{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T16:23:42Z","timestamp":1761582222241},"reference-count":25,"publisher":"American Veterinary Medical Association (AVMA)","issue":"11","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"sc_a1\">\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To evaluate the effects of IM and IV administration of alfaxalone alone and in combination with medetomidine, midazolam, or both on key stress-related neurohormonal and metabolic changes in isoflurane-anesthetized cats undergoing ovariohysterectomy or castration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a2\">\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>72 client-owned mixed-breed cats undergoing ovariohysterectomy or castration between October 4, 2018, and January 10, 2020.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a3\">\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>For each type of surgery, cats were assigned to 1 of 6 premedication protocols groups, with 6 cats\/group: physiologic saline (0.9% NaCl) solution (0.5 mL, IM) and alfaxalone (5 mg\/kg, IV); physiologic saline solution (0.5 mL, IM) and alfaxalone (5 mg\/kg, IM); medetomidine (50 \u03bcg\/kg, IM) and alfaxalone (5 mg\/kg, IV); medetomidine (50 \u03bcg\/kg, IM) and alfaxalone (5 mg\/kg, IM); midazolam (0.5 mg\/kg, IM), medetomidine (50 \u03bcg\/kg, IM), and alfaxalone (5 mg\/kg, IV); or midazolam (0.5 mg\/kg, IM), medetomidine (50 \u03bcg\/kg, IM), and alfaxalone (5 mg\/kg, IM). Venous blood was taken before pretreatment, pre- and postoperatively during anesthesia with isoflurane and oxygen, and during early and complete recovery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a4\">\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Compared with baseline concentrations, plasma adrenaline and noradrenaline concentrations decreased during anesthesia in cats premedicated with alfaxalone alone and in combination with medetomidine. The combination of medetomidine, midazolam, and alfaxalone prevented an excessive increase in catecholamines during anesthesia and surgery in cats. Postoperative plasma cortisol concentration after ovariohysterectomy was lower for cats premedicated with the combination of medetomidine and alfaxalone or the combination of medetomidine, midazolam, and alfaxalone, compared with cats premedicated with alfaxalone alone. Cats treated with combinations that included medetomidine and midazolam had hyperglycemia during anesthesia. Cats treated with medetomidine or medetomidine and midazolam in combination with alfaxalone, compared with alfaxalone alone, had lower concentrations of nonesterified fatty acids during anesthesia. Behavioral recovery scores were lower (better) for cats that received medetomidine in addition to alfaxalone, compared with alfaxalone alone.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a5\">\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>Results indicated that pretreatments with medetomidine and alfaxalone or with medetomidine, midazolam, and alfaxalone were useful for preventing stress-related hormonal and metabolic responses, other than hyperglycemia, during isoflurane anesthesia and surgery in cats.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.22.03.0041","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T12:09:12Z","timestamp":1663157352000},"source":"Crossref","is-referenced-by-count":1,"title":["A randomized clinical trial on effects of alfaxalone combined with medetomidine and midazolam in preventing stress-related neurohormonal and metabolic responses of isoflurane-anesthetized cats undergoing surgery"],"prefix":"10.2460","volume":"83","author":[{"given":"Hirokazu","family":"Kamohara","sequence":"first","affiliation":[{"name":"Department of Clinical Veterinary Science, United Graduate School of Veterinary Science, Yamaguchi University, Yoshida, Yamaguchi, Japan"},{"name":"Kamohara Animal Hospital, Kochi-shi, Kochi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiko","family":"Kamohara","sequence":"additional","affiliation":[{"name":"Kamohara Animal Hospital, Kochi-shi, Kochi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Hikasa","sequence":"additional","affiliation":[{"name":"Department of Clinical Veterinary Science, United Graduate School of Veterinary Science, Yamaguchi University, Yoshida, Yamaguchi, Japan"},{"name":"Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori-shi, Tottori, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"2","key":"B1","series-title":"Vet J","first-page":"141","article-title":"A review of the pharmacology and clinical application of alfaxalone in cats","volume":"203","author":"Warne LN","year":"2015","unstructured":"Warne LN, Beths T, Whittem T, Carter JE, Bauquier SH. A review of the pharmacology and clinical application of alfaxalone in cats. Vet J. 2015;203(2):141\u2013148.25582797"},{"issue":"4","key":"B2","series-title":"N Z Vet J","first-page":"172","article-title":"Pharmacokinetics and effects of alfaxalone after intravenous and intramuscular administration to cats","volume":"66","author":"Rodrigo-Mochol\u00ed D","year":"2018","unstructured":"Rodrigo-Mochol\u00ed D, Escudero E, Belda E, Laredo FG, Hernandis V, Mar\u00edn P. Pharmacokinetics and effects of alfaxalone after intravenous and intramuscular administration to cats. N Z Vet J. 2018;66(4):172\u2013177.29562829"},{"issue":"3","key":"B3","series-title":"Vet Anaesth Analg","first-page":"282","article-title":"Comparison of quality of recovery from anaesthesia in cats induced with propofol or alfaxalone","volume":"39","author":"Mathis A","year":"2012","unstructured":"Mathis A, Pinelas R, Brodbelt DC, Alibhai HI. Comparison of quality of recovery from anaesthesia in cats induced with propofol or alfaxalone. Vet Anaesth Analg. 2012;39(3):282\u2013290."},{"issue":"1","key":"B4","series-title":"J Vet Med Sci","first-page":"73","article-title":"Comparison of the anesthetic effects between 5 mg\/kg of alfaxalone and 10 mg\/kg of propofol administered intravenously in cats","volume":"83","author":"Tamura J","year":"2021","unstructured":"Tamura J, Oyama N, Fukui S, Yamashita K. Comparison of the anesthetic effects between 5 mg\/kg of alfaxalone and 10 mg\/kg of propofol administered intravenously in cats. J Vet Med Sci. 2021;83(1):73\u201377.33431725"},{"issue":"5","key":"B5","series-title":"Br Vet J","first-page":"519","article-title":"Medetomidine sedation in dogs and cats: a review of its pharmacology, antagonism and dose","volume":"152","author":"Cullen LK","year":"1996","unstructured":"Cullen LK. Medetomidine sedation in dogs and cats: a review of its pharmacology, antagonism and dose. 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