidimensional sedation score AMM 13 (0-13) versus 3 (0-10), indicating superior sedative effect in the AMM group, p = 0.01. Success rate of catheter placement was significantly higher in the AMM group (18/23) than in the KMM group (10/23), p = 0.033.

CONCLUSIONS

and clinical relevance Addition of 2 mg kg alfaxalone to 0.3 mg kg methadone and 0.3 mg kg midazolam provided better sedation after IM injection than ketamine 3 mg kg combined with the same doses of methadone and midazolam. This combination of drugs may be particularly desirable as an alternative to α- adrenoceptor agonist-based protocols for cats requiring IM sedation.