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RETROGRADE VENOUS THERAPY — INVESTIGATIONAL LAMINITIS DRUG TREATMENT MATERIALS CHECKLIST for front two feet 1. 2. 3. 4. 5. 6. 7. Combination of 5mg detomidine and 5mg butorphanol 3cc Carbocaine per foot via (25G 5/8 inch needle) (2) 20 gauge butterfly catheters (2) Sterile 50 cc syringes (2) Tourniquet(s) (1) 5 gram vial of investigational laminitis drug per front foot Tape The standing horse is sedated with the combination of 5mg detomidine and 5mg butorphanol (I.V.) in the jugular vein METHOD for each of the two front feet to be treated: Desensitize the foot with 3cc of Carbocaine placed subcutaneously over each common digital nerve at the fetlock. A tourniquet using an Esmarch bandage is applied over 4X4 rolled gauze placed over the palmer digital veins/arteries distally to proximally to remove blood from the superficial vasculature. The Esmarch ends at a pneumatic tourniquet in the mid-metacarpal region. The fetlock is then clipped and aseptically prepped. Using aseptic technique, a 20 gauge butterfly catheter with single-Luer-Lock attachment is inserted into the digital vein at the fetlock and the catheter is secured and taped in place. Using sterile 50cc syringe, the entire contents of (5g vial) of Laminil will be slowly infused via the butterfly catheter into the digital vein at the fetlock. (Ideally, infusion will be over a 1-2 minute time period to avoid blowing the digital vein.) The tourniquet remains in place for approximately 30 minutes post-infusion and will be removed along with the catheter. Laminil will not take effect until the 72-hour mark on acute cases. Note: If you have any questions or concerns with reference to instructions on Retrograde Venous Therapy to administer the drug, please call Dr Allen Landes at 970-566-4296.