Emergency Drug Doses by Weight
Enter the patient's weight to see all crash-cart doses at once. Aligned with RECOVER (Reassessment Campaign on Veterinary Resuscitation) consensus where applicable. Print-friendly: hit Cmd/Ctrl-P after entering the weight to keep a copy at the crash cart.
| Drug | Indication | Dose | Concentration | Total dose | Draw up | Route |
|---|---|---|---|---|---|---|
Epinephrine (low dose) CPR | CPA — first-line, q3–5min | 0.01 mg/kg | 1 mg/mL (1:1000) | — | — | IV / IO |
Epinephrine (high dose) CPR | CPA — after 2–3 cycles without response | 0.1 mg/kg | 1 mg/mL (1:1000) | — | — | IV / IO |
Atropine CPR | Vagally-mediated brady, asystole, PEA | 0.04 mg/kg | 0.54 mg/mL | — | — | IV / IO |
Vasopressin CPR | CPA — alternative to high-dose epinephrine | 0.8 U/kg | 20 U/mL | — | — | IV / IO |
Lidocaine (dog) CPR | Ventricular tachy / fibrillation | 2 mg/kg | 2% (20 mg/mL) | — | — | Slow IV bolus |
Naloxone Reversal | Opioid reversal | 0.04 mg/kg | 0.4 mg/mL | — | — | IV / IO / IM |
Flumazenil Reversal | Benzodiazepine reversal | 0.01 mg/kg | 0.1 mg/mL | — | — | IV |
Atipamezole Reversal | Alpha-2 reversal (dexmed/medetomidine) | 5× the alpha-2 dose by mg | 5 mg/mL | — | — | IM |
50% dextrose (diluted) Metabolic | Hypoglycemia | 0.5 mL/kg of 50% (dilute 1:2) | 500 mg/mL (50%) | — | — | Slow IV |
10% calcium gluconate Metabolic | Hyperkalemia, hypocalcemia | 50–100 mg/kg | 100 mg/mL (10%) | — | — | Slow IV over 10–20 min |
Reference only — verify before administering. This tool is for reference purposes only and does not constitute veterinary medical advice. Always consult a licensed veterinarian and verify dosages against current published literature before administering any medication. ExoticRx is not liable for clinical decisions. Full disclaimer
Notes on the doses
- Epinephrine 1 mg/mL (1:1000): Low-dose 0.01 mg/kg IV/IO is RECOVER first-line during CPR. High-dose 0.1 mg/kg is reserved for prolonged CPA without response after 2–3 cycles.
- Atropine 0.54 mg/mL: 0.04 mg/kg IV/IO for vagally-mediated bradyarrhythmias and asystole/PEA per RECOVER.
- Lidocaine 2% (20 mg/mL): 2 mg/kg slow IV bolus for ventricular arrhythmias (dogs); avoid in cats — they're far more sensitive (use 0.25–0.5 mg/kg titrated, slow).
- Naloxone 0.4 mg/mL: 0.04 mg/kg IV/IO/IM for opioid reversal. Repeat q2–3min if no response. Watch for re-narcotisation as opioid half-life often exceeds naloxone's.
- Flumazenil 0.1 mg/mL: 0.01 mg/kg IV for benzodiazepine reversal. Effect window is short (~60 min); monitor for re-sedation.
- 50% dextrose: 0.5 mL/kg IV diluted 1:2 with saline for hypoglycemia (target 1 mL/kg of the diluted 25% solution). Critical small-mammal/exotic dose with insulinoma history.
- 10% calcium gluconate: 50–100 mg/kg slow IV over 10–20 min for hyperkalemia (cardio- protection) or hypocalcemic tetany. Monitor ECG during infusion.
Why a weight-indexed chart, not memorisation
During a code, the failure mode is rarely "the anesthesiologist forgot the dose." The failure mode is decimal-point math on a 4-kg patient while the chest is being compressed. Every RECOVER initiative report flags drug-dose delay and miscalculation as among the most common preventable contributors to CPR failure. The fix is structural — pre- computed dose sheets at every working weight, accessible in under five seconds. This tool generates that sheet for any weight you type in, on demand.
The standard physical practice is a laminated dose card attached to the crash cart, in 0.5-kg or 1-kg increments, updated whenever protocols change. The digital equivalent — this page — is faster to update, faster to print custom for unusual patient sizes (a 110-g cockatiel, a 350-kg horse), and available on any device the team carries.
Aligned with RECOVER 2024
The doses in the chart follow the 2024 RECOVER consensus update where it gives explicit guidance: low-dose epinephrine 0.01 mg/kg as first-line during CPR, with high-dose 0.1 mg/kg reserved for prolonged arrest after 2–3 cycles without ROSC; atropine 0.04 mg/kg for vagally-mediated arrhythmias and asystole/PEA; defibrillation energy 4–6 J/kg monophasic, 2–4 J/kg biphasic. Where RECOVER is silent (reversal agents, glucose, calcium for hyperkalemia), the chart follows Plumb's 10e and the standard ECC references.
The chart is reference, not protocol. Your practice should have a written code response with role assignments, a stocked and checked crash cart, and a debrief habit. The numbers here are the dose math; the system is the team.
Exotic-species considerations
The per-kg doses on most code drugs (epinephrine, atropine, glucose) extrapolate reasonably to most exotic-pet mammals, birds, and reptiles — receptor pharmacology is broadly conserved, and the published exotic-CPR consensus largely mirrors the small-animal doses. The traps are:
- Tiny patients (under 200 g) need dose dilution; drawing 0.01 mL of stock epinephrine accurately is not realistic. A 1:10 dilution in saline is standard for patients under ~500 g.
- Reptiles in CPA respond to standard drug doses but the metabolic timeline is different — ROSC may take longer to recognise; continue CPR longer than the mammalian time horizon (15+ minutes is reasonable).
- Birds and intra-osseous access: the tibiotarsus or distal ulna is often easier than IV access during a code. IO doses match IV per RECOVER.
- Lidocaine in cats and rabbits: cats are sensitive; some clinicians avoid in rabbits also pending better data.
What the chart does not cover
This page is the bolus-dose code reference. It does not cover:
- CRIs initiated after ROSC (norepinephrine, dopamine, dobutamine titrations) — those go on a separate calculation; see the CRI calculator.
- Antitoxins, antivenins, specific antidotes — event-specific and protocol-dependent; verify against the relevant drug page or a clinical-toxicology reference.
- Sedation and anesthetic doses in stable patients — those are not emergency-code doses; use the main dosage calculator for patient-specific protocols.
- Defibrillation energy — not a drug, but referenced in RECOVER 2024: 4–6 J/kg monophasic, 2–4 J/kg biphasic for VF/pulseless VT, with escalation per protocol.
Frequently asked questions
- Can I print this for the crash cart?
- Yes — that's the design intent. Enter the weight, hit Cmd/Ctrl-P, the print stylesheet hides navigation and the commentary panels and prints the dose table clean on letter or A4. Multiple practices keep a binder of pre-printed sheets at common weights (0.5 kg, 1 kg, 5 kg, 10 kg, 20 kg, 30 kg, 50 kg) in case the lookup tool is offline.
- Does this work offline?
- Once the page is loaded, the calculation runs entirely in the browser. Useful for ambulatory practices, field work, and any disaster scenario where connectivity is the first thing to fail. For permanent offline reference, print the sheet.
- Why are some doses given a range rather than a single number?
- Where RECOVER and the standard references publish a range (e.g. epinephrine low-dose vs high-dose, calcium 50–100 mg/kg), the chart shows the range. Clinical judgment chooses where in the range to dose; the calculator does not eliminate that judgment, it eliminates the arithmetic.
- Why is the cat lidocaine dose so much lower than the dog?
- Feline sensitivity to lidocaine cardiotoxicity is well- published. The 2 mg/kg slow IV bolus standard in dogs is associated with seizures and bradycardia in cats at the same dose. Use 0.25–0.5 mg/kg titrated slowly in cats, and many cardiologists prefer alternative antiarrhythmics (procainamide, sotalol) for stable feline ventricular arrhythmias.
- Should I keep this open on a tablet during a code?
- That works — a wall-mounted or cart-mounted tablet showing this page (or a printed copy) is a reasonable practice standard. Two redundancies are better than one; printed paper does not need power or wifi.
Reference only — not veterinary advice. Doses and concentrations per Plumb's 10e and the RECOVER 2024 consensus update where applicable. Verify drug concentration on the vial before drawing up.