Adverse Reaction Following the Subarachnoid Injection of Xylazine in a Sheep

Simple Summary To maintain high standards of veterinary care, it is crucial adverse events are reported. This case report describes the adverse cardiovascular and respiratory responses to xylazine-a veterinary sedative and pain relief drug. While adverse effects are known to occur following vascular injection of xylazine during anaesthesia in sheep, this is the first report to detail the adverse responses following the injection of xylazine into the subarachnoid space. Injecting xylazine into the subarachnoid space (the space around the spinal cord containing spinal fluid) is commonly performed for the management of pain in sheep; as most clinicians believe this method carries significantly less risks for the patient than vascular routes of administration. The profound cardiovascular and respiratory depression detailed here is therefore of interest to veterinary professionals and scientists involved in the anaesthesia and/or pain management of sheep. Alpha(2) receptor agonists are frequently used to provide sedation and analgesia in sheep. There are numerous reports of adverse pulmonary effects following intravenous (IV) injection; however, adverse effects following subarachnoid injection (SAI) are underreported. An adult Merino wether was one of eighteen animals anaesthetised during an experimental trial modelling intervertebral disc injury. The animal was premedicated with methadone 0.1 mg/kg and midazolam 0.3 mg/kg IV. Anaesthesia was induced using alfaxalone IV and it was maintained using isoflurane, delivered in 100% oxygen by controlled mechanical ventilation. An SAI of xylazine 0.05 mg/kg diluted to 1 mL with 0.9% saline was performed at the lumbosacral site prior to recovery. This resulted in rapid narcosis, oxygen dependency and ventilatory compromise. Treatment with frusemide 1 mg/kg IV and salbutamol 0.2 mg inhaled did not attenuate the adverse cardiopulmonary effects. A rapid improvement in all physiological variables was seen following high dose atipamezole 0.05 mg/kg IV. This case report adds to the current knowledge regarding the risk for potential side effects when using alpha(2) receptor agonists, such as xylazine, for the sedation or regional analgesia in sheep.