Hi Team. Just watched your ketamine webinar, thanks. Super happy to find that we are using ketamine appropriately in our acute pain patients and excited to try it for chronic pain. I do however feel that we might be overly cautious about utilising ketamine in acute pain (perioperative) settings in our renal patients. We are one of the only 24h hospitals in New Zealand's South Island, see lots of major surgery, trauma, major dentistry and frequently have to manage acute pain in patients with renal compromise. Please can you comment on how much we should be avoiding ketamine in these guys? We have in past been worried about the sympathomimetic effect and drop in GFR particularly? We use loading doses of 0.5-1mg/kg and CRI intraop/postop/trauma etc of 2-5Ug/kg as "standard", usually in combo with fentanyl CRI or methadone PRN. Also use paracetamol in renal dogs but not cats of course! Should we be considering renal compromise a contra-indication or caution for ketamine use? Thanks in Advance.