Dr Brock: I rely mostly on gabapentin and Trazadone for PVP. Of course we are referring to the healthy patient but I like to use Gabapentin at a dose of 20mg/kg orally, given at. least 2 hours before coming to the hospital.
Trazadone I use at 5-10mg/kg, also 2 hours before coming. On occasion I will use both drugs together at the same doses; clearly in dog that requires a bit more PVP to calm him/her down. Alternatives exist also: The “Chill Protocol” consists of a combination of Gabapentin, melatonin and acepromazine. I don’t have an issue with this protocol but I have not found to be very helpful in my hands. I look for a PVP that CONSISTENTLY gives me the level of sedation that is necessary without having long lasting effects.
If you know that combination of Trazadone and Gabapentin will not be sufficient; then giving it 12 hours before the visit and then again 2 hours prior to can be helpful. The goal is to render the patient calm enough so that a physical exam can be performed and an IM injection given.
The more drug is given orally, the drowsier the patient will remain at the recovery and can be worrisome to the client. Clearly, getting the dosage right every time is not likely to happen. There will be some degree of trial and error.
Another option is a product (nutraceutical) called Zylkene. It can be added to any drug combination. There are no contraindications. Sometimes, client compliance is the biggest issue with PVP. It is helpful to remind clients to give the meds prior to coming in. Especially if the instructions were given several weeks prior.
It is also useful is clients understand that having the patient calm when they come in will make the anesthesia smoother and more predictable.
