Etomidate: veterinary dose and monograph

At a glance

Drug class

Sedative / anaesthetic

Also known as

Amidate, Etomidate-Lipuro

Species with doses

Dogs, Cats, Rabbits and Ferrets

General dose range

0.5–2 mg/kg IV single induction dose (to effect) — check the species tables for the indication

Routes

IV

Last reviewed

1 October 2026

Indications

• IV induction in patients with significant cardiac disease (e.g. severe valvular/myocardial disease, arrhythmia)
• Induction in shock / haemodynamically unstable or critically ill patients
• Induction where cardiovascular stability is paramount

Etomidate dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Induction (cardiac/critical patients): Plumb’s p.497: 0.5–2 mg/kg IV, with premedication or a benzodiazepine to reduce myoclonus and vomiting (Mama 2002); 1 mg/kg with diazepam 0.5 mg/kg IV (Cornell). Suppresses adrenal cortisol synthesis — consider a physiological glucocorticoid dose beforehand. Not in Papich 5e.

Cats

• Induction (cardiac/critical patients): Plumb’s p.497 (dogs and cats): 0.5–2 mg/kg IV with premedication or a benzodiazepine; adrenocortical suppression — consider a glucocorticoid. The propylene glycol vehicle can cause haemolysis.

Rabbits

• Induction (cardiovascularly unstable): Plumb’s p.497 (Lichtenberger 2006): rabbits 1–2 mg/kg IV after diazepam 0.5 mg/kg IV.

Ferrets

• Induction (critically ill / cardiac): Carpenter's 6th ed (Ferret table): 1 mg/kg IV for induction and intubation of the critically ill ferret — minimal cardiovascular depression. Plumb’s p.497 (Lichtenberger 2006): 1–2 mg/kg IV after diazepam 0.5 mg/kg IV in cardiovascularly unstable ferrets.

Contraindications

Sole use without premedication (myoclonus, retching, pain on injection). Reliance on it where adrenal suppression is dangerous (e.g. avoid infusions/repeated dosing; caution in septic/Addisonian patients). Known hypersensitivity. The propylene-glycol formulation can cause haemolysis/pain (lipid formulations are better tolerated).

Adverse effects

• Pain on injection; myoclonus/muscle twitching at induction
• Retching/vomiting
• Transient adrenocortical suppression (even after a single dose)
• Haemolysis (propylene-glycol formulation, with rapid/large dosing)
• Apnoea (usually mild/brief)

Drug interactions

• Other CNS depressants/opioids/benzodiazepines: additive hypnosis (co-induction is intended to reduce dose and myoclonus)
• No significant cardiovascular drug interactions (its selling point)
• Adrenal-suppressing context: relevant in critically ill/septic patients

Pregnancy and lactation

Limited veterinary data; crosses the placenta. Use only if cardiovascular stability is essential.

Monitoring

• Depth of anaesthesia, respiration/airway (brief apnoea), SpO2
• Cardiovascular parameters (typically stable — its advantage)
• Myoclonus/retching at induction (mitigate with premed)
• In critically ill/repeated dosing: consider adrenal function/cortisol

Toxicity and overdose

Overdose causes prolonged hypnosis and apnoea (but with preserved cardiovascular stability relative to other agents). The distinctive concern is adrenocortical suppression — clinically minor after a single induction dose but significant with infusions/repeated dosing, especially in the critically ill. The propylene-glycol vehicle can cause haemolysis/pain with large/rapid doses.

Management: No antidote. Support ventilation/oxygenation; cardiovascular support is usually less needed than with other agents. Be aware of (and, in the critically ill, consider supplementing for) adrenal suppression after repeated dosing. Supportive care until recovery.

Clinical pearls

• The induction agent for the FRAGILE HEART — outstanding cardiovascular stability when propofol/thiopental hypotension would be dangerous
• ALWAYS co-induce/premedicate (benzodiazepine ± opioid) — alone it causes painful injection, myoclonus and retching
• Remember the adrenal-suppression caveat: fine for a single induction, but avoid infusions/repeat dosing in septic/critical patients
• No analgesia — pair with appropriate analgesics

Mechanism of action

A carboxylated imidazole that potentiates GABA-A receptor activity, producing rapid hypnosis/anaesthesia with minimal effect on the cardiovascular system (it does not significantly depress myocardial contractility, vascular tone or sympathetic output) — hence its haemodynamic stability. Separately, it inhibits 11-β-hydroxylase in the adrenal cortex, transiently suppressing cortisol/aldosterone synthesis. It provides no analgesia.

Formulations and products

• Injection 2 mg/mL
• Amidate / Etomidate-Lipuro — 2 mg/mL injection, Injection (human-label)

Storage

Injection: 15–30 °C, protect from light; do not freeze. Lipid emulsion formulations per label.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other sedatives and anaesthetics

• Azaperone
• Detomidine
• Dexmedetomidine
• Diazepam
• Guaifenesin (GGE)
• Isoflurane
• Ketamine HCl
• Medetomidine

Frequently asked questions