Under AVMA guidance, hypothermia and removing fish from water are unacceptable methods. One study found that prolonged immersion in buffered MS-222 at 1,000 mg/L killed only 7% of adult goldfish. A second study found the same concentration worked in juveniles. Because of results like these, a two-step approach is still recommended for pet fish: anesthesia first, then a secondary method such as pithing, decapitation, or an intracardiac injection.
In reptiles, Petritz recommends confirming heartbeat with Doppler or ultrasound rather than a stethoscope, and listening for at least one to two minutes because heart rates are slow. In a study of sedated leopard geckos, intracardiac injections stopped the heart right away, while intracoelomic pentobarbital took 30 to 35 minutes. Six of nine geckos given intracardiac lidocaine began breathing again and regained a heartbeat hours later, and six of nine given intracardiac KCl had severe muscle spasms. The authors advised against both drugs at the doses studied in that species.
Results for oral and cloacal pentobarbital have been mixed. In red-eared sliders, 75% of turtles given the drug by the cloacal route leaked solution and needed a rescue IV dose. The oral route worked, but cardiac arrest took an average of 18 hours. In bearded dragons, oral dosing led to cardiac arrest after about six hours on average, and in feral green iguanas, every animal needed a rescue IV dose.