Emergency drug sheet: 18 drugs to pin on your clinic wall

At 2 AM, an 8-year-old Golden arrests on your table — you have 10 seconds to recall the epinephrine dose. A wall chart next to your crash tray is faster than unlocking your phone.

These 18 drugs/fluids cover the 5 most common emergencies in small clinics. Doses follow RECOVER 2024, cross-checked with Merck Vet Manual and ACVIM Consensus 2024. Availability verified for Thailand, Malaysia, and Vietnam.

This chart doesn’t replace CPR training. But it keeps you from fumbling doses when your hands are shaking.

RECOVER 2024 — 3 changes that matter

graph TD
    A[RECOVER 2024] --> B[DROP high-dose Epi<br/>standard 0.01 mg/kg only]
    A --> C[Atropine in CPR<br/>once only]
    A --> D[Shock fluids<br/>aliquots not full bolus]
    B --> E[No outcome benefit<br/>more side effects]
    C --> F[Give early if<br/>vagal/non-shockable]
    D --> G[Reassess after<br/>each bolus]

1. CPCR — cardiac arrest

Drug	Dog	Cat	Route	Repeat	Notes
Epinephrine	0.01 mg/kg	0.01 mg/kg	IV/IO/IT	q3-5 min	Stock 1:1,000 (1 mg/mL); IT = double dose
Atropine	0.04 mg/kg	0.04 mg/kg	IV/IO	Once	Give early if vagal/non-shockable
Vasopressin	0.8 U/kg	0.8 U/kg	IV/IO	Alternate with epi	Alternative, not simultaneous

Epi OR Vasopressin every other cycle — not both. RECOVER 2024 eliminated high-dose epi entirely.

2. Anaphylaxis

Step	Drug	Dog	Cat	Route
1	Epinephrine (FIRST-LINE)	0.01 mg/kg	0.01 mg/kg	IM/IV
2	Fluids	10-15 ml/kg bolus	5-10 ml/kg	IV
3	Diphenhydramine	1-4 mg/kg	0.5-2 mg/kg	IM
4	Dexamethasone SP	0.1-0.5 mg/kg	same	IV/IM

Antihistamines and steroids do NOT replace epinephrine. Steroids take 4-6 hours to work.

3. Status epilepticus

Step	Drug	Dose	Route	Repeat
1st	Midazolam (preferred)	0.3 mg/kg; IN: 1 mg/kg	IV/IM/IN	Max 3; CRI 0.3 mg/kg/h
1st	Diazepam	0.5 mg/kg IV; 1 mg/kg PR	IV/PR	Max 3 boluses
2nd	Phenobarbital	4 mg/kg q20-30min	IV slow	Total 16-20 mg/kg
2nd	Levetiracetam	60 mg/kg loading	IV/PO	3-4 times/24h

Midazolam > Diazepam for cats (ACVIM): less CNS depression, good IN route, no hepatotoxicity risk.

⚠️ Diazepam hepatotoxicity in cats — idiosyncratic, potentially fatal after just a few doses.

4. Toxicosis

Scenario	Drug	Dog	Cat	Route
Emesis (dog)	Apomorphine	0.03 IV; 0.04 IM	🔴 BANNED	IV/IM
Emesis (cat)	Dexmedetomidine	—	7 mcg/kg	IM
Emesis (cat)	Xylazine	—	0.44-0.5 mg/kg	IM
Adsorbent	Activated charcoal	1-2 g/kg	same	PO
Rodenticide	Vitamin K1	2.5 mg/kg SC → PO 14-28d	same	SC/PO
OP poisoning	Atropine	0.2-2 mg/kg to effect	same (lower)	IV/IM/SC

🔴 BANNED in cats

• Apomorphine: do not use
• Hydrogen peroxide: do not use — severe hemorrhagic gastritis
• Vitamin K1: NEVER IV — anaphylactoid risk

5. Shock — fluid resuscitation

Fluid	Dog	Cat	Route
Crystalloid (LRS/NaCl)	10-15 ml/kg bolus	5-10 ml/kg bolus	IV
HES colloid	Up to 20 ml/kg (aliquots)	Up to 10 ml/kg	IV
Hypertonic saline 7.5%	4-7 ml/kg / ~10 min	3-4 ml/kg	IV

Full single shock bolus is no longer recommended. Give ¼-⅓ aliquots → reassess → repeat.

SEA reality — where do these drugs come from?

Key insight: most emergency drugs in small SEA clinics come from human pharmaceutical channels. Always recalculate concentration/dilution for veterinary use.

Controlled drugs — regulations in 3 countries

Drug	Thailand	Malaysia	Vietnam
Ketamine	Psychotropic Cat. II	DDA Part III	Psychotropic MOH
Diazepam	Psychotropic Cat. IV	Poisons Group A	Psychotropic MOH
Midazolam	Psychotropic Cat. II	Poisons + Psychotropic	Psychotropic MOH
Phenobarbital	Psychotropic Cat. IV	Poisons + Third Schedule	Psychotropic MOH

Malaysia has the clearest clinic-level requirements: locked cabinet + register + 2-year retention + inspector access.

Pin to your wall — 4 rules

1. CPCR: Epi 0.01 mg/kg q3-5min — NO high-dose — Atropine once
2. Anaphylaxis: Epi IM FIRST — antihistamine/steroid are adjuncts only
3. Seizures: Midazolam IN if no IV access — Levetiracetam as phenobarbital alternative
4. Cats: NO apomorphine, NO H2O2, NO Vit K1 IV — use dexmedetomidine/xylazine for emesis

Practice management software like VetGo can auto-calculate emergency drug doses by weight — enter kg, get dose + volume instantly.

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Sources: RECOVER 2024 Guidelines, RECOVER Drug Dosing Charts, Merck Veterinary Manual, ACVIM Consensus 2024. SEA data: Thai FDA, Malaysia DDA/DVS Directive, Vietnam Circular 12/2020.