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- Author or Editor: Alexandra Hamilton x
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Abstract
Objective—To investigate the safety and efficacy of oral administration of the serotonin antagonist and reuptake inhibitor trazodone hydrochloride to facilitate confinement and calming after orthopedic surgery in dogs.
Design—Prospective open-label clinical trial.
Animals—36 client-owned dogs that underwent orthopedic surgery.
Procedures—Starting the day after surgery, dogs were administered trazodone (approx 3.5 mg/kg [1.6 mg/lb], PO, q 12 h) with tramadol (4 to 6 mg/kg [1.8 to 2.7 mg/lb], PO, q 8 to 12 h) for pain management. After 3 days, administration of tramadol was discontinued, and the trazodone dosage was increased (approx 7 mg/kg [3.2 mg/lb], PO, q 12 h) and maintained for at least 4 weeks. If needed, trazodone dosage was increased (7 to 10 mg/kg [3.2 to 4.5 mg/lb], PO, q 8 h). Owners completed electronic surveys rating their dogs’ confinement tolerance, calmness or hyperactivity level, and responses to specific provocative situations prior to surgery and 1, 2, 3, and 4 weeks after surgery and at the postsurgery evaluation (at 8 to 12 weeks).
Results—Most (32/36 [89%]) of owners reported that their dogs, when given trazodone during the 8 to 12 weeks following orthopedic surgery, improved moderately or extremely with regard to confinement tolerance and calmness. Trazodone was well tolerated, even in combination with NSAIDs, antimicrobials, and other medications; no dogs were withdrawn from the study because of adverse reactions. Owner-reported median onset of action of trazodone was 31 to 45 minutes, and median duration of action was ≥ 4 hours.
Conclusions and Clinical Relevance—Results suggested that oral administration of trazodone was safe and efficacious and may be used to facilitate confinement and enhance behavioral calmness of dogs during the critical recovery period following orthopedic surgery.
Summary
Eighteen eyes of 66 dogs were visual on reevaluation of traumatic proptosis. Twenty-one eyes were enucleated, and 4 dogs were euthanatized. In 18 cats, no eyes regained vision after traumatic proptosis: 12 cats had the affected eye enucleated, 2 had an eye that was considered blind, and 4 cats were euthanatized. Affected eyes of 45 dogs and 2 cats underwent surgical replacement and temporary tarsorrhaphy. Favorable prognostic indicators for eyes undergoing surgical replacement included proptosis in a brachycephalic dog, positive direct or consensual pupillary light response, normal findings on posterior segment examination, and a proptosed eye that had vision on initial examination. Unfavorable prognostic indicators included proptosis in a nonbrachycephalic dog, proptosis in cats, hyphema, no visible pupil, facial fractures, optic nerve damage, and avulsion of 3 or more extraocular muscles.
