From Episode 145 on the Emergency Feed. With Dr Amanda Cavanagh.
Ketamine feels like the one drug that is almost always a safe option for sedation, even in risky patients. But ALMOST always doesn’t mean always… In this sedation masterclass Dr Amanda Cavanagh told us about a few places where you might want to leave the special K out from your sedation cocktails.
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It’s NOT that great for myocardial disease. It increases sympathetic tone (which is exactly what usually makes it such a safe drug), which makes the heart work harder. In an animal with a really thick myocardium or a really diseased myocardium you're increasing how much oxygen that heart consumes when you use ketamine. That may just be too much for the right (or the wrong!) heart.
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It’s not that safe in very sick patients. When ketamine asks the body to increase that sympathetic surge in a body that has already spent all of its sympathetic surging to stay alive, it can cause decompensation.
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Cats need to be able to pee it out, otherwise they’ll just stay sedated. (Not dogs - their livers get rid of the ketamine.) Keep this in blocked cats and cats with severely compromised kidney function.
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