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. 

E'Lise,    What's your experience with Trazadone dosing? I've heard anywhere from 1mg/kg up to 10mg/kg - we typically start our patients on 3mg/kg PO q8hrs for in-hospital anxiety and titrate up. This seems to work well for most patients without causing sedation. 

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.  

Great News! IDEXX will be releasing the SMDA Kidney Biomarker test this summer! It's exciting to see recent research come to light in the clinical setting where we can all take advantage of this new kidney biomarker. A copy of the information about the test from IDEXX can be downloaded.  Go to the SMALL ANIMAL PRACTITIONERS GROUP. (Join the Group if you haven't already done so) ... Click on DOCUMENTS > then download intro-kidney-test-sdma.