Pentobarbital back orders and potential alternatives
AVMA has received multiple reports of short-term back orders of pentobarbital. The Food and Drug Administration Center for Veterinary Medicine (FDA CVM) is aware of the issue and has reached out to sponsors/manufacturers of pentobarbital products to determine the root cause and possible avenues for resolution. Veterinarians can and should report any drug shortage directly to FDA CVM at AnimalDrugShortagesfda [dot] hhs [dot] gov (AnimalDrugShortages[at]fda[dot]hhs[dot]gov).
As a scheduled drug, pentobarbital is regulated by FDA and under the oversight of DEA.
Until this issue is resolved, we know that veterinary practitioners will be looking for alternatives. The following information is summarized from pages 56 through 58 of the AVMA Guidelines for the Euthanasia of Animals: 2020 Edition (AVMA 2020 euthanasia guidelines). Please review the guidelines before deciding the best course of action for your patients and your practice.
Pentobarbital or pentobarbital combination drugs, that are approved by FDA CVM, are a preferred method for euthanasia of dogs, cats, and other small companion animals. Drugs containing pentobarbital that have been approved by FDA CVM and that appear to be currently marketed are summarized in Table 1. During short-term back orders, alternative drugs may need to be considered for euthanasia of these species.
Anesthetic overdose with non-barbiturate injectable drugs may be an acceptable alternative. Options from the AVMA 2020 euthanasia guidelines include ketamine and xylazine given IV, IP, or IM, and propofol given IV. Drugs containing ketamine, xylazine, or propofol that have been approved by FDA CVM and that appear to be currently marketed are listed in Tables 2, 3, and 4.
An overdose of inhaled anesthetic may also be an acceptable alternative under certain conditions. Examples from the AVMA 2020 euthanasia guidelines include an overdose of isoflurane or sevoflurane. Drugs containing isoflurane or sevoflurane approved by FDA CVM and that appear to be currently marketed are summarized in Tables 5 and 6.
Potassium chloride (1 to 2 mmol/kg, 75 to 150 mg/kg, or 1 to 2 mEq K+/kg) administered IV or intracardially may be used adjunctively to euthanize companion animals when they are unconscious (unresponsive to noxious stimuli) or under general anesthesia.
Additional methods in the AVMA 2020 euthanasia guidelines are generally not recommended, but may be used when the conditions described in the guidelines are met.
Comments
Pentobarbital shortage
Thank you for this very useful information.
pentobarbital shortage
A large number of animal shelters, some of which perform high numbers of euthanasias daily, do not have a veterinarian or access to other controlled drugs to anesthetize animals before KCl is injected. This creates a number of critical animal welfare issues. It would be great if AVMA could lobby FDA and/or other regulatory agencies for emergency procedures to assure shelters have continued access to barbiturate euthanasia drugs (e.g. expiration date extensions, new importation sources, etc). Not an easy problem to solve, for sure, but so important.
Pentobarbital shortage
There are large numbers of shelters out there , but most of the Pentobarbital shortage is as a result of the sytem closing down access for everyone to get hold of it .
These days the demand for this products (Pentobarbital) is due to the artificial shortages created because it was discovered that , humans were now using it for suicide. Which gives a painless and peaceful end for any one using the right dose for suicide.
Yes we understand the system doesn't permit or promote suicide , but in some cases where the person in question is terminal , and suffering in a limbo , or in agony and they know the person will end up still the same way , why don't they permit that ? Recently they charged
Daniel Gonzalez-Munguia( Alejandro Vasquez for supplying it to people who wanted to go peacefully , though it's a crime for what he did , but surely they where some persons there who also could be terminal . So the problem is for the system to create a system where they can determine who is terminal and give that that gift of transiting peacefully.
If you have documented proves that you are terminal and in need or your pet see buynembutalinjection at g male
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