BAM

The patented combination of Butorphanol Tartrate,

Azaperone Tartrate & Medetomidine Hydrochloride

Together they work synergistically …

combining the best anesthesia attributes of each compound

at the lowest effective dose rate

 Background & History

Q. Why was BAM developed?

A. To fill the need for a formulation that’s:

 Reversible
 Safe
 Low DEA class
 Small volume
 Broad species application
 Simple dosing schedule
 BAM Components

• Butorphanol
An opiate agonist/antagonist with only
a Class IV restriction from DEA

A totally synthetic, centrally acting, narcotic

agonist-antagonist analgesic

Has a duration of about 4 hours

Reversal: Butorphanol either not reversed or reversed with 0.5 ml
Naltrexone IM (except in fawns where 0.25 ml effective)
 BAM Components

• Azaperone
A member of the Butyrophenone group

Most commonly used in Africa with Etorphine (M99)

and A3080 or alone as a transport aid in hoof stock

Use and knowledge in U.S. limited due to limited

availability until now

Reversal: Azaperone not reversed and provides low level

of sedation for 2-4 hours.
 BAM Components

• Medetomidine
Uses, dose and efficacy in wildlife was widely known
when used with Carfentanil, A3080, Ketamine and
Telazol

Application in combination with Butorphanol and

Azaperone (BAM) was a new concept in 2003

Reversal: Medetomidine reversed with ZooPharm’s 25 mg/ml

Atipamezole at 2:1 ratio based on total BAM dose given
 Wildlife Objectives

Anesthesia:
– Controlled reversible depression of the central nervous system
usually resulting in loss of consciousness and perception of pain

– To handle wildlife we generally have to put them in one or more

of these states:

• Tranquilized or Sedated
• Analgesia
• Anesthesia
 Levels of Anesthesia
Increasing CNS
stimulation

Mania
Where we work

Sleep

Analgesia
Decreasing CNS

Amnesia
Unconsciousness
stimulation

Loss of motor response

Loss of motor tone

Coma
DEATH
Increasing Dose
DOSE

The Sweet Spot

INDUCTION TIME
 Why the world is turning to BAM
for safe, effective immobilizations

• This reversible anesthesia

combination has now been
administered to over 60 species

• Literally thousands of exotics and

non-domestic animals have been
safely anesthetized using BAM with
excellent results.

• It’s why 65 US Zoos and 100’s

of wildlife ranches use this BAM
formulation for safe, efficient
capture.
The BAM Anesthesia Advantage
 … Across a broad variety of captive species

• Cervidae • North American Pronghorn

– White-tailed deer • North American Bovids
– Mule deer – Mtn goats
– Elk
– Bison
– Fallow deer
– Caribou/Reindeer
– Moose
– Axis Deer
 …plus an expanding group of exotics

• Kudu
• Sable
• Gemsbok
• Wildebeest
• Blackbuck
• Arabian Oryx
• Scimitar Horned Oryx
• Impala
…and more
 BAM Administration

The Basics…
• Use long needles
(single port)

• Give sufficient doses

• Insure dart delivered deep

into large muscle masses

• Store BAM vials properly

 BAM Administration
Reversals
• Administer the
2 reversal drugs in
separate syringes
Atipamezole
• For Atipamezole :
– Give at least 2 cc for every
1 cc of BAM administered
• For Naltrexone*:
– Give 0.50 cc for adults in most species
– Give 0.25 cc for fawns, calves and
other young / small animals

*Note: When transporting animals via trailer, it may be

advantageous to NOT ADMINISTER NALTREXONE.
By not reversing the Butorphanol in BAM animals will
remain more relaxed during relocation. Butorphanol
sedation will wear-off (without reversal) in about 1 hour. Naltrexone
 BAM Administration
Needle Tips
• It is important to use darts with long needles from 1” to 1-1/2”
• Only use single, end-port needles that discharge BAM
directly from the tip

• Avoid use of Tri-Port needles because:

– they discharge drug from the tip
plus the two side-ports simultaneously
– it can result in only partial dose delivery into the muscle
– the remaining dose discharging from side ports will be deposited
just below the skin or into the fat layer
– when this occurs BAM continues to be absorbed for up to
72 hours… resulting in re-sedation
 BAM Administration

Seasonal Considerations

• Deer immobilizations become more challenging in the Fall due to

weight gain, heavier coats and thicker fat layers

• In addition, seasonal breeding cycles cause significant hormonal

changes in deer that could also affect capture

• During this period, it is especially critical that animals receive the

complete, recommended BAM dose volume deep into muscle tissues

• This will provide effective anesthesia levels and minimize the

occurrence of re-sedation or post-anesthesia sluggishness

• An injection partially or completely releasing BAM into surrounding fat

or subcutaneous skin layers, can result in re-sedation and require an
additional reversal injection with Atipamezole for full recovery
 BAM Administration
Kit Storage and Care
• All the components of BAM are formulated at near maximum
levels of solubility.
• Be sure to keep BAM at room temperature between 50° to 85°F
at all times (prior to and after use).
• Exposure to temperatures of 40°F and below can cause the
BAM components (butorphanol, azaperone, medetomidine)
to drop out of solution.
• Always check for crystals or cloudiness.
• Such low temperatures can cause the components to precipitate
or crystalize, resulting in loss of formulation stability and potency.
 BAM Tech Tips

1. Do not store loaded darts in cold temperatures for extended periods

prior to use. The BAM formulation can crystalize inside the dart.

2. When carrying BAM into the field (in vials, syringes, darts, etc.) keep
it at the recommended 50°-85°F before use.

3. If in the field for an extended time period at cold temperatures, keep

BAM (vials, syringes, darts) in a heated truck cab or keep warm in
an insulated container until just prior to use.
 Resolving BAM Precipitation
and Crystallization Issues

If you notice crystal-like particles floating in the BAM vial,

here’s the best way to get the BAM back into solution:
1. Hold the BAM vial in one hand and heat it with a hair dryer on the
highest setting.
2. As the vial becomes too warm in hand, move the hair dryer away
for 30 seconds, then continue to heat it.
3. Do this for 6-10 minutes until all crystals/particulates have gone
back into solution and the BAM vial is clear.

NOTES:
• Once the BAM has been put back into solution it should remain at proper solubility levels,
as long as vials remain stored within the recommended 50° to 85°F temperature range.

• This precipitation/crystallization can also occur with Atipamezole or Naltrexone vials.

If so, simply follow one of the procedures described above.
 BAM Troubleshooting Checklist
This troubleshooting form is available to help you pinpoint, understand and correct any events
that may occur effecting the optimal performance of BAM.

Problem Noted Check for the following possible causes:

Animal not going down / staying down properly BAM has precipitated out of solution, particulates,
vial contents not clear

Needle size used (_____ inch) Should be1” or more

Dart may have injected in fat layer

Dart may not have fully discharged

Other (note):

Animal not reversing properly Atipamezole reversal dose given at less than 2:1 ratio

IM Injection not given properly

Other

Animal appears to reverse properly, than re- If animal re-sedates, can give another full dose of atipamezole
sedates (either by hand injection or by dart)
Other (note):

Other incident(s) Notes:

 Artificial Insemination

Use of BAM anesthesia for effective Laparoscopic AI

• 2013 Study conducted to compare AI conception rates administering

butorphanol / azaperone / medetomidine (BAM) vs. Telazol / Xylazine

• Comparative AI results observed between these two different anesthetic

protocols were as follows:

 Equivalent AI conception rates of ~55% reported among does

in both the BAM and T/X treatment groups

 BAM Group Does: 12 Pregnant and 10 Open

 T/X Group Does: 11 Pregnant and 9 Open

 Artificial Insemination

Use of BAM anesthesia for effective Laparoscopic AI

• BAM treatment group exhibited superior quality of reversal recovery
and reduced duration of sedation

• 46% of BAM treated does had no sign of sedation

within 15 minutes of reversal
 Semen Collection
Use of BAM anesthesia for effective semen collection
• 2017 Study compared collection and evaluation of semen quality
using BAM anesthesia vs. Telazol / Xylazine

• Comparative results reported:

 BAM anesthesia provided equal or increased semen collection
volumes as compared to Telazol / Xylazine
 Semen characteristics from test group males immobilized with BAM
exhibited key traits determined to be important for successful fertilization
(including sperm concentration; total sperm number; and sperm motility)
 Respiration measurement under BAM anesthesia recorded average breaths per minute
data at 21% lower than while under Telazol / Xylazine

 Comparison of reversal times recorded following collection was determined to average

just 3.5 minutes using BAM compared to 48.3 minutes when reversing Telazol / Xylazine
 BAM
Wildlife anesthesia you can always count on.

1. Smooth inductions
2. Induction times equal to or shorter than
Med/Ket or Telazol/Xylazine
3. Relaxed respiration (no “frozen chest”)
4. Limited or no increase in body temperature
5. Good blood oxygen levels
6. Great analgesia and relaxation
7. Proven effective for Lap AI and Semen Collection
8. Rapid, smooth and socially acceptable recovery