Bart Gazendam, [16 Nov 2023 at 12:48:18]: Has anyone experienced that the atipamezole / yohimbine mix is not as potent as Antisedan is for example in cats and other species? HO Reuter, [16 Nov 2023 at 13:31:33]: As we only generally use 1/5 of recommended full reversal dosage of atipamezole, I think it is expected to get less reversal effect. Bart Gazendam, [16 Nov 2023 at 15:36:06]: Even at higher dosages I’m sometimes struggling to get an effect… then I give a drop of Antisedan and they wake up 🤷🏻♂️ Gareth Hunter, [16 Nov 2023 at 15:45:14]: Bart, we’ve seen this on a few occasions, mainly with the compounded straight atipamezole. I can’t say it’s been a consistent thing, but Antisedan definitely seems more reliable. At least that’s been my experience. HO Reuter, [16 Nov 2023 at 18:03:23]: I have not used Antisedan for a while, nor other formulations of atipamezole other than V-Tech's. I often do use atipamezole or yohimbine / atipamezole combination at higher doses than some colleagues. In general, I find a dose dependant reversal effect, especially if allowing a bit of time after injection. In other words, I’m satisfied with the effectiveness of these drugs. Bart Gazendam, [16 Nov 2023 at 18:22:49]: Thank you! So how many mls / mg do you give per mg medetomidine in a lion for example? Henry Labuschagne, [16 Nov 2023 at 18:31:11]: I use yohimbine @ 1ml per 100 kg im plus atipamezole @ 2.5 mg per mg medetomidine without any issues. Maaike de Schepper, [16 Nov 2023 at 18:35:02]: In lion, I also use atipamezole 2.5 mg per mg medetomidine dose im and yohimbine 6.25mg per 50 kg body weight slow iv, after darting with ketamine/butorphanol/azaperone/ medetomidine and have very nice wake-ups 5-15 min after reversal. Bart Gazendam, [16 Nov 2023 at 19:21:34]: Alright! Sorry, I was more specifically referring to the V-Tech yohimbine/atipamezole mixture Atipamezole 2 mg + yohimbine 6.25 mg Henry Labuschagne, [16 Nov 2023 at 19:24:48]: Adult female lion, I would give 0,5 ml im of the combination plus 4,5 mg Atipamezole I use 3 mg medetomidine plus 300 mg ketamine in adult female lion. Bart Gazendam, [16 Nov 2023 at 19:27:48]: Thanks Kobus Hoffman, [16 Nov 2023 at 19:47:40]: We use 5 mg atipamezole/mg medetomidine, 1/2 im and the other 1/2 iv. We use yohimbine 6.25 mg/ml, at a dose of 1ml / 50 kg im. We dart adult lioness with 60 mg Zoletil and 5-6 mg medetomidine. Adult males get 80 mg Zoletil and 7-8 mg medetomidine Pierre Nel, [17 Nov 2023 at 07:31:33]: Exactly. I experienced it specifically in sable, but was without yohimbine. They were very sleepy after reversal. I don’t think any harm would have been done, but I was scared they lie in the sun and get hyperthermia. Compounded atipamezole was used at the time and even at 5 x dose, some were very sleepy. Once you add a tad of Antisedan, they become wide awake. Bart Gazendam, [17 Nov 2023 at 08:49:39]: Yes, exactly this. I have also had that with waterbuck (with the V-Tech mixture) Andy Fraser, 17 Nov 2023 Bart: This sub-adult sable bull, I darted with 1mg Thianil + 3 mg medetomidine + 20 mg azaperone. I only used 3 mg medetomidine because it was a stressful situation. I reversed the combination with 2.5 ml of the V-Tech atipamezole/yohimbine mixture IV, followed by 0.3 ml Trexonil IV. I don't see an issue with its effect even at this low dosage reversal at what I consider a higher medetomidine dosage. These animals may lie down showing slight medetomidine tranquilisation a bit later on. On predators I like to use atipamezole IM unless a very rapid reversal is needed. Then yohimbine or the atipamezole/ yohimbine mix can be used IV. I'm not fond of atipamezole IV though. Bart Gazendam, [17 Nov 2023 at 10:40:42]: Andy, I think the difference then is the intravenous administration perhaps, or a batch difference - I’ m not sure 🤷🏻♂️ Erik Verrynne, [17 Nov 2023 at 10:44:49]: I also believe it’s the iv administration. I have a much slower response to im administration of the atipamezole/yohimbine mixture in sable and roan, than with atipamezole only im. I don’t like giving it iv but recently resorted to that to get them up faster. Pierre Nel, [17 Nov 2023 at 11:29:01]: On high dose opioid, Thianil in white rhino specifically was deemed risky. What is safety like on a Thianil 2 mg + 10 mg medetomidine combination without giving butorphanol - for longer procedures? Hendrik Hansen, [17 Nov 2023 at 13:20:59]: Pierre, if you use less Thianil and slightly more medetomidine for induction of an adult sable cow (Thianil 0.5 + medetomidine 5 mg + azaperone 10 mg), and administer reversal with Vtech (compounded) atipamezole/yohimbine combination or Kyron yohimbine and atipamezole/yohimbine mix, you need a lot less to antagonise the alpha-2 agonist. 1:1 iv is more than enough for almost complete reversal. There must be a potentiating effect that causes the antagonistic effect of atipamezole/ yohimbine to be less potent as you use higher opioid. I use atipamezole/yohimbine iv for complete reversal 1:1 in all antelope. I prefer to use Thianil at lower dosages of opioid combinations - in that combination, it gives a more effective knockdown without the known side effect of hypoxia with the higher dose of opioid without alpha-2 in the mixture. The effect is much more potent iv and I haven't seen any of the known side effects in antelope iv. described in dogs and cats. I always use the compounded atipamezole/yohimbine combinations.
