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The effect of doxapram on survival and APGAR score in newborn puppies delivered by elective caesarean: A randomized controlled trial
Journal article   Open access   Peer reviewed

The effect of doxapram on survival and APGAR score in newborn puppies delivered by elective caesarean: A randomized controlled trial

Timothy H Hyndman, Shelby Fretwell, Ross S Bowden, Flaminia Coaicetto, Peter C Irons, Joshua W Aleri, Nino Kordzakhia, Stephen W Page, Gabrielle C Musk, S Jonathan Tuke, …
Journal of veterinary pharmacology and therapeutics, Vol.46(6), pp.353-364
2023
DOI: https://doi.org/10.1111/jvp.13388
PMID: 37211671
Appears in  Open Access via Read & Publish Agreements
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CC BY-NC-ND V4.0,  Open Access

Abstract

time to event CONSORT Dopram bitch dog GEE
Doxapram is marketed as a respiratory stimulant and is used by some veterinarians to help with neonatal apnoea, especially in puppies delivered by caesarean. There is a lack of consensus as to whether the drug is effective and data on its safety are limited. Doxapram was compared to placebo (saline) in newborn puppies in a randomized, double-blinded clinical trial using two outcome measures: 7-day mortality rate and repeated APGAR score measurements. Higher APGAR scores have been positively correlated with survival and other health outcomes in newborns. Puppies were delivered by caesarean and a baseline APGAR score was measured. This was immediately followed by a randomly allocated intralingual injection of either doxapram or isotonic saline (of the same volume). Injection volumes were determined by the weight of the puppy and each injection was administered within a minute of birth. The mean dose of doxapram administered was 10.65 mg/kg. APGAR scores were measured again at 2, 5, 10 and 20 min. One hundred and seventy-one puppies from 45 elective caesareans were recruited into this study. Five out of 85 puppies died after receiving saline and 7 out of 86 died after receiving doxapram. Adjusting for the baseline APGAR score, the age of the mother and whether the puppy was a brachycephalic breed, there was insufficient evidence to conclude a difference in the odds of 7-day survival for puppies that received doxapram compared to those that received saline (p = .634). Adjusting for the baseline APGAR score, the weight of the mother, the litter size, the mother's parity number, the weight of the puppy and whether the puppy was a brachycephalic breed, there was insufficient evidence to conclude a difference in the probability of a puppy having an APGAR score of ten (the maximum APGAR score) between those that received doxapram compared to those that received saline (p = .631). Being a brachycephalic breed was not associated with an increased odds of 7-day mortality (p = .156) but the effect of the baseline APGAR score on the probability of having an APGAR score of ten was higher for brachycephalic than non-brachycephalic breeds (p = .01). There was insufficient evidence that intralingual doxapram provided an advantage (or disadvantage) compared to intralingual saline when used routinely in puppies delivered by elective caesarean and that were not apnoeic.

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Domestic collaboration
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3 Agriculture, Environment & Ecology
3.232 Veterinary Sciences
3.232.1281 Veterinary Reproductive Health
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Pharmacology & Pharmacy
Veterinary Sciences
ESI research areas
Plant & Animal Science
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