Research paper| Volume 45, ISSUE 3, P241-249, May 2018

Comparison of the effects of alfaxalone and propofol with acepromazine, butorphanol and/or doxapram on laryngeal motion and quality of examination in dogs

Published:February 06, 2018DOI:



      To compare the effects of alfaxalone and propofol, with and without acepromazine and butorphanol followed by doxapram, on laryngeal motion and quality of laryngeal examination in dogs.

      Study design

      Randomized, crossover, blinded study.


      Ten female Beagle dogs, aged 11–13 months and weighing 7.2–8.6 kg.


      The dogs were administered four intravenous (IV) treatments: alfaxalone (ALF), alfaxalone+acepromazine and butorphanol (ALF–AB), propofol (PRO) and propofol+AB (PRO–AB). AB doses were standardized. Dogs were anesthetized 5 minutes later by administration of alfaxalone or propofol IV to effect. Arytenoid motion during maximal inspiration and expiration was captured on video before and after IV doxapram (0.25 mg kg−1). The change in rima glottidis surface area (RGSA) was calculated to measure arytenoid motion. An investigator blinded to the treatment scored laryngeal examination quality.


      A 20% increase in RGSA was the minimal arytenoid motion that was detectable. RGSA was significantly less in ALF before doxapram compared with all other treatments. A <20% increase in RGSA was measured in eight of 10 dogs in PRO and in all dogs in ALF before doxapram. After doxapram, RGSA was significantly increased for PRO and ALF; however, 20% of dogs in PRO and 50% of dogs in ALF still had <20% increase in RGSA. A <20% increase in RGSA was measured in five of 10 dogs in PRO–AB and ALF–AB before doxapram. All dogs in PRO–AB and ALF–AB with <20% increase in RGSA before doxapram had ≥20% increase in RGSA after doxapram. Examination quality was significantly better in PRO–AB and ALF–AB.

      Conclusions and clinical relevance

      The use of acepromazine and butorphanol improved the quality of laryngeal examination. Any negative impact on arytenoid motion caused by these premedications was overcome with doxapram. Using either propofol or alfaxalone alone is not recommended for the evaluation of arytenoid motion.


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        • Ambros B.
        • Duke-Novakovski T.
        • Pasloske K.S.
        Comparison of the anesthetic efficacy and cardiopulmonary effects of alfaxalone-2-hydroxypropyl-beta-cyclodextrin and propofol in dogs.
        Am J Vet Res. 2008; 69: 1391-1398
        • Amengual M.
        • Flaherty D.
        • Auckburally A.
        • et al.
        An evaluation of anesthetic induction in healthy dogs using rapid intravenous injection of propofol or alfaxalone.
        Vet Anaesth Analg. 2013; 40: 115-123
        • Arrioja A.
        Arrioja A. Compendium of Veterinary Products. 6th edn. Bayley AJ/North American Compendiums Inc., USA2001: 1349-1350
        • Broome C.
        • Burbidge H.M.
        • Pfeiffer D.U.
        Prevalence of laryngeal paresis in dogs undergoing general anaesthesia.
        Aust Vet J. 2000; 78: 769-772
        • Ferré P.J.
        • Pasloske K.
        • Whittem T.
        • et al.
        Plasma pharmacokinetics of alfaxalone in dogs after intravenous bolus of Alfaxan-CD RTU.
        Vet Anaesth Analg. 2006; 33: 229-236
        • Franz D.
        Central nervous system stimulants.
        in: Gilman A.G. Goodman L.S. Rall T.W. Murad F. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 7th ed. Macmillan Publishing Co, USA1985: 582-588
        • Gaber C.E.
        • Amis T.C.
        • LeCouteur R.A.
        Laryngeal paralysis in dogs: a review of 23 cases.
        J Am Vet Med Assoc. 1985; 186: 377-380
        • Gross M.E.
        • Dodam J.R.
        • Pope E.R.
        • Jones B.D.
        A comparison of thiopental, propofol, and diazepam-ketamine anesthesia for evaluation of laryngeal function in dogs premedicated with butorphanol-glycopyrrolate.
        J Am Anim Hosp Assoc. 2002; 38: 503-506
        • Hardie R.J.
        Translaryngeal percutaneous arytenoid lateralization technique in a canine cadaveric study.
        J Vet Emerg Crit Care. 2016; 26: 659-663
        • Jackson A.M.
        • Tobias K.
        • Long C.
        • et al.
        Effects of various anesthetic agents on laryngeal motion during laryngoscopy in normal dogs.
        Vet Surg. 2004; 33: 102-106
        • Lambert J.J.
        • Belelli D.
        • Peden D.R.
        • et al.
        Neurosteroid modulation of GABAA receptors.
        Prog Neurobiol. 2003; 71: 67-80
        • Maney J.K.
        • Shepard M.K.
        • Braun C.
        • et al.
        A comparison of cardiopulmonary and anesthetic effects of an induction dose of alfaxalone or propofol in dogs.
        Vet Anaesth Analg. 2013; 40: 237-244
        • McKeirnan K.L.
        • Gross M.E.
        • Rochat M.
        • Payton M.
        Comparison of propofol and propofol/ketamine anesthesia for evaluation of laryngeal function in healthy dogs.
        J Am Anim Hosp Assoc. 2014; 50: 19-26
        • Miller C.J.
        • McKiernan B.C.
        • Pace J.
        • Fettman M.J.
        The effects of doxapram hydrochloride (dopram-V) on laryngeal function in healthy dogs.
        J Vet Intern Med. 2002; 16: 524-528
        • Muir W.
        • Lerche P.
        • Wiese A.
        • et al.
        Cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in dogs.
        Vet Anaesth Analg. 2008; 35: 451-462
        • Musk G.C.
        • Pang D.S.
        • Beths T.
        • Flaherty D.A.
        Target-controlled infusion of propofol in dogs – evaluation of four targets for induction of anesthesia.
        Vet Rec. 2005; 157: 766-770
        • Nelissen P.
        • Corletto F.
        • Aprea F.
        • White R.A.
        Effect of three anesthetic induction protocols on laryngeal motion during laryngoscopy in normal cats.
        Vet Surg. 2012; 41: 876-883
        • Omori K.
        • Slavit D.H.
        • Kacker A.
        • Blaugrund S.M.
        Influence of size and etiology of glottal gap area in glottic incompetence dysphonia.
        Laryngoscope. 1998; 108: 514-518
        • Plumb D.C.
        Plumb D.C. Plumb’s Veterinary Drug Handbook. 7th ed. Wiley-Blackwell, USA2011: 325-326
        • Psatha E.
        • Alibhai H.
        • Jimenez-Lozano A.
        • et al.
        Clinical efficacy and cardiorespiratory effects of alfaxalone, or diazepam/fentanyl for induction of anesthesia in dogs that are a poor anesthetic risk.
        Vet Anaesth Analg. 2011; 38: 24-36
        • Rowe R.S.
        • Sheskey P.J.
        • Quinn M.E.
        Rowe R.C. Sheskey P.J. Quinn M.E. Handbook of Pharmaceutical Excipients. 6th ed. Pharmaceutical Press, UK2009: 17-19 (168–171)
        • Rudorf H.
        • Barr F.J.
        • Lane J.G.
        The role of ultrasound in the assessment of laryngeal paralysis in the dog.
        Vet Radiol Ultrasound. 2001; 42: 338-343
        • Smalle T.M.
        • Hartman M.J.
        • Bester L.
        • et al.
        Effects of thiopentone, propofol and alfaxalone on laryngeal motion during oral laryngoscopy in healthy dogs.
        Vet Anaesth Analgesia. 2017; 44: 427-434
        • Tobias K.M.
        • Jackson A.M.
        • Harvey R.C.
        Effects of doxapram HCl on laryngeal function of normal dogs and dogs with naturally occurring laryngeal paralysis.
        Vet Anaesth Analgesia. 2004; 31: 258-263
        • White R.A.S.
        Unilateral arytenoid lateralization: an assessment of technique and long term results in 62 dogs with laryngeal paralysis.
        J Small Anim Pract. 1989; 30: 543-549