Vet360 Vol 4 Issue 4 August 2017 Vet 360 | Page 16

CPD ACCREDITED ARTICLE
Medetomidine Premedication
for Caesarean Section in the Bitch
It is Safe for the Dam and Puppies
K G M De Cramer, BVSc, MMed-
Vet(Gyn), PhD
K E. Joubert B.V.Sc M.Med Vet (Anaes)
This study shows that medetomidine hydrochloride in the protocol
used is a safe premedicant in bitches prior to caesarean section and
is associated with good puppy vigour as well as 2h and 7d puppy sur-
vival rates.
The ideal anaesthetic protocol for caesarean section
(CS) should provide adequate muscle relaxation, an-
algesia and narcosis for optimal operating conditions,
be safe for the bitch 2 and should not affect the via-
bility and survival of the puppies 3,4 . Additional recom-
mendations include using drugs with a short duration
of action 5 and using drugs which are reversible 6 . In-
duction using propofol and maintenance of anaesthe-
sia using isoflurane is widely accepted and associated
with good outcome 4,7-12. The use of alpha-2-adren-
ergic agonists before anaesthesia for CS, is however,
controversial. The alpha-2-adrenergic agonist xyla-
zine, is not recommended in patients undergoing CS
because it was identified as a risk factor for increased
puppy mortality 12,13 , associated with increased risk of
death in the dog 14,15 and caused severe maternal and
neonatal cardiovascular depression 16 .
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Issue 04 | AUGUST 2017 | 16
The greatest objection to the use of the alpha-2-adr-
energic agonists are the cardiopulmonary effects
which include transient hypertension followed by mild
hypotension, bradycardia, increased systemic vascu-
lar resistance, reduced cardiac output, and respiratory
depression. In recent surveys of anaesthetic mortality
in the dog however, premedication with medetomi-
dine prior to anaesthesia for routine surgery, was not
identified as an increased risk factor for mortality 17 and
data from human literature has shown that dexme-
detomidine is associated with a reduction in all causes
of mortality when used for non-cardiac, cardiac and
vascular surgery 18,19 .
No studies in veterinary medicine have been conduct-
ed on the use of medetomidine for CS.