Peer-reviewed veterinary case report
Using rocuronium and sugammadex to stop breathing during dog
By Elliott, James et al.·Published in Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association·2026·Southfields Veterinary Specialists, United Kingdom·View original on PubMed →
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Original publication title: Utility of Rocuronium-Sugammadex Combination to Induce Apnea in Dogs Undergoing Stereotactic Radiation Therapy.
- Species:
- dog
Plain-English summary
Fourteen dogs undergoing stereotactic radiation therapy (SRT) for tumors were given a combination of rocuronium and sugammadex to temporarily stop their breathing during treatment. This method was effective in keeping most dogs still, especially when the medication was given continuously. While some dogs experienced mild side effects like increased carbon dioxide levels, these were mostly manageable, and only a few had temporary drops in heart rate and blood pressure. All dogs recovered quickly after the treatment, with no lasting effects. This approach seems promising for improving the precision of radiation therapy in dogs.
People also search for: dog cancer treatment · dog radiation therapy side effects · rocuronium sugammadex for dogs
Abstract
Stereotactic radiation therapy (SRT) requires extreme precision due to its high dose per treatment, high total dose, and very small error margins. Even small positioning errors may result in serious normal tissue toxicity or underdosing the tumor. Respiratory motion (resulting in tumor motion) represents a significant challenge to the delivery of SRT in some tumor types. A retrospective study of pet dogs receiving a rocuronium-sugammadex combination (ROC-SUG) as a means of inducing apnea was performed. The study included 14 pet dogs (43 treatments; 1-5 treatments per patient) undergoing SRT. A bolus of ROC was effective in preventing spontaneous breathing during treatment in 3/11 (27%) treatments and in 28/32 (88%) treatments when an ROC constant rate infusion (CRI) was given throughout treatment delivery, following the initial bolus. The median duration of apnea per treatment session was 6 min (range 4-7 min). The longest period of apnea during any treatment without interruption was 7 min. Adverse effects encountered during treatment include hypercapnia, bradycardia, and hypotension. Hypercapnia was observed in 34/43 treatments (79%). However, only 1/43 treatments (2%) resulted in bradycardia and hypotension, which were rapidly reversed. All dogs recovered rapidly following SUG with complete neuromuscular blockade reversal in a median of 1 min (range: 1-2 min), and there was no evidence of recurarization in any patient. The ROC-SUG combination, particularly when used with an ROC CRI, facilitated the induction of apnea without significant adverse effects. Future studies should use a uniform treatment protocol to confirm efficacy and patient safety.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/42089395/