Procedural Sedation in Dogs and Cats
What Is Procedural Sedation?
Procedural sedation uses sedative and analgesic drugs to keep dogs and cats calm, comfortable, and still for examinations, imaging, minor procedures and minor surgeries, without progressing to full general anesthesia.
Sedation ranges from mild (easily roused) to deep (difficult to arouse). If the patient tolerates intubation, this should be considered general anesthesia.
Situational Awareness
Sedation is not safer than anesthesia. Deep sedation often requires higher drug doses and can cause significant respiratory depression as well as delayed recovery. General anesthesia is preferable for brachycephalic breeds, aggressive patients, patients with comorbidities that are associated with deteriorating health and detectable symptoms, and procedures where pain cannot be controlled with local/regional anesthesia. Airway compromise, aspiration and hypoxemia are the major risks during deep sedation, always have an intubation plan ready.
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Get ready to perform sedation procedures in dogs and cats
- Pre-visit medications: Ensuring that the patient is calm prior to the sedation is key. Consider using Pre-visit medications.
- IM sedative combinations:
- ◦ Dogs: dexmedetomidine or medetomidine or Zenalpha® + butorphanol
- ◦ Cats: dexmedetomidine or medetomidine + butorphanol ± ketamine.
- Local anesthesia should be used whenever possible to help reduce pain.
- Their pet will receive medications to keep them calm and comfortable.
- A dedicated team member monitors heart rate, breathing, blood pressure and oxygenation throughout.
- Reversal agents allow predictable and rapid recovery.
- Temporary side effects may include sedation, wobbliness, or mild GI signs.
Key Points for Successful Sedation
- Sedation ≠ safer; monitor as carefully as anesthesia.
- Always provide supplemental oxygen.
- Place an IV catheter once the patient is relaxed.
- Use small IV boluses (ketamine or alfaxalone) if brief deepening is needed.
- Always have intubation equipment ready.
- Use local/regional blocks to minimize systemic drug requirements.
Get Ready to Sedate: Materials & Expectations
Materials:
IM sedatives, local anesthetics, IV catheter supplies, oxygen face masks, stethoscope, Doppler or BP monitor, pulse oximeter,
capnograph, and full intubation equipment.
Workflow:
- 1. Pre-visit meds at home.
- 2. IM sedation → quiet rest.
- 3. Place IV catheter and start oxygen.
- 4. Add small IV bolus if deeper sedation is required.
- 5. Apply local blocks.
- 6. Monitor continuously until full recovery or reversal.
