Reply from Banfield re: ACE

[sjt3409]

This is in response to an email I wrote to Banfield regarding their use of ACE on Boxers.

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Several veterinary drug texts do note that certain breeds may be extra-sensitive to the effects of this drug. However, The appropriate use of acepromazine at the appropriate dose is a common and accepted practice, even in Boxers- emphasis on the word appropriate.

The manufacturer's label dose and many reported tranquilization doses for acepromazine in dogs are very high- high enough to cause negative side effects in many dogs regardless of the breed and high enough to frequently cause problems for breeds that are thought to be sensitive. Its at these doses that the problems occur.

I can't speak for what other practices do, but can comment on the use of acepromazine in anesthesia at Banfield. Acepromazine is used at very low doses in conjunction with other medication(s) as a pre-medication sedation prior to anesthesia in many healthy Pets at Banfield. Additional drugs are then used for the actual anesthesia.

In fact, in this healthy Pet protocol, Banfield uses acepromazine at a dose that is at least 20 times LESS than the manufacturer's recommended injectable dose (and 40 times less than the oral dose). Used in this careful way, Pets (including Boxers) require LESS actual anesthetic drug(s) and therefore are LESS likely to experience the negative effects that can be caused by all anesthetic drugs (low blood pressure, cardiac/respiratory depression, cardiac rhythm changes and more), making anesthesia safer.

Thanks for your question,
xxxxx xxxxxx, DVM

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[boxer]

Umm - this is the veterinary practice that insisted on using Acepromazine on your dog after you asked them not to, right?

Well, irrespective of their "opinion" of the risks, no vet has the right to insist on using a particular drug on your dog, and especially not after they've been told you don't want it used. As I think you were advised in your earlier post, there are plenty of alternative drugs around if a pre-anasthetic sedative is necessary. Why did the vet not use valium instead?

The fact that they appear to acknowledge that the manufacturers suggested doses are too high - and are departing from recommended practice - is not something that I would take as a positive. Quite the reverse, in fact. They acknowledge the drug is dangerous to breeds known to be sensitive, so instead of using an alternative they continue to use ACE, but at a doseage they consider 'safe'. Since that's markedly different from the recommended dose, one wonders how they found what their so-called 'safe' doseage is...

Nope, sorry. That response just isn't good enough. If it had been me, there is no way I'd have allowed the use of Acepromazine on my dog - I'd have gone elsewhere to have him neutered. I don't really understand why you did not. The risks of using Ace on boxers is well documented, and just because not every dog has a reaction doesn't make it worth risking the dog's death - just for the sake of a particular type of sedative. Needless to say, I wouldn't be using that vet in the future either, and I'd make sure they knew why.

 

[Maniago]

Nope, sorry. That response just isn't good enough. If it had been me, there is no way I'd have allowed the use of Acepromazine on my dog

I agree. The vet is being paid for a service, and we should be treated as customers. They have absolutely no right to insist upon the use of a product I do not want used.

 

[haleyandmark]

If you are the same person, I think I remember your post from a while back about Banfield and ACE (we go to Banfield too, but they do not use ACE on Boxers in particular - they tell the owner why - like me - because a lot of them aren't educated on the subject)! I can't believe the same chain, just a couple of states away, has two totally different standpoints!

And it's not necessarily for their opinion on the use of ACE (which still bothers me...), it's that you asked them not to use ACE and they still did, which is wrong in many more ways than just one.

Apparently, this vet does not respect YOUR wishes, which leads me to believe they are un-trustworthy and I wouldn't be going back, and like 'Boxer said, I would make my reasoning known without a doubt.

If someone went behind my back and did something to my baby (Asia) that I asked them not to because of it having problems in the breed, even if she did come out okay, I would never even think twice about going back...

I am glad your baby came out of surgery okay

 

[sjt3409]

I never actually told them not to use it, I questioned the vet tech on the use of it. He basically made it sound like it was almost a requirement to use it and that the dogs would be better off because it does sedate them pretty heavily. Anyway I am considering switching vets anyway. I am on their Wellness plan, but am searching for another insurance plan.

 

[Boxerhelper]

My experience with ACE

I'm not picking sides or trying to get in the middle of things here, but rather just sharing what my vet told me. She said that ACE is okay to use *provided the boxer has never had any seizures or a history of medical problems. Naomi was given an "ACE mix" and had no side effects. The reason I allowed her to administer the drug was because when Maggie needed sedationj after her spay, the other meds had no effect. We could not raise the dose on the other meds because it would have been way too much.

I had to weigh my options with the ACE. NAomi came to me because of aggression problems and does not do well with strangers or new places. I could not run the risk of her attacking someone in panic--I would have lost her for certain. I stayed with her before, during, and after the vet administered the ACE just to be on the safe side.

Again, this is just my experience, not a pro-ACE argument.

 

[Thomas Liggin]

I had a discussion about ACE with our vet, and she does not use ACE on either Indy or Ava. She did however concur with what they told you at Banfield. She showed me on a syringe, what the company recommends and how much they use. It was about one twentieth of the recommended dosage.

Her research and experience have proven that it actually takes very little ACE to sedate a dog in preparation for anesthesia and surgery. Sounds like the pharmaceutical company is trying to sell more than is actually needed.

Who knows? If they had recommended the appropriate dosage to begin with ACE would not have its current reputation as being dangerous.

She is aware of the sensitivity in Boxers however, and has never questioned our wishes.

 

[Evie&Adam]

Her research and experience have proven that it actually takes very little ACE to sedate a dog in preparation for anesthesia and surgery. Sounds like the pharmaceutical company is trying to sell more than is actually needed.

If this is true, they why do SO MANY vets use the "recommended dosage"??? If this research is available to us, the vets surely have this research. If these vets TRULY care about the wellbeing of these animals, they should respect the decisions of the owners. period.

For me, my vet is totally against using ace on boxers (and some other breeds) because she has in the past experienced problems.

 

[JulieM]

She said that ACE is okay to use *provided the boxer has never had any seizures or a history of medical problems.

Here's the problem with that theory. The common complications with ACE are cardiac-related - the Banfield vet even mentioned "cardiac rhythm changes". The most prevalent genetic conditions in Boxers are heart conditions. Neither of them are "clearable" at the age a Boxer typically goes in for a spay/neuter. Neither of them are easily identifiable at a visit to a regular vet - both require a cardiologist and special equipment, except in very severe cases. One of them is characterized by "cardiac rhythm changes." A Boxer can have AS or ARVC and yet be completely asymptomatic. Why gamble with a dog's life, when there are preanesthetics that don't have the high incidence of cardiac complications?

 

[boxer]

Whether a vet administers a dosage that is a fraction of that recommended by the manufacturer or not, it doesn't change the fact that the boxer breed has been shown to have a sensitivity to the drug that can lead to death. That doesn't mean that the majority of boxers will react badly to the drug. In fact, it is a minority of boxers that react to Acepromazine, though that minority is significant enough for the breed to have a registered sensitivity to the drug. And the minority who DO react are likely to die as a result. How does the vet know that it is their lowered dosage that is OK, and not just blind luck in not striking a non-susceptible individual? If they've done any clinical trials, I'd love to know But I suspect they're doing their "experiments" in the field. Well, not on MY dog

IMHO it is simply not worth taking the risk - because until the dog has a reaction, you never know whether it is susceptible or not. And the risks for the boxer breed are well known. It is not just a question of dosage.

Even if a vet is not convinced by the evidence against using ACE on boxers, they really don't have any right to be taking a known risk with a dogs life. Anyone (who didn't know better) would think that there weren't perfectly safe alternative sedatives available...