Comparison of the effects of three different combinations of general anesthetics on the electroretinogram of dogs

Comparisons of α2-Adrenergic Agents, Medetomidine and Xylazine, with Pentobarbital for Anesthesia: Important Pitfalls in Diabetic and Nondiabetic Rats

Purpose: Anesthesia is necessary to conduct rodent electroretinograms (ERGs). We evaluated utility of the α2-agonist medetomidine versus xylazine for ERG studies in nondiabetic and diabetic rats. Pentobarbital was included as a comparator. Methods: Male Sprague-Dawley rats, with and without streptozotocin (STZ)-induced diabetes, were anesthetized with medetomidine (1 mg/kg), xylazine (10 mg/kg) (both with ketamine 75 mg/kg), or pentobarbital (70 mg/kg). The depth of anesthesia was assessed, and if adequate, scotopic ERGs were recorded. Blood glucose was monitored. Results: In nondiabetic rats, all three agents induced satisfactory anesthesia, but with differing durations: medetomidine > pentobarbital > xylazine. ERG responses were similar under medetomidine and xylazine, but relatively reduced under pentobarbital. Both α2-agonists (but not pentobarbital) elicited marked hyperglycemia (peak values 316.1 ± 42.6 and 300.3 ± 29.5 mg/dL, respectively), persisting for 12 h. In diabetic rats, elevated blood glucose concentrations were not affected by any of the agents, but the depth of anesthesia under medetomidine and xylazine was inadequate for ERG recording. Conclusions: In nondiabetic rats, medetomidine and xylazine elicited comparable effects on ERGs that differ from pentobarbital, but both perturbed glucose metabolism, potentially confounding experimental outcomes. In STZ-diabetic rats, neither α2-agent provided adequate anesthesia, while pentobarbital did so. Problems with α2-anesthetic agents, including medetomidine, must be recognized to ensure meaningful interpretation of experimental results.

Repeated measurements of ERGs and VEPs using chloral hydrate sedation and propofol anesthesia in young children

PURPOSE

Sedation with chloral hydrate or anesthesia using propofol allow ocular examination and testing in young children, but these drugs may affect electrophysiologic recordings. We compared the flash and pattern ERGs and VEPs recorded with each drug in a cohort of young children enrolled in a prospective study of optic nerve hypoplasia (ONH) syndrome.

METHODS

ERGs and VEPs to light-adapted, standard, full-field flashes, to standard and steady-state pattern-reversal (PR) were recorded with cycloplegia in 9 participants. Age range at the first session, with chloral hydrate was 8-23 mo; at the second session with propofol it was 20-29 mo. Examiners masked to the drug and clinical conditions measured the waveforms for longitudinal, paired comparisons between the sessions.

RESULTS

Flash ERG amplitudes did not differ between sessions; peak times were longer at the second session (propofol) by clinically insignificant amounts (< 2 ms, p = 0.002). Standard PERGs had larger amplitudes and later peaks in the second session (propofol) than with chloral hydrate (P50 2.9 vs 4.7 μV, p = 0.016 and 43 vs 52 ms, p < 0.001; N95 4.0 vs 6.1 μV, p = 0.003 and 91 vs 98.5 ms p = 0.034.). These differences were present for those with an interval of  > 10 mo between sessions (n = 5, 10 eyes) but not for those with a shorter inter-test interval (< 8 mo, p > 0.05, n = 4). Magnitudes of the steady-state PERGs did not differ between tests but the waveforms had earlier peaks at the second test with propofol. Flash VEP waveforms were present in 10/18 eyes and showed 72% agreement for recordability between sessions. Standard pattern VEPs were recordable in only a few eyes in this cohort with ONH.

CONCLUSIONS

Light-adapted flash ERG waveforms were generally similar with chloral hydrate and with propofol. Larger PERGs with later peaks, found in the second session (propofol) could reflect maturation of the PERG generators, as the differences found were associated with a greater age difference between the sessions, but we do not rule out that small differences in the waveforms may be drug-related. There are insufficient VEP data from these children with ONH to identify drug-related or maturational effects on VEPs.

Electroretinography (ERG) in the wild giant panda (Ailuropoda melanoleuca)

PURPOSE

Using a quick electroretinography (ERG) protocol for rapid assessment of the retinal function of wild giant pandas (Ailuropoda melanoleuca) performed in field conditions to demonstrate the range of ERG recordings in giant pandas of unknown retinal status.

ANIMALS STUDIED

Nine free range giant pandas.

PROCEDURE

All the giant pandas were anesthetized using an intramuscular dexMTZ injection, which is a combination of dexmedetomidine and tiletamine-zolazepam. After 20 mins of dark adaptation, scotopic ERGs were obtained by using three flash intensities: -25 dB (0.0087 cd·s/m² ), 0 dB (2.75 cd·s/m² ), and +5 dB (8.7 cd·s/m² ). Next, photopic ERGs were acquired using a single flash protocol with a flash intensity of 3.0 cd·s/m² after 10 minutes of light adaptation.

RESULTS

In scotopic ERG at 0.0087 cd·s/m² , mean b-wave amplitude and peak time were 82.26 µV (SD ± 16.65 and 95% CI 68.33-96.18) and 66.97 ms (SD ± 10.86 and 95% CI 57.90-76.05), respectively. This flash intensity was below a-wave threshold and resulted in b waves with greater peak times compared to those with higher intensities. At 2.75 cd·s/m² , the mean a-wave amplitude and peak time were 53.95 µV (SD ± 11.63 and 95% CI 44.23-63.67) and 16.13 ms (SD ± 2.62 and 95% CI 13.94-18.31), and mean b-wave amplitude and peak time were 119.57 µV (SD ± 15.54 and 95% CI 106.57-132.56) and 32.00 ms (SD ± 6.47 and 95% CI 26.59-37.41). At 8.7 cd·s/m² , the mean a-wave amplitude and peak time were 58.85 µV (SD ± 14.90 and 95% CI 46.39-71.31) and 15.59 ms (SD ± 2.63 and 95% CI 13.40-17.79), and the mean b-wave amplitude and peak time were 132.97 µV (SD ± 22.11 and 95% CI 114.48-151.46) and 32.66 ms (SD ± 6.87 and 95% CI 26.91-38.40). In photopic ERG at 2.75 cd·s/m² , the mean a-wave amplitude and peak time were 62.08 µV (SD ± 16.61 and 95% CI 48.19-75.97) and 16.28 ms (SD ± 0.90 and 95% CI 15.53-17.03), and the mean b-wave amplitude and peak time were 214.93 µV (SD ± 70.41 and 95% CI 156.07-273.80) and 33.09 ms (SD ± 1.27 and 95% CI 32.03-34.15).

CONCLUSION

Using a portable ERG system with a brief ERG protocol to perform electroretinographies in wild giant pandas is a practical, useful, and reliable method for the rapid assessment of their retinal function.

Intravenous ketamine for long term anesthesia in rats

Ketamine/xylazine anesthesia has been used primarily for short term procedures in animals, but two prior reports used intravenous ketamine/xylazine for experiments taking many hours. However, there is a discrepancy about the appropriate dose, which is resolved here. Adult Long-Evans rats were used for recording from the retina. Doses of Ketamine/xylazine were adjusted to minimize anesthetic in terminal experiments lasting 10 h. An allometric relation was fitted to the resulting data on doses as a function of body weight, and compared to prior work. The allometric relationship between the continuously infused specific dose and weight was: dose = 9.13 (weight)^−1.213 (r² = 0.73), where dose is in mg-kg⁻¹-hr⁻¹ and rat weight is in kg. The dose of xylazine was 3.3% of the ketamine dose. No attempt was made to explore different relative doses of xylazine and ketamine. Prior work is consistent with this relationship, showing that the earlier discrepancy resulted from using rats of different sizes. Ketamine at the doses used here still depressed the electroretinogram relative to historical controls using urethane. We conclude that intravenous ketamine dosing in rats should not use the same mg-kg⁻¹-hr⁻¹ dose for all rats, but take into account the strong allometric relationship between dose and rat weight. There is an advantage in using smaller doses in order to prevent unnecessary depression of neural responses.

A modified silent substitution electroretinography protocol to separate photoreceptor subclass function in lightly sedated dogs

OBJECTIVE

A previously published study successfully isolated photoreceptor responses from canine rods, long/medium-wavelength (L/M) cones, and short-wavelength (S) cones using silent substitution electroretinography (ERG) performed under general anesthesia. We hypothesized that responses would be similar in dogs under sedation and that a curtailed protocol suitable for use in clinical patients could effectively isolate responses from all three photoreceptor subtypes.

ANIMALS STUDIED

Three normal adult purpose-bred beagles (2 females and 1 male).

METHODS

Dogs were dark-adapted for 1 hour. Sine wave color stimuli were delivered using LEDs in a Ganzfeld dome. The ERG protocol under anesthesia was performed as previously published; sedated ERG protocols were performed after a 3-day washout period. Intravenous sedation (dexmedetomidine 1.25 mcg/kg, butorphanol 0.1 mg/kg) was administered for sedation. Statistical analysis was performed using two-way repeated-measures ANOVA and linear regression.

RESULTS

In both anesthetized and sedated animals, rod-derived responses peaked at low frequency (4-12 Hz), L/M-cone responses peaked at high frequency (32-38 Hz), and S-cone responses peaked at low frequency (4-12 Hz). The frequencies eliciting maximal responses were similar in sedated and anesthetized protocols, although rod amplitudes were significantly higher in the sedated protocols compared with anesthetized (P < .001).

CONCLUSION

We present a clinically applicable method to consistently isolate rod and cone subclass function in sedated dogs. This may allow detailed evaluation of photoreceptor function in clinical patients with rod or cone subclass deficits without the need for general anesthesia or protracted adaptation times.

Morphologic and electrophysiologic findings of retinal degeneration after intravitreal sodium iodate injection following vitrectomy in canines

We developed and characterized a canine model of outer retinal degeneration induced by sodium iodate (SI) intravitreal injection after vitrectomy. In the preliminary study, we repeatedly injected SI intravitreally into the eyes of three canines to develop outer retinal degeneration two weeks after vitrectomy. Based on the preliminary study, a single dose of either 1.2 mg or 1.0 mg SI/0.05 mL was also injected (1.2 mg in n = 5 canines, 1.0 mg in n = 2 canines). Spectral domain-optical coherence tomography (OCT), electroretinography (ERG), and histological examinations were performed at baseline and following intravitreal injection. In the preliminary study, after a 0.5-mg SI injection and a 1.0-mg SI injection and after two 0.8-mg SI injections, retinal degeneration with retinal thinning was observed on OCT imaging. In the second study, after a single 1.0- or 1.2-mg SI injection, outer retinal degeneration was induced. All eyes showed diffuse outer retinal degeneration on OCT and a loss of both cone and rod responses in ERG. Histological examination also showed the loss of outer retinal layer. Intravitreally injected SI (1.0–1.2 mg) in a vitrectomized canine model induced outer retinal degeneration effectively, and could be evaluated through in vivo ophthalmic examination.

Effect of Three Different Sedatives on Electroretinography Recordings in Domestic Pigeons (Columba livia)

This study was conducted to compare the effects of 3 different sedative agents on electroretinography (ERG) in domestic pigeons (Columba livia). Six pigeons were sedated with alfaxalone, xylazine, and medetomidine at separate times with a 1-week washout period between sedative administration. After sedation with each agent, pigeons underwent the modified ERG protocol adapted from the standardized protocol for dogs. The scotopic mixed rod and cone response was recorded after 20 minutes of dark adaptation, and the photopic cone response and photopic flicker response were recorded after 10 minutes of light adaptation. Either a 1-way analysis of variance or a Kruskall-Wallis test was used to compare the a-wave and b-wave implicit time and amplitude. No significant differences were observed in the scotopic mixed rod and cone response among all 3 sedatives used. Compared with alfaxalone, medetomidine significantly prolonged the a-wave implicit time, depressed the b-wave amplitude of photopic cone response, and prolonged the peak implicit time of the photopic flicker response (P < .05). These results show that medetomidine has a depressant effect on photopic ERG in pigeons at a dosage that produces light sedation.

Electroretinography in eight species of neotropical deer

ABSTRACT The aim of this study was to establish normal baseline ERG values of 23 anesthetized deer belonging to 8 neotropical species (Mazama americana, Mazama nemorivaga, Mazama gouazoubira, Mazama nana, Mazama bororo, Ozotocerus bezoarticus, Odocoileus virginianus and Blastocerus dichotomus). Only right eyes were studied. Chemical restraint was performed using xylazine associated with ketamine, IM, for M. americana, M. gouazoubira, M. nemorivaga, M. nana, M. bororo, O. bezoarticus and O. virginianus. A combination of tiletamine/zolazepam diluted in xylazine 2% was used for B. dichotomus individuals. After 20min of dark adaptation, electroretinograms were obtained using a handheld electroretinography (ERG) machine using the QuickRetCheck Protocol at three different light intensities: 0.01cd.s/m2, 3cd.s/m2, and 10cd.s/m2. After light adaptation, photopic phase was recorded. A-wave amplitude recorded during pattern mixed rod/cone response in M. americana was significantly lower when compared to B. dichotomus. No other differences were observed between the species studied. ERG in Neotropical deer is applicable using a portable ERG system and did not show differences among species in relation to the retinal response at different light intensities. Therefore, the lifestyle of the species is more dictated by the selection pressure of the environment than by physiological factors.

Comparison of two sedation protocols for short electroretinography in cats

Objectives The objectives were to compare two different sedative combinations, xylazine-ketamine and dexmedetomidine-ketamine, for the short electroretinography (ERG) protocol and their impact on sedative effect, reversal times and physiological variables in cats. Methods Six healthy spayed female domestic cats were sedated using one of two ketamine-containing protocols: intramuscular xylazine hydrochloride (1 mg/kg) plus ketamine hydrochloride (3 mg/kg) (XK), and dexmedetomidine hydrochloride (5 µg/kg) plus ketamine hydrochloride (3 mg/kg) (DK). A short ERG protocol was recorded from the left eye of each cat under XK and DK sedation. Thirty minutes later, the effects were reversed with yohimbine or atipamezole for the XK and DK treatment, respectively. The cats were evaluated for time to recumbency, time to head elevation, and time to standing position after reversal treatments. Other variables recorded were: systolic blood pressure, cardiac rhythm, heart rate, pulse oximetry and respiratory rate. Recorded ERG variables included a- and b-wave amplitudes and implicit times under photopic, scotopic and scotopic mixed ERG conditions. Results Time to lateral recumbency with XK was shorter than for DK ( P <0.05). After reversal, head elevation and standing position times were significantly longer for the XK than the DK group ( P <0.05). Heart rate increased and systolic blood pressure decreased from baseline in both groups ( P <0.05), but there were no significant differences between treatment groups. The b-wave amplitude recorded in the photopic study of cats treated with XK was lower than in animals treated with DK ( P <0.05). No other significant differences in ERG variables were observed between treatment groups ( P >0.05). Conclusions and relevance The present study shows that XK and DK treatments are chemical restraint alternatives for ERG recording in cats, with significant differences only in the photopic b-wave amplitude.

Normal clinical electroretinography parameters for poodle, Labrador retriever, Thai ridgeback, and Thai Bangkaew

The purpose of the present study was to establish normal electroretinogram (ERG) parameters using 56 normal eyes of four dog breeds common in Thailand: poodle, Labrador retriever, Thai ridgeback, and Thai Bangkaew. Standard ERG findings were bilaterally recorded using a handheld multi-species ERG unit with an ERG-jet lens electrode for 28 dogs under preanesthesia with diazepam, anesthesia with propofol, and anesthesia maintenance with isoflurane. There were significant differences in the mean values of ERG amplitudes and implicit times among the four dog breeds (p < 0.05) except for the b-wave implicit time of the photopic 30 Hz flicker response with 3 cd.s/m(2) (p = 0.610). Out of the four breeds, Thai Bangkaew had the longest implicit time (p < 0.001) of scotopic low intensity responses, b-wave of scotopic standard intensity responses (3 cd.s/m(2)), a-wave of the higher intensity response (10 cd.s/m(2)), and a-wave of the photopic single flash response (3 cd.s/m(2)). For the b/a ratio, only the ratio of the Cone response was significantly different among the different breeds. In this summary, normal ERG parameters for four dog breeds were reported. Data from the investigation supported the hypothesis that determination of breed-specific limits of normality for ERG responses is necessary for individual clinics and laboratories.

Effects of chemical restraint on electroretinograms recorded sequentially in awake, sedated, and anesthetized dogs

OBJECTIVE

To quantitatively and qualitatively compare electroretinography (ERG) recordings in awake, sedated, and anesthetized dogs.

ANIMALS

Six 6-month-old Beagles.

PROCEDURES

A brief ERG protocol for dogs was used. Following 1-minute and subsequent 5-minute dark adaptation, mixed rod-cone responses were recorded bilaterally with a handheld multispecies ERG device with dogs in each of 3 states of consciousness: awake, sedated (dexmedetomidine and butorphanol), and anesthetized (atropine and hydromorphone, followed by propofol and midazolam and anesthetic maintenance with isoflurane). Low- and high-frequency noise levels were quantified via Fourier analysis, and the effect of consciousness state on signal amplitude, implicit time, and noise was analyzed via repeated-measures ANOVA. In addition, 13 veterinary ophthalmologists who were unaware of the dogs' consciousness states subjectively graded the ERG recording quality, and scores for each tracing were compared.

RESULTS

ERG amplitudes were highest in awake dogs and lowest in anesthetized dogs. Implicit times were shortest in awake dogs and longest in anesthetized dogs. Differences in b-wave amplitudes and a-wave implicit times were significant. Neither low- nor high-frequency noise levels differed significantly among consciousness states. Furthermore, no significant differences were identified among observers' scores assigned to ERG tracings.

CONCLUSIONS AND CLINICAL RELEVANCE

Anesthesia and sedation resulted in significant attenuation and delay of ERG responses in dogs. Chemical restraint of dogs had no consistently significant effect on low- or high-frequency noise levels or on observer perception of signal quality.

The effect of pentobarbital sodium and propofol anesthesia on multifocal electroretinograms in rhesus macaques

We compared the suitability of pentobarbital sodium (PB) and propofol (PF) anesthetics for multifocal electroretinograms (mfERGs) in rhesus macaques. mfERGs were collected from 4 ocularly normal rhesus macaques. All animals were pre-anesthetized with intramuscular ketamine (10-15 mg/kg). Intravenous PB induction/maintenance levels were 15 mg/kg/2-10 mg/kg and for PF, 2-5 mg/kg/6-24 mg/kg/h. There were 3 testing sessions with PB anesthesia and 5-7 testing sessions with PF anesthesia. All PB sessions were carried out before PF. First-order (K1) and second-order (first slice) kernels (K2.1) response density amplitude (RDA), implicit time (IT), and root mean square signal-to-noise ratios (RMS SNR) of the low-frequency (LFC) and high-frequency (HFC) components were evaluated. The use of PF or PB anesthesia resulted in robust, replicable mfERGs in rhesus macaques; however, RMS SNR of K1 LFC in ring and quadrant analyses was significantly larger for PF than for PB. Additionally, K1 RDA under PF was significantly larger than under PB for N1, P1, and P2 components (ring and quadrant) and for N2 (quadrant). PF IT was significantly prolonged (<1 ms) relative to PB IT for N1, P1 (ring), and N1 (quadrant), while PB IT was significantly prolonged (0.8-4.2 ms) relative to PF IT for N2 and P2 (ring and quadrant). K1 HFC and K2.1 LFC did not differ significantly between PB and PF in the ring or quadrant analyses. The response differences found with PB and PF anesthesia likely arise from variable relative effects of the anesthetics on retinal γ-aminobutyric acid (GABA(A)) receptors, and in part, on glycine and on glutamate receptors. Given the advantages of a stable anesthetic plane with continuous intravenous infusion and a smoother, more rapid recovery, PF is an appealing alternative for mfERG testing in rhesus macaques.