Alfaxalone: Dosage, Uses, and Side Effects

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Alfaxalone for Dogs, Cats, Equine, and All Animals: Dosage, Uses, and Side Effects Guide

Alfaxalone For Dogs, Cats, Equine, And All Animals: Dosage, Uses, And Side Effects Guide

Overview

Alfaxalone is a neuroactive steroid anesthetic with no analgesic properties. It acts by modulating GABA receptors, leading to CNS depression and anesthesia. Its fast onset and rapid recovery make it suitable for induction and maintenance of anesthesia across multiple veterinary species.

Uses of Alfaxalone

  • Dogs:
    • Induction and maintenance of general anesthesia.
    • Suitable for anesthesia in sighthounds.
    • Used for laryngeal motion assessment during anesthesia.
  • Cats:
    • Sedation, induction, and maintenance of anesthesia.
    • Ideal for high-risk patients (e.g., geriatric or critical cases).
    • Facilitates echocardiography without altering cardiac parameters.
  • Ferrets: Induction of general anesthesia.
  • Goats and Rabbits: For sedation or anesthesia maintenance.
  • Horses: Total Intravenous Anesthesia (TIVA) protocols for short field procedures.
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Alfaxalone Dose For Dogs, Cats, Equine, and All Animals

Species Condition Dosage & Notes
Dogs Induction of anesthesia 1.5โ€“4.5 mg/kg IV without premedication; 1.1โ€“2 mg/kg IV with premedication.
Note: Slow IV injection recommended to prevent respiratory depression.
Maintenance of anesthesia 1.2โ€“2.2 mg/kg IV bolus every 10 min, or constant rate infusion : 6โ€“9 mg/kg/hour.
Note: Reduces the need for inhalation anesthetics by up to 50%.
Short procedures (IM sedation) 0.5โ€“1 mg/kg IM with methadone.
Note: Oxygen supplementation is advised.
Cats Induction of anesthesia 2.2โ€“9.7 mg/kg IV; 2.3โ€“3.6 mg/kg IV with premedication.
Note: Use lower end of range for stable patients to prevent hypotension.
Maintenance of anesthesia 1.1โ€“1.5 mg/kg IV bolus every 10 min, or constant rate infusion : 7โ€“10 mg/kg/hour.
Note: Avoid rapid infusion to prevent excitement during recovery.
Sedation for diagnostic procedures 2โ€“3 mg/kg IM with butorphanol.
Note: Ensure quiet recovery environment to prevent agitation.
Rabbits Induction of anesthesia 6 mg/kg IM with butorphanol and dexmedetomidine.
Note: Oxygen supplementation is advised during anesthesia.
Ferrets Induction of anesthesia 2.5 mg/kg IV with medetomidine 0.02 mg/kg IM.
Note: Monitor heart rate to detect bradycardia during anesthesia.
Goats Induction of anesthesia 2 mg/kg IV with lidocaine; CRI: 6.7 mg/kg/hour.
Note: Premedicate with xylazine for smoother induction.
With xylazine premedication 2.3 mg/kg IV.
Note: Ensure oxygen supply to prevent hypoxia during procedures.
Horses TIVA protocol 1โ€“2 mg/kg IV with medetomidine, followed by CRI at 0.5โ€“1.5 mg/kg/hour.
Note: Monitor closely for muscle tremors during recovery.
Cattle (Calves) Sedation 1.2 mg/kg IV after premedication with xylazine 0.1 mg/kg IM.
Note: Monitor respiratory function closely during sedation.

Drug Dosage Calculator

You Should Give:

Common Side Effects of Alfaxalone

  • Cardiorespiratory depression: Especially with rapid IV administration.
  • Apnea: Often following induction; supplemental oxygen may be needed.
  • Hypothermia: External warming is recommended during anesthesia.
  • Excitement during recovery: May manifest as vocalization, paddling, or tremors.

Contraindications of Alfaxalone

  • Known hypersensitivity to alfaxalone or its components.
  • Avoid in animals with liver dysfunction or respiratory compromise.
  • Do not mix with other IV anesthetic agents (e.g., propofol) due to the risk of postinduction apnea.

Some Notes:

  1. Monitoring Requirements:
    • Continuous monitoring of oxygen saturation (SpO2) and ventilatory status is essential.
    • Administer pain control medications as alfaxalone provides no analgesia.
  2. Drug Interactions:
    • Combined use with benzodiazepines, opioids, or alpha-2 agonists enhances the sedative effect.
    • Avoid concurrent use with propofol or thiopental due to increased risk of CNS depression.
  3. Recovery Tips:
    • Recovery should occur in a quiet, low-stimulation environment.
    • Preanesthetic drugs like benzodiazepines can reduce excitement during recovery.
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