Propofol at Single Bolus and Continuous Rate Infusion Significantly Increases Serum Triglycerides, but not Cholesterol, In Healthy Bitches Undergoing Elective Ovariohysterectomy

High carbohydrate is preferable to high lipid parenteral nutrition in healthy dogs undergoing prolonged sedation

Parenteral nutrition (PN) is commonly used in intensive care units (ICUs) and is associated with earlier hospital outcome. However, there is scarcity of information about the metabolic effects of PN caloric distribution for dogs. Considering the high tolerance of dogs to lipids and, also, that hospitalized animals usually present insulin resistance, PN formulation with high fat instead high glucose can provide metabolic benefits in this specie. This study evaluated two PN protocols, based on high lipid or high carbohydrate in 12 healthy dogs under sedation/ventilation during 24 h. For baseline data, blood samples were collected 24 h before the study beginning. After fasting, the dogs were anesthetized and put under mechanical ventilation without energy support for 12 h to obtain: daily energy expenditure (DEE), respiratory quotient (RQ), oxygen consumption (VO2), carbon dioxide production (VCO2), lactate, glucose, cholesterol, and triglycerides concentrations. After, the dogs were allocated into two groups: lipid-based energy group (LEG) and carbohydrate-based energy group (CEG). Both groups received the PN infusions at a rate of 3 mL/kg/h for 12 h. Blood tests were performed 12, 24, and 48 h after infusion's completion. VO2 increased after PN in LEG, increasing energy expenditure compared to CEG. RQ remained close to 1 in CEG, indicating carbohydrate preferential consumption. Triglycerides increased in both groups after propofol infusion, remaining higher in LEG until the end of the evaluation. Glycaemia increased in CEG compared to baseline. In conclusion, both PN protocols can be used in healthy animals undergoing prolonged sedation protocols. However, high lipid PN had higher VO2 and DEE, and resulted in higher triglycerides concentrations and lower glycaemia indexes than carbohydrate, making high carbohydrate PN preferable to high lipid PN. Therefore, for use in critically ill patients, the data obtained in this study should be extrapolated, taking into consideration the specificity of each case.

Changes in Hematological and Biochemical Profiles in Ovariohysterectomized Bitches Using an Alfaxalone–Midazolam–Morphine–Sevoflurane Protocol

Simple Summary

Laboratory tests are an integral part of the overall diagnostic procedures for both physiological and pathological conditions. Ovariohysterectomy (OHE) in bitches is an invasive procedure, producing moderate to severe pain. The response to surgical stress is characterized by a series of neuroendocrine and metabolic changes that can be represented on hematological and biochemical profiles. The objective of this study was to evaluate the physiological response to surgical stress, predict the presence of possible post-surgical complications, and where appropriate, establish the appropriate treatment based on the hematochemical changes during and after OHE in healthy bitches. OHE in this study induced transient changes in certain hematological and biochemical parameters. Knowledge of the hematochemical changes in response to stress and trauma induced by OHE in healthy dogs would allow to predict possible post-surgical complications.

Abstract

The aim of this study was to monitor hematochemical changes during and after OHE in bitches. Twenty-four females were anesthetized with alfaxalone, midazolam, morphine and sevoflurane. Blood samples were taken before anesthesia (T0), at 30 (T1), and 60 min (T2), at 3 (T3), 6 (T4), 12 (T5), and 24 h (T6), and at 3 (T7) and 7 days (T8) from the start of surgery. Red blood cells (RBC) and packed cell volume (PCV) decreased significantly from T1 to T5 and hemoglobin (HB) concentration from T4 to T6. Both the white blood cell (WBC) and neutrophil (NFS) count increased significantly from T3 to T6, monocyte (MON) from T2 to T5, and eosinophil (EOS) at T5. Platelet (PLT) and plateletcrit (PCT) significantly decreased at T5 and increased from T6 to T8; platelet distribution width (PDW) increased significantly from T3 to T6. Creatine kinase (CK) activity increased significantly from T5 to T7. Glucose (GLU) concentrations increased significantly at T2 and P from T2 to T3. TG levels decreased from T2 to T4 and blood urea nitrogen (BUN) levels from T1 to T7, subsequently increasing until T8. Changes possibly resulting from stress and surgical trauma, as well as hemodilution and splenic storage, are due to anesthesia and surgery. In healthy bitches, these changes tend to gradually stabilize after the ending of OHE. A post-operative follow-up is essential to detect possible post-operative complications.