Transient echocardiographic and cardiovascular changes temporally associated with trazodone administration in a geriatric dog.

Ensure adequate intravascular volume before trazodone administration in geriatric dogs to avoid transient cardiovascular changes.

This case report describes transient cardiovascular changes temporally associated with trazodone administration in a 14-year-old neutered male Toy Poodle presented for elective bilateral phacoemulsification surgery. Oral trazodone (5 mg/kg) was administered approximately 2 hours prior to anesthesia to facilitate preoperative handling. Approximately 1 hour post-trazodone administration, a previously undocumented grade 3/6 left apical systolic heart murmur was auscultated. Focused echocardiography revealed subjectively reduced left ventricular internal dimensions with an appearance suggestive of concentric hypertrophy. Mild elevation in symmetric dimethylarginine (SDMA) was noted (16 μg/dL; RI 0–14 μg/dL), though no overt clinical dehydration was identified. Elective anesthesia was postponed, and the patient received overnight intravenous fluid therapy. Repeat cardiovascular assessment approximately 22 hours post-trazodone revealed complete resolution of the murmur and normalization of left ventricular dimensions on echocardiography. Subsequent trazodone dosing under conditions of improved intravascular volume status did not reproduce similar findings. This case highlights trazodone's known vasodilatory and alpha-1 adrenergic antagonist properties as a plausible mechanism, suggesting that relative hypovolemia may unmask or exacerbate cardiovascular changes. Clinicians should be aware of the potential for trazodone to induce transient hemodynamic alterations, particularly in geriatric patients with compromised intravascular volume, and should ensure adequate hydration status prior to trazodone administration in preoperative settings.

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