Vetdrugs 2.0Detomidine is an alpha2-adrenergic agonist used predominantly in horses for sedation and analgesia. It facilitates standing examinations and minor procedures and is used as an adjunct to general anesthesia. Injectable and oromucosal formulations have different clinical applications, with oromucosal gel used mainly for sedation during handling and husbandry procedures.
Group
Alpha-2 adrenergic agonist
Mechanism of Action
Detomidine activates central alpha2-adrenergic receptors, reducing norepinephrine release and sympathetic neurotransmission. Suppression of arousal pathways produces sedation, while effects in spinal and supraspinal pain pathways reduce nociceptive transmission and provide analgesia. The depth and duration of these effects are dose dependent. Peripheral alpha2-receptor activation also influences vascular tone and other autonomic functions.
Dose Rates
Dog
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Sedation | 5 mcg/kg | IV | Do not use in: Shock or severe cardiovascular compromise | |
| Sedation | 10–20 mcg/kg | IM | Do not use in: Shock or severe cardiovascular compromise | |
| Sedation | Reference only | OTM | Do not use in: Shock or severe cardiovascular compromise; Gel: 0.5 mg/m² for mild sedation, 1 mg/m² for greater sedation, or 2–4 mg/m² for profound sedation; apply to upper gingiva. BSA calculation required. Reversal: atipamezole 0.1 mg/kg IM. |
Cat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Sedation with ketamine | Reference only | OTM | Do not use in: Shock or severe cardiovascular compromise; Injectable detomidine 0.5 mg/kg plus ketamine 10 mg/kg sprayed into the mouth. Combination protocol. | |
| Sedation | Reference only | OTM | Do not use in: Shock or severe cardiovascular compromise; Gel 2–4 mg/m²; vomiting is common. BSA calculation required. Reversal: atipamezole 0.1 mg/kg IM. |
Horse
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Sedation | 20–40 mcg/kg | IV, IM | Do not use in: Shock or severe cardiovascular compromise | |
| Sedation — Initial | 10–20 mcg/kg | IV, IM | Do not use in: Shock or severe cardiovascular compromise; Lower initial regimen; repeat according to effect. Doses as low as 5 mcg/kg have been used in draft horses. | |
| Analgesia | 20 mcg/kg | IV, IM | Do not use in: Shock or severe cardiovascular compromise; A 40 mcg/kg dose may prolong analgesia. | |
| Sedation | 40 mcg/kg | OTM | Do not use in: Shock or severe cardiovascular compromise; Sublingual gel. | |
| Sedation infusion | Reference only | IV | Do not use in: Shock or severe cardiovascular compromise; 10 mcg/kg IV loading bolus, then 0.5 mcg/kg/min for 15 minutes; progressively reduce toward 0.1 mcg/kg/min according to effect. | |
| Analgesia | 30–40 mcg/kg | IV | ||
| Caudal epidural analgesia | 0.06 mg/kg | EPIDURAL | Injection at S4–S5; reported analgesia 2–3 hours. | |
| Combined epidural analgesia | Reference only | EPIDURAL | Detomidine 0.03 mg/kg plus morphine 0.2 mg/kg; the source prints an anatomically inconsistent S1–L6 injection site, which must be resolved before procedural use. Reported duration exceeds 6 hours. | |
| Sedation | 0.06 mg/kg | PO | Alternative when injection is impractical; onset may take approximately 45 minutes. | |
| Standing restraint infusion alternatives | Reference only | IV | Alternative A: load 7.5 mcg/kg, infuse 0.6 mcg/kg/min for 15 minutes, then halve the rate every 15 minutes. Alternative B: load 8.4 mcg/kg, then 0.5 mcg/kg/min for 15 minutes, 0.3 for 15 minutes, and 0.15 thereafter. Additional local analgesia or butorphanol may be needed. |
Cattle
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Sedation | Reference only | IV | Do not use in: Shock or severe cardiovascular compromise; The source gives 2–10 mcg/kg but an inconsistent parenthetical conversion of 0.002–0.1 mg/kg. Resolve the endpoint before calculation. | |
| Sedation | 5–40 mcg/kg | IM | Do not use in: Shock or severe cardiovascular compromise | |
| Calf sedation | 30 mcg/kg | IV | Do not use in: Shock or severe cardiovascular compromise; Calves. | |
| Calf sedation | 80 mcg/kg | OTM | Do not use in: Shock or severe cardiovascular compromise; Calves; equine oral mucosal gel. | |
| Sedation | 30–60 mcg/kg | IV, IM | ||
| Analgesia | 10 mcg/kg | IV | Reported duration approximately 30 minutes. |
Sheep
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthesia with propofol | Reference only | IM | Detomidine 0.01 mg/kg IM followed by propofol 3–5 mg/kg IV. | |
| Analgesia | Reference only | IV, IM | The source gives 0.005–0.05 mg/kg IV or IM but combines “every 3–6 hours” with “once”; the repeat schedule is contradictory. |
Goat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthesia with propofol | Reference only | IM | Detomidine 0.01 mg/kg IM followed by propofol 3–5 mg/kg IV. | |
| Analgesia | Reference only | IV, IM | The source gives 0.005–0.05 mg/kg IV or IM but combines “every 3–6 hours” with “once”; the repeat schedule is contradictory. |
Llama
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Analgesia | Reference only | IV, IM | The source gives 0.005–0.05 mg/kg IV or IM but combines “every 3–6 hours” with “once”; the repeat schedule is contradictory. |
Alpaca
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Analgesia | Reference only | IV, IM | The source gives 0.005–0.05 mg/kg IV or IM but combines “every 3–6 hours” with “once”; the repeat schedule is contradictory. |
Bird
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Sedation and analgesia | 0.3 mg/kg | IM | Limited information on duration and adverse effects. |
Indications
- Sedation of horses for standing diagnostic examinations and minor procedures.
- Analgesia for selected painful equine conditions, including short-term relief of visceral pain associated with colic.
- Preanesthetic medication and adjunctive sedation or analgesia in equine anesthesia protocols.
- Oromucosal sedation of horses for minor handling and husbandry procedures, such as clipping, shoeing or trimming.
- Extra-label sedation of selected dogs, cats or calves under veterinary supervision, with a smaller evidence base than in horses.
Contraindications
- Use cautiously with cardiac disease, bradycardia, hypotension or pregnancy.
Interactions
- IV sulfonamides may trigger arrhythmias.
- Other sedatives, opioids and anesthetics enhance depression.
Adverse effects
- Bradycardia, AV block and variable blood pressure
- Ataxia, sweating, diuresis
- Vomiting, especially in cats
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Detomidine injection 10 mg/mL | Injection | 10 mg / mL | IV, IM |
| Detomidine oral mucosal gel 7.6 mg/mL | Oral Gel | 7.6 mg / mL | OTM |
Monitoring and Administration
Monitor ECG, heart rate, blood pressure and respiration. Routine atropine treatment of alpha-2-associated bradycardia is not indicated.
Apply oral gel to the mucosa; onset is slower than injection. Atipamezole can reverse effects in small animals.
Intravaginal equine gel administration has been studied at 40 mcg/kg; this route is not supported by the app.