Page 86 - 2026 SMOG

MWD ANALGESIA AND SEDATION
Indications Indications
• Trauma or pain • The goal of analgesia is to reduce pain to a
• Need for chemical restraint tolerable level while still protecting the K9
• Continued sedation airway and mentation.
• Anxiety • The goal of sedation/chemical restraint is
• Irritable/Quarrelsome/Unruly to stop awareness of painful procedures and
prevent injury to medical personnel.
Treatment
• Mild Pain
˚ Opioid alone (if K9 is not unruly, an opioid may be all that is needed)
Morphine 0.25–0.5mg/kg IM (equivalent to one 10mg morphine autoinjector) OR
■
■ Hydromorphone 0.1mg/kg IV/IO/IM or
■ Fentanyl (injectable) q20–30min at 2–5mcg/kg IV/IO or 10mcg/kg IM
˚ Ketamine 50mg IV/IM/IO + Midazolam 10mg IV/IO/IM
• Moderate to Severe Pain
˚ Ketamine 50mg IV/IM/IO + Opioid
˚
Ketamine 50mg IV/IM/IO + Midazolam 10mg IV/IO/IM + Opioid
• Chemical Restraint/Sedation
˚ Ketamine 100mg IV/IM/IO + Midazolam 10mg IV/IO/IM OR
˚
Ketamine 100mg IV/IM/IO + Opioid
• Naloxone should be available when using opioid analgesics
˚ Recommended doses are: 2mg IV/IO OR 4mg IM/IN prn
• Constant Rate Infusion (CRI)
˚ Induction – Propofol 10mg
Induce with a bolus of Propofol 6–8mg/kg
■
■ Unconsciousness is maintained by CRI of 100–300mcg/kg/min (0.1–0.3mg/kg/min), titrated to
effect based on indicators of plane of anesthesia.
■ Patient too deep: the CRI is reduced by 50mcg/kg/min, depth reassessed in 5–10min
■ Patient too light: bolus 500–1000mcg/kg and the CRI is increased by 50mcg/kg/min
˚ Analgesia—Opioids
Morphine (15mg) 0.1–0.25mg/kg/hr
■
■ Hydromorphone (2mg) 0.02–0.05mg/kg/hr
■ Fentanyl (50mcg) 0.1–1.0mcg/kg/min
Notes, Cautions, Warnings
• CAUTION: Do NOT use Acetaminophen or Ibuprofen in MWDs, as these drugs can cause liver
toxicity. AVOID use of NSAIDs such as Naproxen and Aspirin in emergently ill or injured MWDs.
• DO NOT administer Oral Transmucosal Fentanyl Citrate (OFTC) to a K9 orally or per rectum.
• Opioid doses for K9s are significantly higher than those for humans and often cause vomiting, so
handlers and medics should be prepared to remove the muzzle after administration of an opioid.
• Hydromorphone causes excessive panting; use caution with head injuries and respiratory disease.
• Head injury and/or nonpenetrating eye injury do not preclude the use of Ketamine in K9s at the
K9TCCC recommended doses. Use caution with IV/IO Ketamine or Midazolam in a head injury, as
this makes it difficult to perform a neurological exam or determine if the casualty is decompensating.
• The sole use of routine benzodiazepines such as Midazolam is NOT recommended for analgesia.
• If a K9 appears to be partially dissociated, it is more efficacious to administer more Ketamine than to
administer more benzodiazepine.
• Polypharmacy is recommended in K9s; benzodiazepines can be used in conjunction with Ketamine
and/or opioid analgesia.
Reference: K9 CPGs
78 • MILITARY WORKING DOG (MWD)