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Marangoni S, Ubiali M, Ambrosini F, Jahnel L, Vilani JM, Steagall PV, Vilani RGDDC. Effects of different rates of propofol with or without S-ketamine on ventricular function in healthy cats - a randomized study. Front Vet Sci 2023; 10:1272949. [PMID: 38152595 PMCID: PMC10752607 DOI: 10.3389/fvets.2023.1272949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/24/2023] [Indexed: 12/29/2023] Open
Abstract
Propofol is used for anesthetic induction in cats and procedural sedation in countries where alfaxalone is not available. Studies have reported propofol-related effects in echocardiography variables in dogs and humans. However, there is a lack of echocardiography studies investigating propofol-related effects on cats. This study aimed to use echocardiography to investigate echocardiographic changes in three protocols using propofol: propofol-slow (2 mg/kg/min, PS); propofol-fast (8 mg/kg/min, PF); propofol-ketamine (S-ketamine 2 mg/kg bolus followed by propofol 2 mg/kg/min; PK) in healthy premedicated (gabapentin-buprenorphine-acepromazine; 200 mg/cat, 0.4, and 0.1 mg/kg, respectively), non-intubated cats. Echocardiographic measurements were obtained at three time points: baseline (before the administration of propofol), end of propofol titration (end-point, T0), and 15 min after T0 (T15). Propofol at a lower rate continued from T0 to T15. Echocardiographic and physiological variables included fractional shortening (FS%), ejection fraction (EF%), HR, BP, and others. Propofol requirements at T0 for PF, PS, and PK groups were 5.0 ± 0.9, 3.8 ± 0.7, and 2.4 ± 0.5 mg/kg, respectively. EF% neither change over time nor between groups. PF and PK showed a reduction in FS% at T0 (47 ± 6 to 34 ± 6 and 42 ± 6 to 36 ± 5, respectively). BP reduced significantly in PF and PS groups (136 ± 26 to 105 ± 13 and 137 ± 22 to 115 ± 15 mmHg, respectively). It is unclear whether changes in echocardiography variables were of clinical relevance related to treatment groups or a result of within-group individual responses.
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Affiliation(s)
- Sabrine Marangoni
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Matheus Ubiali
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Francieli Ambrosini
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Larissa Jahnel
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Julia M. Vilani
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Paulo V. Steagall
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
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St Denis K, Saffire A, Michael H, Drake C, Burton W. Cat Friendly Practice improves feline visits, resulting in increased laboratory testing and increased diagnosis of certain common feline conditions. J Feline Med Surg 2023; 25:1098612X231204199. [PMID: 37961891 PMCID: PMC10812006 DOI: 10.1177/1098612x231204199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVES Cat Friendly Practices (CFPs) were compared with non-CFP control practices to determine whether CFPs had an increased proportion of clinical visits, number of visits per cat per year and inclusion of diagnostic testing. To measure diagnostic testing behavior, the numbers and types of tests analyzed and clinically relevant findings were compared. METHODS In a retrospective analysis comparing CFPs and non-CFPs, clinic financial data and associated diagnostic tests from a commercial laboratory for 2018 and 2021 were analyzed. Data were stratified based on visit type and included revenue per visit type, revenue per patient, the number of visits per year and the proportion of visits that included diagnostic testing. Analyses of clinical findings for June 2021 to June 2022 examined clinical findings associated with biochemistry, complete blood count, urinalysis and thyroid testing categories at diagnostic patient visits, the proportion of clinical visits in which each finding was observed, the volume of testing categories as a proportion of clinical visits, and the proportion of diagnostic visits with one, two, three or four testing categories. RESULTS The average revenue per feline visit and visits that included diagnostic testing were higher at CFPs. There was no difference in the proportion of wellness visits; however, CFPs had higher mean visits per year per patient. CFPs performed diagnostic testing at 12% more clinical visits, and had higher annual revenue per feline patient for all visits and for visits including diagnostic testing. CFPs had higher odds of patients having >1 visit that included bloodwork or urinalysis. They were more likely to include all four testing categories and less likely to include only one category at a diagnostic visit. CFPs identified a higher number of cats with clinical findings. CONCLUSIONS AND RELEVANCE CFPs exhibited unique diagnostic testing behavior by performing more diagnostic tests more frequently and identifying a higher number of cats with abnormal findings.
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Affiliation(s)
- Kelly St Denis
- St. Denis Veterinary Professional Corporation, Powassan, ON, Canada
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Taylor S, St Denis K, Collins S, Dowgray N, Ellis SLH, Heath S, Rodan I, Ryan L. 2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines. J Feline Med Surg 2022; 24:1133-1163. [PMID: 36259498 PMCID: PMC10845436 DOI: 10.1177/1098612x221128763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE The '2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines' (hereafter the 'Cat Friendly Veterinary Environment Guidelines') describe how the veterinary clinic environment can be manipulated to minimise feline patient distress. Many components of a veterinary clinic visit or stay may result in negative experiences for cats. However, much can be done to improve a cat's experience by making the veterinary clinic more cat friendly. Exposure to other cats and other species can be reduced, and adjustments made with consideration of the feline senses and species-specific behaviour. Caregivers can prepare cats for a clinic visit with appropriate advice. Waiting rooms, examination rooms, hospital wards and other clinic areas can be designed and altered to reduce stress and hence encourage positive emotions. Changes need not be structural or expensive in order to be effective and make a difference to the cats and, in turn, to cat caregivers and the veterinary team. Moreover, by improving the all-round experience at the veterinary clinic, there are positive effects on preventive healthcare, identification of and recovery from illness, and compliance with treatment. CLINICAL CHALLENGES Good feline healthcare necessitates visiting the veterinary clinic, which, simply by being outside of a cat's territory and familiar surroundings, may lead to negative experiences. Such experiences can trigger negative (protective) emotions and associated physiological stress, which can result in misleading clinical findings, patient distress, prolonged recovery from illness, further difficulties with handling at subsequent visits and potential veterinary personnel injury. There may be a mistaken belief that veterinary clinics must undergo significant renovation or building work to become cat friendly, and that, if species cannot be separated, then clinics cannot improve their care of cats. These Guidelines aim to dispel any such misconceptions and provide detailed practical advice. EVIDENCE BASE These Guidelines have been created by a Task Force of experts convened by the International Society of Feline Medicine and American Association of Feline Practitioners, based on an extensive literature review and, where evidence is lacking, the authors' experience. Endorsements: These Guidelines have been endorsed by a number of groups and organisations, as detailed on page 1161 and at icatcare.org/cat-friendly-guidelines and catvets.com/environment.
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Affiliation(s)
- Samantha Taylor
- International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK
| | - Kelly St Denis
- St Denis Veterinary Professional Corporation, Powassan, Ontario, Canada
| | - Sarah Collins
- International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK
| | - Nathalie Dowgray
- International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK
| | | | - Sarah Heath
- Behavioural Referrals Veterinary Practice, Chester, UK
| | - Ilona Rodan
- Cat Behavior Solutions, Cat Care Clinic, Madison, WI, USA
| | - Linda Ryan
- Inspiring Pet Teaching, Fordingbridge, Hampshire, UK
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Rodan I, Dowgray N, Carney HC, Carozza E, Ellis SLH, Heath S, Niel L, St Denis K, Taylor S. 2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques. J Feline Med Surg 2022; 24:1093-1132. [PMID: 36259500 PMCID: PMC10845437 DOI: 10.1177/1098612x221128760] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE The '2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques' (hereafter the 'Cat Friendly Veterinary Interaction Guidelines') support veterinary professionals with feline interactions and handling to reduce the impact of fear and other protective (negative) emotions, in so doing enhancing feline welfare and In implementing these Guidelines, team satisfaction and cat caregiver confidence in the veterinary team will increase as the result of efficient examinations, better experience, more reliable diagnostic testing and improved feline wellbeing. Veterinary professionals will learn the importance of understanding and appropriately responding to the current emotional state of the cat and tailoring each visit to the individual. CLINICAL CHALLENGES Cats have evolved with emotions and behaviors that are necessary for their survival as both a predator and prey species. A clinical setting and the required examinations and procedures to meet their physical health needs can result in behavioral responses to protective emotions. Cat friendly interactions require understanding, interpreting and appropriately responding to cats' emotional states and giving them a perceived sense of control while performing the required assessment. EVIDENCE BASE These Guidelines have been created by a Task Force of experts convened by the American Association of Feline Practitioners and the International Society of Feline Medicine, based on an extensive literature review and, where evidence is lacking, the authors' experience. ENDORSEMENTS These Guidelines have been endorsed by a number of groups and organizations, as detailed on page 1127 and at catvets.com/interactions and icatcare.org/cat-friendly-guidelines.
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Affiliation(s)
- Ilona Rodan
- Cat Behavior Solutions, Cat Care Clinic, Madison, WI, USA
| | - Nathalie Dowgray
- International Society of Feline Medicine, International Cat Care, Tisbury, Wi ltshire, UK
| | | | | | | | - Sarah Heath
- Behavioural Referrals Veterinary Practice, Chester, UK
| | - Lee Niel
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Kelly St Denis
- St Denis Veterinary Professional Corporation, Powassan, Ontario, Canada
| | - Samantha Taylor
- International Society of Feline Medicine, International Cat Care, Wiltshire, Tisbury, UK
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