ACUP103.

01

Rabbit Anesthesia

The intent of this Animal Care and Use Procedure (ACUP) is to describe commonly used methods to anesthetize rabbits. This ACUP is intended for use by those at the Cornell Center for Animal Resources and Education (CARE) staff and investigators who anesthetize rabbits. This procedure is approved by the Cornell Institutional Animal Care and Use Committee (IACUC). Any deviation must be approved by the IACUC prior to its implementation. TABLE OF CONTENTS 1. 2. 3. 4. 5. 6. 7. Introduction Materials Procedures Personnel safety Animal related contingencies References Appendices

1. Introduction This ACUP presents anesthetic considerations and protocol options commonly encountered with rabbits; refer to Appendices 1-5 for examples of pre-anesthetic and anesthetic drugs, and drug protocols. All drugs must be approved by the IACUC prior to use. Check the expiration dates on all drugs; do not use any drugs past the expiration date. 2. Materials Gas anesthesia machine Anesthesia monitoring devices Anesthesia record sheet (see link) Endotracheal tubes Laryngoscope Plain gauze roll Gauze squares Sterile eye lubricant Lidocaine lubricant Long cotton swab

Sterile 0.9% saline or Lactated Ringers Solution (LRS) Intra-venous drip set (pediatric 60 drip/ml) Intra-venous catheter and cap Bandage tape Antiseptic (e.g., Nolvasan) Needles and syringes Anesthesia/analgesia drugs see appendix 1-3

3. Procedures a. Consider factors that can affect the choice of anesthetics. These include: i. Breed, age, health status, concurrent medication, and demeanor/disposition of patient. ii. Length and type of operation or procedure to be performed. iii. Possible effect of the anesthesia on the scientific objectives of the study. iv. Special facilities and equipment required (e.g., volatile anesthetics). v. Personal knowledge, experience, preference and skill with available agents. b. Perform a pre-anesthetic evaluation of the rabbit and obtain an accurate weight. c. Fast rabbits for 16 hours prior to anesthesia. d. Premedication: administer per Appendix 1, 0-5 minutes before induction if given IV and 10-20 minutes before induction if given SQ or IM. NOTE: An analgesic must be administered preoperatively for procedures that may result in pain. i. Intravenous injection locations: Cephalic vein Lateral saphenous veinAuricular vein ii. Intramuscular injection locations: Cranial thigh (quadriceps) Lumbar spinal epaxial muscles Caudal thigh muscles (point the needle posteriorly) NOTE: Sciatic nerve damage can occur if the needle is pointed medially or cranially for a caudal thigh muscle injection. Avoid injecting into areas of pathology or surgical implants. iii. Subcutaneous injections: administer subcutaneous injections in the interscapular region, the lateral thoracic, or lumbar dorsal region. iv. e. Place an intravenous catheter to maintain venous access and administration of intravenous fluids. i. Shave or pluck and aseptically prepare the catheter site ii. Cannulate and secure IV catheter in one of the following locations:

For arterial blood collection, central ear artery is applicable. iii. Administer 0.9% saline or Lactated Ringers Solution at an average rate of 10 mL/kg/hour. f. Injectable anesthesia: see Appendix 2 i. Can be used alone for short, non-invasive procedures. ii. Used for induction prior to intubation and the use of inhalant anesthesia. g. Use inhalant anesthetics for induction and/or maintenance of anesthesia. i. Use a tight-fitting mask or induction chamber for inhalant induction of the patient.

For peripheral vein access, use the auricular vein or cephalic vein If central vein access is required, place a jugular catheter.

ii. Following sedation by injectable anesthetics or inhalant agents, place an endotracheal tube to maintain a level plane of anesthesia. h. Endotracheal intubation i. Have appropriate sized endotracheal tubes ready (2.03.5 mm). Uncuffed tubes are preferred. ii. Open the mouth and pull the tongue forward into the diastema. Advance the laryngoscope from the diastema on the other side of the mouth until the epiglottis and soft palate are visualized. Use the introducer to reposition the epiglottis in front to the soft palate if necessary. iii. Spray the larynx with local anesthetic or dab larynx with lidocaine gel by using a long cotton-tip applicator. iv. Use the laryngoscope to guide the tube into the trachea v. Use a BAAM (Beck Airway Airflow Monitor) and/or look forcondensation on the inside of the tubeduring expiration indicating correct placement. vi. Secure endotracheal tube by tying roll gauze around the tube and then behind the animals head. vii. Hook up the endotracheal tube to the gas anesthesia machine and start the oxygen (400-800mL/min) and gas anesthesia (1.5-2.0%). i. Maintenance of Anesthesia: i. Keep rabbit warm by providing a heat source that will not burn throughout the duration of the anesthesia and until the rabbit has fully recovered from anesthesia. ii. Use monitoring devices to assess vital signs and anesthetic depth (ex: pulse oximetry, blood pressure, EKG, thermometer). iii. Never leave the rabbit unattended while anesthetized. j Recovery: i. Turn off gas anesthetic vaporizer but keep oxygen running for 5 minutes. ii, Remove endotracheal tube when the rabbit begins to swallow. iii. Observe rabbit during recovery until fully awake. k. Postoperative Care iv. Provide 24 hours of quiet recovery time in a warm, dry area. v. Supply food as soon as fully awake to promote gastrointestinal motility and prevent stasis. Use metoclopramide, fluids and force-feeding as needed if stasis occurs. 4. Personnel Safety Use only anesthetic machine with valid certificate (<12 months). Avoid vapors from volatile drugs such as anesthetics, by proper use of scavenging equipment. Refer to ACUP 712: Waste Anesthetic Gas Scavenging Systems. Contact Cornell Environmental Health and Safety at http://www.ehs.cornell.edu or255-8200 for concerns regarding the use of chemical agents and monitoring of waste anesthetics gas. Monitor the use of chemical agents and assure that product safety recommendations are followed to protect the health and welfare of the humans and animals that are exposed to the agents. Drugs that come under the control of the Drug Enforcement Agency (DEA) must be stored in a double-locked cabinet in a secure area. Medical emergencies: call 911.

When working with animals wear appropriate PPE, observe proper hygiene, and be aware of allergy, zoonosis, and injury risks. Refer to the CARE Occupational Health and Safety webpage for more information.

5. Animal Related Contingencies Emergency veterinary care is available at all times including after working hours and on weekends and holidays, call the CARE (pager 1-800-349-2456) For veterinary questions, contact CARE veterinary staff at 607-253-4378 or care@cornell.edu.

6. References ACUP 712: Waste Anesthetic Gas Scavenging Systems http://www.research.cornell.edu/care/documents/ACUPs/ACUP712.pdf Heard, D.L., Ed. The Veterinary Clinics of North America Exotic Animal Practice: Analgesia and Anesthesia, W.B. Saunders Company: Philadelphia, 2001. Quesenberry, K.E. and Carpenter, J.W.Ferrets, Rabbits and Rodents: Clinical Medicine and Surgery, Saunders: St. Louis, 2004. McKelvey, D. and Hollingshead, K.W. Veterinary Anesthesia and Analgesia, Mosby: St. Louis, 2003. Kohn, D.F., Wixson, S.F., White, W.J. and Benson, G.J., Eds. Anesthesia and Analgesia in Laboratory Animals,Academic Press: New York, 1997. Plumb, D.C. Veterinary Drug Handbook; IowaState Press: Ames, Iowa, 1995. Harcourt-Brown, F. Textbook of Rabbit Medicine: Reed Educational and Professional Publishing Ltd: Woburn, 2002.CARE Occupational Health and Safety webpage. http://www.research.cornell.edu/care/OHS.html Norwegian Reference Centre for Laboratory Animal Science & Alternatives http://film.oslovet.norecopa.no 7. Appendices See the following pages

Rev. #: Author .01:M. Martin, V. Kirsipuu;

Rev #: Effective date .01 : May 2006

Review date June 2011

Referee: J. Morrisey

ACUP ACUP 103.01

.01 : May 2012

May 2012

Appendix 1. Table of Rabbit Tranquilizers, Sedatives and Other Agents

Drug Glycopyrrolate Dose/Route 0.010.1 mg/kg SC, IM, IV Duration of Effect 60 minutes Notes Reduced bronchial and salivary secretions, inhibition of vagal responses. Elevated heart rate may result Moderate sedative, peripheral vasodilation, no analgesia. Sedation, can be mixed in same syringe For cardiac arrest. Can be given into trachea. 30180 minutes 15 minutes Sedative No analgesia Respiratory stimulant Warm before use 3060 minutes Sedative, analgesic, muscle relaxant. Avoid in sick ordebilitated animals, reverse withYohimbine. Sedative, analgesic. Immobilized at higher doses. Can cause bradycardia and respiratory depression. Reverse with equal volume atipamazole. 8-12 hours <2 hours IM: 1 hour IV: 15-20 min. 24 hours 612 hours 24 hours 23 hours Analgesia 2040 minutes anestheic time 14 hours sleep time Sedation analgesia Premedicationanesthesia GI motility stimulant for post-operative stasis Sedation Sedation Analgesic Moderate analgesia Analgesia

Acepromazine

0.251.0 mg/kg SC, IM, IV 0.5 mg/kg + 0.5 mg/kg SC, IM 20 g/kg SC, IV 0.55 mg/kg SC, IV, IM 5 mg/kg IM, IV 1020 mL/kg/h IV 1015 mL/kg/h SC 15 mg/kg IM, IV

4 hours

Acepromazine + Butorphanol Epinephrine Diazepam Doxapram Fluid Therapy (LRS or 0.9% NaCl) Xylazine

Dexedetomidine

0.050.25 mg/kg IM, IV

Metoclopramide Midazolam Ketamine Butorphanol Buprenorphine Morphine Meperidine Oxymorphone Fentanyl/droperidol

0.5 mg/kg SC, IM 0.55 mg/kg IM, IV 1015 mg/kg IM, IV 0.10.5 mg/kg q4h 0.010.05 mg/kg IM, IV, SC q6-12h 15 mg/kg IM, SC q4h 510 mg/kg IM, SC q24h 0.05-0.2 mg/kg IM, IV, SC q 8-12h 0.22 mL/kg IM

Appendix 1.
Drug Carprofen

(continued)

Dose/Route 4 mg/kg IM, SC q24h 1.5 PO q12h 0.52 IM, SC 3 mg/kg IM, SC q24h 0.2 mg/kg IM, SC 0.3 PO q24h 0.51.0 mg/kg depending on dose of medetomidine administered 1 mg/kg IM, SC, IV

Duration of Effect 24 hours

Notes Moderate analgesia

Flunixin Ketoprofen Meloxicam Yohimbine

1224 hours 1224 hours

Analgesia Analgesia Analgesia Xylazine reversal agent.

Atipamazole

Medetomidine reversal agent

Appendix 2. Rabbit Injectable Anesthetics and Combinations

Anesthetic Ketamine Ketamineacepromazine Dose and Route 1530 mg/kg IM 1530 mg/kg Ketamine + 0.2 mg/kg acepromazine IM, IV 35 mg/kg ketamine + 5 mg/kg xylazine IM, IV 1020 mg/kg ketamine + 0.5 mg/kg diazepam IV, IM 525 mg/kg IM, IV 2030 minutes anesthesia 12 hours sleep 2030 minutes 10 minutes Duration of Effect Notes Immobilization Surgical anesthesia

Ketamine-xylazine

Surgical anesthesia

Ketamine-diazepam

Surgical anesthesia

Tiletamine/zolazepam

Reported to cause renal necrosis in New Zealand White Rabbits. Lightmedium planes of anesthesia, dissociative. Induction agent Anesthesia

Propofol Ketaminedexmedetomidine Dexmedetomidine + Ketamine + Butorphanol Ketamine + xylazine + butorphanol Ketamine/midazolam

310 mg/kg IV 25 mg/kg ketamine + 0.25 mg/kg medetomidine IM 0.1 mg/kg + 10 mg/kg + 0.05 mg/kg SC 35 mg/kg ketamine + 5 mg/kg xylazine +0.2 mg/kg butorphanol IM 1530 mg/kg ketamine + 2-5 mg/kg midazolam IM 0.008 mg/kg fentanyl + 0.17 mg/kg medetomidine IV

Until discontinued

3040 minutes anesthesia 14 hr sleep

Induction Can be mixed in same syringe Anesthesia

20 minutes

Surgical anesthesia.

Fentanyl/dexmedetomidine

Anesthesia

Appendix 3. Rabbit Inhalation Anesthetics

Drug Isoflurane Sevoflurane Dose and Route 5% induction 1%3% maintenance 6%8% induction 3%6% maintenance Duration of Effect Until discontinued Until discontinued Notes Inhalant anesthetic Inhalant anesthetic

Appendix 4. Example of an Anesthesia Protocol for Laparotomy (i.e.,spay) Preanesthetic/Induction

Drug EMLA cream Dose/Route Topically over venipuncture site for 30 minutes 0.1 mg/kg 1 mg/kg 10 mg/kg Duration of Effect Notes Topical local anesthetic Mix all in same syringe and administer IM

Dexedetomidine + Butorphanol + Ketamine

Intubate Administer fluids IV at a rate of 10 mL/kg/hour

Maintenance
Drug Isoflurane Dose/Route 1.5%3% Duration of Effect Until discontinued Notes Inhalant anesthetic

Post-Operative
Drug Carprofen Dose/Route 4 mg/kg SC Duration of Effect 24 hours Notes Moderate analgesia

Appendix 5: Example of an Anesthesia Protocol for Exsanguination

Drug Acepromazine 10mg/mL Ketamine 100mg/mL 10 mg IM 100 mg IM Dose/Route Notes Mix acepromazine and ketamine in same syringe

After injection, wait 610 minutes until rabbit is anesthetized to begin procedure.