Hi Beth, Great to hear from you!
Dog Appeasing Pheromone / Adaptil is the only one I use. It comes in a spray, a diffuser, and a collar. This pheromone has been studied for noise phobias, separation anxiety, supporting puppy socialization, and fear during car rides. The form I use depends on the case. There are some other pheromones out from other companies, but I don't use those because I have yet to see what evidence they have that they are functional even part of the time. In my experience, we have a number of patients that improve on DAP. However, we are also doing a number of interventions at one time. It is rare to see a really startlingly positive effect that goes away once the pheromone runs out and then returns when the pheromone is renewed, but it absolutely happens. It is incredibly rare in my experience to have a patient respond poorly to DAP. I've had one in the last decade who appeared quite fearful once the collar was opened and only resolved when the collar was thrown out.
We use DAP spray and diffusers on a DAILY basis in our ICU and I can tell you first hand that they work! My ICU nurses typically add it on the treatment sheet PRN. I agree that we are doing other interventions (Trazadone has been life saving) but I have also seen some patients (esp. cats that start eating, grooming, and relaxing within minutes) once pheromone therapy is added.
Thanks so much for your comment, Melissa! We are working hard to encourage use of pheromones in veterinary hospitals along with low-stress handling and restraint. I'm so glad to hear of your experience and will be sure to share it with others. :) Trazodone works great for those hospitalized patients as well. I'm so glad you are using it and liking it. You are helping those animals have a much faster recovery and be less stressed while they are at it.
Hi Melissa!
Sorry about the delay. Was in lectures all day...
I love trazodone and people are reporting great success with it in post operative patients as detailed in the study by Margaret Gruen. I use the dose range published in this paper (similar to what you are doing). This paper is so great because it shows the use of combinations of trazodone with tramadol. Without this paper, I would never have done this combo for fear of serotonin syndrome. But it's looking like it's a winning combo.
Do you see any vomiting or diarrhea in your patient load when you use trazodone in the ICU? Are you combining with tramadol?
E'Lise
E'Lise
This was a great article and I am happy to say that our entire surgical department has adapted this protocol for their post-op ortho cases with good success.
I use Tramadol & Trazadone in conjunction with about 80% of my patients. I have not seen any major problems. One of my surgeons did report one case that had excessive sedation but patient was hemodynamically stable and the effects resolved with a lower dose.
I have not see vomiting associated with trazadone dosing. I do occasionally see diarrhea but very uncommon. My nursing staff is instructed to use the prescribed trazadone dose as needed q8hrs - some patients may only get one of those 3 doses if they don't need it. Which I find becomes true for some patients if they have been in the hospital for a few days and settled in so to speak.
I also agree with this study that it takes about 30 minutes to take effect - and in some patients it only last 4-6 hours.
