The recommendation for routine preemptive atropine administration in dogs receiving ephedrine is premature

Abstract

In the June JAVMA article titled “Emergency administration of ephedrine for general anesthesia-induced hypotension requires preemptive atropine in dogs but not cats,” Seki et al1 reported a retrospective study evaluating the cardiovascular effects of IV ephedrine—with or without preemptive atropine—in anesthetized dogs and cats. The authors concluded that preemptive atropine administration is recommended in dogs to enhance the vasopressor effect of ephedrine. While the study provides valuable data, we are concerned that this clinical recommendation is not adequately supported by the study design.