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Horses and anesthesia make for a high stakes mix, and the numbers prove it. We open the barn door on a new study of oral trazodone in healthy adult horses that boosted sedation but, at a low dose, unexpectedly increased xylazine requirements at induction. Our award-winning guest, Dr. Emmett Swanton, walks us through the why behind the work, what the data actually say, and how to turn mixed results into smarter, safer protocols.

We dig into the global context first: equine perioperative mortality remains several times higher than in small animals, with most disasters happening during recovery. That’s where behavior, physiology, and pharmacology collide. Could a preoperative oral sedative soften the edges—calmer handling, smoother transitions, less panic? The study offers a nuanced yes: trazodone clearly increases calm, but clinicians shouldn’t assume an alpha-2 sparing effect at low dose. Instead, we talk practical use cases where trazodone shines today—pre-visit anxiolysis, postoperative stall rest—and where the next wave of research should go, especially recovery scoring and dose-timing strategies that might translate sedation into fewer complications.

Along the way, Emmett shares candid career lessons from residency to journal recognition and makes a compelling case for bridging small animal best practices to equine medicine without copy-pasting expectations. If you manage anxious horses, plan elective procedures, or obsess over safer recoveries, you’ll find concrete takeaways to test in your own barn: when to reach for trazodone, how to think about xylazine titration, and why the recovery phase deserves as much design as induction.

If this conversation helped you rethink your protocol, follow the show, share it with a colleague, and leave a quick review. Your feedback helps more veterinarians and horse owners find evidence-based strategies that keep horses safer.

AJVR article: https://doi.org/10.2460/ajvr.24.07.0185

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