Ilium Ketamil

Actions
Rapid pharmacological action characterised by profound analgesia, mild cardiac stimulation, normal pharyngeal-laryngeal reflexes and mild respiratory depression. It produces cataleptic anaesthesia (dissociative anaesthesia). It causes complex reactions in the brain depressing certain areas and stimulating others, which enables it to anaesthetise and cause seizures in overdose. It increases the release of dopamine and noradrenaline which are excitatory and increase the release or serotonin, which is a depressant. It produces paralysis with some muscle rigidity, good analgesia, complete amnesia. Many reflexes are retained; swallowing, coughing, pedal, corneal, laryngeal, however the animal does not blink and the cornea should be kept lubricated during long operations.

Indications
A dissociative anaesthetic for use singly or in combination with muscle relaxants or tranquillisers in horses, cattle, sheep, pigs, dogs, cats, goats, reptiles, birds, wombats, koalas, kangaroos, camels & deer.

Presentation
Injection 10mL, 50mL

Directions for use
Horses: 2.2mg/kg bodyweight ketamine base i.v. combined with 1.1mg/kg bodyweight xylazine base i.v. (10mL KETAMIL injection i.v. plus 5mL XYLAZIL 100 injection i.v. per 450kg bodyweight) provides analgesia and light anaesthesia.

Cattle: 2.0mg/kg bodyweight Ketamine base i.v. given simultaneously with 0.1 - 0.2mg/kg bodyweight xylazine base i.m.
(8mL KETAMIL injection i.v. plus 2 - 4mL XYLAZIL 100 injection i.m. per 400kg bodyweight).

Sheep: 22mg/kg bodyweight ketamine base i.m. combined with 0.55mg/kg bodyweight acetylpromazine i.m. (2.2mL KETAMIL injection i.m. plus 5.5mg acetylpromazine i.m. per 10kg bodyweight).

Deer: The dosage chart below contains combination ketamine/xylazine dosage for immobilisation by intramuscular administration in various species.

For i.v. injection administer one half of the corresponding i.m. dose.

Pigs: 10 - 15mg/kg bodyweight ketamine base i.m. combined with
0.5 1.0mg/kg bodyweight xylazine base i.m. (10-15mL KETAMIL injection i.m. plus 0.25 – 0.5mL XYLAZIL 20
injection i.m. per 10kg bodyweight).

Dogs: 2.2mg/kg bodyweight xylazine base i.m. (1.65mL XYLAZIL 20 injection i.m. per 15kg bodyweight) followed 10-15 minutes later by
11mg/kg bodyweight ketamine base (1.65mL KETAMIL injection per 15kg bodyweight) i.v. to effect. This regimen provides chemical restraint and analgesia suitable for minor surgery, dentistry or restraint during examination.

Cats: KETAMIL alone –
Intramuscular: 15 - 20mg/kg ketamine base per kg (0.75 - 1.0mL KETAMIL injection i.m. per 5kg bodyweight).

Intravenous: 5 - 6mg ketamine base per kg (0.25-0.3mL KETAMIL injection i.v. per 5kg bodyweight). KETAMIL in combination with xylazine base: 11 - 22mg/kg bodyweight ketamine base i.m. preceded by
0.55 - 1.1mg/kg xylazine base i.m. (0.55 - 1.1mL KETAMIL injection i.m. preceded by 0.14-0.28mL XYLAZIL 20 injection i.m.
per 5kg bodyweight.)

Goats: 11mg/kg bodyweight
ketamine base i.v. preceded by 0.22mg/kg xylazine base i.m. (1.1mL KETAMIL injection i.v. preceded by 0.11mL XYLAZIL 20 injection i.m. per 10kg bodyweight.)

Reptiles: Sedation –
20 - 40mg/kg bodyweight ketamine base i.m.
(0.2 - 0.4mL KETAMIL injection per kg, i.m.)

Birds: KETAMIL should not be used in poultry producing meat or eggs for human consumption.

Under 100g: 0.1 - 0.2mg/g bodyweight ketamine base i.m. (0.1 - 0.2mL KETAMIL injection per 100g bodyweight i.m.).

250g-500g: 0.05 - 0.1mg/g bodyweight ketamine base i.m. (0.25 - 0.5mL KETAMIL injection per 500g bodyweight i.m.).

500g-1kg: 0.02-0.1mg/g bodyweight ketamine base i.m. (0.2-1.0mL KETAMIL injection per 1kg bodyweight i.m.).

Over 3kg: 0.02 - 0.5mg/g bodyweight ketamine base i.m. (1.0 - 2.5mL KETAMIL injection per 5kg bodyweight i.m.).

Note: Use of KETAMIL alone does not produce satisfactory analgesia in the domestic chicken.

In pigeons, KETAMIL alone does not produce a state of anaesthesia, even at high doses.

Wombat, Koala: 25mg/kg bodyweight ketamine base i.m. (0.25mL KETAMIL injection per kg bodyweight i.m.).

Camel: 1- 2mg/kg bodyweight ketamine base i.m. or i.v. combined with 1 - 2mg/kg bodyweight xylazine i.m. or i.v. (1 - 2mL KETAMIL injection i.m. or i.v. combined with 5 - 10mL XYLAZIL 20 injection per 100kg bodyweight i.m. or i.v.

Withholding Period Meat – do not use less than 28 days before slaughter for human consumption. Milk – milk collected from cows, ewes, does within 7 days following treatment must not be used for human consumption or processing. This milk should not be fed to bobby calves.

Contraindications
Animals with renal insufficiency and in animals with a history of epilepsy.

Storage
Store below 25ºC. (air conditioning). Protect from light.

Composition
Ketamine (as Hydrochloride) 100mg/mL

Pharmacology
KETAMIL is a congener of phencyclidine with less adverse effect (e.g. tremor, tonic spasticity, convulsion, oculogyric activity) than phencyclidine. KETAMIL is classified as a dissociative anaesthetic by virtue of is concurrent activation of the limbic system and depression of the thalamocortical nucleus. Anaesthesia results paradoxically from stimulation of the central nervous system, producing a loss of sensory perception or response and cataleptic state. KETAMIL produces better somatic than visceral anaesthesia, a characteristic related to the different innervation of those sites. The pharmacological mechanisms involved are complex and vary between species. Stage III anaesthesia is not reached under KETAMIL alone.

When major surgery is undertaken, KETAMIL must be supplemented by gaseous or barbiturate anaesthetics or muscle relaxant agents. KETAMIL causes cardiac stimulation and this offsets the cardiopulmonary depressant effects of the centrally acting muscle relaxant, xylazine. KETAMIL increases cardiac output, mean aortic pressure, central venous pressure and myocardial consumption of oxygen.

KETAMIL causes salivation which may be prevented by atropine premedication. An effective means of administration in fractious cats is to spray KETAMIL (20mg/kg) into the open mouth while the animal is hissing. This route causes more pronounced salivation.

KETAMIL preserves laryngeal and pharyngeal reflexes, and laryngospasm, bronchospasm and coughing can be expected on manipulation of the oropharynx. Direct topical application of a local anaesthetic is recommended before attempting intubation of any laryngeal/pharyngeal technique.

The increased muscle activity seen under KETAMIL may be effectively mediated by the muscle relaxant agents xylazine & guaiphenesin. KETAMIL alone causes undesirable levels of myoclonic spasticity, opisthotonos and convulsive seizure(s).

Antagonism of KETAMIL has been reported experimentally by combinations of l-amphetamine and yohimbine, and of 4-aminopyridine and yohimbine. The mechanism of action has been postulated as a release of central neural dopamine and noradrenaline.

Precautions
•     Do not use in poultry producing meat or eggs for human consumption.
•     KETAMIL should be used with caution in patients with cardiovascular insufficiency, myocardial damage or cardiac arrhythmia.
•     KETAMIL should not be used for maintenance of hypovolaemic animals (particularly haemorrhaging dogs) as greater myocardial oxygen debt is accumulated and cardiovascular parameters may rapidly deteriorate.
•     KETAMIL should be used with caution in patients with cerebral trauma or intracranial lesions, as the anaesthetic action of KETAMIL relies on a functioning cerebral cortex.

•     KETAMIL may cause pain on injection by i.m. or s.c. routes and sufficient physical restraint during injection should be available to prevent injury to animal or handler.

•     KETAMIL has been shown to cross the placenta, and depression of neonates may occur if KETAMIL is used for induction of anaesthesia for caesarean section.

•     Adverse effects during recovery can be reduced by the use of Acetylpromazine or Xylazine

•     KETAMIL has been reported to cause convulsive seizures in some cats which receive KETAMIL in therapeutic doses.

•     When major surgery is undertaken, KETAMIL must be supplemented by gaseous or barbiturate anaesthetic or muscle relaxant agents.

Registration
All states

APVMA Number
51188