Effects of butorphanol versus dexmedetomidine sedation on intradermal allergen and histamine responses in dogs with atopic dermatitis

Abstract

Sedation is commonly used during intradermal testing (IDT). Morphine and its derivatives have long been avoided because of their histamine-releasing effects. Butorphanol, an opioid agonist/antagonist, will not adversely affect IDT in dogs. Ten client-owned dogs diagnosed with atopic dermatitis. Dogs were randomized to be sedated with butorphanol (0.4 mg/kg) or dexmedetomidine (5 μg/kg). Routine IDT along with intradermal injections of various dilutions of histamine were performed on the lateral thorax, followed 7 days later by the alternative sedative and IDT on the opposite side. The injection sites were subjectively scored and objectively measured by one investigator, blinded to the sedatives, and compared between groups. When the mean wheal diameters from the objective measurements of all antigens, including saline and histamine dilutions, were compared, butorphanol was associated with significantly smaller reactions than dexmedetomidine (P = 0.0001). There was a high level of agreement between sedatives when positive reactions subjectively scored as ≥3+ were compared (κ = 0.91). When mean wheal diameters of histamine at concentrations of 1:100,000, 1:400,000, 1:1,600,000 and 1:6,400,000 were compared, there were no significant differences between sedative types. Moreover, the percentage agreement when comparing subjective interpretation of all histamine dilutions between sedations was high (κ = 0.90). However, there was only 69% agreement beyond chance when objective and subjective interpretations of all antigens were compared between sedative groups. Although butorphanol resulted in significantly smaller wheal size in comparison to dexmedetomidine, it did not affect the overall subjective interpretation of the results of IDT.