Anesthetization of large animals, such as the horse, is a challenge for veterinarians and compounding pharmacists. This article discusses the technique of intravenous anesthesia by using a combination of xylazine and ketamine in the horse for short-term unconsciousness; a combination of xylazine, diazepam, and ketamine, for improved sedation and muscle relaxation; and a combination of xylazine, ketamine, and guaifenesin, referred to as Triple Drip, for the maximum 1-hour duration of unconsciousness. Compounding pharmacists that have the facilities and training required to prepare sterile compounds can greatly assist equine surgeons in the treatment of veterinarians' most challenging patients.