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Martins LCT, Guimarães JB, Ferraz HT, de Oliveira FA, Gomes LDS, Chafes CJC, Santos TDCC, Ogliari K, de Moraes RS, Ribeiro D, Ramos DGDS, Rocha TASDS, Regalin D. Assessing the Analgesic Efficacy of Lumbosacral Epidural Morphine in Cats Undergoing Ovariohysterectomy: A Comparative Study of Two Doses. Vet Sci 2024; 11:360. [PMID: 39195814 PMCID: PMC11358909 DOI: 10.3390/vetsci11080360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 07/26/2024] [Accepted: 08/05/2024] [Indexed: 08/29/2024] Open
Abstract
Opioids are administered epidurally (PV) to provide trans- and postoperative analgesia. Twenty healthy female cats aged between 6 and 24 months and weighing between 2 and 3.7 kg, undergoing elective ovariohysterectomy (OVH), were induced with propofol (8 mg/kg), followed by continuous infusion (0.1-0.4 mg/kg/min). Three groups were defined: CG (0.1 mL/kg of iodinated contrast, n = 6), G0.1 (0.1 mg/kg of morphine, n = 7), and G0.2 (0.2 mg/kg of morphine, n = 7) per VP. All received 0.1 mL/kg of iodinated contrast per VP and injection water to obtain a total of 0.3 mL/kg. Heart rate (HR), systolic blood pressure (SBP), temperature, expired CO2, oxygen saturation, and number of rescue analgesics were monitored. Postoperatively, a multidimensional scale was used to assess acute pain in cats for 12 h. The mean HR and SBP in the CG were higher at the time of maximum noxious stimulation and required fentanyl in all groups. Postoperatively, 83%, 28%, and 7% of the animals in CG, G0.1, and G0.2, respectively, received rescue analgesia. In cats undergoing OVH, epidural morphine at doses of 0.1 and 0.2 mg/kg did not prevent the need for intraoperative rescue analgesia but reduced the postoperative analgesic needed.
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Affiliation(s)
- Ludimilla C. T. Martins
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Jéssica B. Guimarães
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Henrique T. Ferraz
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | | | - Leidiane de S. Gomes
- Residency in Clinics and Surgery of Companion Animals, Federal University of Goiás (UFG), Goiânia 74690-900, Brazil;
| | - Clóvis Júnior C. Chafes
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Thalita de C. C. Santos
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Kaline Ogliari
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Reiner S. de Moraes
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu 18618-681, Brazil; (R.S.d.M.); (D.R.)
| | - Diego Ribeiro
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu 18618-681, Brazil; (R.S.d.M.); (D.R.)
| | - Dirceu Guilherme de Souza Ramos
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Thiago André S. de S. Rocha
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
| | - Doughlas Regalin
- School of Veterinary Medicine and Animal Bioscience, Federal University of Jataí (UFJ), Jataí 75804-068, Brazil; (L.C.T.M.); (J.B.G.); (H.T.F.); (C.J.C.C.); (T.d.C.C.S.); (K.O.); (D.G.d.S.R.); (T.A.S.d.S.R.)
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dos-Santos JD, Ginja M, Martins J, Cabral P, Alves-Pimenta S, Ribeiro L, Otero PE, Colaço B. Comparison between Bilateral Ultrasound-Guided Quadratus Lumborum Block and Sacrococcygeal Epidural in Cats Undergoing Ovariectomy. Vet Sci 2024; 11:25. [PMID: 38250931 PMCID: PMC10819764 DOI: 10.3390/vetsci11010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Ultrasound-guided quadratus lumborum block (QLB) and sacrococcygeal epidural anaesthesia (ScE) have been used for neutering cats, providing effective pain relief. OBJECTIVES To compare the effects of the QLB with those of ScE in cats undergoing ovariectomies. METHODS Feral cats undergoing ovariectomy were premedicated with dexmedetomidine (20 μg kg-1) and methadone (0.2 mg kg-1) intramuscularly. Anaesthesia was induced with 2-4 mg kg-1 of propofol intravenously and maintained with isoflurane in oxygen. The cats were randomly allocated to the groups QLB (bilateral QLB with 0.4 mL kg-1 of 0.25% bupivacaine) and ScE (0.3 mL kg-1 of 0.25% bupivacaine). Hemodynamic data and analgesia rescue were collected at four intraoperative periods. The pain scale and motor block were assessed in both groups during the postoperative period. RESULTS The ScE results in increased hypotension, prolonged extubation time, and higher postoperative motor block than the QLB (p < 0.05). The QLB and ScE groups required a similar number of intraoperative rescues and presented the same postoperative pain scale classification. CONCLUSIONS The QLB with 0.25% bupivacaine is a potential alternative to ScE with 0.25% bupivacaine in perioperative pain management in elective cat ovariectomy. The QLB promoted less hypotension and postoperative motor block when compared with the ScE group.
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Affiliation(s)
- José Diogo dos-Santos
- VetOeiras—Veterinary Hospital, 2780-114 Oeiras, Portugal
- Department of Veterinary Science, University Lusófona, 1749-024 Lisbon, Portugal
- CECAV—Animal and Veterinary Research Centre UTAD, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal Department of Veterinary Science, University Lusófona, 1300-477 Lisbon, Portugal
| | - Mário Ginja
- CECAV—Animal and Veterinary Research Centre UTAD, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal Department of Veterinary Science, University Lusófona, 1300-477 Lisbon, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - João Martins
- Department of Veterinary Science, University Lusófona, 1749-024 Lisbon, Portugal
- CECAV—Animal and Veterinary Research Centre UTAD, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal Department of Veterinary Science, University Lusófona, 1300-477 Lisbon, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Patrícia Cabral
- Department of Veterinary Science, University Lusófona, 1749-024 Lisbon, Portugal
| | - Sofia Alves-Pimenta
- CECAV—Animal and Veterinary Research Centre UTAD, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal Department of Veterinary Science, University Lusófona, 1300-477 Lisbon, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Lénio Ribeiro
- Department of Veterinary Science, University Lusófona, 1749-024 Lisbon, Portugal
| | - Pablo E. Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427CWN CABA, Argentina
| | - Bruno Colaço
- CECAV—Animal and Veterinary Research Centre UTAD, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal Department of Veterinary Science, University Lusófona, 1300-477 Lisbon, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
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Polo-Paredes G, Laredo FG, Gil F, Soler M, Agut A, Belda E. Modified Ultrasound-Guided Dorsal Quadratus Lumborum Block in Cat Cadavers. Animals (Basel) 2023; 13:3798. [PMID: 38136835 PMCID: PMC10741190 DOI: 10.3390/ani13243798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
The quadratus lumborum (QL) block is an ultrasound-guided locoregional anesthesia technique which aims to provide analgesia to the abdomen. The main objective of this study was to assess a modified ultrasound-guided dorsal QL block in cat cadavers. For this purpose, a volume of 0.4 mL kg-1 of a mixture of iopromide and methylene blue was administered between the psoas minor muscle and the vertebral body (VB) of the first lumbar vertebra, and its distribution was assessed in thirteen cat cadavers. We hypothesized that this injection point would be feasible, offering a more cranial distribution of the injectate and a more consistent staining of the truncus sympathicus. The study was divided into two phases. Phase 1 consisted of an anatomical study (three cadavers were dissected). Phase 2 consisted of the ultrasound-guided administration of the injectate and the assessment of its distribution by computed tomography and anatomical dissection. The results showed a consistent distribution of contrast media within five (4-8) VBs from T10 to L5. Methylene blue stained three (2-6) rami ventrales, affecting T11 (10%), T12 (20%), T13 (60%), L1 (85%), L2 (95%) and L3 (65%). The truncus sympathicus was dyed in all cadavers with a spread of five (3-7) VBs. Finally, the splanchnicus major nerve was stained in all cadavers (100%). These results suggest that this technique could provide analgesia to the abdominal viscera and the abdominal wall, probably with the exception of the cranial aspects of the abdominal wall.
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Affiliation(s)
- Gonzalo Polo-Paredes
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain; (G.P.-P.); (F.G.L.); (M.S.); (A.A.)
| | - Francisco G. Laredo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain; (G.P.-P.); (F.G.L.); (M.S.); (A.A.)
| | - Francisco Gil
- Departamento de Anatomía y Anatomía Patológica Comparada, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain;
| | - Marta Soler
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain; (G.P.-P.); (F.G.L.); (M.S.); (A.A.)
| | - Amalia Agut
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain; (G.P.-P.); (F.G.L.); (M.S.); (A.A.)
| | - Eliseo Belda
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain; (G.P.-P.); (F.G.L.); (M.S.); (A.A.)
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ZAHRA JOL, SEGATTO CZ, ZANELLI GR, BRUNO TDS, NICÁCIO GM, GIUFFRIDA R, CASSU RN. A comparison of intra and postoperative analgesic effects of sacrococcygeal and lumbosacral epidural levobupivacaine in cats undergoing ovariohysterectomy. J Vet Med Sci 2023; 85:1172-1179. [PMID: 37793832 PMCID: PMC10686773 DOI: 10.1292/jvms.23-0114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
The aim of this study was to compare the intra and postoperative analgesic effects of sacrococcygeal epidural levobupivacaine with those of lumbosacral levobupivacaine in feline ovariohysterectomy. Thirty-six cats were premedicated with intramuscular acepromazine (0.05 mg/kg) and meperidine (6 mg/kg). Anesthesia was induced with intravenous propofol and maintained with isoflurane in oxygen. The cats were randomly assigned one of the three treatments receiving 0.33% levobupivacaine (0.3 mL/kg) into the sacrococcygeal (S-C group, n=12) or lumbosacral (L-S group, n=12) epidural space, or the same volume of 0.9% saline solution into one of the epidural approaches (Control group, n=12). Intraoperatively, cardiorespiratory variables, end-tidal isoflurane concentration (FE´ISO), and fentanyl requirements were recorded. Postoperative pain was assessed by the UNESP (Universidade Estadual Paulista)-Botucatu multidimensional composite pain scale and the Glasgow feline composite measure pain scale up to 8 hr post-extubation. Morphine was administered as rescue analgesia. Overall FE´ISO and fentanyl requirements were lower in the L-S and S-C compared to the Control (P=0.002-0.048, respectively). There was no significant difference in the cardiorespiratory variables during anesthesia, postoperative pain and rescue analgesia among groups. The time to standing after anesthesia was prolonged in the L-S and S-C groups than in the Control (P<0.001). Lumbosacral and sacrococcygeal epidural levobupivacaine resulted in similar decreases in isoflurane requirements and intraoperative fentanyl supplementation in the cats, with no postoperative benefits.
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Affiliation(s)
- Julia Oliveira Lima ZAHRA
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
| | - Camila Zanetti SEGATTO
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
| | - Gustavo Ricci ZANELLI
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
| | - Tatiane dos Santos BRUNO
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
| | - Gabriel Montoro NICÁCIO
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
| | - Rogerio GIUFFRIDA
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
| | - Renata Navarro CASSU
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, Brazil
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Salla K, Åhlberg T, Lepajoe J, Kallio-Kujala I, Mölsä S, Casoni D. Efficacy of lumbosacral and sacrococcygeal epidural ropivacaine in dogs undergoing surgery for perineal hernia. Front Vet Sci 2023; 10:1163025. [PMID: 37808102 PMCID: PMC10551457 DOI: 10.3389/fvets.2023.1163025] [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: 02/10/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023] Open
Abstract
Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare the efficacy of two epidural approaches in dogs undergoing surgery for a perineal hernia. A secondary aim was to compare motor blockade. Intact ASA 1 and 2 male dogs, weighing ≤25 kg with no previous surgery for perineal hernia were enrolled. After premedication with IM acepromazine 0.02 mg/kg and butorphanol 0.3 mg/kg, general anesthesia was induced with propofol and maintained with sevoflurane in oxygen. Dogs were randomly allocated to receive either a lumbosacral (LS, n = 30) or a sacrococcygeal (SC, n = 26) epidural injection with ropivacaine 1% (0.2 mL/kg) under computed tomography guidance. Successful analgesia was defined as no need of intraoperative rescue analgesia (fentanyl 3 μg/kg IV). Clinical failure was defined as the need of more than two boluses of fentanyl/h each dog received meloxicam 0.2 mg/kg IV at the end of the surgery. The Glasgow Composite Pain Scale short form (GCPS-SF), tactile sensitivity, pressure pain thresholds and motor blockade were assessed at 4, 6, 8, and 24 h after the epidural injection. Methadone (0.2 mg/kg, IV) was administered if the GCPS-SF was ≥6/24 points. Differences between groups were analyzed with the Mann-Whitney U test, Student's t-test or Fisher's Exact test, as appropriate. Success rate was assessed for non-inferiority between groups. The non-inferiority margin was set at -10%. Epidural analgesia was successful in 24 dogs in group LS and 17 dogs in group SC (p = 0.243), resulting in success rates of 80 and 65% in LS and SC groups, respectively. The non-inferiority of group SC versus group LS was confirmed. Clinical failure was recorded in two dogs in group LS and one dog in group SC. No significant differences between groups were detected in the GCPS-SF score, tactile sensitivity, pressure pain thresholds, need of post-operative methadone, or motor blockade. Both epidural techniques are valuable analgesic options for perineal hernia repair in dogs.
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Affiliation(s)
- Kati Salla
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Cain J, Davidson A. Canine Cesarean Section: Emergency and Elective. Vet Clin North Am Small Anim Pract 2023:S0195-5616(23)00069-4. [PMID: 37246012 DOI: 10.1016/j.cvsm.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Canine Cesarean Section (CS) is primarily performed to increase survival of newborns and less commonly to save the life or reproductive future of the dam. Conducting proper ovulation timing to accurately predict the due date will allow a planned, elective CS as an excellent alternative to a high-risk natural whelping, and possible dystocia, for certain breeds and situations. Techniques for ovulation timing, anesthesia, and surgery tips are provided.
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Affiliation(s)
- Janice Cain
- Canine Reproduction Center at Ironhorse Vet Care, 7660 Amador Valley Boulevard, Suite E, Dublin, CA 94568, USA.
| | - Autumn Davidson
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Dr, Davis, CA 95616, USA
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Rhee S, Son WG, Kim D, Shin D, Kim J, Sung T, Yoon S, Lee I. Evaluation of an automatic approach device to the epidural space of Beagle dogs. Vet Anaesth Analg 2023:S1467-2987(23)00079-X. [PMID: 37271718 DOI: 10.1016/j.vaa.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare the epidural anesthesia device (EPIA), which facilitates an automatic approach to location of the epidural space, with the performance of clinicians using tactile sensation and differences in pressure when inserting an epidural needle into the epidural space of a dog. STUDY DESIGN Prospective, crossover experiment. ANIMALS A total of 14 Beagle dogs weighing 7.5 ± 2.4 kg (mean ± standard deviation). METHODS Each dog was anesthetized three times at 2 week intervals for three anesthesiologists (two experienced, one novice) to perform 14 epidural injections (seven manual and EPIA device each). The sequence of methods was assigned randomly for each anesthesiologist. The dogs were anesthetized with medetomidine (10 μg kg-1), alfaxalone (2 mg kg-1) and isoflurane and positioned in sternal recumbency with the pelvic limbs extended cranially. Epidural puncture in the manual method was determined by pop sensation, hanging drop technique and reduced injection pressure, whereas using the device a sudden decrease in reaction force on the device was detected. A C-arm identified needle placement in the epidural space, and after administration of iohexol (0.3 mL), the needle length in the epidural space was defined as the mean value measured by three radiologists. Normality was tested using the Kolmogorov-Smirnov test, and significant differences between the two methods were analyzed using an independent sample t test. RESULTS In both methods, the success rates of epidural insertion were the same at 95.2%. The length of the needle in the epidural space using the device and manual methods was 1.59 ± 0.50 and 1.68 ± 0.88 mm, respectively, with no significant difference (p = 0.718). CONCLUSIONS AND CLINICAL RELEVANCE EPIA device was comparable to human tactile sense for an epidural needle insertion in Beagle dogs. Further research should be conducted for application of the device in clinical environments.
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Affiliation(s)
- Suehyung Rhee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Won-Gyun Son
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Dalhae Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Donghwi Shin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jiyoung Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Taehoon Sung
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sangjin Yoon
- Department of Urology, Gachon University Gil Medical Center, Incheon, Republic of Korea; RIMSCIENCE Co. Ltd, Seoul, Republic of Korea.
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea.
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Martinez i Ferre B, Re Bravo V, Drozdzynska M. Opioid‐sparing anaesthesia techniques in dog and cat undergoing bilateral thoracotomy. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Torruella X, Potter J, Huuskonen V. Sacrococcygeal epidural administration of 0.5% bupivacaine in seven cats undergoing pelvic or hind limb orthopaedic procedures. Ir Vet J 2023; 76:1. [PMID: 36726137 PMCID: PMC9893688 DOI: 10.1186/s13620-023-00231-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/26/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Epidural administration of local anaesthetic agents provides good intraoperative antinociception for orthopaedic procedures of the pelvis and the pelvic limb. However, in cats the spinal cord extends approximately to the level of the first sacrococcygeal vertebra, and therefore the sacrococcygeal epidural could be a safer alternative to the lumbosacral epidural in cats. This case series describes perioperative analgesia and the haemodynamic status of seven client-owned cats that received sacrococcygeal epidural injection of 0.5% bupivacaine and underwent orthopaedic hind leg or pelvic surgeries under general anaesthesia. CASE PRESENTATION Each cat received either 0.2 or 0.3 mL/kg of 0.5% bupivacaine with or without 0.2 mg/kg of morphine in the sacrococcygeal epidural space. Intraoperative antinociceptive response to surgical stimulus and haemodynamic changes were monitored and reported. CONCLUSION In these seven anaesthetised cats, 0.2 or 0.3 mL/kg of 0.5% bupivacaine, administered alone or in combination with morphine into the sacrococcygeal epidural space, enhanced antinociception so that intraoperative rescue analgesia was unnecessary in all but one cat. It also reduced the anticipated requirement for postoperative opioid use. However, a high incidence of hypotension was observed in the cats in this report, and hence intraoperative blood pressure monitoring should be considered mandatory in anaesthetised cats following epidural injection of local anaesthetic agents, regardless of injection site.
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Affiliation(s)
- Xavier Torruella
- grid.7886.10000 0001 0768 2743UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6 Ireland
| | - Joanna Potter
- grid.7886.10000 0001 0768 2743UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6 Ireland
| | - Vilhelmiina Huuskonen
- grid.7886.10000 0001 0768 2743UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6 Ireland
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Caramalac SM, Albuquerque VB, Oliveira AR, Caramalac SM, Jardim PHDEA, Barbosa CF, Frazílio FDEO. Analgesic, cardiorespiratory effects and motor block characteristics of epidural levobupivacaine alone or in combination with methadone or dexmedetomidine in bitches undergoing unilateral total mastectomy. AN ACAD BRAS CIENC 2022; 94:e20210082. [PMID: 36477226 DOI: 10.1590/0001-3765202220210082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to evaluate the latency, extent of analgesia, and duration of motor block of levobupivacaine alone and combined with methadone or dexmedetomidine after epidural administration during and after mastectomy in dogs. Twenty-four mature, mixed-breed female dogs were randomly divided into three experimental groups with eight animals each, according to the agents used in lumbosacral epidural analgesia: levobupivacaine 0.75% alone (1.5mg/kg - control group), levobupivacaine 0.75% (1.5 mg/kg) + methadone 1% (0.3 mg/kg), or levobupivacaine 0.75% (1.5 mg/kg) + dexmedetomidine 0.05% (3 µg/kg). During surgery, cardiorespiratory parameters were evaluated. Rescue analgesia was given when there were signs of nociception and was necessary in all three treatment groups. Since all animals received rescue analgesia during the surgery and immediately post-surgery, the duration of the sensitive block were not evaluated. The extent of sensory block was between the 12º and 13º thoracic vertebrae for the control group, 7º thoracic vertebra to 5º lumbar vertebra (methadone group), and 8º thoracic vertebra to 4º lumbar vertebra for the dexmedetomidine group. Methadone or dexmedetomidine combined with levobupivacaine increased the extent of the sensory block and the duration of the motor block in bitches when administered via the epidural route.
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Affiliation(s)
- Simone M Caramalac
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Veronica B Albuquerque
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Alice R Oliveira
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Medicina Veterinária e Zootecnia, Departamento de Anestesiologia de Medicina Veterinária, Campus Botucatu, Rua Prof. Doutor Walter Mauricio Correa, s/n, 18618-681 Botucatu, SP, Brazil
| | - Silvana M Caramalac
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Paulo Henrique DE A Jardim
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Carolynne F Barbosa
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Fabrício DE O Frazílio
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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Sambugaro B, De Gennaro C, Hattersley RD, Vettorato E. Extradural anaesthesia-analgesia in dogs undergoing cholecystectomy: A single centre retrospective study. Front Vet Sci 2022; 9:966183. [PMID: 36157172 PMCID: PMC9500543 DOI: 10.3389/fvets.2022.966183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To assess the effects of extradural anaesthesia-analgesia (EAA) in dogs undergoing cholecystectomy. Materials and methods Medical records of dogs undergoing cholecystectomy between 2011 and 2019 were retrieved and allocated to two groups depending if analgesia was provided systemically (group SA) or extradurally (EAA). Preoperative data, intraoperative antinociceptive medications, postoperative analgesia, perioperative complications, and food intake were compared. Results Overall 41 medical records were included in the study: 19 and 22 dogs were allocated to groups SA and EAA, respectively. In group EAA, an extradural catheter was placed preoperatively in 8 dogs; in the remaining, it was placed postoperatively but an extradural injection was performed preoperatively. The extradural catheter tip was between the 4th lumbar and the 10th thoracic vertebrae. Intraoperatively, nociception was more likely to occur in group SA [OR 55.42 (2.97–1,035.06)]. During the first 24 and 48 h postoperatively, more dogs in group SA required methadone [OR 24 (2.81–268.4) and OR 11.56 (2.37–45.06), respectively] and additional analgesic drugs [OR 25 (3.47–281.9) and OR 35.29 (1.86–668.2), respectively] compared to group EAA. Voluntary postoperative food intake was also significantly higher in group EAA. Clinical significance Compared to systemic analgesia, the use of extradural anaesthesia-analgesia reduced perioperative analgesic requirement and promoted postoperative food intake in dogs undergoing cholecystectomy.
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Local and Regional Anaesthetic Techniques in Canine Ovariectomy: A Review of the Literature and Technique Description. Animals (Basel) 2022; 12:ani12151920. [PMID: 35953908 PMCID: PMC9367435 DOI: 10.3390/ani12151920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This review stems from a general trend of increasing attention toward surgical nociception in the veterinary field. Indeed, veterinarian anaesthetists are becoming more careful in relieving perioperative nociception, improving the analgesic protocols and therefore optimising surgical outcomes. Canine ovariectomy is a common surgical procedure with a moderate level of pain. Therefore, intraoperative analgesia is very important because pain causes various systemic inflammatory effects that slow patient recovery. This review aims to collect all recent information about local and regional anaesthetic/analgesic techniques in a review of the literature describing the technique utilised. In addition, the present review aims to provide practical guidelines for veterinary practitioners to improve the anaesthetic techniques in canine neutering through an overview of the available literature. In fact, the methods described, considering the relative simplicity of execution, can be used in daily routine practice. Abstract Canine ovariectomy is an elective surgery with a moderate level of pain. Despite its relative simplicity, it requires surgical pain management. This study aimed to collect all recent information about local and regional anaesthetic/analgesic techniques in a review of the literature describing the technique utilised. The various procedures described in this review use local anaesthetics to improve analgesia in the routine systemic anaesthetic protocol. The approach described in this paper is called multimodal analgesia and is used in addition to the normal standard anaesthetic protocol. These techniques proved effective in minimising responses to the surgical stimulus and ensured adequate intraoperative and postoperative analgesia. The routine use of multimodal analgesia is considered a useful alternative for pain management in canine ovariectomy, in that it minimises patient suffering, improves the recovery of rescue analgesia, increases drug savings, and improves animal outcomes. In addition, the use of these local and regional techniques ensures satisfactory analgesic coverage that lasts for the first hours postoperatively.
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Rondelli V, Otero PE, Romano F, Verdier N, Bettschart-Wolfensberger R, Portela DA. Incidence of dural sac puncture during neuraxial anesthesia in cats: an observational, retrospective study. J Feline Med Surg 2022; 24:398-401. [PMID: 34096380 PMCID: PMC10812255 DOI: 10.1177/1098612x211021292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the occurrence of dural puncture, indicated by cerebrospinal fluid (CSF) outflow, in cats receiving neuraxial anesthesia through a lumbosacral injection guided by a pop sensation method. METHODS This was an observational, retrospective study. Cats that were scheduled for lumbosacral neuraxial anesthesia were included. Medical records were analyzed to investigate: (1) demographic data; (2) neuraxial anesthesia performed (epidural/spinal); (3) type of needle used, including gauge and length; (4) presence of CSF (yes/no) and/or blood (yes/no) in the hub of the needle; and (5) flicking of the tail during needle advancement (yes/no). RESULTS A total of 94 medical records were analyzed. A 22 G 50 mm Tuohy needle was used in all cats scheduled for an epidural injection (n = 60), whereas a 22 G 40 mm Quincke needle was used in all cats scheduled for an intrathecal injection (n = 34). CSF outflow was detected in 55/60 (91.7%) cats in which a Tuohy needle was used, and 34/34 (100%) of the cats in which a Quincke needle was used (P = 0.15). Flicking of the tail was detected in 41/60 (68.3%) and in 24/34 (70.6%) injections with Tuohy and Quincke needles, respectively (P >0.99). Traces of blood, but not active blood outflow, were detected via staining of the first drops of CSF in 2/34 cats in which Quincke needles were used and in none of the cats in which Tuohy needles were used (P = 0.12). CONCLUSIONS AND RELEVANCE This study shows that the lumbosacral approach for neuraxial anesthesia in cats may result in a dural sac puncture when 22 G Quincke or Tuohy needles are used. The pop sensation method should be deemed effective in predicting intrathecal but not epidural needle placement.
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Affiliation(s)
- Vincenzo Rondelli
- Anicura Veterinary Institute of Novara, Granozzo con Monticello, Italy
| | - Pablo E Otero
- Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina
| | - Francesca Romano
- Anicura Veterinary Institute of Novara, Granozzo con Monticello, Italy
| | - Natali Verdier
- Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina
- Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria
| | | | - Diego A Portela
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Crooks AV, Hsue W, Tschabrunn CM, Gelzer AR. Feasibility of electroanatomic mapping and radiofrequency catheter ablation in Boxer dogs with symptomatic ventricular tachycardia. J Vet Intern Med 2022; 36:886-896. [PMID: 35307868 PMCID: PMC9151449 DOI: 10.1111/jvim.16412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Treatment for Boxers with ventricular tachycardia (VT) is limited. Electroanatomic mapping (EAM) facilitates identification of arrhythmogenic substrate for radiofrequency catheter ablation (RFCA). Objective Describe the use of EAM to guide RFCA in Boxers with VT. Animals Five client‐owned Boxers with symptomatic VT or persistent VT despite antiarrhythmic medications. Methods Case series evaluating clinical, EAM, and before and after RFCA Holter data. Results Sustained VT was inducible in 3 dogs, but required aggressive stimulation protocols. Low‐voltage areas consistent with electroanatomic scar were found in 2 dogs, located at the right ventricular (RV) outflow tract and cranial RV. Two dogs had a focal activation pattern of VT and 1 dog had a reentrant mechanism. After RFCA, all dogs no longer collapsed and had fewer runs of VT, 3 of which had 0 runs of VT. Number of ventricular premature beats increased in 3 dogs and decreased in 2 dogs, 1 of which had nearly complete resolution of all arrhythmias. Procedural complications included ventricular fibrillation (n = 2) with successful defibrillation, bruising or hemorrhage at the vascular access site (n = 4), retroperitoneal hemorrhage (n = 1), aortic and mitral regurgitation (n = 1), onset of frequent supraventricular tachycardia (n = 1), and persistent right pelvic limb lameness (n = 1). Conclusions and Clinical Importance Electroanatomic mapping and RFCA are feasible in Boxers with VT. Based on this small cohort, RFCA may help decrease runs of VT and improve clinical signs. The anatomic substrate and electrophysiologic mechanisms are variable and require further study.
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Affiliation(s)
- Alexandra V. Crooks
- Department of Clinical Sciences and Advanced Medicine School of Veterinary Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Weihow Hsue
- Department of Clinical Sciences and Advanced Medicine School of Veterinary Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
- Cardiac Electrophysiology Section, Division of Cardiovascular Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA
| | - Cory M. Tschabrunn
- Cardiac Electrophysiology Section, Division of Cardiovascular Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA
| | - Anna R. Gelzer
- Department of Clinical Sciences and Advanced Medicine School of Veterinary Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
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Epidural Volume of Injectate Using a Dose Regimen Based on Occipito-Coccygeal Spinal Length (OCL): Randomized Clinical Study Comparing Different Ropivacaine Concentrations, with or without Morphine, in Bitches Undergoing Total Unilateral Mastectomy. Animals (Basel) 2022; 12:ani12050587. [PMID: 35268154 PMCID: PMC8909377 DOI: 10.3390/ani12050587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
A prospective, randomized clinical trial was designed to compare four epidural treatments in dogs undergoing total unilateral mastectomy. The epidural volume of injectate was based on the individual occipito-coccygeal length (OCL) aiming to reach the first thoracic vertebra (T1). The first ten dogs were allocated in a control group (C) and did not receive epidural treatment. Subsequently, forty dogs were randomly allocated in four groups of ten: epidural ropivacaine 0.5% (R0.5%); morphine 0.1 mg kg−1 plus ropivacaine 0.5% (MR0.5%); morphine 0.1 mg kg−1 plus ropivacaine 0.35% (MR0.35%); morphine 0.1 mg kg−1 plus ropivacaine 0.25% (MR0.25%). Intraoperatively, isoflurane requirement (1.3% vs. <1.1% FE’Iso) and fentanyl requirement (9.8 vs. <1.1 µg kg−1 h−1) were significantly higher in C group compared to all epidural groups. Postoperatively, methadone requirement was higher (1.8 mg kg−1 vs. <0.8 mg kg−1) for C group compared to all epidural treatment groups. The ability to walk and to urinate returned 4 h earlier in MR0.35% and MR0.25%. The mean epidural volume of ropivacaine, using a dose regimen based on OCL, to reach T1 was about 0.15 mL cm−1. The addition of morphine further reduced the methadone requirement, without affecting urinary and motor functions.
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17
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Real-time ultrasound-guided lumbosacral epidural anaesthesia in obese or appropriate body condition score dogs: A randomized clinical trial. Vet J 2022; 280:105791. [DOI: 10.1016/j.tvjl.2022.105791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 11/22/2022]
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Fink DM, Ferreira TH, Mans C. Neuraxial administration of morphine combined with lidocaine induces regional antinociception in inland bearded dragons (Pogona vitticeps). Am J Vet Res 2021; 83:212-217. [PMID: 34968185 DOI: 10.2460/ajvr.21.08.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the antinociceptive efficacy and safety of neuraxial morphine in inland bearded dragons (Pogona vitticeps). ANIMALS 10 healthy adult bearded dragons. PROCEDURES Animals were sedated with alfaxalone (15 mg/kg) SC prior to neuraxial injections. In a randomized, blinded, placebo-controlled, crossover design, animals received preservative-free morphine (0.5 mg/kg) combined with lidocaine (2 mg/kg) or lidocaine (2 mg/kg) only (control treatment). For both treatments, saline (0.9% NaCl) solution was used for dilution to a total volume of 0.3 mL/kg. If the initial injection did not result in motor block of the pelvic limbs or cloaca relaxation within 10 minutes, a second injection was performed. Measurements consisted of bilateral mechanical stimulation of the limbs and at 25%, 50%, and 75% of the trunk's length as well as cloacal tone to assess spread and duration of motor block. Pelvic limb withdrawal latencies in response to a thermal noxious stimulus were measured over a 48-hour period to assess antinociception. RESULTS Success rate following the first injection was 90% (18/20 injections) and increased to 100% following a second injection. Motor block occurred within 5 minutes with both treatments. Pelvic limb withdrawal latencies were significantly prolonged following neuraxial morphine versus control treatment for at least 12 hours after injection. By 24 hours, no effect of morphine on pelvic limb latencies was detectable. CLINICAL RELEVANCE These results demonstrated that neuraxial administration of morphine results in regional antinociceptive effects for at least 12 hours and has no clinically relevant adverse effects in healthy bearded dragons. This technique has potential for providing regional analgesia in this species.
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Doyle CR, Riccó Pereira CH, Wanstrath AW, Lerche P, Aarnes TK, Bednarski RM, Werre SR. Evaluation of perfusion index as a noninvasive tool to determine epidural anesthesia effectiveness in dogs. Vet Anaesth Analg 2021; 48:782-788. [PMID: 34362690 DOI: 10.1016/j.vaa.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate perfusion index (PI) as a noninvasive tool to determine effectiveness and onset of epidural anesthesia in dogs. STUDY DESIGN Prospective clinical trial. ANIMALS A total of 21 adult dogs, aged 6.5 ± 3 years and weighing 34.9 ± 6.4 kg, undergoing a tibial plateau leveling osteotomy. METHODS Dogs were premedicated intramuscularly with acepromazine (0.03 mg kg-1) and hydromorphone (0.1 mg kg-1) and anesthetized with intravenous propofol (to effect) and isoflurane in oxygen. A surface transflectance probe was secured to the tail base to monitor PI and a dorsal pedal artery catheter was placed for invasive blood pressure monitoring. A lumbosacral epidural was performed with the dog in sternal recumbency. Dogs were randomly assigned for inclusion of epidural morphine (0.1 mg kg-1) or morphine (0.1 mg kg-1) and lidocaine (4 mg kg-1). PI was recorded following instrumentation of each dog just prior to the epidural (baseline), at 10 minute intervals for 30 minutes, before and after the surgical skin incision and before and after completion of the osteotomy. Physiological variables and end-tidal isoflurane were recorded at the same time points. RESULTS There was no significant difference in PI between the groups at any time point. There was a significant change in end-tidal isoflurane before and after the skin incision in the epidural morphine and epidural morphine-lidocaine groups (p = 0.04, p = 0.05, respectively) and before and after the osteotomy in each group for heart rate (p = 0.001, p = 0.04), diastolic (p = 0.01, p = 0.01) and mean arterial blood pressure (p = 0.03, p = 0.05). CONCLUSIONS AND CLINICAL RELEVANCE PI did not provide an objective means for determining the onset or effectiveness of epidural anesthesia in anesthetized dogs and alternate methods of noninvasive assessment should be investigated.
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Affiliation(s)
- Crystal R Doyle
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Carolina H Riccó Pereira
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
| | - Audrey W Wanstrath
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Phillip Lerche
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Turi K Aarnes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Richard M Bednarski
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Stephen R Werre
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
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Santos MA, Lucera TM, Horr M, Santana IN, Mattos-Junior E. Comparative study on epidural administration of dexmedetomidine, dexmedetomidine-lidocaine or lidocaine in conscious rabbits. Lab Anim 2021; 55:341-349. [PMID: 33588626 DOI: 10.1177/0023677221993156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to compare the cardiorespiratory, arterial blood gas and antinociceptive effects of dexmedetomidine (D), dexmedetomidine-lidocaine (DL) or lidocaine (L) administered epidurally on conscious rabbits. Eight six-month-old male New Zealand rabbits were randomly distributed into three treatments: D (2.5 μg/kg); DL (2.5 μg/kg; 2 mg/kg); and L (2 mg/kg). The drugs were injected epidurally via a catheter. Cardiorespiratory, arterial blood gas and antinociceptive variables were recorded before administration, 5 and 10 min after drug administration, then every 10 min until the animals presented a positive response to nociceptive stimulation of perineal dermatomes. Two animals had permanent paralysis after DL treatment due to hemorrhage and congestion with neuron necrosis in spinal cord segments. There was a reduction in mean arterial pressure in treatment L at 5 and 10 min, compared with the baseline, and in treatment DL at 10-30 min. Increases in pH were observed in treatment D at 5 and 10 min, and in DL at all the times evaluated, compared with the baseline. No alterations were observed in other blood gas or electrolyte variables. Antinociceptive effects were evaluated in the perineal, sacral and lumbar regions, and were restricted to the perineal region following D and L treatment. The antinociceptive effects following DL were greater than D and L alone in all of the regions. L and D promotes short-term antinociceptive effects for up to 15 min and, when used in combination with D, increased the duration and extent of sensory block by up to 45 min.
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Affiliation(s)
- Maria Aap Santos
- Veterinary Science Graduate Program, University of Franca, Brazil
| | - Tiago Mc Lucera
- Veterinary Science Graduate Program, University of Franca, Brazil
| | - Mônica Horr
- Veterinary Science Graduate Program, University of Franca, Brazil
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Cima DS, Credie LDFGA, Futema F, Luna SPL. Lumbar Epidural: Anatomical and Clinical Study in Dogs Submitted to Ovariohysterectomy. Front Vet Sci 2020; 7:527812. [PMID: 33240944 PMCID: PMC7669829 DOI: 10.3389/fvets.2020.527812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 10/08/2020] [Indexed: 12/02/2022] Open
Abstract
Epidural anesthesia minimizes perioperative pain in dogs. It is considered that epidural solution dispersion in cadavers is similar to alive dogs. The objective of the anatomical study was to compare the dispersion of 0.2 mL/kg 0.25% bupivacaine and iohexol via lumbar epidural (L1–L2) under fluoroscopic guidance in 10 thawed cadavers (GC) and 13 female dogs (G0.25) (5–15 kg; body score 4/5). The objective of the clinical study was to evaluate postoperative analgesic consumption and sedation for 6 h after extubation of dogs submitted to ovariohysterectomy when using 0.25% (G0.25; n = 10) bupivacaine with the intraoperative use of fentanyl (GF; n = 10). Parametric data were compared by the t-test and non-parametric data by the Mann Whitney test. Pain and sedation scores were evaluated over time by the Friedman test, followed by the Dunn test. Alive dogs presented greater epidural dispersion (17 ± 3 vertebrae) than thawed cadavers (11 ± 4 vertebrae; p = 0.002). All dogs treated with fentanyl and only one dog treated with 0.25% epidural bupivacaine presented pain scores above the cut-off point of the Glasgow Composite Measure Pain Scale Short-Form (GCMPS-SF) and required postoperative rescue analgesia up to 6 h after extubation. The sedation score was higher at all postoperative moments compared to preoperative moments in the G0.25 and GF, except for evaluations performed at 5 and 6 h after extubation in the GF. Greater sedation was observed immediately after extubation in the GF compared to the G0.25, and there was greater sedation in the G0.25 compared to the GF from 3 to 6 h after extubation. The conclusion of the anatomical study was that L1–L2 epidural bupivacaine dispersion is lower in canine thawed cadavers than in alive dogs. Conclusion of the clinical study was that lumbar epidural anesthesia improved postoperative analgesia and produced longer postoperative sedation when compared to fentanyl.
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Affiliation(s)
- Daniela Santilli Cima
- Department of Anesthesiology, Medical School, São Paulo State University (Unesp), Botucatu, Brazil
| | | | - Fábio Futema
- School of Veterinary Medicine, São Judas Tadeu University, São Paulo, Brazil
| | - Stelio Pacca Loureiro Luna
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, Brazil
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Thomas L, Francini L, Sinotti J, Chan W, Druziani J, Fukushima F. Bloqueio motor e sensitivo da lidocaína ou da ropivacaína peridural em cães. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se avaliar o bloqueio sensitivo e motor da administração peridural de 0,2mL/kg de duas concentrações de ropivacaína em comparação à lidocaína em cães. Utilizaram-se 24 cães, distribuídos em quatro grupos: NaCl a 0,9% (GS), lidocaína a 2% (GL), ropivacaína a 0,5% (GR5) e ropivacaína a 0,75% (GR7,5). Avaliaram-se a presença de movimentação espontânea, deambulação, sensibilidade superficial e profunda nos momentos cinco, 10, 15, 20, 25, 30, 45, 60, 90, 120, 180, 240 e 300 minutos após peridural. O retorno à movimentação espontânea foi semelhante entre GL (42,50 ± 6,12) e GR7,5 (69,2 ± 58,9). O tempo para deambulação foi mais prolongado em GR7,5 (107,5 ± 79,3) que em GS (9,2 ± 3,8) e em GR5 (32,5 ± 20,9). O retorno da sensibilidade profunda foi maior em GR 7,5 (152,5 ± 89,2) que em GS (5,8 ± 2,0), GR5 (46,7 ± 46,3) e GL (52,5 ± 20,7). O tempo de retorno da sensibilidade superficial foi maior em GR7,5 (205,0 ± 129,3) que em GS (7,5 ± 2,7), GL (72,5 ± 19,9) e GR5 (97,5 ± 55,1). Apesar do retorno precoce da movimentação, ropivacaína 0,75% está relacionada a tempo prolongado de recuperação da função muscular e bloqueio sensitivo mais prolongado que lidocaína e ropivacaína 0,5%.
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Affiliation(s)
| | | | | | - W.S. Chan
- Universidade Federal de Minas Gerais, Brazil
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Boff G, Naspolini B, Marco CD, Andrades J, Caye P, Kalb A, Guim T, Gehrcke M. Dispersão da lidocaína administrada por via epidural em cães posicionados em decúbito lateral ou esternal. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi verificar clinicamente a dispersão da lidocaína no espaço epidural de cães posicionados em diferentes decúbitos. Foram utilizados 16 cães, com peso médio de 17,5 quilogramas. Esses foram tranquilizados com acepromazina, anestesiados com propofol e alocados em dois grupos, conforme o decúbito de posicionamento: decúbito esternal (GE) e decúbito lateral direito (GLD). Ambos os grupos receberam lidocaína a 2%, no volume de 0,25mL/kg, e permaneceram no mesmo decúbito por 20 minutos. Em seguida, avaliou-se o bloqueio dos membros pélvicos e a extensão do bloqueio, a partir da sétima vértebra lombar, por meio de pinçamento interdigital e do panículo paravertebral. Foi, então, realizada cirurgia de orquiectomia. Após tal procedimento, avaliou-se o tempo total de bloqueio dos membros pélvicos. Todos os cães apresentaram bloqueio bilateral, sem diferenças quanto à extensão cranial entre os grupos, sendo a mediana de 7,5 (1-14) vértebras para GE e de 4 (1-14) para GLD. O tempo de bloqueio dos membros direito e esquerdo foi de 123 ± 26 e 130 ± 20 minutos, para GE, e de 120 ± 21 e 121 ± 20 minutos, para GLD, sem diferenças entre os grupos ou entre os membros. Conclui-se que o decúbito não interfere na distribuição da lidocaína administrada por via epidural.
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Affiliation(s)
- G.A. Boff
- Universidade Federal de Pelotas, Brazil
| | | | | | | | - P. Caye
- Universidade Federal de Pelotas, Brazil
| | - A.C. Kalb
- Universidade Federal de Pelotas, Brazil
| | - T.N. Guim
- Universidade Federal de Pelotas, Brazil
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Neves ECD, Pelizzari C, Oliveira RSD, Kassab S, Lucas KDA, Carvalho YKD. 3D anatomical model for teaching canine lumbosacral epidural anesthesia. Acta Cir Bras 2020; 35:e202000608. [PMID: 32667587 PMCID: PMC7357831 DOI: 10.1590/s0102-865020200060000008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 05/14/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose To develop a 3D anatomical model for teaching canine epidural anesthesia (3DMEA) and to assess its efficacy for teaching and learning prior to the use of live animals. Methods The creation of 3DMEA was based on 3D optical scanning and 3D printing of canine bone pieces of the fifth to the seventh lumbar vertebrae, sacrum and pelvis. A total of 20 male dogs were scheduled for castration. 20 veterinary students watched a video showing epidural anesthesia in dogs before the clinical attempt and were assigned to control or 3DMEA groups. Students in the 3DMEA group trained in the model after the video. For the clinical trial, the epidural procedure was performed by students under the veterinary supervision. When observed the absence of response to nociceptive stimuli, the epidural was considered successful. Then, all students answered a questionnaire evaluating the main difficulty founded in the technique and its degree of difficulty. Results The 3DMEA group reported a lower degree of difficulty to perform the epidural anesthesia technique when compared with the control group (p=0.0037). The 3DMEA reproduced the anatomical structures, allowing the perception of the distance of needle in relation to the iliac prominences during epidural anesthesia. Its mobility allowed simulation of the animal in standing position and sternal recumbency. Conclusion The use of 3DMEA demonstrated greater efficacy in the execution of the technique, being effective in the teaching and learning process before the epidural anesthesia in live animals.
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Justo AA, Garofalo NA, Teixeira-Neto FJ, Freirias CD, Silva SL, Pinho RH. Epidural anesthesia in Eira barbara Linnaeus, 1758 (Carnivora: Mustelidae). BRAZ J BIOL 2020; 81:495-496. [PMID: 32428095 DOI: 10.1590/1519-6984.225891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/28/2019] [Indexed: 11/22/2022] Open
Affiliation(s)
- A A Justo
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo - USP, Rua Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, CEP 05508-270, São Paulo, SP, Brasil
| | - N A Garofalo
- b Hospital Veterinário, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista - UNESP, Rua Prof. Dr. Walter Mauricio Correa, s/n, Rubião Junior, CEP 18618-681, Botucatu, SP, Brasil
| | - F J Teixeira-Neto
- Departamento de Cirurgia Veterinária e Reprodução Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista - UNESP, Rua Prof. Dr. Walter Mauricio Correa, s/n, Rubião Junior, CEP 18618-681, Botucatu, SP, Brasil
| | - C D Freirias
- Departamento de Cirurgia Veterinária e Reprodução Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista - UNESP, Rua Prof. Dr. Walter Mauricio Correa, s/n, Rubião Junior, CEP 18618-681, Botucatu, SP, Brasil
| | - S L Silva
- d Departamento de Anestesiologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Rua Prof. Mário Rubens Guimarães Montenegro, s/n, Rubião Junior, CEP 18618-687, Botucatu, SP, Brasil
| | - R H Pinho
- d Departamento de Anestesiologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Rua Prof. Mário Rubens Guimarães Montenegro, s/n, Rubião Junior, CEP 18618-687, Botucatu, SP, Brasil
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Gomes SA, Lowrie M, Targett M. Single dose epidural methylprednisolone as a treatment and predictor of outcome following subsequent decompressive surgery in degenerative lumbosacral stenosis with foraminal stenosis. Vet J 2020; 257:105451. [PMID: 32546351 DOI: 10.1016/j.tvjl.2020.105451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
Abstract
Alternative treatments to surgery in canine degenerative lumbosacral stenosis (DLSS) remain limited and reliable predictors of outcome are lacking. The aims of this clinical trial were threefold: to assess the usefulness of single epidural steroid injection (ESI) in DLSS, to compare the outcomes of ESI and decompressive surgery, and evaluate ESI as a predictor of outcome following decompressive surgery. Dogs diagnosed with DLSS were prospectively recruited and administered an ESI. If clinical signs persisted or relapsed, decompressive surgery was recommended. Follow-up was obtained. Thirty-two dogs underwent ESI with 17 having subsequent surgery. Improvement after ESI was seen in 27/32 dogs (84.4%), with 17/22 (77.2%) relapsing within 6 months (n = 15/17 relapsing within 2 months). Five dogs failed to respond to ESI and another five (15.6%) presented a persistent post-ESI favourable response (mean follow-up time, 9.4 months). Post-surgical improvement occurred in all dogs. Outcome appeared more favourable following surgical decompression, with a trend towards reduced pain, increased mobility, and greater quality of life score. This study was unable to demonstrate that ESI could predict surgical outcome. ESI was confirmed as an effective treatment in most but not all cases, leading to transient alleviation of clinical signs for longer than previously reported. ESI provided a complete and apparently long-term sustained resolution of clinical signs in a subset of dogs. Despite this, there was indication that surgical decompression can lead to a more favourable outcome. Epidural steroid injection has a role in the management of DLSS dogs, particularly when surgery is not an option.
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Affiliation(s)
- S A Gomes
- Dovecote Veterinary Hospital, 5 Delven Lane, Castle Donington, Derby DE74 2LJ, UK.
| | - M Lowrie
- Dovecote Veterinary Hospital, 5 Delven Lane, Castle Donington, Derby DE74 2LJ, UK
| | - M Targett
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Leicestershire, LE12 5RD, UK
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Martinez-Taboada F, Otero PE, Laredo F, Belda E. Identification of the sacrococcygeal epidural space using the nerve stimulation test or the running-drip method in dogs. Vet Anaesth Analg 2020; 47:385-390. [PMID: 32276884 DOI: 10.1016/j.vaa.2019.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/28/2019] [Accepted: 09/08/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To compare the nerve stimulation test (group NS) with the running-drip method (group RUN) for successful identification of the sacrococcygeal (SCo) epidural space prior to drug administration in dogs. ANIMALS A total of 62 dogs. STUDY DESIGN A randomized clinical study. METHODS Dogs requiring an epidural anaesthetic as part of the multimodal anaesthetic plan were randomly allocated to one of the two study groups. In group NS, the epidural space was located using an insulated needle connected to a nerve stimulator; in group RUN, the epidural space was identified using a Tuohy needle connected to a fluid bag elevated 60 cm above the spine via an administration set. The success of the technique was assessed 5 minutes after epidural injection by the disappearance of the patella reflex. Data were checked for normality, nonparametric data was analysed using a Mann-Whitney U test and success rate was analysed using a Fisher's exact test. The significance level was set at p < 0.05, and the results are presented in absolute values, percentage (95% confident interval) and median (range). RESULTS The success in identification of the epidural space did not differ between groups NS and RUN [87.1% (70.2%-96.4%) versus 90.3% (74.2%-98%); p = 1.000]. The time required for identification of the epidural space was shorter in group RUN [26 (15-53) seconds] than in group NS [40 (19-137) seconds] (p = 0.0225). No other differences were found in any studied variables. CONCLUSION and clinical relevance In this study, both RUN and NS techniques were successful in identifying the epidural space at the SCo intervertebral space. RUN requires no specialised equipment, can be performed rapidly and offers an alternative to the NS for use in general veterinary practice.
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Affiliation(s)
- Fernando Martinez-Taboada
- The University Veterinary Teaching Hospital, The School of Veterinary Science, The University of Sydney, New South Wales, Australia; Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain.
| | - Pablo E Otero
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Anestesiología y Algiología, Buenos Aires, Argentina
| | - Francisco Laredo
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Eliseo Belda
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
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Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2). Vet Med Sci 2020; 6:218-234. [PMID: 31965749 PMCID: PMC7196680 DOI: 10.1002/vms3.218] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 07/27/2019] [Accepted: 10/27/2019] [Indexed: 11/30/2022] Open
Abstract
Pain management in veterinary patients is a crucial component of appropriate patient care. Local anaesthetic drugs used in local and regional blockade can completely block the transmission of nociceptive impulses, decreasing both intra‐operative nociception and postoperative pain, while decreasing the potential incidence of adverse effects that can be associated with systemic boluses of drugs. For efficacy and safety, this class of drugs is recommended as part of the analgesic protocol in the majority of surgical procedures and traumatic injuries. Numerous local and regional blocks are proven effective in dogs and cats, thus providing the clinician with ample opportunity to include these blocks in practice. This manuscript, Part 2 of a two‐part instalment, focuses on brief descriptions of select commonly used local/regional anaesthesia techniques for dogs and cats that cover a multitude of painful surgeries/injuries and that can be implemented in any practice. In Part 1 of this topic, detailed information on local anaesthetic drugs commonly used in small animal practice was reviewed (Grubb & Lobprise, 2020).
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Lonc KM, Kaneene JB, Carneiro PAM, Kruger JM. Retrospective analysis of diagnoses and outcomes of 45 cats with micturition disorders presenting as urinary incontinence. J Vet Intern Med 2019; 34:216-226. [PMID: 31859391 PMCID: PMC6979103 DOI: 10.1111/jvim.15683] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
Background In contrast to dogs, the causes and outcomes of urinary incontinence (UI) in cats are largely unknown. Objectives To determine the causes, identify comorbid conditions, and assess outcomes of cats with micturition disorders presenting as UI. Animals Forty‐five cats with UI. Methods Retrospective study. Medical records of cats presented from January 2006 to December 2017 were searched using 45 keywords related to UI. History, presenting complaint, and physical examination findings were used to confirm a diagnosis. Cases were categorized based on functional and anatomic localizations. Results Forty‐five cats met inclusion criteria. Spinal cord disease was the most common cause of UI (n = 18), followed by urethral (n = 17), bladder (n = 9), and ureteral (n = 1) disorders. Proportions of voiding and storage phase disorders were similar (53% and 47%, respectively). However, voiding‐phase disorders were observed more frequently in males and younger‐aged cats (P < .03). Urinary tract infection was detected in 11 of 28 (39%) cats. Outcomes were available in 38/45 cases; 16 cats (42%) regained continence, 3 (8%) improved with treatment, and 19 (50%) remained incontinent or were euthanized. Multiple variable logistic regressions indicated that spinal cord disease was significantly more likely to be associated with poor outcomes compared to bladder or urethral disorders (P < .04). Conclusions and Clinical Importance Urinary incontinence in cats was associated with a variety of congenital and acquired disorders that affected both phases of micturition with similar frequency. Incontinent cats with spinal cord disorders were common and warrant a more guarded prognosis than do cats with bladder or urethral disorders.
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Affiliation(s)
- Kaitlin M Lonc
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - John B Kaneene
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.,Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Paulo A M Carneiro
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.,Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - John M Kruger
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
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Ronchi S, Gehrcke M, Regalin D, Oleskovicz N. Período de latência, progressão e duração do bloqueio da anestesia epidural com lidocaína, bupivacaína ou sua associação em cães. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar latência, duração do efeito, progressão cranial da lidocaína e da bupivacaína isoladas, ou em associação, pela via epidural, em cães, além de mensurar a pressão média do canal epidural antes e após a realização dela. Utilizaram-se 18 cães, alocados em três grupos, os quais receberam, por via epidural: lidocaína 2% (GL) 0,25mL/kg; bupivacaína 0,5% (GB) no mesmo volume, ou a associação de ambas (GLB) na proporção de 1:1. Avaliaram-se as frequências cardíaca e respiratória e a pressão arterial sistólica (PAS) previamente aos tratamentos (M0) e até 60 minutos após a anestesia epidural. Ainda, avaliou-se a pressão no canal epidural antes e após a administração dos tratamentos, o período de latência, a progressão e a duração do bloqueio pelo pinçamento interdigital e do panículo paravertebral. Houve redução de 12% da PAS no GL em todos os momentos e de 16% aos 30 minutos no GLB quando comparados ao basal. A pressão média no espaço epidural antes e após a anestesia epidural foi de -1,5 (±3,9) e 41 (±16) mmHg; 55% apresentaram pressão negativa no espaço epidural. O período de latência não diferiu entre os grupos (GL: 3,5±1,6; GB: 4,5±4,5; e GLB: 2,4±1 minutos) e a duração do bloqueio foi maior no GB em relação ao GL (GL: 125±24; GB: 176±24; e GLB: 153±35 minutos). A progressão máxima dos anestésicos foi até L1-T13 no GL, L4-L3 no GB e L3-L2 no GLB. Conclui-se que a associação de lidocaína com bupivacaína não apresenta vantagens em relação ao uso dos fármacos isolados pela via epidural, tendo a lidocaína progredido mais cranialmente em relação à bupivacaína ou à associação. A lidocaína promoveu redução da PAS, mesmo quando associada à bupivacaína, permanecendo dentro dos valores de referência. Apenas 55% dos cães apresentaram pressão média negativa no espaço epidural antes da administração dos fármacos, dessa forma o teste da gota pendente pode não ser eficiente para localização do espaço epidural em todos os animais.
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Affiliation(s)
- S.J. Ronchi
- Universidade do Estado de Santa Catarina, Brazil
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Sande J, Souza T, Kersul I, Anjos N, Martins Filho E, Barbosa V. Avaliação da anestesia epidural com lidocaína associada ao tramadol ou à dexmedetomidina, em gatas submetidas à ovariosalpingohisterectomia, anestesiadas com propofol. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se comparar os efeitos fisiológicos, analgésicos e sobre a taxa de infusão de propofol, decorrentes da anestesia epidural com lidocaína, associada ao tramadol ou à dexmedetomidina, em felinas submetidas à ovariosalpingohisterectomia (OSH). Para tal, 16 felinas hígidas foram pré-tratadas com acepromazina 0,08mg/kg/IM, utilizando-se propofol para a indução (dose-efeito) e manutenção anestésicas. Após indução, as gatas foram aleatoriamente distribuídas em dois grupos (n=8), designados: grupo lidocaína-tramadol (GLT), tratado com lidocaína (3,0mg/kg) associada ao tramadol (2,0mg/kg); e grupo lidocaína-dexmedetomidina (GLD), tratado com lidocaína (3,0mg/kg) associada à dexmedetomidina (2µg/kg), pela via epidural. Durante a OSH, a infusão de propofol foi aumentada ou reduzida, objetivando-se manutenção de plano anestésico cirúrgico. Foram avaliados os parâmetros: f, FC, SPO2, EtCO2, PAS, PAD, PAM, T°C, nos períodos pré (M1) e transoperatórios (M2 a M7); a taxa mínima de propofol necessária; o tempo de recuperação anestésica e a qualidade da analgesia pós-cirúrgica durante seis horas. Ambos os tratamentos garantiram baixas taxas mínimas de infusão de propofol, todavia o uso da dexmedetomidina resultou em bradicardia inicial, elevação da pressão arterial, maior tempo de recuperação e menor qualidade analgésica, quando comparada ao tramadol.
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The effect of neuraxial morphine on postoperative pain in dogs after extrahepatic portosystemic shunt attenuation. Vet Anaesth Analg 2019; 47:111-118. [PMID: 31718938 DOI: 10.1016/j.vaa.2019.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/19/2019] [Accepted: 06/25/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the analgesic effect of epidural morphine after surgical extrahepatic portosystemic shunt (EHPSS) attenuation. STUDY DESIGN Randomized clinical trial. ANIMALS A total of 20 dogs with a congenital EHPSS. METHODS Dogs were randomly allocated to be given either a single epidural dose of 0.2 mg kg-1 preservative-free morphine (group M) or not (group C) before surgery. All dogs were administered 0.3 mg kg-1 methadone intravenously (IV) as preanaesthetic medication. Pain scores were determined every 2 hours for the first 24 hours postoperatively using the short-form Glasgow Composite Measure Pain Scale (GCMPS-SF). Dogs with a GCMPS-SF pain score >4/20 or >5/24 received 0.1 mg kg-1 methadone IV as rescue analgesia and were reassessed 30 minutes later. If more than three doses of methadone were administered in a 2 hour period, alternative pain relief was provided and a treatment failure recorded. The GCMPS-SF pain scores and number of rescue analgesia injections were analysed over 24 hours. The last observation carried forward method was applied in case of treatment failure. Food consumption and time to first urination were recorded. Data were analysed using a Mann-Whitney U test and presented as median (minimum-maximum range), with significance set at p < 0.05. RESULTS Group M showed lower GCMPS-SF pain scores [15 (11-41) versus 31 (11-86); p = 0.023] and lower postoperative methadone requirements [0 (0-0.2) versus 0.25 (0-0.5) mg kg-1; p = 0.029] than group C. There were three treatment failures in group C only. Food consumption and time to first urination did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE Epidural morphine reduced the requirement for postoperative analgesia in this study population.
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Dancker C, MacFarlane P, Love EJ. Pruritus and myoclonus following five consecutive doses of morphine administered through an epidural catheter in a dog. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | - Emma J Love
- Bristol Veterinary SchoolUniversity of BristolLangfordUK
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Khan Z, Munro E, Shaw D, Faller KM. Variation in the position of the conus medullaris and dural sac in adult dogs. Vet Rec 2019; 185:20. [PMID: 31092707 DOI: 10.1136/vr.105279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/03/2022]
Abstract
Although it has long been stated that the level of spinal cord termination varies depending on the size of the dog, the evidence for this remains limited. The aim of this study is to investigate the position of the conus medullaris (CM) and dural sac (DS) in a population of dogs of varying size. MRIs of the thoracolumbosacral spine of 101 dogs were included. The location of CM and DS was determined on sagittal T2-weighted images and T1-weighted images, respectively, by three independent observers. The bodyweight and the back length were used as markers of size. Regression analysis showed that the termination point of the CM had a statistically significant relationship with bodyweight (R2=0.23, P<0.05). Although not statistically significant (P=0.058), a similar relationship was found between CM and back length (R2=0.21). No statistically significant relationship was found between the termination point of the DS and bodyweight (P=0.24) or back length (P=0.19). The study confirms the terminal position of the CM is dependent on size, with a more cranial position with increasing size; however, the termination point of DS remains constant irrespective of dog size.
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Affiliation(s)
- Zohra Khan
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Elizabeth Munro
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Darren Shaw
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Kiterie Me Faller
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
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Andrade N, Santos B, Caires L, Azevedo M, Martins Filho E, Sande J, Costa Neto J, Barbosa V. Ropivacaína isolada ou associada à metadona ou à morfina, pela via epidural, em cadelas submetidas à ovário-histerectomia. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se avaliar os efeitos fisiológicos, sedativos e analgésicos da administração peridural de ropivacaína isolada ou associada à morfina ou à metadona. Para tal, 24 cadelas submetidas à ovário-histerectomia receberam acepromazina, e a anestesia foi induzida e mantida com propofol e isoflurano (FiO2 = 1,0), respectivamente. De acordo com o protocolo peridural, formaram-se três grupos de igual número: GR (ropivacaína - 2,0mg/kg); GRMETA (ropivacaína - 2,0mg/kg e metadona - 0,3mg/kg) e GRMORF (ropivacaína - 2,0mg/kg e morfina - 0,1mg/kg). Registraram-se os parâmetros fisiológicos intraoperatórios e os graus de sedação e analgesia pós-operatórios. No GR constataram-se maiores médias de pressões arteriais 30 minutos após a anestesia epidural em relação ao GRMETA (sistólica e média) e ao final do procedimento cirúrgico comparativamente ao GRMORF (sistólica, diastólica e média). Não foram observadas diferenças significativas entre os grupos relativamente à analgesia e ao grau de sedação pós-operatórios. A administração epidural de ropivacaína é segura e eficaz e proporciona boa analgesia, independentemente da sua associação com morfina ou metadona.
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Vesovski S, Makara M, Martinez-Taboada F. Computer tomographic comparison of cranial spread of contrast in lumbosacral and sacrococcygeal epidural injections in dog cadavers. Vet Anaesth Analg 2019; 46:510-515. [PMID: 31155379 DOI: 10.1016/j.vaa.2019.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/10/2018] [Accepted: 02/13/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare the cranial spread of epidural injectates between lumbosacral (LS) and sacrococcygeal (SCo) approaches in order to guide volume selection for SCo epidural anaesthesia in the dog. STUDY DESIGN Prospective, randomized cadaveric experimental study. ANIMAL A group of 13 adult greyhound cadavers. METHODS The greyhound cadavers were randomly allocated to receive an epidural injection of diluted contrast via the LS or SCo approach. Incremental volumes (0.1, 0.2, 0.4 and 0.6 mL kg-1) were injected consecutively, and a computed tomography (CT) scan was completed following every volume increment. Cranial spread of contrast was recorded by counting the number of vertebrae cranial to the LS space that the injectate had reached, expressed as a vertebral value (n). This vertebral value was measured taking into consideration the percentage of the cord surrounded by contrast (vertebral canal coverage, %). RESULTS The cranial spread of contrast was similar at 0.1 mL kg-1 [1 (0-3) versus 2 (1-3) n], 0.2 mL kg-1 [3 (0-10) versus 3 (1-5) n], 0.4 mL kg-1 [12 (9-18) versus 11 (3-19) n] and 0.6 mL kg-1 [18 (12-20) versus 15 (10-23) n] for the LS and SCo injections, respectively (p = 0.945). There was a significant interaction between the volume injected and vertebral canal coverage (p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE The cranial spread of contrast was similar, independent of whether the epidural injection was performed in the LS or SCo intervertebral space. Current volume guidelines used for the LS approach may produce similar distribution patterns when the SCo approach is used. Further studies are required in order to evaluate the in vivo effectiveness and the adequacy in differently sized dogs of the results found herein.
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Affiliation(s)
- Stella Vesovski
- The University Veterinary Teaching Hospital, The School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Mariano Makara
- The University Veterinary Teaching Hospital, The School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia
| | - Fernando Martinez-Taboada
- The University Veterinary Teaching Hospital, The School of Veterinary Science, The University of Sydney, Camperdown, NSW, Australia.
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Groppetti D, Di Cesare F, Pecile A, Cagnardi P, Merlanti R, D'Urso ES, Gioeni D, Boracchi P, Ravasio G. Maternal and neonatal wellbeing during elective C-section induced with a combination of propofol and dexmedetomidine: How effective is the placental barrier in dogs? Theriogenology 2019; 129:90-98. [PMID: 30826722 DOI: 10.1016/j.theriogenology.2019.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/14/2019] [Accepted: 02/21/2019] [Indexed: 01/05/2023]
Abstract
Anaesthetics administered during C-section (CS) can cross the placenta and the foetal blood-brain barrier contributing to distress up to neonatal mortality. Therefore, to prevent neonatal risks, sedatives and analgesics are not commonly administered to the bitch until all pups are delivered. This study aims to evaluate the effect of a new anaesthetic and analgesic protocol for elective CS in dogs, focused on both maternal and neonatal wellbeing. General anaesthesia was induced by a combination of propofol (PPF) and dexmedetomidine (DEX) and maintained with isoflurane. DEX was added to PPF in order to provide analgesia and to reduce PPF dose. Propofol and DEX concentrations in maternal blood, amniotic fluid, and placenta were correlated to maternal and neonatal parameters. Maternal pain score was assessed with Glasgow Composite Measure Pain Scale short-form. Nine healthy purebred dogs scheduled for elective CS delivered 54 pups. The 77.8% of pups were vigorous at birth and assigned to the highest Apgar score (AS). The lowest AS was recorded in pups from mothers receiving additional doses of PPF (p < 0.001). Apgar scores improved with the increase in time between induction and pups' extraction, starting from 30 min after induction (p < 0.01). This study could contribute to clarify the controversy about the optimal extraction's time of pups after induction i.e. the best time between PPF administration and birth. No bitch showed post-operative pain or required additional analgesic doses based on their pain score. Maternal blood PPF and DEX, as well as placental PPF concentrations, decreased over time (p < 0.01). Conversely, placental DEX was fair uniformly detected in littermate pups. Both PPF and DEX were not detectable in amniotic fluid. Placenta resulted an effective barrier against foetal DEX exposure, making this protocol safe, analgesic and advisable for elective CS in dogs.
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Affiliation(s)
- Debora Groppetti
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy.
| | - Federica Di Cesare
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Via Celoria 10, 20133, Milan, Italy
| | - Alessandro Pecile
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
| | - Petra Cagnardi
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Via Celoria 10, 20133, Milan, Italy
| | - Roberta Merlanti
- Department of Comparative Biomedicine and Food Science, Università degli Studi di Padova, Viale dell'Università 16, 35020, Legnaro, Padova, Italy
| | - Elisa S D'Urso
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
| | - Daniela Gioeni
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
| | - Patrizia Boracchi
- Department of Clinical Sciences and Community Health, Università; degli Studi di Milano, Via Vanzetti 5, 20133, Milan, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
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Geddes AT, Stathopoulou T, Viscasillas J, Lafuente P. Opioid‐free anaesthesia (OFA) in a springer spaniel sustaining a lateral humeral condylar fracture undergoing surgical repair. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alexander Thomas Geddes
- Department of Surgical SciencesUniversity of Wisconsin Madison School of Veterinary MedicineMadisonWisconsinUSA
| | | | - Jaime Viscasillas
- Clinical Sciences and ServicesThe Royal Veterinary CollegeHatfieldUK
| | - Pilar Lafuente
- Clinical Sciences and ServicesThe Royal Veterinary CollegeHatfieldUK
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Azari O, Seyyedin S, Molaei MM, Hassibi H, Madani BH. Analgesic and sedative effects of caudal epidural tramadol in dromedary camels. BULGARIAN JOURNAL OF VETERINARY MEDICINE 2019. [DOI: 10.15547/bjvm.2052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study aimed to investigate the analgesic efficacy of caudal epidural administration of tramadol in dromedary camels (Camelus dromedarius). A total of 10 dromedary camels of both sexes were selected and randomly assigned to one of two groups to receive epidurally either 1 mg/kg or 2 mg/kg of tramadol hydrochloride. The injections were made into the epidural space at first intercoccygeal junction. Using a pinprick method, analgesia was tested. Duration and onset of complete perineal analgesia were determined. Ataxia and sedation were also assessed and recorded. Clinical parameters including heart rate, respiratory rate and rectal temperature were measured. The lower dose (1 mg/kg) of tramadol induced analgesia only in the tail but the higher dose produced complete antinociception in the tail, anus and perineum. Analgesia of the hind limbs was not achieved after either doses of tramadol. The mean times to onset and duration of complete analgesia in camels receiving epidural tramadol at a dose of 2 mg/kg were 22±2.55 min and 65±8.66 min, respectively. Various degrees of ataxia occurred in all camels. Mild to deep sedation was observed following both doses. Mean heart rate, respiratory rate, and rectal temperature tended to increase for the first 15 or 30 min after injection. Based on the results of this study, analgesic effects of caudal epidural tramadol were dose dependent. Epidural tramadol at a dose of 2 mg/kg would provide suitable postoperative analgesia for various manipulations in the tail, anus and perineum in standing dromedary camels.
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Panti A, Greenhalgh SN, Longo M, Liuti T. The effect of recumbency and hindlimb position on the lumbosacral interlaminar distance in dogs: a cadaveric computed tomography study. Vet Anaesth Analg 2018; 45:802-810. [DOI: 10.1016/j.vaa.2018.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/29/2018] [Accepted: 05/15/2018] [Indexed: 10/28/2022]
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Garcia-Pereira F. Epidural anesthesia and analgesia in small animal practice: An update. Vet J 2018; 242:24-32. [PMID: 30503540 DOI: 10.1016/j.tvjl.2018.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/15/2022]
Abstract
Epidural anesthesia is a commonly performed technique in both human and veterinary medicine. The technique is relatively simple following appropriate training and provides anesthesia and analgesia for acute and chronic pain. Several drug combinations have been administered by this route with variable success and duration. Multiple techniques to guide or confirm correct epidural needle placement are discussed in this article, as well as anatomical features of the epidural space, effect of drug volume and concentration, and adverse effects of the technique in small animal practice. This article is not an exhaustive review of the literature, but an update of some new findings over the last decade.
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Affiliation(s)
- F Garcia-Pereira
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610 USA.
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Dias RSG, Soares JHN, Castro DDSE, Gress MAKDA, Machado ML, Otero PE, Ascoli FO. Cardiovascular and respiratory effects of lumbosacral epidural bupivacaine in isoflurane-anesthetized dogs: The effects of two volumes of 0.25% solution. PLoS One 2018; 13:e0195867. [PMID: 29668768 PMCID: PMC5906007 DOI: 10.1371/journal.pone.0195867] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 03/30/2018] [Indexed: 12/04/2022] Open
Abstract
The purpose of this study was to compare cardiovascular and respiratory effects of two volumes of bupivacaine 0.25% (0.2 mL kg-1-treatment BUP02-and 0.4 mL kg-1 -treatment BUP04) administered epidurally at the lumbosacral intervertebral space in dogs anesthetized with isoflurane. This experimental prospective randomized crossover design trial used six mixed breed adult dogs, four neutered males and two spayed females. Each dog was anesthetized on three different occasions: the first for isoflurane minimum alveolar concentration (MAC) measurement, and the following two assigned treatments (BUP02 or BUP04). On the two treatment days, anesthesia was induced and maintained with isoflurane at 1.3 MAC during the experiments. Cardiovascular and respiratory measurements were recorded before (T0) and 5, 15, 30, 60 and 90 minutes after the epidural administration of bupivacaine. Comparisons between and within groups were performed by a mixed-model ANOVA and Friedman's test when appropriate followed by Bonferroni post-hoc test or Dunnet's test to compare time points within each treatment with T0 (p < 0.05). Mean arterial pressure decreased significantly from 15 to 90 minutes after the administration of BUP02 and from 5 to 60 minutes in BUP04, with lower values in BUP04 than in BUP02 lasting up to 30 minutes after bupivacaine administration. No significant changes in cardiac output and systemic vascular resistance were observed in either treatment. Hypoventilation was only detected in BUP04. Hemoglobin concentration and arterial oxygen content decreased after both treatment of bupivacaine with no significant decrease in oxygen delivery. Two dogs in BUP04 developed Horner's syndrome. The epidural administration of 0.4 mL.kg-1 of bupivacaine to dogs in sternal recumbency anesthetized with isoflurane 1.3 MAC caused more cardiovascular and respiratory depression than 0.2 mL.kg-1.
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Affiliation(s)
- Raquel Sartori Gonçalves Dias
- Graduate Program in Cardiovascular Sciences, College of Medicine, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - João Henrique Neves Soares
- Department of Small Animal Clinical Sciences, Virginia–Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Douglas dos Santos e Castro
- Department of Large Animal Clinical Sciences, Anesthesia and Pain Management Service, University of Florida, Gainesville, Florida, United States of America
| | | | - Marcela Lemos Machado
- Graduate Program in Cardiovascular Sciences, College of Medicine, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Pablo E. Otero
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Anestesiología y Algiología, Buenos Aires, Argentina
| | - Fabio Otero Ascoli
- Graduate Program in Cardiovascular Sciences, College of Medicine, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Myoclonus and hypersensitivity of the tail following intrathecal administration of morphine and bupivacaine in a cat. Vet Anaesth Analg 2018; 45:238-239. [PMID: 29428303 DOI: 10.1016/j.vaa.2017.09.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/25/2017] [Accepted: 09/06/2017] [Indexed: 11/21/2022]
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Dos Santos Silva P, Fantinato-Neto P, Silva ANE, Junior EHB, Carregaro AB. Thoracolumbar epidural anaesthesia with 0.5% bupivacaine with or without methadone in goats. Ir Vet J 2017; 70:15. [PMID: 28560030 PMCID: PMC5446691 DOI: 10.1186/s13620-017-0093-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 05/11/2017] [Indexed: 11/21/2022] Open
Abstract
Background Epidural anaesthesia is one of the most commonly used locoregional techniques in ruminants. The lumbosacral epidural technique is reasonably easy to perform and requires low volumes of local anaesthetic drug to allow procedures caudal to the umbilicus. However, surgical procedures in the flank of the animal would require an increased volume of drugs. The anaesthetized area provided by thoracic epidural technique is larger than the lumbosacral technique; however the former is rather challenging to perform. Therefore, access through lumbosacral area to introduce a catheter into the thoracolumbar space is a potential alternative to thoracic access. Epidural anaesthesia is achieved with local anaesthetics; opioids can be added to improve analgesia. This study aimed to evaluate the effects of 0.5% bupivacaine with or without methadone, administered through an epidural catheter inserted through the lumbosacral access and advanced to the thoracolumbar space, on thoracolumbar epidural anaesthesia in goats. Methods Six animals received two treatments each in a randomized crossover study: BUP treatment consisted of 0.5% bupivacaine (1 mL per each 10 cm of spine column; 1 ± 0.2 mg/kg BW) and BMT treatment was the same; however 1 mL of bupivacaine was replaced by 1 mL (0.22 ± 0.03 mg/kg BW) of methadone (10 mg/mL). The treatments were administered near to T11-T12 through an epidural catheter. Motor blockade and analgesia were evaluated by electrical stimulation. Results Heart rate, respiratory rate, ruminal motility and rectal temperature were evaluated before and after the treatment. Motor blockade was observed on both treatments, up to 6 h post-treatment. Analgesia was observed on BUP up to 4 h and on BMT up to 6 h post-treatment. Physiological values did not change at any moment. Conclusions Bupivacaine-methadone combination promoted longer-lasting analgesia in goats compared to bupivacaine alone when administered through an epidural catheter into the thoracolumbar space. Electronic supplementary material The online version of this article (doi:10.1186/s13620-017-0093-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Priscila Dos Santos Silva
- Department of Veterinary Science, School of Animal Science and Food Engineering, University of São Paulo, 225th, Duque de Caxias Norte Avenue, Campus Pirassununga, 13635-000 Pirassununga, SP Brazil
| | - Paulo Fantinato-Neto
- Department of Veterinary Science, School of Animal Science and Food Engineering, University of São Paulo, 225th, Duque de Caxias Norte Avenue, Campus Pirassununga, 13635-000 Pirassununga, SP Brazil.,Moura Lacerda University Center, 1520th, Dr. Oscar de Moura Lacerda Avenue, Campus Ribeirão Preto, 14076-510 Ribeirão Preto, SP Brazil
| | - André Nicolai Elias Silva
- Department of Veterinary Science, School of Animal Science and Food Engineering, University of São Paulo, 225th, Duque de Caxias Norte Avenue, Campus Pirassununga, 13635-000 Pirassununga, SP Brazil
| | - Eduardo Harry Birgel Junior
- Department of Veterinary Science, School of Animal Science and Food Engineering, University of São Paulo, 225th, Duque de Caxias Norte Avenue, Campus Pirassununga, 13635-000 Pirassununga, SP Brazil
| | - Adriano Bonfim Carregaro
- Department of Veterinary Science, School of Animal Science and Food Engineering, University of São Paulo, 225th, Duque de Caxias Norte Avenue, Campus Pirassununga, 13635-000 Pirassununga, SP Brazil
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Vieira BHB, Nishimura LT, Carvalho LL, Auckburally A, Mattos-Junior E. Cardiopulmonary and sedative effects of intravenous or epidural methadone in conscious dogs. J Vet Pharmacol Ther 2017; 40:e65-e68. [DOI: 10.1111/jvp.12416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 04/05/2017] [Indexed: 11/26/2022]
Affiliation(s)
- B. H. B. Vieira
- Veterinary Science Graduate Program; University of Franca; Franca SP Brazil
| | - L. T. Nishimura
- Veterinary Science Graduate Program; University of Franca; Franca SP Brazil
| | - L. L. Carvalho
- Veterinary Science Graduate Program; University of Franca; Franca SP Brazil
| | - A. Auckburally
- Department of Small Animal Clinical Sciences; School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow UK
| | - E. Mattos-Junior
- Veterinary Science Graduate Program; University of Franca; Franca SP Brazil
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Steagall PVM, Simon BT, Teixeira Neto FJ, Luna SPL. An Update on Drugs Used for Lumbosacral Epidural Anesthesia and Analgesia in Dogs. Front Vet Sci 2017; 4:68. [PMID: 28553642 PMCID: PMC5427076 DOI: 10.3389/fvets.2017.00068] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/20/2017] [Indexed: 12/20/2022] Open
Abstract
This review aims to report an update on drugs administered into the epidural space for anesthesia and analgesia in dogs, describing their potential advantages and disadvantages in the clinical setting. Databases searched include Pubmed, Google scholar, and CAB abstracts. Benefits of administering local anesthetics, opioids, and alpha2 agonists into the epidural space include the use of lower doses of general anesthetics (anesthetic “sparing” effect), perioperative analgesia, and reduced side effects associated with systemic administration of drugs. However, the potential for cardiorespiratory compromise, neurotoxicity, and other adverse effects should be considered when using the epidural route of administration. When these variables are considered, the epidural technique is useful as a complementary method of anesthesia for preventive and postoperative analgesia and/or as part of a balanced anesthesia technique.
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Affiliation(s)
- Paulo V M Steagall
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Francisco J Teixeira Neto
- Faculty of Veterinary Medicine and Animal Science, Department of Veterinary Surgery and Anaesthesiology, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Stelio P L Luna
- Faculty of Veterinary Medicine and Animal Science, Department of Veterinary Surgery and Anaesthesiology, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
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Comparison of the hanging-drop technique and running-drip method for identifying the epidural space in dogs. Vet Anaesth Analg 2017; 44:329-336. [DOI: 10.1016/j.vaa.2016.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 02/04/2016] [Accepted: 03/04/2016] [Indexed: 11/20/2022]
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Otero PE, Verdier N, Zaccagnini AS, Fuensalida SE, Sclocco M, Portela DA, Waxman S. Sonographic evaluation of epidural and intrathecal injections in cats. Vet Anaesth Analg 2016; 43:652-661. [DOI: 10.1111/vaa.12361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
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49
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DeRossi R, Hermeto LC, Jardim PHA, de Andrade Bicudo N, de Assis KT. Postoperative pain control in cats: clinical trials with pre-emptive lidocaine epidural co-administered with morphine or methadone. J Feline Med Surg 2016; 18:882-888. [PMID: 26310819 PMCID: PMC11132221 DOI: 10.1177/1098612x15602738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives The aim of the study was to evaluate the effectiveness of epidural lidocaine in combination with either methadone or morphine for postoperative analgesia in cats undergoing ovariohysterectomy. Methods Under general anesthesia, 24 cats that underwent ovariohysterectomy were randomly allocated into three treatment groups of eight each. Treatment 1 included 2% lidocaine (4.0 mg/kg); treatment 2 included lidocaine and methadone (4.0 mg/kg and 0.3 mg/kg, respectively); and treatment 3 included lidocaine and morphine (4.0 mg/kg and 0.1 mg/kg, respectively). All drugs were injected in a total volume of 0.25 ml/kg via the lumbosacral route in all cats. During the anesthetic and surgical periods, the physiologic variables (respiratory and heart rate, arterial blood pressure and rectal temperature) were measured at intervals of time zero, 10 mins, 20 mins, 30 mins, 60 mins and 120 mins. After cats had recovered from anesthesia, a multidimensional composite pain scale was used to assess postoperative analgesia 2, 4, 8, 12, 18 and 24 h after epidural. Results The time to first rescue analgesic was significantly ( P <0.05) prolonged in cats that received both lidocaine and methadone or lidocaine and morphine treatments compared with those that received lidocaine treatment alone. All cats that received lidocaine treatment alone required rescue analgesic within 2 h of epidural injections. All treatments produced significant cardiovascular and respiratory changes but they were within an acceptable range for healthy animals during the surgical period. Conclusions and relevance The two combinations administered via epidural allowed ovariohysterectomy with sufficient analgesia in cats, and both induced prolonged postoperative analgesia.
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Affiliation(s)
- Rafael DeRossi
- Department of Veterinary Medicine – Surgery and Anesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, MS, Brazil
| | - Larissa Correa Hermeto
- Postgraduate Program in Veterinary Surgery, School of Agrarian and Veterinary Sciences, UNESP, Jaboticabal, SP, Brazil
| | | | - Natalia de Andrade Bicudo
- Department of Veterinary Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Klebs Tavares de Assis
- Department of Veterinary Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
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Littlewood KE, Mellor DJ. Changes in the Welfare of an Injured Working Farm Dog Assessed Using the Five Domains Model. Animals (Basel) 2016; 6:ani6090058. [PMID: 27657140 PMCID: PMC5035953 DOI: 10.3390/ani6090058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/07/2016] [Accepted: 09/14/2016] [Indexed: 02/03/2023] Open
Abstract
Simple Summary The Five Domains Model is now increasingly used to assess the welfare status of a wide range of species in markedly different circumstances. Particular strengths are that the Model facilitates structured, systematic and comprehensive evaluations of animals’ negative and positive mental experiences, the overall balance of which underlies their welfare status or quality of life. Importantly, the Model also clarifies the specific internal and external factors that give rise to those experiences. The welfare evaluation published here is the first to use the most up-to-date version of the Model, and stands as a detailed example that may assist others undertaking such welfare evaluations in other species and contexts. Moreover, it is the first such evaluation of a companion animal. It employs a fictitious scenario involving a working farm dog before, during and after it sustains a serious hind leg injury requiring amputation and its subsequent rehoming as a pet. A wide range of negative and positive experiences are graded, interactions between them are revealed, and the balance between negative and positive states at different stages of the scenario is described. Such Model evaluations can highlight current practices that merit re-evaluation. More generally, when major welfare issues are identified, use of the Model could enhance expert witness participation in related prosecutions by highlighting scientifically supported connections between indicative physical/functional states and behaviours and their associated negative experiences in ill-treated animals. Five Domains Model evaluations can also facilitate quality of life assessments and end-of-life decisions. Abstract The present structured, systematic and comprehensive welfare evaluation of an injured working farm dog using the Five Domains Model is of interest in its own right. It is also an example for others wanting to apply the Model to welfare evaluations in different species and contexts. Six stages of a fictitious scenario involving the dog are considered: (1) its on-farm circumstances before one hind leg is injured; (2) its entanglement in barbed wire, cutting it free and transporting it to a veterinary clinic; (3) the initial veterinary examination and overnight stay; (4) amputation of the limb and immediate post-operative recovery; (5) its first four weeks after rehoming to a lifestyle block; and (6) its subsequent life as an amputee and pet. Not all features of the scenario represent average-to-good practice; indeed, some have been selected to indicate poor practice. It is shown how the Model can draw attention to areas of animal welfare concern and, importantly, to how welfare enhancement may be impeded or facilitated. Also illustrated is how the welfare implications of a sequence of events can be traced and evaluated, and, in relation to specific situations, how the degrees of welfare compromise and enhancement may be graded. In addition, the choice of a companion animal, contrasting its welfare status as a working dog and pet, and considering its treatment in a veterinary clinical setting, help to highlight various welfare impacts of some practices. By focussing attention on welfare problems, the Model can guide the implementation of remedies, including ways of promoting positive welfare states. Finally, wider applications of the Five Domains Model are noted: by enabling both negative and positive welfare-relevant experiences to be graded, the Model can be applied to quality of life assessments and end-of-life decisions and, with particular regard to negative experiences, the Model can also help to strengthen expert witness testimony during prosecutions for serious ill treatment of animals.
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Affiliation(s)
- Katherine E Littlewood
- Animal Welfare Science and Bioethics Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - David J Mellor
- Animal Welfare Science and Bioethics Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North 4442, New Zealand.
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