The effects of alpha 2 adrenoceptor agonists on airway pressure in anaesthetized sheep

Breath-by-breath assessment of acute pulmonary edema using electrical impedance tomography, spirometry and volumetric capnography in a sheep (Ovis Aries) model

Background

The bedside diagnosis of acute pulmonary edema is challenging. This study evaluated the breath-by-breath information from electrical impedance tomography (EIT), respiratory mechanics and volumetric capnography (VCap) to assess acute pulmonary edema induced by xylazine administration in anesthetized sheep.

Objective

To determine the ability and efficiency of each monitoring modality in detecting changes in lung function associated with onset of pulmonary edema.

Methods

Twenty healthy ewes were anesthetized, positioned in sternal (prone) recumbency and instrumented. Synchronized recordings of EIT, spirometry and VCap were performed for 60 s prior to start of injection, during xylazine injection over 60 s (0-60 s) and continuously for 1 min (60-120 s) after the end of injection. After visual assessment of the recorded mean variables, statistical analysis was performed using a mixed effect model for repeated measures with Bonferroni's correction for multiple comparisons, to determine at which breath after start of injection the variable was significantly different from baseline. A significant change over time was defined as an adjusted p < 0.05. All statistics were performed using GraphPad Prism 0.1.0.

Results

Electrical impedance tomography showed significant changes from baseline in all but two variables. These changes were observed simultaneously during xylazine injection at 48 s and were consistent with development of edema in dependent lung (decreased end-expiratory lung impedance, ventilation in centro-ventral and ventral lung region) and shift of ventilation into non-dependent lung (decreased non-dependent silent spaces and increased center of ventilation ventral to dorsal and increased ventilation in centro-dorsal and dorsal lung region). All changes in lung mechanics also occurred during injection, including decreased dynamic respiratory system compliance and increased peak expiratory flow, peak inspiratory pressure and airway resistance at 48, 54 and 60 s, respectively. Changes in VCap variables were delayed with all occurring after completion of the injection.

Conclusion

In this model of pulmonary edema, EIT detected significant and rapid change in all assessed variables of lung function with changes in regional ventilation indicative of pulmonary edema. Volumetric capnography complemented the EIT findings, while respiratory mechanics were not specific to lung edema. Thus, EIT offers the most comprehensive method for pulmonary edema evaluation, including the assessment of ventilation distribution, thereby enhancing diagnostic capabilities.

Retrospective Comparison of the Anesthetic Effects of Tiletamine-Zolazepam with Dexmedetomidine and Ketamine with Dexmedetomidine in Captive Formosan Serow (Capricornis swinhoei)

Formosan serows are endemic to the mountainous regions of Taiwan. This crossover study aimed to assess and compare the anesthetic induction and recovery using either dexmedetomidine-tiletamine-zolazepam (DZ) or dexmedetomidine-ketamine (DK) by intramuscular injection from a blow-dart in a zoo environment. Ten anesthetic procedures were performed with five adult Formosan serows. Each participant was anesthetized with both combinations at least once with a minimal 12-month washout. The average dosages were 22.6 ± 8.3 µg/kg and 35.8 ± 2.5 µg/kg for dexmedetomidine and 185.6 ± 123.6 and 357.8 ± 25.2 µg/kg for atipamezole for the DZ and DK groups, respectively. The doses of tiletamine-zolazepam and ketamine were 2.1 ± 0.25 mg/kg and 3.6 ± 0.3 mg/kg, respectively, in the DZ and DK groups. All participants were induced within 10 min (median: 8 min for both groups), except one serow in the DK group with an induction time of 22 min. Serows in the DZ group had a lower respiratory rate (p = 0.016) and lower rectal temperature (p = 0.008) than those in the DK group. The quality of recovery was poor for DZ because of paddling, prolonged recovery, and ataxia after antagonism of dexmedetomidine with atipamezole. The induction of anesthesia with dexmedetomidine-tiletamine-zolazepam was uneventful and rapid. However, recovery from this combination was not smooth.

Comparison of pulmonary function in isoflurane anaesthetized ventilated sheep (Ovis aries) following administration of intravenous xylazine versus medetomidine

Alpha2 receptor agonists (alpha2-agonists) are useful sedative and analgesic agents in sheep, but have adverse pulmonary effects, which are reportedly similar between different alpha2-agonists. This randomized crossover study compared pulmonary function after intravenous administration of an alpha2-agonist, either xylazine or an equipotent dose of medetomidine in 34 female sheep anaesthetized twice. Pulmonary function was assessed using spirometry, volumetric capnography, arterial blood gas analysis 1 min prior to, and 5 and 10 min after administration of the allocated alpha 2 agonist drug. Pulmonary structural changes were subsequently assessed using computed tomography (CT). Tachypnoea or hypoxaemia prompted reversal with atipamezole and exclusion of data. Data were analysed for a fixed effect of drug using a mixed effect linear model with significance set at p < 0.05. Ten sheep administered xylazine required atipamezole while none of sheep receiving medetomidine did. Xylazine produced significantly higher respiratory frequency, airway pressures, airway resistance and arterial carbon dioxide (CO2), and lower dynamic compliance, tidal volume, CO2 elimination and end tidal CO2 tension and arterial oxygen tension than medetomidine. This was associated with a significantly lower % of aerated tissue and higher % poorly and non-aerated tissue in CT images of sheep receiving xylazine versus medetomidine. In conclusion, xylazine administration produced marked decreases in pulmonary function, in ventilated isoflurane anaesthetized sheep, when compared to an equipotent dose of medetomidine when administered as an intravenous bolus supporting the use of medetomidine when alpha2-agonists are required.

Effects of vatinoxan on xylazine-induced pulmonary alterations in sheep

It was hypothesized that premedication with vatinoxan, a peripheral α₂ -adrenoceptor antagonist, would mitigate xylazine-induced pulmonary alterations in sheep. Fourteen adult sheep were allotted into two equal groups and premedicated with either vatinoxan (750 µg/kg IV) or saline and sedated 10 min later with xylazine (500 µg/kg IV). Arterial oxygen saturation (SpO₂ ) was measured and respiratory rate (RR) counted at intervals. The sheep were euthanized with IV pentobarbital 10 min after xylazine administration. The severity of pulmonary parenchymal alterations was assessed and graded grossly and histologically and correlations of the morphological changes with SpO₂ evaluated. Following xylazine injection, SpO₂ was significantly higher and RR significantly lower with vatinoxan than with saline and the sheep administered vatinoxan exhibited significantly smaller quantities of tracheal foam than those receiving saline. No significant differences in macroscopic oedema scores were detected between treatments. In contrast, the vatinoxan-treated animals exhibited significantly graver microscopic interstitial alveolar oedema and haemorrhage than saline-treated animals. The histological severity scores did not correlate with changes in SpO₂ . In conclusion, xylazine induced a marked reduction in SpO₂ which was abolished by the prior administration of vatinoxan. The histologically detected alterations after pentobarbital euthanasia with vatinoxan premedication need to be studied further.

Application of α2 -adrenergic agonists combined with anesthetics and their implication in pulmonary intravascular macrophages-insulted pulmonary edema and hypoxemia in ruminants

Alpha₂ -adrenergic agonists have been implicated in the development of pulmonary edema (PE) and sustained hypoxemia that lead to life-threatening pulmonary distress in ruminants, especially with sensitive and compromised animals. Recently, there is limited understanding of exact mechanism underlying pulmonary alterations associated with α₂ -adrenergic agonist administration. Ruminants have a rich population of pulmonary intravascular macrophages (PIMs) in the pulmonary circulation, which may be involved in the development of pulmonary alveolo-capillary barrier damage. Hence, the central thesis of this review is overviewing the literatures regarding the systemic use of α₂ -adrenergic agonists in domestic ruminants, focusing on their pulmonary side effects, especially on the influence of PIMs on the lung. At this moment, further studies are needed to provide a clear emphasis and better understanding of the potential role of PIMs in the lung pathophysiology associated with α₂ -adrenergic agonists. These preliminary studies would be potentially to develop future medications and intervention targets that may be helpful to alleviate or prevent the critical striking pulmonary effects, and thereby improving the safety of α₂ -agonist application in ruminants.

Cardiopulmonary effects of vatinoxan in sevoflurane-anaesthetised sheep receiving dexmedetomidine

The effects of pre-treatment with vatinoxan (MK-467) on dexmedetomidine-induced cardiopulmonary alterations were investigated in sheep. In a crossover study design with a 20-day washout, seven sheep were anaesthetised with sevoflurane in oxygen and air. The sheep were ventilated with the pressure-limited volume-controlled mode and a positive end-expiratory pressure of 5cmH₂O. Peak inspiratory pressure (PIP) was set at 25cmH₂O. The sheep received either 150μg/kg vatinoxan HCl (VAT+DEX) or saline intravenously (IV) 10min before IV dexmedetomidine HCl (3μg/kg, DEX). Cardiopulmonary variables were measured before treatments (baseline), 3min after vatinoxan or saline, and 5, 15 and 25min after dexmedetomidine. Computed tomography (CT) of lung parenchyma was performed at baseline, 2min before dexmedetomidine, and 10, 20 and 30min after DEX. Bronchoalveolar lavage (BAL) was performed after the last CT scan and shortly before sheep recovered from anaesthesia. After VAT, cardiac output significantly increased from baseline. DEX alone significantly decreased partial arterial oxygen tension, total dynamic compliance and tidal volume, whereas PIP was significantly increased. With VAT+DEX, these changes were minimal. No significant changes were detected in haemodynamics from baseline after DEX. With VAT+DEX, mean arterial pressure and systemic vascular resistance were significantly decreased from baseline, although hypotension was not detected. On CT, lung density was significantly increased with DEX as compared to baseline. No visual abnormalities were detected in bronchoscopy and no differences were detected in the BAL fluid after either treatment. The pre-administration of vatinoxan alleviates dexmedetomidine-induced bronchoconstriction, oedema and hypoxaemia in sevoflurane-anaesthetised sheep.

Sedative-hypnotic effects of midazolam in goats after intravenous and intramuscular administration

OBJECTIVE

To examine the effect of dose and route of administration on the sedative-hypnotic effects of midazolam.

DESIGN

Prospective randomized controlled study ANIMALS: Six indigenous, African bred goats.

METHODS

Pilot studies indicated that the optimum dose of midazolam for producing sedation was 0.6 mg kg^-1 for intramuscular (IM) injection, while the optimum intravenous (IV) doses causing hypnosis without, and with loss of palpebral reflexes were 0.6 mg kg^-1 and 1.2 mg kg^-1, respectively. These doses and routes of administration were compared with a saline placebo in a randomized block design in the main experiment, and the sedative-hypnotic effects evaluated according to pre-determined scales.

RESULTS

Intramuscular midazolam produced sedation with or without sternal recumbency in all animals with the peak effect occurring 20 minutes after administration. The scores for IM sedation with midazolam were significantly different (p < 0.05) from placebo. Intravenous midazolam at 0.6 mg kg^-1 resulted in hypnosis, and at 1.2 mg kg^-1 increased reflex suppression was observed. The maximum scores for hypnosis at both doses were obtained 5 minutes after IV injection. The mean (± SD) duration of lateral recumbency was 10.8 (± 3.8) minutes after IV midazolam (0.6 mg kg^-1) compared to 20 (± 5.2) minutes after midazolam at 1.2 mg kg^-1. Compared to baseline, the heart rate increased significantly (p < 0.05) after high dose IV midazolam.

CONCLUSION

Intramuscular midazolam (0.6 mg kg^-1) produced maximum sedation 20 minutes after injection. Intravenous injection produced maximum hypnosis within 5 minutes. Increasing the IV dose from 0.6 to 1.2 mg kg^-1 resulted in increased reflex suppression and duration of hypnosis.

CLINICAL RELEVANCE

For a profound effect with rapid onset midazolam should be given IV in doses between 0.6 and 1.2 mg kg^-1.

Ergovaline, an endophytic alkaloid. 2. Intake and impact on animal production, with reference to New Zealand

On the basis of published reports, the daily intake of the alkaloid ergovaline from the consumption of endophyte-containing ryegrass in New Zealand ranges from 0.008 to 0.287 mg ergovaline/kg LW0.75.day. Most of the reports are based on the use of standard endophyte-containing ryegrass and, thus, it is difficult to disassociate the impact of ergovaline consumption from that of lolitrem B. However, physiological effects of ergovaline consumption, such as reduced circulating prolactin concentration, vasoconstriction and elevated core temperature, have been detected at fairly low ergovaline intake, whereas decreased feed intake, liveweight gain and milk production have not generally been observed in animals at an intake below 0.07 mg ergovaline/kg LW0.75.day. Intakes above this value represent only 17% of published values. There are insufficient data to suggest a threshold ergovaline intake associated with heat stress with animal-welfare implications. The relationship between published ergovaline intake and the corresponding ergovaline concentration in pasture is poor (R2 = 0.48), but on average an intake of 0.07 ergovaline/kg LW0.75.day is associated with an ergovaline concentration in ryegrass of 0.70 mg/kg DM. About 16–18% of published ergovaline concentrations in ryegrass pasture exceed this value. The ergovaline concentration in ryegrass is greater in the basal parts of the plant than in the leaf and during the late summer–autumn than in spring. Animals grazing in the lower sward horizons (horizontal grazing plane) are more at risk of high ergovaline intake, although the reduction in grazing intake induced by grazing at low pasture height aids in limiting ergovaline intake. As pasture growth rates decline in late summer, supplementary feed may be used to maintain stocking rate and, if such feeds have zero ergovaline concentration, they serve to dilute the mean dietary ergovaline intake. Ergovaline-containing ryegrass pastures are widely used in New Zealand. It appears that farmers consider the risks of depressed animal production on these pastures to be less than the benefits ergovaline bestows through its deterrent effect of specific insect attack and thus greater survival and pasture persistence.

Ergovaline, an endophytic alkaloid. 1. Animal physiology and metabolism

Ergovaline is an ergot alkaloid found in some endophyte-infected ryegrasses and it has been implicated in the expression of ergotism-like symptoms of grazing livestock, as well as in the protection of the plant against invertebrate predation and abiotic stresses. These selection pressures have resulted in a conflict between the needs of the pasture for persistence and the needs of the animal for production. Ergovaline has not been well studied in terms of animal physiology until recently. There are several putative mechanisms that limit the bioavailability of ergovaline, ranging from microbial biotransformation to post-absorptive hepatic detoxification. Although there are mechanisms that protect the animal from ergovaline exposure, tissues are very sensitive to ergovaline, indicating that ergovaline is very potent and that small quantities have the potential to cause noticeable physiological effects. The range of physiological effects, including decreased circulating prolactin, vasoconstriction and increased susceptibility to heat stress are all linked to the interaction of ergovaline with biogenic amine receptors found throughout the body. This review will focus on understanding the variation of ergovaline concentration in terms of bioavailability, the myriad of hurdles a molecule of ergovaline must overcome to cause an effect, what the ergovaline-induced effects are in New Zealand livestock and how this relates to the potency of ergovaline.

Transplacental transfer of medetomidine and ketamine in pregnant ewes

The extent of placental transfer of medetomidine and ketamine is unknown in pregnant ewes. Date-mated singleton (n = 8) and twin (n = 8) pregnant merino cross ewes were anaesthetized for Caesarean delivery of preterm lamb fetuses. A combination of medetomidine (20 μg/kg) and ketamine (10 mg/kg) was administered by intravenous injection and surgery performed immediately thereafter. Blood samples were collected from the ewe at one, five and 10 min after intravenous injection and from the umbilical vein of the fetus at delivery. Non-pregnant ewes were also anaesthetized (n = 8). There was no difference in the plasma concentration of medetomidine or ketamine when comparing singleton and twin ewes or pregnant and non-pregnant ewes for the short duration of the study. Fetal plasma concentrations of each drug were comparable to the maternal concentrations at the same time. We conclude that both drugs cross the placenta readily and provide anaesthesia and analgesia for the fetus when it is delivered.

Pain and analgesia in domestic animals

The biggest challenge to the use of analgesic agents in animals is the determination of the efficacy of these agents. In humans, the verbal communication of the alleviation of pain is fundamental to the effective use of analgesics. In animals, the lack of verbal communication not only confounds the diagnosis and characterisation of the experience of pain, but also challenges the evaluation of the analgesic therapy. As animals possess the same neuronal pathways and neurotransmitter receptors as humans, it seems reasonable to expect that their perceptions of painful stimuli will be similar, and this is a basis for the use of laboratory animals for screening of analgesics for human use. However, as the evaluation in the laboratory animal tests is based mainly on behavioural responses, and although some physiological responses do occur, it is often difficult to separate these from stress responses. The use of behavioural responses to evaluate analgesics in a range of species is complicated by the fact that different species show different behaviours to a similar pain stimulus, and different pain stimuli produce different pain responses in the same species. Thus behaviours may be species- and pain-specific and this can complicate analgesic evaluation. As most animals possess similar neuronal mechanisms to humans for pain perception, it is not surprising that the standard human pain control strategies can be applied to animals. For instance, local anaesthetics, opioids, non-steroidal anti-inflammatory drugs (NSAIDs), as well as other analgesics used in humans are all found to be effective for animal use. Differences in metabolism and distribution between various species, as well as financial considerations in larger animals can affect efficacy and thus limit their use. In addition, the use of any drug in a species that may be intended for human consumption will be limited by residue considerations. The treatment of pain in animals presents many challenges, but the increasing public concerns regarding animal welfare will ensure that studies into the nature and control of animal pain will continue to have a high profile.

Respiratory mechanics in sedated and nonsedated adult llamas

OBJECTIVE

To validate the use of noninvasive pulmonary function testing in sedated and nonsedated llamas and establish reference range parameters of respiratory mechanical function.

ANIMALS

10 healthy adult llamas.

PROCEDURES

Pulmonary function testing in llamas included the following: measurement of functional residual capacity (FRC) via helium dilution, respiratory inductance plethysmography (RIP) to assess breathing pattern and flow limitations, esophageal-balloon pneumotachography, and a monofrequency forced oscillatory technique (FOT; 1 to 7 Hz) before and after IM administration of xylazine (0.2 mg/kg).

RESULTS

The following mean +/- SD measurements of respiratory function were obtained in nonsedated llamas: FRC (5.60 +/- 1.24 L), tidal volume (1.03 +/- 0.3 L), dynamic compliance (0.83 +/- 0.4 L/cm H(2)O), pulmonary resistance (R(L); 1.42 +/- 0.54 cm H(2)O/L/s), and respiratory system resistance (2.4 +/- 0.9, 2.3 +/- 0.7, 2.2 +/- 0.6, 2.7 +/- 0.7, and 2.5 +/- 0.5 cm H(2)O/L/s at 1, 2, 3, 5, and 7 Hz, respectively) by use of FOT. Measurements of flow limitations via RIP were comparable to other species. Sedation with xylazine induced significant increases in R(L) and maximum change in transpulmonary pressure. Following sedation, a mean 127% increase in R(L) and mean 116% increase in respiratory system resistance were observed across 1 to 7 Hz. The magnitude of change in respiratory system resistance increased with decreasing impulse frequency, suggesting bronchoconstriction.

CONCLUSIONS AND CLINICAL RELEVANCE

Noninvasive pulmonary function testing is well tolerated in untrained unsedated llamas. These techniques have clinical applications in the diagnosis and treatment of respiratory tract disease, although testing should not be performed after sedation with xylazine.

Dexmedetomidine-induced pulmonary alterations in sheep

Alpha(2) agonist-induced pulmonary oedema in sheep might be related to alterations in pulmonary haemodynamics and/or activation of inflammatory processes. In seven sevoflurane-anaesthetized sheep pulmonary haemodynamics, arterial oxygen tensions, nitric oxide and prostaglandin E(2) concentrations were determined before and after intravenous dexmedetomidine (2microg kg(-1)). In a second trial, lung tissue was sampled for histopathology and quantitative real-time PCR for IL-1beta and iNOS mRNA in a control sheep and 2, 10 and 30min after dexmedetomidine. Computer tomography of the lung under sevoflurane anaesthesia before and after dexmedetomidine was performed. Two minutes after dexmedetomidine mean pulmonary artery pressure, pulmonary arterial occlusion pressure and estimated capillary pressurewere significantly increased to 34.5mmHg, 22.2mmHg and 27.1mmHg, respectively. On computer tomography, lung density increased immediately after dexmedetomidine, with maximal density occurring between 9 and 12min. Histopathology was consistent with vascular congestion followed by protein and erythrocyte extravasation into alveoli. Increased iNOS mRNA levels were detected in sevoflurane anaesthetized animals only. An IL-1beta signal occurred after morphological changes had occurred in lung tissue. These findings support hydrostatic stress as the underlying cause of alpha(2) agonist-induced pulmonary oedema in sheep.

A 2 -agonists in sheep: a review

OBJECTIVE

To review the use and adverse effects of alpha(2)-agonists in sheep.

STUDY DESIGN

Literature review.

MATERIAL AND METHODS

'Pubmed' of the United States National Library of Medicine and 'Veterinary Science' of CAB International were searched for references relating sheep to alpha(2)-agonists. The bibliographies of retrieved articles were further scrutinized for pertinent references, and relevant articles were selected manually.

RESULTS

Reports on the use of clonidine, xylazine, detomidine, romifidine, medetomidine and dexmedetomidine, MPV-2426 and ST-91 in sheep were found in the literature. Most of the studies described xylazine followed by medetomidine and clonidine. The literature on detomidine and romifidine in sheep was sparse. Reports included pharmacokinetic studies, evaluation of sedative, analgesic, and anaesthetic techniques with or without cardiovascular effects, and experimental investigations of adverse effects (mainly hypoxaemia) including the mechanisms of pulmonary oedema and impaired oxygenation after alpha(2)-agonist administration.

CONCLUSIONS

A(2)-agonists are potent and effective analgesics in sheep. In combination with ketamine, they are frequently used for the induction and maintenance of anaesthesia, in this case analgesia is satisfactory. The degree of hypoxaemia which occurs with all commercially available alpha(2)-agonists is highly variable and depends on individual or breed-related factors; the most severe reactions occur after intravenous (IV) injection and during general anaesthesia. Clinical relevance Subclinical respiratory disease is common in sheep. Rapid IV injection of alpha(2)-agonists without supplementary oxygen should be avoided whenever hypoxaemia may be critical.

Cardiopulmonary effects of dexmedetomidine in sevoflurane-anesthetized sheep with and without nitric oxide inhalation

OBJECTIVE

To determine whether inhaled nitric oxide (NO) prevents pulmonary hypertension and improves oxygenation after i.v. administration of a bolus of dexmedetomidine in anesthetized sheep.

ANIMALS

6 healthy adult sheep.

PROCEDURE

In a crossover study, sevoflurane-anesthetized sheep received dexmedetomidine (2 microg/kg, i.v.) without NO (DEX treatment) or with inhaled NO (DEX-NO treatment). Cardiopulmonary variables, including respiratory mechanics, were measured before and for 120 minutes after bolus injection of dexmedetomidine.

RESULTS

Dexmedetomidine induced a transient decrease in heart rate and cardiac output. A short-lived increase in mean arterial pressure (MAP) and systemic vascular resistance (SVR) was followed by a significant decrease in MAP and SVR for 90 minutes. Mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance increased transiently after dexmedetomidine injection. The Pao2 was significantly decreased 3 minutes after injection and reached a minimum of (mean +/- SEM) 13.3 +/- 78 kPa 10 minutes after injection. The decrease in Pao2 was accompanied by a sudden and prolonged decrease in dynamic compliance and a significant increase in airway resistance, shunt fraction, and alveolar dead space. Peak changes in MPAP did not differ between the 2 treatments. For the DEX-NO treatment, Pao2 was significantly lower and the shunt fraction significantly higher than for the DEX treatment.

CONCLUSIONS AND CLINICAL RELEVANCE

Inhalation of NO did not prevent increases in pulmonary arterial pressures induced by i.v. administration of dexmedetomidine. Preemptive inhalation of NO intensified oxygenation impairment, probably through increases in intrapulmonary shunting.

An animal model for ultrasound lung imaging

In the past decade, a number of clinical investigators have used ultrasound (US) to image the lung during video-assisted thoracoscopic surgery (VATS). In contrast, animal studies have shown prohibitively high attenuation levels in the lung, incompatible with the ability to image the lung. We hypothesized that the use of anesthesia during VATS augments lung collapse upon exposure to atmospheric pressure; thus, making US lung imaging possible. To test this hypothesis, we compared the effect of two commonly used anesthetic protocols on our ability to image 200 microL of US gel injected in rabbit lungs using a pulse echo transducer at 13 MHz. The anesthetic protocol, using acepromazine, ketamine and isoflurane, allowed US lung imaging in rabbits. It is concluded that US at 13 MHz can detect 200 microL of US gel injected into the lung parenchyma in a rabbit model.

Cardiovascular, respiratory, and body temperature responses of sheep to the ergopeptides ergotamine and ergovaline

OBJECTIVE

To compare the effects of the ergot alkaloid ergovaline with effects of ergotamine on blood pressure, heart rate, respiratory rate, and body temperature in conscious sheep.

ANIMALS

3 sheep with indwelling arterial catheters.

PROCEDURE

Ergotamine and ergovaline were injected IV (20 nmol/kg), and their effects on arterial blood pressure, heart rate, respiratory rate and pattern, body temperature, and skeletal muscle electromyographic activity were compared with control values obtained following injections of saline (0.9% NaCI) solution or acetone.

RESULTS

Both ergopeptides caused immediate and significant increases in blood pressure (50 to 75 mm Hg) without concomitant increases in heart rate. Ergovaline but not ergotamine significantly increased pulse pressure (35 mm Hg). Both ergopeptides resulted in decreased respiratory rate and increased respiratory depth within the first hour of administration. Body temperature was decreased slightly upon ergopeptide administration but continued to increase thereafter, with greater increases developing with ergovaline than with ergotamine. Increased body temperatures of 3.0 to 3.5 C were maintained for at least 10 hours. Respiratory rate was increased to rates as high as 210 to 220 breaths/min in association with hyperthermia. Ergopeptides had no effect on skeletal muscle electromyographic activity.

CONCLUSIONS AND CLINICAL RELEVANCE

In sheep, ergovaline has similar effects to ergotamine on cardiovascular and pulmonary function and body temperature but is more potent. These effects are consistent with clinical signs observed in the toxicoses developed when ruminants ingest grass with high concentrations of ergopeptides.

Comparison of medetomidine and dexmedetomidine as premedication in isoflurane anaesthesia for orthopaedic surgery in domestic sheep

The objective of the present study was to determine the potency of dexmedetomidine in relation to medetomidine in sheep undergoing orthopaedic surgery by comparing the anaesthetic requirements and cardiovascular changes at a dose relationship that represented equipotency in vitro. Twenty-four non-pregnant, female sheep were used. The study was carried out as a blind, randomized, experimental trial. Group 1 received 5 micrograms/kg bodyweight (BW) dexmedetomidine and group 2 received 10 micrograms/kg BW medetomidine intravenously 5 min prior to induction of anaesthesia. Anaesthesia was induced with ketamine (2.0 mg/kg BW intravenously) and maintained with isoflurane in 100% oxygen. End expired anaesthetic concentration (FEIso), end expired carbon dioxide concentration (FECO2), respiratory frequency (fR), direct arterial blood pressures, heart rates (HR) and arterial blood gases were monitored. Data were averaged over time and tested for differences between groups by independent t-tests, and analysis of variance for repeated measures. Average FEIso concentrations required to maintain a surgical plane of anaesthesia were not different between groups (1: 1.02 +/- 0.04%; 2: 0.99 +/- 0.07%). There was no difference in HR, arterial blood pressures, fR, FECO2 and arterial blood gases between groups. Average mean PaO2 were 279.54 +/- 113.37 mmHg and 220.21 +/- 102.15 mmHg with individual minimum values of 27.2 mmHg and 58.5 mmHg in groups 1 and 2, respectively. In conclusion, intravenous dexmedetomidine at 5 micrograms/kg BW and medetomidine at 10 micrograms/kg BW have the same effects on isoflurane requirements and cardiopulmonary parameters in sheep, indicating an equipotent dose relationship. Both preparations induced moderate to severe hypoxaemia in individual sheep.

Characterisation of the cardiovascular pharmacology of medetomidine in the horse and sheep

Medetomidine was administered to sheep and horses at a dose rate of 5 microg kg(-1) (i.v.). Heart rate and blood pressure were recorded. Medetomidine induced bradycardia and a biphasic blood pressure response consisting of a transient hypertension followed by hypotension. Administration of prazosin (an alpha1 adrenoceptor antagonist; 100 microg kg(-1), i.v.) had no effect on the cardiovascular response to medetomidine (5 microg kg(-1), i.v.), but inhibited the cardiovascular response of methoxamine (an alpha1 adrenoceptor agonist; 75 microg kg(-1), i.v.). L-659,066 (an alpha2 adrenoceptor antagonist which does not cross the blood brain barrier; 264 microg kg(-1), i.v.) attenuated the medetomidine induced bradycardia, but had no effect on the cardiovascular response to methoxamine. L659,066 also reduced the medetomidine induced hypertension in sheep, but had less effect on the horse. It is concluded that both alpha1 and alpha2 adrenoceptors are important in the control of cardiovascular function in horses and sheep. Medetomidine appears to act on alpha2 adrenoceptors alone in the sheep. The cardiovascular effects of medetomidine in the horse are complex and may be influenced by central alpha2 adrenoceptor regulation or effects on other receptor subtypes as well as direct stimulation of peripheral alpha2 adrenoceptors.

Impairment of gas exchange due to alveolar oedema during xylazine sedation in sheep; absence of a free radical mediated inflammatory mechanism

We studied the mechanism of impairment of gas exchange following sedation with the alpha2 adrenoreceptor agonist, xylazine, in Suffolk cross-bred sheep spontaneously breathing room air. Xylazine caused a significant fall in PaO2 from a mean (pre-xylazine) of 97.9 mm Hg (6.7 mm Hg SEM) to a mean of 38.1 mm Hg (3.2 mm Hg SEM) one minute after injection with a transient increase in PaCO2 from a mean (pre-xylazine) of 32.6 mm Hg (1.9 mm Hg SEM) to a mean of 40.2 mm Hg (3.0 mm Hg SEM). There was no significant fall in mean arterial pressure or in white cell count. There was no significant change in a number of indices of free radical release which included ascorbyl radical, plasma antioxidant potential and alpha-tert-butyl phenyl nitrone (PBN) spin adduct measured simultaneously in both arterial and venous blood. In all sheep given xylazine there was no histological evidence of platelet emboli but lung histopathology showed evidence of pulmonary oedema and intense microvascular congestion with red cells extravasated into alveoli. No such histological changes were seen in the lungs of normal sheep. The impaired gas exchange during sedation with xylazine in sheep is caused, not by an oxidant mediated inflammatory mechanism or by platelet emboli, but by intense alveolar oedema which is probably due to pulmonary venospasm.

Anesthesia in sheep with propofol or with xylazine-ketamine followed by halothane

OBJECTIVE

This study evaluates the clinical usefulness and anesthetic effect of propofol, and compares these effects with those of xylazine-ketamine-halothane anesthesia in sheep.

STUDY DESIGN

Prospective, randomized, clinical trial.

ANIMALS OR SAMPLE POPULATION

Fourteen healthy adult male sheep.

METHODS

Sheep were randomly assigned to two different drug regimens: (1) Bolus injection of propofol (3 mg/kg, intravenously [i.v.]) followed by continuous intravenous infusion and (2) xylazine (0.11 mg/kg, i.v.) and ketamine (2.2 mg/kg, i.v.) for induction followed by halothane anesthesia. Heart rate, respiratory rate, and arterial blood pressures were monitored during anesthesia. Venous blood samples were collected for blood gas analysis. Quality of induction and recovery were also recorded.

RESULTS

The average dose of propofol used to induce and maintain anesthesia was 6.63 +/- 2.06 mg/kg and 29.3 +/- 11.7 mg/kg/hr (0.49 +/- 0.20 mg/kg/min), respectively. The duration of propofol anesthesia was 45.3 +/- 13.2 minutes and recovery to standing occurred in 14.7 +/- 5.7 minutes. Sheep receiving xylazine-ketamine-halothane were anesthetized for 35.9 +/- 4.0 minutes and recovery to standing occurred within 28.5 +/- 7.5 minutes. Sheep anesthetized with propofol had a significantly higher heart rate, diastolic blood pressure and Pvo2, and a lower Pvco2 at 30 minutes and lower BE at 15 and 30 minutes than sheep anesthetized with xylazine-ketamine-halothane.

CONCLUSIONS

Propofol anesthesia was characterized by a smooth induction, effective surgical anesthesia and rapid recovery which was comparable to anesthesia with xylazine-ketamine-halothane.

CLINICAL RELEVANCE

Propofol may be indicated in situations when it is desirable to maintain anesthesia with an intravenous infusion followed by a rapid recovery in healthy sheep.

General anesthetic techniques in ruminants

Sedation, anesthesia, protection of the airway during general anesthesia, and control of pain in the perioperative period are important considerations in the management of sheep, goats, and cattle. Though ruminants are classically considered farm animals and are often intended for the production of food and fiber, these species are used extensively in research and teaching and they are increasingly important as companion animals. Whatever their use may be, anesthetic and analgesic drugs and techniques should be used to ensure minimal stress and discomfort during the perioperative period.

Cardiopulmonary effects of medetomidine in sheep and in ponies

Medetomidine was administered intravenously to six sheep at 5, 10 and 20 micrograms kg-1 and to one horse and four ponies at 5 and 10 micrograms kg-1. In both species medetomidine resulted in significant decreases in heart rate and cardiac output and, initially, in an increase in arterial blood pressure. In the ponies this increase in blood pressure was followed by a significant and prolonged decrease, but in the sheep the secondary decrease in blood pressure was not statistically significant. In the sheep, the three doses of medetomidine resulted in profound and significant decreases in arterial oxygen tensions, which were significantly dose related, but in the ponies the arterial blood oxygen tensions were not significantly decreased. In both species medetomidine caused a small but significant increase in arterial blood carbon dioxide tensions.

The effect of xylazine on plasma thromboxane B2 concentration in sheep

alpha 2-adrenoceptor agonist drugs can cause respiratory changes leading to a short period of hypoxaemia in sheep. It has been suggested that this is due to transient platelet aggregation and pulmonary microembolism. If platelet aggregation were to follow platelet activation in response to the administration of alpha 2 agonists, plasma thromboxane levels would be expected to rise. This study was carried out to measure plasma thromboxane B2 concentrations before and after the intravenous administration of the alpha 2-agonist drug xylazine at a dose of 0.1 mg/kg. It was found that the plasma thromboxane concentration rose by 320% and, furthermore, the rise was prevented by the prior administration of atipamezole hydrochloride (0.125 mg/kg), an alpha 2-adrenoceptor antagonist.

The effect of xylazine epidural anaesthesia on blood gas and acid-base parameters in rams

The blood gas and acid-base effects of epidural xylazine were studied in rams. Xylazine at a dose of 0.4 mg kg-1 led to a metabolic alkalosis with a significant increase of pH, plasma bicarbonate and base excess and respiratory depression. Epidural administration of xylazine provided prolonged and very effective analgesia during abdominal and hindlimb surgery in rams.

The effect of xylazine on the isolated sheep trachea

The effect of xylazine on the isolated sheep trachea and its possible interactions with the alpha 2-adrenergic antagonist, atipamezole, and the anticholinergic agent, atropine, was studied. The mechanical responses of the tracheal preparations were recorded after exposing each one to cumulatively increasing concentrations of xylazine alone or in the presence of atipamezole or atropine. Xylazine exerted a concentration-dependent contractile effect, with a threshold concentration of 10(-7) M while the maximum activity was produced at a concentration of 10(-5) M (EC50 = 2.3 x 10(-7). This xylazine-induced contractile effect was inhibited by atipamezole, but not significantly modified by atropine. Thus, it is concluded that alpha 2-adrenoceptors exist in the sheep trachea and it is suggested that alpha 2-adrenoceptor agonists may act on airways in sheep directly through stimulation of peripheral alpha 2-adrenergic receptors and indirectly via central alpha 2-adrenergic receptor activation of parasympathetic tone.

Increased airway pressure in response to xylazine is inhibited by both atipamezole and atropine in sheep

The effect on airway pressure of xylazine alone or following the administration of atipamezole or atropine was studied in 31 halothane-anaesthetized sheep. Xylazine produced a significant increase in airway pressure which lasted for at least 30 min. This effect was inhibited by both atipamezole and atropine. The results suggest that the xylazine-induced increase in airway pressure in sheep is alpha 2-adrenergically mediated. Moreover, activation of central alpha 2-adrenoceptors leading to vagal stimulation may be involved.

Comparison of tiletamine-zolazepam-ketamine and tiletamine-zolazepam-ketamine-xylazine anaesthesia in sheep

The anaesthetic effects of intravenous tiletamine-zolazepam 6.6 mg/kg-ketamine 6.6 mg/kg (TK) and tiletamine-zolazepam 6.6 mg/kg-ketamine 6.6 mg/kg-xylazine 0.11 mg/kg (TKX) were evaluated in six wethers. Heart rate, respiration rate, arterial blood pressure, and the electrocardiogram were monitored during anaesthesia. Analgesia was tested by electrical stimulation in the left flank. Atropine (0.03 mg/kg) was given intramuscularly before induction, but after recording of baseline heart rate and respiratory rate. The duration of analgesia was 28.7 +/- 6.9 min with TK and 82.8 +/- 26.6 min with TKX. Heart rate increased significantly within 5 min after TK or TKX administration. Respiratory rate remained unchanged after TK administration, but increased significantly from 5 to 45 min after TKX administration. Arterial blood pressure decreased significantly at 15 min with TK and 30 min with TKX. Sheep remained recumbent for 201 min with TK and 166 min with TKX. All recovered uneventfully. We conclude that either TK or TKX may be used for anaesthetising sheep.

Ventilatory, hemodynamic and sedative effects of the alpha 2 adrenergic agonist, dexmedetomidine

Dexmedetomedine is a potent alpha 2 adrenergic agonist which can reduce anesthetic requirements by over 90% in rats and dogs. This study examined the effects of various doses of dexmedetomidine on the following monitored variables in New Zealand white rabbits: arterial blood gases, mean arterial pressure, respiratory rate, heart rate, and level of sedation. Following the percutaneous insertion of arterial and venous catheters, 21 rabbits received an infusion of saline or dexmedetomidine (20, 80 or 320 micrograms/kg). Monitored variables were recorded at 5, 15, 30 and 60 min following the infusion. Dexmedetomidine produced significant dose-dependent increases in PaCO2 and level of sedation. There were significant decreases in heart rate, PaO2 and respiratory rate. There was no significant change in mean arterial pressure even at the highest (320 micrograms/kg) dose. To examine the ability of an alpha 2 adrenergic antagonist to reverse the effects of dexmedetomidine, 5 rabbits initially received 320 micrograms/kg of dexmedetomidine as described above. Seven minutes after completion of the infusion, 900 micrograms/kg of the alpha 2 adrenergic antagonist, idazoxan, was administered. This resulted in a prompt and sustained reversal of the hypercarbia and sedation produced by the dexmedetomidine.

Alpha-2 adrenoreceptors mediate clonidine-induced hypoinsulinaemia in sheep

Insulin and glucose concentrations in the blood of sheep were measured before, and up to 7 h after, feeding. The patterns reported by other workers were confirmed, namely: an early insulin concentration peak and decline in glucose concentration and, later, more prolonged changes. Intravenous injection of clonidine (2 micrograms/kg or 5 micrograms/kg) just before offering food caused hypoinsulinaemia and hyperglycaemia, abolishing the normal patterns. Administration of idazoxan (0.1 mg kg-1), an alpha-2 adrenoreceptor antagonist, before a 2 micrograms/kg dose of clonidine, completely blocked the effects of clonidine. By contrast, with prior injection of prazosin (0.1 mg/kg), an alpha-1 adrenoreceptor antagonist, the hypoinsulinaemia in response to clonidine still occurred and the hyperglycaemia appeared to be enhanced. The antagonists injected alone had only slight effects: idazoxan caused a slight hypoglycaemia and prazosin a slight hyperglycaemia. The results indicate that clonidine causes hypoinsulinaemia and hyperglycaemia by action on alpha-2 receptors. Possible mechanisms are discussed.

Investigations into the effect of two sedatives on the stress response in cattle

The effects of the sedatives acepromazine (an alpha-adrenergic antagonist) and xylazine (an alpha 2-adrenergic agonist) on plasma indicators of stress in cows were assessed after intramuscular injection and transport. After blood samples had been taken for baseline values, nine cows were given an intramuscular injection of saline (2.5 ml), acepromazine (0.05 mg/kg in 2.5 ml) or xylazine (0.05 mg/kg in 2.5 ml) on different occasions at least 1 week apart. The animals were then transported for 5 min by truck to a different environment and blood sampled for a further 1-3 h. There was a significant increase in plasma cortisol concentration (3.29 +/- 1.59 x baseline) after the injection of saline and transport. The injection of acepromazine also resulted in a significant increase in cortisol concentration (2.84 +/- 0.84 x baseline). There was no similar increase after injection of xylazine. This suggests that alpha 2-adrenergic receptors are involved in the response of plasma cortisol concentrations to stressors. An hyperglycaemic response occurred after xylazine (1.66 +/- 0.49 x baseline) and saline (1.20 +/- 0.1 x baseline) but not after acepromazine. Both sedatives produced a metabolic alkalosis (1.13 +/- 0.01 x baseline pH after xylazine and 1.034 +/- 0.02 x baseline pH after acepromazine). A greater decrease in haematocrit was seen after both sedatives (0.88 +/- 0.04 x baseline after xylazine, 0.81 +/- 0.08 x baseline after acepromazine) than after the injection of saline (0.97 +/- 0.06 x baseline).

Anesthesia techniques in sheep and goats

A variety of techniques can be used to anesthetize and restrain sheep and goats safely and humanely both in the clinic and in the field. The use of inhalational, injectable, and local anesthetic agents is discussed. Nontraditional agents (opioids and alpha-2 adrenergic agonists) for epidural analgesia also are reviewed because of their promising clinical application.

The role of hypoxia in the hyperglycaemic effect of xylazine in sheep

Xylazine (0.2 mg/kg, i.v.) was administered to sheep breathing room air (group X) or oxygen (group XO). Xylazine induced a rise in serum glucose concentration which, following a sharp increase in the first 30 minutes, remained at similar high levels (about 165% of the pre-injection value) for another 2.5 hours. Arterial PCO2 was slightly increased and reached a significant level at 5 and 15 minutes following xylazine injection in group X. In group XO, at all sampling times after the injection, PaCO2 showed a similar pattern of increase, although the effect was not significant. Arterial PO2 was decreased significantly for at least 60 minutes. Hypoxia by itself can induce hyperglycaemia, but its prevention by administering oxygen did not alter the hyperglycaemic effect of xylazine. It was concluded that the hypoxia following administration of xylazine was not severe enough to produce a rise in catecholamine concentrations eliciting hyperglycaemia.

The cardiorespiratory effects of intrathecal xylazine in the conscious rabbit

The alpha 2 agonist xylazine produced a dose-dependent decrease in mean arterial blood pressure in conscious rabbits when injected intrathecally (i.t.) through a cannula previously implanted under general anaesthesia. Intrathecal administration of 200 and 400 micrograms of xylazine produced a significant reduction in arterial blood pressure from control values (maximum depressions of 25% and 33%, respectively). There was little effect on cardiac output and arterial carbon-dioxide tension and no effect on respiratory rate, arterial oxygen tension and pulse rate. Intrathecal injection of 100 microliters of 0.9% saline had no effect. Intravenous (i.v.) tolazoline (0.5 mg/kg) abolished xylazine-induced hypotension (200 micrograms) in four rabbits. Contrast radiography revealed that 100 microliters of solution injected i.t. in anaesthetized rabbits spread distally over eight vertebral spaces. There was little rostral spread. It was concluded that xylazine-induced hypotension following i.t. injection was due to local activation of alpha 2 adrenoceptors present in the thoracic spinal cord. It is postulated that spinal alpha 2 adrenoceptors may play an important role in the hypotension recorded in animals after parenteral injection of xylazine.

Regulation of bronchomotor tone in conscious calves

The purpose of this study was to investigate the effects of some alpha and beta sympathomimetic and sympatholytic drugs on respiratory impedance in healthy conscious calves. Ten Friesian calves were investigated in this study. The forced oscillation technique was used to measure the resistance (Rrs) and the reactance (Xrs) of the respiratory system at frequencies ranging from 4 to 26 Hz. Isoprenaline (1 microgram/kg i.v.), propranolol (3 micrograms/kg i.v.), noradrenaline (2 micrograms/kg i.v.), xylazine (20 micrograms/kg i.v.) and yohimbine (0.25 mg/kg i.v.) were were administered. Isoprenaline induced a significant decrease of Rrs. An increase of Rrs after administration of propranolol was observed but without any change of the frequency dependence of Rrs. A small increase in the resonant frequency was also recorded. A decrease of Rrs was recorded after yohimbine injection. Noradrenaline and xylazine administration increased the resistances and the resonant frequency and induced a negative frequency dependence of Rrs. These results suggest that (1) the major effects of beta adrenergic drugs are on the central airways, (2) the alpha adrenergic system may play a role on the regulation of bronchomotor tone in calves, (3) the effects of alpha adrenergic drugs are on both central and peripheral airways and (4) the forced oscillation technique allows the differentiation of calibre changes occurring in small and large airways.

Effects of xylazine and acepromazine on bronchomotor tone of anaesthetised ponies

The effects of xylazine (an alpha 2-adrenoceptor agonist) and acepromazine (an alpha-adrenoceptor antagonist) on bronchomotor tone were investigated in seven anaesthetised, apnoeic ponies using a computer aided forced oscillation technique, which separates changes in bronchial calibre from changes in lung volume. Both agents produced bronchodilatation and a decrease in lung volume.