Medetomidine HCl/Ketamine HCl/Butorphanol Tartrate/Midazolam HCl Injectable

Giving your pet an injection might feel intimidating at first, but with practice, it becomes routine. Follow these steps for safe and stress-free injections.

Get Your Supplies Ready

1. Medication vial or pre-filled syringe
2. Alcohol swabs
3. Sterile syringe & needle (if not pre-filled)
4. Sharps container for safe needle disposal

Drawing Up the Dose (if needed)

1. Clean the vial top with an alcohol swab
2. Attach needle to syringe
3. Pull in air equal to the dose
4. Insert needle into vial, push air in
5. Draw out the correct dose
6. Tap out air bubbles

Pick the Injection Site

1. Subcutaneous (under the skin): Loose skin between shoulder blades or side
2. Intramuscular (into muscle): As directed by your vet

Prep the Area

1. Pinch a fold of skin to form a “tent” (for subcutaneous). Wipe with alcohol if recommended.

Inject the Medication

1. Hold the syringe like a pencil
2. Insert the needle into the base of the skin tent at a 45° angle
3. Push the plunger slowly to inject

After the Injection

1. Remove the needle smoothly
2. Place it immediately in the sharps container (don’t recap)
3. Pat the area and give your pet praise or a treat

Safety Tips

1. Never reuse needles
2. Always dispose of used needles properly
3. Ask your vet for help if unsure

This compounded formulation combines active ingredients from different drug classes: medetomidine, an alpha-2 adrenergic agonist; ketamine, a dissociative anesthetic; butorphanol, an opioid analgesic; and midazolam, a benzodiazepine. In compounding practice, clinicians may consider a multi-ingredient preparation like this to address more than one aspect of a patient's physiology at once. Your veterinarian determines whether it is appropriate based on your animal's diagnostic findings.

This description reflects the general pharmacology of the active ingredient's drug class; your veterinarian determines whether this approach is appropriate for your animal.

Prescription only. Use only under the direction of a licensed veterinarian. This information is not a substitute for veterinary diagnosis, prescribing or monitoring. Compounded drugs are not approved by the FDA for safety or effectiveness.

At a pharmacological level, these four agents are considered to influence the central nervous system by acting on alpha-2, NMDA, opioid and GABA receptors. Commonly observed effects include behavioral shifts such as deep sedation, muscle relaxation and changes in heart and respiratory rates. Your veterinarian will monitor for observational signs of cardiovascular status and oxygenation during the procedure. Owners should provide a quiet environment during the recovery period and monitor for any unusual behavioral shifts, contacting their veterinarian promptly with any concerns.