{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:26:02Z","timestamp":1764937562927,"version":"3.40.5"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,21]],"date-time":"2023-05-21T00:00:00Z","timestamp":1684627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Vet Pharm &amp; Therapeutics"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Doxapram is marketed as a respiratory stimulant and is used by some veterinarians to help with neonatal apnoea, especially in puppies delivered by caesarean. There is a lack of consensus as to whether the drug is effective and data on its safety are limited. Doxapram was compared to placebo (saline) in newborn puppies in a randomized, double\u2010blinded clinical trial\u00a0using two outcome measures: 7\u2010day mortality rate and repeated APGAR score measurements. Higher APGAR scores have been positively correlated with survival and other health outcomes in newborns. Puppies were delivered by caesarean and a baseline APGAR score was measured. This was immediately followed by a randomly allocated intralingual injection of either doxapram or isotonic saline (of the same volume). Injection volumes were determined by the weight of the puppy and each injection was administered within a minute of birth. The mean dose of doxapram administered was 10.65\u2009mg\/kg. APGAR scores were measured again at 2, 5, 10 and 20\u2009min. One hundred and seventy\u2010one puppies from 45 elective caesareans were recruited into this study. Five out of 85 puppies died after receiving saline and 7 out of 86 died after receiving doxapram. Adjusting for the baseline APGAR score, the age of the mother and whether the puppy was a brachycephalic breed, there was insufficient evidence to conclude a difference in the odds of 7\u2010day survival for puppies that received doxapram compared to those that received saline (<jats:italic>p<\/jats:italic>\u2009=\u2009.634). Adjusting for the baseline APGAR score, the weight of the mother, the litter size, the mother's parity number, the weight of the puppy and whether the puppy was a brachycephalic breed, there was insufficient evidence to conclude a difference in the probability of a puppy having an APGAR score of ten (the maximum APGAR score) between those that received doxapram compared to those that received saline (<jats:italic>p<\/jats:italic>\u2009=\u2009.631). Being a brachycephalic breed was not associated with an increased odds of 7\u2010day mortality (<jats:italic>p<\/jats:italic>\u2009=\u2009.156) but the effect of the baseline APGAR score on the probability of having an APGAR score of ten was higher for brachycephalic than non\u2010brachycephalic breeds (<jats:italic>p<\/jats:italic>\u2009=\u2009.01). There was insufficient evidence that intralingual doxapram provided an advantage (or disadvantage) compared to intralingual saline when used routinely in puppies delivered by elective caesarean and that were not apnoeic.<\/jats:p>","DOI":"10.1111\/jvp.13388","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T04:23:46Z","timestamp":1684729426000},"page":"353-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The effect of doxapram on survival and APGAR score in newborn puppies delivered by elective caesarean: A randomized controlled trial"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4083-562X","authenticated-orcid":false,"given":"Timothy H.","family":"Hyndman","sequence":"first","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"},{"name":"Harry Butler Institute Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelby","family":"Fretwell","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"},{"name":"Applecross Veterinary Hospital  Applecross Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross S.","family":"Bowden","sequence":"additional","affiliation":[{"name":"Mathematics and Statistics Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flaminia","family":"Coaicetto","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter C.","family":"Irons","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua W.","family":"Aleri","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"},{"name":"Harry Butler Institute Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nino","family":"Kordzakhia","sequence":"additional","affiliation":[{"name":"School of Mathematical and Physical Sciences Macquarie University  Macquarie Park New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen W.","family":"Page","sequence":"additional","affiliation":[{"name":"Advanced Veterinary Therapeutics  Newtown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle C.","family":"Musk","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Jonathan","family":"Tuke","sequence":"additional","affiliation":[{"name":"Mathematics and Statistics The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Mosing","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven S.","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"Applecross Veterinary Hospital  Applecross Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,21]]},"reference":[{"issue":"4","key":"e_1_2_11_2_1","first-page":"260","article-title":"A proposal for a new method of evaluation of the newborn infant","volume":"32","author":"Apgar V.","year":"1953","journal-title":"Current Researches in Anesthesia & Analgesia"},{"key":"e_1_2_11_3_1","unstructured":"APVMA PubCRIS Database. 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