We should probably use dex or butorphanol (based on the previous study) for sedation for feline abdominal US

Effect of common sedation agents on feline splenic size determined via ultrasonography

E Short 1, J Chagas 1, M Kurihara 1, Y Ishikawa 1, J P Chambers 1, J Bridges 1, H Sano 1

Background
The spleen in cats can change size due to physiological, pathological, or drug-induced factors. Identifying whether sedation affects splenic size is clinically significant, as splenomegaly can be confused with pathological conditions. This study evaluated the effects of three common sedation protocols—acepromazine (ACE), alfaxalone (ALF), and dexmedetomidine (DEX), each combined with morphine—on feline splenic size using ultrasonography.

Methods
A prospective study was conducted on 24 healthy client-owned cats undergoing elective or minor procedures. Cats were randomly assigned to one of three sedation protocols:

-ACE group: 0.05 mg/kg acepromazine IM with 0.5 mg/kg morphine.
-ALF group: 3 mg/kg alfaxalone IM with 0.5 mg/kg morphine.
-DEX group: 10 μg/kg dexmedetomidine IM with 0.5 mg/kg morphine.

Splenic thickness was measured at the head, body, and tail using standardized ultrasonography before sedation (T0) and at 10 (T10), 20 (T20), and 30 (T30) minutes after drug administration. Sedation scores and vital parameters (e.g., heart rate, blood pressure) were also recorded.

Results
Splenic Size:
-Significant splenic enlargement occurred in the ACE and ALF groups:
-ACE group: Splenic body increased from 8.9 mm at T0 to 10.5 mm at T30 (p = 0.001).
-ALF group: Splenic body increased from 8.8 mm at T0 to 10.3 mm at T30 (p = 0.022).
-No significant change was observed in the DEX group.

Sedation Scores:
-DEX provided the highest and most stable sedation scores over 30 minutes, while ACE and ALF showed variable sedation levels.

Vital Parameters:
-Mean arterial pressure (MAP) was significantly higher in the DEX group compared to ACE and ALF groups (p = 0.002).

Limitations
The study did not include a control group without sedation. The sample size was small, and the cats were primarily young and healthy, potentially limiting generalizability. Additionally, the duration of splenic enlargement beyond 30 minutes post-sedation was not assessed.

Conclusions
Acepromazine and alfaxalone cause significant splenic enlargement in cats, likely due to relaxation of splenic smooth muscle and vascular changes. In contrast, dexmedetomidine does not significantly alter splenic size, possibly due to its vasoconstrictive properties. Clinicians should consider the effects of sedation protocols when interpreting splenomegaly on ultrasound in sedated cats.

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