CPD ACCREDITED ARTICLE Medetomidine Premedication for Caesarean Section in the Bitch It is Safe for the Dam and Puppies K G M De Cramer, BVSc, MMed- Vet(Gyn), PhD K E. Joubert B.V.Sc M.Med Vet (Anaes) This study shows that medetomidine hydrochloride in the protocol used is a safe premedicant in bitches prior to caesarean section and is associated with good puppy vigour as well as 2h and 7d puppy sur- vival rates. The ideal anaesthetic protocol for caesarean section (CS) should provide adequate muscle relaxation, an- algesia and narcosis for optimal operating conditions, be safe for the bitch 2 and should not affect the via- bility and survival of the puppies 3,4 . Additional recom- mendations include using drugs with a short duration of action 5 and using drugs which are reversible 6 . In- duction using propofol and maintenance of anaesthe- sia using isoflurane is widely accepted and associated with good outcome 4,7-12. The use of alpha-2-adren- ergic agonists before anaesthesia for CS, is however, controversial. The alpha-2-adrenergic agonist xyla- zine, is not recommended in patients undergoing CS because it was identified as a risk factor for increased puppy mortality 12,13 , associated with increased risk of death in the dog 14,15 and caused severe maternal and neonatal cardiovascular depression 16 . vet360 Issue 04 | AUGUST 2017 | 16 The greatest objection to the use of the alpha-2-adr- energic agonists are the cardiopulmonary effects which include transient hypertension followed by mild hypotension, bradycardia, increased systemic vascu- lar resistance, reduced cardiac output, and respiratory depression. In recent surveys of anaesthetic mortality in the dog however, premedication with medetomi- dine prior to anaesthesia for routine surgery, was not identified as an increased risk factor for mortality 17 and data from human literature has shown that dexme- detomidine is associated with a reduction in all causes of mortality when used for non-cardiac, cardiac and vascular surgery 18,19 . No studies in veterinary medicine have been conduct- ed on the use of medetomidine for CS.