Sedation Protocol Options and Doses Designed for Home Euthanasia Use

Loading Dose Option #1 for Dogs:

$$$Telazol+Ace+Atropine+Xylazine SQ 27g – 29g needle

  • $$$Telazol (100mg/ml) = 0.3ml per 10#
  • Consider reconstituting your euthanasia-only Telazol with 2.5ml Ace + 2.5ml Atropine (dry mouth significantly lessens vomiting) instead of 5.0ml sterile water to maximize volume efficiency and minimize injection pain
  • Xylazine (100mg/ml)=0.050ml per 10# (Weight divided by 2, then divided by 100). Do not overdose (vomiting).

100# dog 0.5 ml Xylazine (or less) + 3.0 ml Telazol

80# dog 0.4 ml Xylazine (or less) + 3.0 ml Telazol

60# dog 0.3 ml Xylazine (or less) + 2.5 ml Telazol

40# dog 0.2 ml Xylazine (or less) + 2.0 ml Telazol

20# dog 0.1 ml Xylazine  (0r less) + 1.0 ml Telazol

10# dog 0.05 ml Xylazine (or less) + 0.5 ml Telazol

Loading Dose Option #2 for Dogs:

Ketamine+Ace+Atropine+Xylazine SQ 27g-29g needle

100# dog 0.5 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace

80# dog 0.4 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace

60# dog 0.3 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace

40# dog 0.2 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace

20# dog 0.1 ml Xylazine  (0r less) + 0.5 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace

10# dog 0.05 ml Xylazine (or less) + 0.5 ml Telazol

Subsequent Doses in Dogs Every 5 Minutes Until Unconscious:

1.0 ml Ketamine + 2.0 ml Ace 27-29g needle SQ, maybe IM

  • Ketamine/Ace and Telazol can be massively overdosed when sedating for euthanasia
  • Xylazine will cause vomiting when overdosed. Only use Xylazine once in your loading dose. Atropine causes dry mouth which helps immensely to minimize vomiting side effect of Xylazine.
  • All dogs are different. Some go down with loading dose alone. Some require 1 – 4+ subsequent doses depending on how unstable their failing body is.

Cats: Telazol+Ace+Atropine SQ, never IM, 29g needle

  • 0.5ml Telazol
  • Consider reconstituting your euthanasia-only Telazol with 2.5ml Ace + 2.5ml Atropine instead of 5.0ml water to maximize volume efficiency and minimize injection pain
  • Use insulin syringe 29g needle
  • Slow pulse one unit at a time can be better tolerated than fast push
  • IM is almost never necessary in cats, you should almost always go SQ
  • SQ is challenging in emaciated cats: the needle often wants to go all the way through the thin skin tent, not under. I prefer back of head injection location where neck meets skull farther forward than scruff, needle directed backwards towards shoulders away from nose

Most Painless Euthanasia Goals and Concepts:

  • Comfort (Use smallest needle possible in most comfortable SQ location. Minimize injection volume of sedative drugs.)
  • Relaxation (Consider Ace, DexDomitor$$$, Xylazine as options in your drug combo.)
  • Achieve unconscious anesthesia before attempting painful venipuncture on failing old veins that break very easily. (Consider Telazol$$$ or Ketamine combos. See Option #1 and Option #2 Below.)
  • Maintain blood pressure to maximize venipuncture success (Atropine)
  • Prevent vomiting (Atropine causes dry mouth which dramatically lessens vomiting side effect of Xylazine)
  • Relatively quick, smooth, deep sedation for tranquil setting in front of family (It’s better to wait for unconscious anesthesia for as long as it takes rather than experience a painful vein issue nightmare.)
  • What are advantages/disadvantages of SQ route vs. IM route? IM route – may be smoother/quicker induction but more painful injection area than SQ. You risk yelping with IM route which can haunt family forever. SQ route can be smooth and relatively quick in many pets depending on their body type (thin, emaciated, little fat), disease state and personality (mellow, accepting). SQ may be slower/rougher induction in some pets (fat, strong personality, unstable disease state). SQ can be least painful/least risk of yelping. Most cats and emaciated dogs have quick SQ absorption. Fatty pets and strong personalities can have slower SQ absorption or require higher dosing. Can start sedation injection SQ and proceed deeper if well-tolerated. Some pets seem completely oblivious to IM injection with small 27g-29g needle, especially when food distraction technique is employed during sedation administration. Consider lumbar musculature location in dogs giving family plenty of space to comfort pet’s head.

Non-traditional venipuncture sites (alternative options required in some situations):

  • Distal cephalic vein where it runs along inner wrist/medial carpus
  • Medial saphenous in dogs
  • Lateral saphenous where it runs higher up behind knee
  • Maximize your visibility and enhance your space for venipuncture attempts by shaving a long extent of vein
  • Keep knee pushed back in full extension to stretch vein fully, preventing rolling, while keeping skin pulled up toward body
  • For sedated cats with failing veins, consider intra-renal injection of euthanasia solution. Secure left kidney, inject 3+mls Fatal Plus, avoid renal pelvis, death in seconds/minutes. I use this technique very often. It can be a “better looking” option when kids are watching (no shaving, bald skin and vein can look disturbing).

Favorite Euthanasia Solution:

  • Fatal Plus
  • reasonably priced
  • thin solution for 25g flow

Clean Tip: Line folded towel with white tall kitchen garbage bag, place under hind end once pet is deeply sedated to contain leaking urine and protect family carpet/sofa, etc.