{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:29:09Z","timestamp":1791286149031,"version":"4.1.0"},"reference-count":39,"publisher":"American Veterinary Medical Association (AVMA)","issue":"2","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"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":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"sc_a1\">\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>\n                      To compare dexmedetomidine-ketamine (DK; 0.1 and 10 mg\/kg, respectively) with midazolam (M; 1.0 mg\/kg) or 0.9% sodium chloride (S; 0.2 mL\/kg) administered IM in the forelimb (F) or hindlimb (H) in eastern box turtles (\n                      <jats:italic>Terrapene carolina carolina<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a2\">\n                    <jats:title>ANIMALS<\/jats:title>\n                    <jats:p>20 clinically healthy, captive adult eastern box turtles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a3\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In a randomized, blinded, complete crossover study with 1-week washout periods, turtles were administered each of 3 treatments: F-DKS, F-DKM, or H-DKM. Palpebral reflex, muscle tone, and withdrawal responses were serially assessed and used to calculate cumulative sedation scores at each 5-minute time point. The ability to intubate was evaluated. At 60 minutes, atipamezole (1.0 mg\/kg) and either flumazenil (F-DKM, H-DKM; 0.05 mg\/kg) or 0.9% sodium chloride (F-DKS; 0.5 mL\/kg) were administered IM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a4\">\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      All treatments resulted in clinically relevant anesthetic effects. F-DKM produced significantly higher sedation scores than H-DKM or F-DKS at all time points between 10 and 60 minutes (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Sedation score variability was observed with all treatments with significantly higher variability for H-DKM (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Intubation was successful in 32, 89, and 11% of turtles in F-DKS, F-DKM, and H-DKM, respectively. Median (range) recovery time was 10 (5\u201322), 16 (7\u201345), and 12 (4\u201328) minutes for F-DKS, F-DKM, and H-DKM, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a5\">\n                    <jats:title>CLINICAL RELEVANCE<\/jats:title>\n                    <jats:p>In eastern box turtles, forelimb dexmedetomidine-ketamine resulted in clinically relevant anesthetic effects that were heightened with the addition of midazolam. Hindlimb administration of midazolam-dexmedetomidine-ketamine resulted in reduced and more variable anesthetic effects compared to forelimb administration, supporting a hepatic first-pass effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/ajvr.23.10.0226","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T08:16:24Z","timestamp":1701418584000},"source":"Crossref","is-referenced-by-count":4,"title":["Anesthetic efficacy of dexmedetomidine-ketamine in eastern box turtles (Terrapene carolina carolina) is enhanced with the addition of midazolam and when administered in the forelimb versus the hindlimb"],"prefix":"10.2460","volume":"85","author":[{"given":"Ashlyn C.","family":"Heniff","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia A.","family":"Petritz","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel G.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Lewbart","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie. 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