Comparison of pentobarbital-phenytoin alone vs propofol prior to pentobarbital-phenytoin for euthanasia in 436 client-owned dogs. 2019

Jessica M Bullock, and Travis M Lanaux, and Justin W Shmalberg
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL.

OBJECTIVE To report the incidence of adverse events during euthanasia of client-owned dogs administered either intravenous pentobarbital/phenytoin (PP) or PP after propofol delivery. METHODS Prospective, observational, multi-site study. METHODS Four hundred thirty-six dogs undergoing client-elected euthanasia over a 1-year period. METHODS Interventions included placement of an IV catheter and delivery of euthanasia agents (PP for the PP group, propofol followed by PP for the propofol group). Seven pre-determined adverse events were recorded: agonal breaths, urination, defecation, vocalization, muscle activity, dysphoria, and catheter complications. Euthanasia scores for each patient were defined as the sum of all adverse events (0-7) the patient exhibited. RESULTS Two hundred thirty-six dogs were in the PP group and 200 dogs were in the propofol group. No significant differences were detected in the dose of PP administered (166.9 ± 105.6 mg/kg for PP group, 182.6 ± 109.8 mg/kg for propofol group). Propofol dogs received 4.5 ± 2.9 mg/kg propofol. The incidence of ≥ 1 adverse event was 35.2% in the PP group and 26.5% in the propofol group (P = 0.052). Mean euthanasia scores (0.47 PP group, 0.32 propofol group) were not significantly different (P = 0.08). Propofol significantly reduced the incidence of muscle activity (6% vs. 14%, odds ratio 0.39; P = 0.0079). CONCLUSIONS There was no difference in the likelihood of the studied adverse events during client-elected euthanasia in dogs when propofol was used prior to PP. There was a significant reduction in perimortem muscle activity if propofol was given prior to PP.

UI MeSH Term Description Entries
D008297 Male Males
D010424 Pentobarbital A short-acting barbiturate that is effective as a sedative and hypnotic (but not as an anti-anxiety) agent and is usually given orally. It is prescribed more frequently for sleep induction than for sedation but, like similar agents, may lose its effectiveness by the second week of continued administration. (From AMA Drug Evaluations Annual, 1994, p236) Mebubarbital,Mebumal,Diabutal,Etaminal,Ethaminal,Nembutal,Pentobarbital Sodium,Pentobarbital, Monosodium Salt,Pentobarbitone,Sagatal,Monosodium Salt Pentobarbital
D010672 Phenytoin An anticonvulsant that is used to treat a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. Diphenylhydantoin,Fenitoin,Phenhydan,5,5-Diphenylhydantoin,5,5-diphenylimidazolidine-2,4-dione,Antisacer,Difenin,Dihydan,Dilantin,Epamin,Epanutin,Hydantol,Phenytoin Sodium,Sodium Diphenylhydantoinate,Diphenylhydantoinate, Sodium
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013035 Spasm An involuntary contraction of a muscle or group of muscles. Spasms may involve SKELETAL MUSCLE or SMOOTH MUSCLE. Muscle Spasm,Muscular Spasm,Spasm, Ciliary Body,Spasm, Generalized,Ciliary Body Spasm,Ciliary Body Spasms,Generalized Spasm,Generalized Spasms,Muscle Spasms,Muscular Spasms,Spasm, Muscle,Spasm, Muscular,Spasms,Spasms, Ciliary Body,Spasms, Generalized,Spasms, Muscle,Spasms, Muscular
D013781 Texas State bounded on the north by Oklahoma, on the east by Arkansas and Louisiana, on the south by Mexico, and on the west by New Mexico.

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