Pulse - August 2023 - 18

TOOLS FOR SUCCESS
Wielding the Perfect Potion
Kitty Magic and other medicinal compounds fall under
state and federal regulations.
Courtesy of Today's Veterinary Business
Y
ou securely stored a bit of magic in the
treatment room. It is inside a small,
inconspicuous vial wrapped with a DIY
label and the words " Kitty Magic " in purple
marker. You know that a tiny amount
of this potion will tame the most fractious
feline patients. However, you are unaware
that your patient-focused concerns made
you oblivious to a plethora of potential
regulatory violations. Kitty Magic is a
clinic-concocted combination of agents
mixed for use in feline sedation.
The drugs and their amounts can vary from one hospital
to the next to create the " perfect " potion. Kitty Magic combines
ketamine, telazol, dexdomitor and buprenorphine (or
butorphanol). You might call it Kitty Magic, TTDex, TKD
or something else. The name and combination of ingredients
is not what matters. What does matter is your potion includes
at least one controlled substance mixed with something else.
Feline patients are notoriously difficult to manage. A bit of
sedation can make a world of difference in examining and
treating them effectively and safely. However, a single drug
might not be ideal due to the potential side effects and desired
duration, so you might use a combination of agents. Theoretically,
you could calculate the amount of each ingredient
and draw it up individually. The problem is that some cats
are extra small, and the doses needed are minuscule, resulting
in volumes difficult to measure accurately. In those cases,
you could dilute the drugs, but that falls into compounding
and creates additional math, leading to an increased risk of
overdosing or underdosing a patient. Also, the multiple drugs
must be combined into a single syringe, or you'll need to inject
the patient numerous times. All this adds to the opportunity
for error. Kitty Magic is desirable at practices that frequently
see feline patients because preparing a mixture in advance is
much easier than concocting one on a busy day. However,
we don't have benefits without risk, and we don't have magic
without a dark side.
The Dark Side: Drug Diversion
As all good science fiction readers know, magic has a dark side,
and Kitty Magic is no different. Its power comes from mixing
substances. Dexdomitor is not a federally controlled sub18
stance,
but ketamine, buprenorphine, telazol and butorphanol
are. Therefore, the standalone controlled substances used in
Kitty Magic, in addition to the mixture itself, are at risk for diversion.
Let us briefly recap the drugs. Ketamine: A Schedule
III drug under the Controlled Substance Act, the injectable,
short-acting anesthetic is used in people and animals. It is referred
to as a dissociative anesthetic because it makes patients
feel detached and can induce a state of sedation, immobility,
relief from pain and amnesia. For those reasons, ketamine is
a highly sought-after controlled substance for illicit use that
gained popularity when users discovered it produced effects
like those associated with PCP. Buprenorphine: A Schedule
III controlled substance under the CSA, the narcotic analgesic
is a long-acting (24 to 72 hours) opioid agonistantagonist
capable of producing significant euphoria. It has gained popularity
as a heroin substitute and is a primary drug of abuse.
Telazol (tiletamine/zolazepam): A Schedule III controlled
substance under the CSA, it is a fixed-ratio combination of
the dissociative anesthetic tiletamine and the tranquilizer zolazepam.
Comparable to ketamine in efficacy, telazol is used
for anesthesia and can be abused for recreational purposes.
Torbugesic (butorphanol): A Schedule IV controlled substance
under the CSA, it is a synthetic, centrally acting, agAUGUST
2023
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Pulse - August 2023

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