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Haralambus R, Juri M, Mokry A, Jenner F. The impact of opioid administration on the incidence of postanaesthetic colic in horses. FRONTIERS IN PAIN RESEARCH 2024; 5:1347548. [PMID: 38440199 PMCID: PMC10910105 DOI: 10.3389/fpain.2024.1347548] [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: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
Effective management of postoperative pain is essential to ensure patient welfare, reduce morbidity and optimize recovery. Opioids are effective in managing moderate to severe pain in horses but concerns over their adverse effects on gastrointestinal (GI) motility and associated increased colic risk limit their widespread use. Studies investigating the impact of systemic opioids on both GI motility and colic incidence in horses have yielded inconclusive outcomes. Therefore, this retrospective study aims to assess the influence of systemic administration of butorphanol, morphine, and methadone on post-anaesthetic colic (PAC) incidence. Horses undergoing general anaesthesia for non-gastrointestinal procedures that were hospitalized for at least 72 h post-anaesthesia were included in this study. Anaesthetised horses were stratified by procedure type into horses undergoing diagnostic imaging without surgical intervention, emergency or elective surgery. In addition, patients were grouped by opioid treatment regime into horses receiving no opioids, intraanaesthetic, short- (<24 h) or long-term (>24 h) postoperative opioids. Administered opioids encompassed butorphanol, morphine and methadone. The number of horses showing signs of colic in the 72 h after anaesthesia was assessed for each group. A total of 782 horses were included, comprising 659 undergoing surgical procedures and 123 undergoing diagnostic imaging. The overall PAC incidence was 15.1%. Notably, horses undergoing diagnostic imaging without surgery had a significantly lower PAC rate of 6.5% compared to those undergoing surgery (16.7%, p = 0.0146). Emergency surgeries had a significantly lower PAC rate of 5.8% compared to elective procedures (18%, p = 0.0113). Of the 782 horses, 740 received intraoperative opioids and 204 postoperative opioids, 102 of which long-term (≥24 h). Neither intraoperative (p = 0.4243) nor short-term postoperative opioids (p = 0.5744) increased PAC rates. Notably, only the long-term (≥24 h) administration of morphine significantly increased PAC incidence to 34% (p = 0.0038). In contrast, long-term butorphanol (5.3% PAC, p = 0.8482) and methadone (18.4% PAC, p = 0.6161) did not affect PAC rates. In summary, extended morphine administration was the only opioid treatment associated with a significantly increased risk of PAC.
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Affiliation(s)
- Rhea Haralambus
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | | | - Florien Jenner
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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Jodzio D, DeNotta S, Plummer C, Sanchez C. Pain scoring systems in hospitalized horses with ocular disease. J Vet Intern Med 2024; 38:388-397. [PMID: 37982362 PMCID: PMC10800174 DOI: 10.1111/jvim.16933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 10/26/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Pain recognition in hospitalized horses is challenging, and the utility of pain scoring systems in horses with ocular disease has not been well-described. HYPOTHESIS/OBJECTIVES Evaluate the horse grimace scale (HGS) and behavior pain score (BPS) in hospitalized horses with ocular disease. We hypothesized that HGS and BPS would be associated with different clinical progressions. ANIMALS Privately owned horses hospitalized for ocular disease between September 2018 and September 2020. METHODS Retrospective observational study. The HGS and BPS were recorded daily throughout hospitalization. Clinical progressions were categorized as: (a) discharge from hospital after medical treatment, (b) ophthalmic surgery (eg, keratectomy, conjunctival flap, amniotic membrane transplantation, corneal transplant), or (c) enucleation. Temporal trends in HGS and BPS were assessed using linear regression. Correlations among slope, intercept, and progression were determined using the Kruskal-Wallis test. RESULTS Of 65 horses that met inclusion criteria, 29 (45%) were discharged after exclusively medical management, 28 (43%) underwent ophthalmic surgery, and 8 (12%) underwent enucleation. Two horses (3%) had 2 ophthalmic surgeries performed. The BPS scores at admission were higher in horses that were managed medically than in those that underwent enucleation (P = .01). Horses requiring enucleation had higher increases in HGS (P = .02) and BPS (P = .01) during hospitalization than horses that were medically managed and a higher increase in BPS (P = .04) than horses that required ophthalmic surgery. CONCLUSIONS AND CLINICAL IMPORTANCE Pain scoring may represent a useful tool for monitoring progression and response to treatment in hospitalized horses with ocular disease.
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Affiliation(s)
- Dayna Jodzio
- Department of Large Animal Clinical SciencesUniversity of Florida College of Veterinary MedicineGainesvilleFloridaUSA
| | - Sally DeNotta
- Department of Large Animal Clinical SciencesUniversity of Florida College of Veterinary MedicineGainesvilleFloridaUSA
| | - Caryn Plummer
- Department of Large Animal Clinical SciencesUniversity of Florida College of Veterinary MedicineGainesvilleFloridaUSA
- Department of Small Animal Clinical SciencesUniversity of Florida College of Veterinary MedicineGainesvilleFloridaUSA
| | - Chris Sanchez
- Department of Large Animal Clinical SciencesUniversity of Florida College of Veterinary MedicineGainesvilleFloridaUSA
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Ortega McCormack JJ, Reed RA, Epstein KL, Camus MS, Knych HK. Longitudinal evaluation of fentanyl concentrations in equine plasma and synovial fluid following application of transdermal fentanyl patches over one carpal joint. Vet Surg 2023; 52:1150-1157. [PMID: 37537748 DOI: 10.1111/vsu.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/12/2023] [Accepted: 06/18/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To determine if transdermally delivered fentanyl can achieve greater concentrations of fentanyl in synovial fluid when applied over a synovial structure. STUDY DESIGN Randomized, experimental study. ANIMALS Six healthy adult horses. METHODS Each horse had two 100 μg/h fentanyl matrix patches applied on the dorsal aspect of one, randomly assigned, carpometacarpal joint (CMCJ) for 48 h. Whole blood and bilateral synovial samples from the intercarpal joint were obtained at 0, 2, 6, 12, 24, 36 and 48 h. Fentanyl concentrations were measured with liquid chromatography-mass spectrometry. RESULTS All subjects achieved detectable concentrations of fentanyl in both plasma and synovial fluid. Time to peak synovial and plasma concentration was 12 h. At 6 h, the synovial concentration in the untreated carpus (0.104 ng/mL ± 0.106) was lower than plasma fentanyl concentrations 0.31 ± 0.27 (p = .036). At 12 h, both treated (0.55 ng/mL ± 0.3) and untreated (0.53 ng/mL ± 0.28) synovial fluid fentanyl concentrations were lower than plasma (0.87 ng/mL ± 0.48) concentrations (p < .001 and p = .001, respectively). Synovial concentrations of fentanyl did not differ between treated and untreated joints (p > 0.608 for all time points). CONCLUSION Application of fentanyl matrix patches directly over the CMCJ did not result in increased fentanyl concentrations in the synovial fluid of the treated intercarpal joint in normal horses. CLINICAL SIGNIFICANCE There is likely no analgesic advantage to placing fentanyl patches directly over the affected joint, as it did not result in increased synovial concentrations at the tested site.
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Affiliation(s)
- John J Ortega McCormack
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Rachel A Reed
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Kira L Epstein
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Melinda S Camus
- Department of Pathobiology, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Heather K Knych
- KL Maddy Equine Analytical Pharmacology Lab, University of California, Davis, California, USA
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Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses. Animals (Basel) 2021; 11:ani11102922. [PMID: 34679943 PMCID: PMC8532720 DOI: 10.3390/ani11102922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
Controversy continues to surround the use of opioids in equine anaesthesia, with variable effects reported. This blinded clinical study aimed to investigate the influence of a low-dose fentanyl continuous rate infusion (CRI) on isoflurane requirements, parasympathetic tone activity (PTA), and anaesthetic parameters in horses during general anaesthesia. All of the twenty-two horses included in the research underwent a standard anaesthetic protocol. Eleven horses in the fentanyl group (Group F) received a loading dose of fentanyl at 6 µg/kg, followed by a CRI of 0.1 µg/kg/min during anaesthesia. A further 11 horses in the control group (Group C) received equivalent volumes of normal saline. Anaesthetic parameters and PTA index were recorded during anaesthesia. The achieved mean fentanyl plasma concentration was 6.2 ± 0.83 ng/mL. No statistically significant differences between groups were found in isoflurane requirements, MAP values, and mean dobutamine requirements. However, horses in Group F required a significantly lower dose of additional ketamine to maintain a sufficient depth of anaesthesia. Significantly higher PTA values were found in the fentanyl group. Further research is warranted to determine the limitations of PTA monitoring, and the influence of various anaesthetics on its values.
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Skrzypczak H, Reed R, Barletta M, Quandt J, Sakai D. A retrospective evaluation of the effect of perianesthetic hydromorphone administration on the incidence of postanesthetic signs of colic in horses. Vet Anaesth Analg 2020; 47:757-762. [PMID: 32830037 DOI: 10.1016/j.vaa.2020.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe the incidence of postanesthetic signs of colic (PASC) in horses and determine if perianesthetic administration of hydromorphone was associated with an increased risk of PASC. STUDY DESIGN Retrospective, cohort study. ANIMALS A total of 409 horses. METHODS Anesthesia and clinical records of horses admitted for various procedures from July 2018 to September 2019 were reviewed. Signs of colic and interventions were recorded up to 48 hours after anesthesia. A binomial logistic regression model was used to evaluate the association between the type of surgery, administration of hydromorphone, the duration of anesthesia and the incidence of PASC. RESULTS Overall, 25 (6.1%) horses developed PASC within 48 hours of general anesthesia. Of 60 horses that underwent colic surgery, 16 (26.7%) developed PASC. Of 349 horses that underwent noncolic procedures, nine (2.6%) developed PASC. Thus, the incidence of PASC was higher in horses that underwent colic surgery than in horses that underwent noncolic procedures [odds ratio (OR) = 13.74 (5.73-32.95)]. No effect of hydromorphone on the incidence of PASC was identified [OR = 1.61 (0.71-3.62)]. Longer procedures (>2 hours) were identified as an independent risk factor for PASC [OR = 4.13 (1.52-11.22)]. CONCLUSIONS No association between hydromorphone and an increase in the incidence of PASC was identified. Anesthesia for colic surgery and duration of anesthesia were associated with an increased risk of PASC. CLINICAL RELEVANCE Hydromorphone did not increase the incidence of PASC in this population.
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Affiliation(s)
- Heather Skrzypczak
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - Rachel Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jane Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Daniel Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Küls N, Trujanovic R, Otero PE, Larenza-Menzies MP. Ultrasound-Guided Transversus Abdominis Plane Block in Shetland Ponies: A Description of a Three-Point Injection Technique and Evaluation of Potential Analgesic Effects. J Equine Vet Sci 2020; 90:102994. [PMID: 32534772 DOI: 10.1016/j.jevs.2020.102994] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/03/2020] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
Abstract
Colic surgery is one of the most painful procedures carried out in horses. Common strategies to alleviate immediate postsurgical abdominal pain include the administration of potent systemic analgesics; however, these may cause unwanted adverse effects such as cardiovascular depression, ileus, and ataxia. The administration of local anesthetics at the incision site in form of an ultrasound-guided subcostal transversus abdominis plane (TAP) block may therefore be preferred to provide adequate analgesia without significant side effects. To date, no technique for a TAP block in horses undergoing median celiotomy has been described. The objective of the study was to develop a TAP block technique, which will lead to the desensitization of the ventrolateral abdominal wall and adjacent skin area of experimental Shetland Ponies using bupivacaine 0.125%. This is a prospective, blinded, self-controlled trial. A cadaver study was performed to determine the ideal injection points and the volume required to stain the nerves responsible for the sensation of the ventrolateral abdominal wall and skin in Shetland pony cadavers (i.e., T9-L 2). Subsequently, using the ideal injectate volume and the landmarks obtained in the first phase of the study, six Shetland ponies received a bilateral TAP injection, either with a local anesthetic solution (bupivacaine 0.125%) or with saline in a randomized, crossover, blinded fashion. Effectiveness was determined over a 4 hour postinjection time, by using a pinprick technique. Significant differences were found to the responses of the pinprick evaluation between the bupivacaine- and saline-treated sides after 30 minutes of TAP block injection. Reported "learned behavior" could have affected the results of the pinprick testing. The TAP block technique reported in this study using bupivacaine 0.125% appeared effective in desensitizing the lower abdomen of ponies for up to 2 hours. Further research is required to apply this technique in horses undergoing celiotomy. Potentially larger volumes and/or higher concentrations of bupivacaine may be necessary to provide longer duration of action of the block.
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Affiliation(s)
- Nina Küls
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria.
| | - Robert Trujanovic
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria
| | - Pablo E Otero
- Department of Anaesthesiology, Faculty of Veterinary Medicine, University of Buenos Aires, Argentina
| | - M Paula Larenza-Menzies
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria
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Louro LF, Fernández‐Flores FF, Bautista OD, Senior M. Postanaesthetic brachial compartmental syndrome in a horse. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-000974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Luís Filipe Louro
- Equine Clinical ScienceUniversity of Liverpool Institute of Veterinary ScienceLiverpoolUK
| | | | | | - Mark Senior
- Equine Clinical ScienceUniversity of Liverpool Institute of Veterinary ScienceLiverpoolUK
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Bowen IM, Redpath A, Dugdale A, Burford JH, Lloyd D, Watson T, Hallowell GD. BEVA primary care clinical guidelines: Analgesia. Equine Vet J 2020; 52:13-27. [PMID: 31657050 DOI: 10.1111/evj.13198] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 10/18/2019] [Indexed: 02/07/2023]
Abstract
Primary care guidelines provide a reference point to guide clinicians based on a systematic review of the literature, contextualised by expert clinical opinion. These guidelines develop a modification of the GRADE framework for assessment of research evidence (vetGRADE) and applied this to a range of clinical scenarios regarding use of analgesic agents. Key guidelines produced by the panel included recommendations that horses undergoing routine castration should receive intratesticular local anaesthesia irrespective of methods adopted and that horses should receive NSAIDs prior to surgery (overall certainty levels high). Butorphanol and buprenorphine should not be considered appropriate as sole analgesic for such procedures (high certainty). The panel recommend the continuation of analgesia for 3 days following castration (moderate certainty) and conclude that phenylbutazone provided superior analgesia to meloxicam and firocoxib for hoof pain/laminitis (moderate certainty), but that enhanced efficacy has not been demonstrated for joint pain. In horses with colic, flunixin and firocoxib are considered to provide more effective analgesia than meloxicam or phenylbutazone (moderate certainty). Given the risk of adverse events of all classes of analgesic, these agents should be used only under the control of a veterinary surgeon who has fully evaluated a horse and developed a therapeutic, analgesic plan that includes ongoing monitoring for such adverse events such as the development of right dorsal colitis with all classes of NSAID and spontaneous locomotor activity and potentially ileus with opiates. Finally, the panel call for the development of a single properly validated composite pain score for horses to allow accurate comparisons between medications in a robust manner.
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Affiliation(s)
- I M Bowen
- Oakham Veterinary Hospital/University of Nottingham, Sutton Bonington, Loughborough, UK
| | - A Redpath
- Oakham Veterinary Hospital/University of Nottingham, Sutton Bonington, Loughborough, UK
| | - A Dugdale
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - J H Burford
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - D Lloyd
- ChesterGates Veterinary Specialists, Chester, UK
| | - T Watson
- Waterlane Equine Vets, Stroud, UK
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Crabtree NE, Mochal-King CA, Sloan PB, Eddy AL, Wills RW, Meredith AN, Fontenot RL. Synovial butorphanol concentrations and mechanical nociceptive thresholds after intravenous regional limb perfusion in standing sedated horses. Vet Surg 2019; 48:1473-1482. [PMID: 31513300 DOI: 10.1111/vsu.13309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 07/05/2019] [Accepted: 07/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine synovial butorphanol concentrations and mechanical nociceptive threshold (MNT) changes after butorphanol intravenous regional limb perfusion (IVRLP). STUDY DESIGN Experimental ANIMALS: Six adult horses. METHODS Cephalic IVRLP was performed with 10 mg butorphanol in sedated horses with a wide rubber tourniquet and a total volume of 30 mL. Radiocarpal synovial fluid and serum concentrations along with MNT were evaluated prior to and 0.5, 1, 2, 4, and 6 hours after IVRLP. Butorphanol concentrations were determined with liquid chromatography coupled to tandem mass spectrometry positive electrospray ionization. RESULTS Butorphanol concentrations reached mean (SD) peak concentrations of 9.47 ng/mL (±12.00) in synovial fluid and 3.89 ng/mL (3.29) in serum 30 minutes after IVRLP. Concentrations remained above baseline for 4 hours in synovial fluid (P ≤ .017) and for 2 hours in serum (P ≤ .016). The only difference in MNT was detected 1 hour after IVRLP, when MNT were higher in controls than in treated horses (P = .047). CONCLUSION Butorphanol IVRLP seemed well tolerated and resulted in measurable levels of butorphanol in the radiocarpal synovial fluid of five of six horses. CLINICAL SIGNIFICANCE Intravenous regional limb perfusion appears to be a viable alternative to administer butorphanol, but additional investigation is required to evaluate the dose and local concentrations required for analgesia.
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Affiliation(s)
- Naomi E Crabtree
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Cathleen A Mochal-King
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Pearce B Sloan
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Alison L Eddy
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Robert W Wills
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Ashley N Meredith
- Mississippi State Chemical Laboratory, Mississippi State University, Mississippi State, Mississippi
| | - Robin L Fontenot
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
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Curtis L, Burford JH, England GCW, Freeman SL. Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes. PLoS One 2019; 14:e0219307. [PMID: 31295284 PMCID: PMC6622499 DOI: 10.1371/journal.pone.0219307] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/20/2019] [Indexed: 12/20/2022] Open
Abstract
Acute abdominal pain (colic) is the most common reason for emergency veterinary treatment in the horse. Consolidation of data through a systematic review is important to inform evidence-based medicine and clinical guidelines, but there are currently no published systematic reviews on colic in the horse. The aim of this study was to identify, categorize and appraise the evidence on factors associated with increased risk of developing abdominal pain (colic) due to gastrointestinal disease in the adult horse. A scoping review was performed to identify and categorize evidence on all risk factors for colic. A systematic review of management-related risk factors was then performed following PRISMA guidelines. Both searches were conducted in Medline, CAB Abstracts and Web of Science databases, and publications were assessed against inclusion and exclusion criteria. For the scoping review, study and participant characteristics of included publications and key results were extracted and tabulated. For the systematic review, cohort, case-control or cross-sectional studies investigating acute abdominal pain in horses within two weeks of management changes were assessed. Study characteristics, participant characteristics and study results of included publications for the systematic review were extracted and tabulated. Included publications were appraised using the Joanna Briggs Institute Critical Appraisal Tools for cohort, case-control and cross-sectional studies. The scoping review search identified 3,756 publications. Fifty eight studies met final inclusion criteria, and 22 categories of risk factors were identified. These were grouped into three broad areas: horse-related factors, management-related factors and environment-related factors. The largest body of evidence related to management change. The systematic review of management change identified 410 publications: 14 met inclusion criteria for analysis. These consisted of one cohort, eight case-control and five cross-sectional studies. The studies were conducted between 1990-2008, and the majority of studies were located in the USA (8/14) or UK (3/14). The risk factors related to management change that were assessed were feed, carer, exercise, pasture, water and housing. The largest bodies of evidence for increased risk of colic associated with management change were changes in feed (5/14 publications) and recent change in housing (3/14). Most studies (8/14) did not meet the JBI criterion on confounding factors. There was marked heterogeneity of study methodologies and measures. This is the first study to use a combined scoping and systematic review to analyse evidence for modifiable risk factors for a common condition in the horse. It provides a comprehensive review that will be a key resource for researchers, veterinary practitioners and horse owners. It identified modifiable risk factors associated with an increased risk of colic which should be a key target for preventative health programmes. The findings from the critical appraisal were used to develop recommendations for future research to improve the quality of evidence-based veterinary medicine.
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Affiliation(s)
- Laila Curtis
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom
| | - John H. Burford
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom
| | - Gary C. W. England
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom
| | - Sarah L. Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom
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Bruniges N, Milner P, Bardell D. The use of multimodal analgesia in the management of suspected extremity compartment syndrome in the pelvic limb of a horse. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- N. Bruniges
- Institute of Veterinary Sciences University of Liverpool Leahurst Cheshire UK
| | - P. Milner
- Institute of Veterinary Sciences University of Liverpool Leahurst Cheshire UK
| | - D. Bardell
- Institute of Veterinary Sciences University of Liverpool Leahurst Cheshire UK
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Thibault CJ, Wilson DV, Robertson SA, Sharma D, Kinsley MA. A retrospective study of fecal output and postprocedure colic in 246 horses undergoing standing sedation with detomidine, or general anesthesia with or without detomidine. Vet Anaesth Analg 2019; 46:458-465. [PMID: 31196750 DOI: 10.1016/j.vaa.2019.03.006] [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: 08/28/2018] [Revised: 03/18/2019] [Accepted: 03/25/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine time to first passage of feces, total fecal piles and incidence of colic in the first 24 hours postprocedure in horses undergoing standing sedation with detomidine, or general anesthesia with or without detomidine. STUDY DESIGN Retrospective cohort study. ANIMALS A total of 246 horses. METHODS Records of all horses that underwent standing sedation or general anesthesia between December 2012 and March 2016 were reviewed. Horses aged <6 months, admitted for colic or cesarean section, with inadequate data, and those not administered xylazine and/or detomidine were excluded. Records included patient signalment, fasting duration, procedure performed, drugs administered, time to first feces, number of fecal piles during 24 hours postprocedure and mention of colic. Chi-square, Fisher's exact and Tukey's post hoc comparison tests were used. Parametric data were reported as mean ± standard deviation with significance defined as p <0.05. RESULTS In total, 116 and 57 horses underwent general anesthesia without detomidine (group GA) and with detomidine (group GA-D), respectively, and remaining 73 horses underwent standing sedation with detomidine (group S-D). Detomidine dose was significantly higher in group S-D than in group GA-D. Time to first feces was longer (7.1 ± 4.2 hours), and group S-D horses passed one fewer fecal pile (6.3 ± 2.4) than group GA horses. There was no interaction between detomidine treatment and preprocedure food withholding and the time to first feces or the number of fecal piles in the first 24 hours postprocedure. Overall, seven horses (2.8%) showed signs of colic (five, one and one in GA, GA-D and S-D, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Detomidine administration, as part of an anesthetic protocol or for standing sedation procedures, should not be expected to contribute to postprocedural colic.
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Affiliation(s)
- Christopher J Thibault
- Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Deborah V Wilson
- Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
| | | | - Dhruv Sharma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, USA
| | - Marc A Kinsley
- Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
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Tessier C, Pitaud JP, Thorin C, Touzot-Jourde G. Systemic morphine administration causes gastric distention and hyperphagia in healthy horses. Equine Vet J 2019; 51:653-657. [PMID: 30835841 DOI: 10.1111/evj.13090] [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: 10/09/2017] [Accepted: 02/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are no data investigating the effect of systemic morphine on the size of the stomach or the food consumption in horses. OBJECTIVES To evaluate gastrointestinal side effects of morphine administered systemically in healthy horses by the means of clinical and ultrasonographic evaluations. STUDY DESIGN In vivo experiment. METHODS On day 1 of the experiment, six healthy French Trotter mares were evaluated clinically and an abdominal ultrasonography was performed three times 4 h apart to record the size of the stomach, the number of contractions per minute of the duodenum, jejunum, caecum, left and right ventral colons. On Day 2, morphine was administered three times 4 h apart at the dose of 0.1 mg/kg i.v. and the same ultrasonographic examinations performed. On Day 3, only clinical and ultrasonographic examinations were performed as on Day 1. Amounts of hay and water ingested, frequency and weight of faeces were recorded throughout the study. RESULTS Number of contractions of the duodenum, caecum, left and right ventral colons were significantly decreased after morphine administration. Size of the stomach was increased significantly with a cumulative effect of repeated doses of morphine. Hay (+0.4 kg/h, P<0.001) and water (+1.1 L/h, P<0.001) consumption were significantly increased. MAIN LIMITATIONS The study was performed in healthy horses. CONCLUSIONS Systemic morphine administration causes gastrointestinal depression, gastric distention and hyperphagia in horses. Clinical and ultrasonographical examinations are valuable tools to identify side effects of morphine administration in horses. Further studies are needed to assess side effects and monitoring in clinically painful cases. Horses receiving systemic morphine administration should be closely monitored for signs of gastric distention and, specifically, the amount of food given while receiving treatment should be controlled to avoid complications.
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Affiliation(s)
- C Tessier
- ONIRIS-Ecole Nationale Vétérinaire de Nantes, Equine Hospital, Nantes Cedex, France
| | - J-P Pitaud
- Clinique Vétérinaire des Faluns, Saint Grégoire, France
| | - C Thorin
- Department of Animal Physiopathology and Physiology, ONIRIS-Ecole Nationale Vétérinaire de Nantes, Nantes Cedex, France
| | - G Touzot-Jourde
- Department of Anesthesia and Analgesia, ONIRIS-Ecole Nationale Vétérinaire de Nantes, Nantes Cedex, France
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Curto EM, Griffith EH, Posner LP, Walsh KT, Balko JA, Gilger BC. Factors associated with postoperative complications in healthy horses after general anesthesia for ophthalmic versus non-ophthalmic procedures: 556 cases (2012-2014). J Am Vet Med Assoc 2019; 252:1113-1119. [PMID: 29641332 DOI: 10.2460/javma.252.9.1113] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare complications between healthy horses undergoing general anesthesia for ophthalmic versus non-ophthalmic procedures and identify potential risk factors for the development of complications. DESIGN Retrospective case series. ANIMALS 502 horses (556 anesthetic procedures). PROCEDURES Medical records from January 2012 through December 2014 were reviewed to identify horses undergoing general anesthesia. Signalment, body weight, drugs administered, patient positioning, procedure type (ophthalmic, orthopedic, soft tissue, or diagnostic imaging), specific procedure, procedure time, anesthesia time, recovery time, recovery quality, and postoperative complications were recorded. RESULTS Patients underwent general anesthesia for ophthalmic (n = 106), orthopedic (246), soft tissue (84), diagnostic imaging (110), or combined (10) procedures. Mean procedure, anesthesia, and recovery times were significantly longer for patients undergoing ophthalmic versus non-ophthalmic procedures. Excluding diagnostic imaging procedures, there was a significant positive correlation between surgery time and recovery time. Within ophthalmic procedures, surgery time, anesthesia time, and recovery time were significantly greater for penetrating keratoplasty versus other ophthalmic procedures. There was a significantly higher rate of postoperative colic following penetrating keratoplasty, compared with all other ophthalmic procedures. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in healthy horses, duration of general anesthesia should be minimized to decrease the risk of postanesthetic complications. Judicious use of orally administered fluconazole is recommended for horses undergoing general anesthesia. For horses undergoing a retrobulbar nerve block during general anesthesia, use of the lowest effective volume is suggested.
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Secor EJ, Gutierrez-Nibeyro SD, Clark-Price SC. Comparison of complication rates following elective arthroscopy performed as inpatient versus outpatient surgery in horses. J Am Vet Med Assoc 2018; 253:346-354. [DOI: 10.2460/javma.253.3.346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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O'Brien EJO, Biggi M, Eley T, Fiske-Jackson AR, Smith KC, Chesworth M, Civello A, Smith RKW. Third tarsal bone osteonecrosis associated with chronic recurrent cellulitis in an adult horse. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- E. J. O. O'Brien
- Department of Clinical Sciences and Services; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - M. Biggi
- Department of Clinical Sciences and Services; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - T. Eley
- Department of Pathobiology and Population Sciences; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - A. R. Fiske-Jackson
- Department of Clinical Sciences and Services; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - K. C. Smith
- Department of Pathobiology and Population Sciences; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - M. Chesworth
- Department of Clinical Sciences and Services; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - A. N. Civello
- Department of Pathobiology and Population Sciences; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
| | - R. K. W. Smith
- Department of Clinical Sciences and Services; The Royal Veterinary College; University of London; North Mymms Hatfield Hertfordshire UK
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Affiliation(s)
| | - E. J. Love
- School of Veterinary Sciences University of Bristol Bristol UK
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Scherrer NM, Lassaline M, Richardson DW, Stefanovski D. Interval prevalence of and factors associated with colic in horses hospitalized for ocular or orthopedic disease. J Am Vet Med Assoc 2017; 249:90-5. [PMID: 27308887 DOI: 10.2460/javma.249.1.90] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine interval (1-year) prevalence of and factors associated with colic in horses hospitalized for ocular or orthopedic disease. DESIGN Cross-sectional study. ANIMALS 105 horses with ocular disease and 197 horses with orthopedic disease admitted to a veterinary teaching hospital between July 1, 2011, and June 30, 2012. PROCEDURES Medical records were reviewed to determine whether colic (abnormal behavior prompting abdominal palpation per rectum or nasogastric intubation) was observed during hospitalization. Data were collected on putative risk factors for colic, including reason for admission, signalment, and medical or surgical interventions received. RESULTS No significant difference in interval prevalence of colic was identified between horses with ocular disease (8/105 [8%]) or orthopedic disease (9/197 [5%]). However, horses with ocular disease differed significantly from other horses in median age (10 vs 3 years, respectively); proportions of sexually intact males (3% vs 30%), Thoroughbreds (28% vs 62%), and those receiving general anesthesia (65% vs 80%); and median duration of hospitalization (3 vs 2 days). For every 1 mg/kg increase in daily NSAID dose, the odds of colic increased by 98%. No difference between groups was identified in median duration of colic (1 day), hospitalization (7 vs 3 days), or systemic NSAID administration (7 vs 5 days). Colic in both groups resolved with medical management for all but 1 horse with ocular disease. CONCLUSIONS AND CLINICAL RELEVANCE Horses hospitalized for ocular disease were at no greater odds for colic than were horses hospitalized for orthopedic disease. Medical management of colic appeared adequate for most horses.
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Affiliation(s)
- C. Mackenzie
- Institute of Veterinary Science; Department of Equine Clinical Science; The University of Liverpool; Neston Cheshire UK
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21
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Dönselmann Im Sande P, Hopster K, Kästner S. [Effects of morphine, butorphanol and levomethadone in different doses on thermal nociceptive thresholds in horses]. Tierarztl Prax Ausg G Grosstiere Nutztiere 2017; 45:98-106. [PMID: 28075433 DOI: 10.15653/tpg-160655] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/14/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Various opioids are available for use in equine medicine. Studies directly comparing their analgesic effects and side effects are rare. Therefore, the aim of this study was to compare the antinociceptive effect and the duration of analgesia of two different doses of morphine, butorphanol and levomethadone in horses. MATERIAL AND METHODS Eight adult, healthy horses were used for this randomized, placebo-controlled, blinded cross-over trail. Each horse received placebo (P = 0.9% saline) and morphine (M0.1 = 0.1 mg/kg; M0.2 = 0.2 mg/kg), butorphanol (B0.1 = 0.1 mg/kg; B0.2 = 0.2 mg/kg) and levomethadone (L0.1 = 0.1 mg/kg; L0.2 = 0.2 mg/kg) in a low and a high dose and with a wash-out period of 14 days. Thermal thresholds were determined by incremental contact heat applied to the skin at the withers. Single stimulations were performed 15 minutes prior and 10, 30, 60, 90, 120, 180, 240, 300, 360, 420, 540 and 1350 minutes after treatment. Threshold values, gastrointestinal auscultation score and horses' behavior were recorded. Data were analyzed with analysis of variance for repeated measurements (p < 0.05). RESULTS In group M0.1, changes in thermal thresholds did not reach significance. Thermal threshold increased significantly in the groups M0.2, B0.1, B0.2, L0.1 and L0.2 for 240, 90, 90, 60 and 300 minutes, respectively. Behavioural changes, increased locomotion and decreased bowel sounds as well as delayed time until defecation were noticed in all groups. CONCLUSIONS Levomethadone induced a dose-dependent increase and prolongation of analgesia, whereas with butorphanol there was no difference between dosages regarding duration and intensity of analgesia. Morphine provided detectable analgesia only in the high dose of 0.2 mg/kg. CLINICAL RELEVANCE Levomethadone and morphine in the low dose (0.1 mg/kg) produced only minor and short lived anti-nociception and further studies are necessary to give a profound dose recommendation for the use of these drugs in horses.
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Affiliation(s)
| | | | - Sabine Kästner
- Prof. Dr. Sabine Kästner, Klinik für Pferde, Tierärztliche Hochschule Hannover, Bünteweg 9, 30559 Hannover, E-Mail:
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Borland KJ, Shaw DJ, Clutton RE. Time-related changes in post-operative equine morbidity: A single-centre study. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. J. Borland
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; Roslin UK
| | - D. J. Shaw
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; Roslin UK
| | - R. E. Clutton
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; Roslin UK
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Raftery AG, Morgan RA, MacFarlane PD. Perioperative trends in plasma colloid osmotic pressure in horses undergoing surgery. J Vet Emerg Crit Care (San Antonio) 2015; 26:93-100. [PMID: 26397385 DOI: 10.1111/vec.12369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 01/31/2014] [Accepted: 07/24/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To compare perioperative trends in plasma colloid osmotic pressure (COP) between horses undergoing orthopedic and colic surgery. DESIGN Prospective clinical study September 2009-January 2011. SETTING Veterinary university teaching hospital. ANIMALS Thirty-three healthy, client-owned horses presenting for orthopedic surgery (non-GI) and 85 client-owned horses presenting for emergency exploratory celiotomy (GI, gastrointestinal). INTERVENTIONS None. MEASUREMENTS Data relating to the horse's parameters on presentation, surgical lesion, post-operative management and survival were extracted from computerized clinical records. Heparinized blood samples were taken on presentation (PreOp, pre-operative), on recovery from anesthesia (T0), at 12 (T12) and 24 (T24) hours post recovery. COP was measured within 4 hours of collection. RESULTS There was no significant difference in PreOp or T0 COP between groups. Both groups had a significant decrease in COP during anesthesia. When compared to their respective pre-operative values, horses in the non-GI group had significantly increased COP at T12, whereas those in the GI group had significantly reduced COP. This trend was continued at T24. Horses in the GI group placed on intravenous crystalloid isotonic fluids post-operatively had a significantly lower COP at T12 and T24. Horses in the GI group that did not survive had significantly lower post-operative COP values at T24. CONCLUSIONS Horses undergoing exploratory celiotomy had significantly lower COP post-operatively than those horses undergoing orthopedic surgery. This difference was more marked in those horses receiving isotonic crystalloid intravenous fluid therapy post-operatively and in those that did not survive to discharge. In the non-GI group an increase in COP post-operatively was common.
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Affiliation(s)
- Alexandra G Raftery
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, CH64 7TE, UK
| | - Ruth A Morgan
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, CH64 7TE, UK
| | - Paul D MacFarlane
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, CH64 7TE, UK
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Jago RC, Corletto F, Wright IM. Peri-anaesthetic complications in an equine referral hospital: Risk factors for post anaesthetic colic. Equine Vet J 2015; 47:635-40. [DOI: 10.1111/evj.12475] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 06/09/2015] [Indexed: 11/29/2022]
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Taylor PM, Hoare HR, de Vries A, Love EJ, Coumbe KM, White KL, Murrell JC. A multicentre, prospective, randomised, blinded clinical trial to compare some perioperative effects of buprenorphine or butorphanol premedication before equine elective general anaesthesia and surgery. Equine Vet J 2015; 48:442-50. [PMID: 25772950 PMCID: PMC5033022 DOI: 10.1111/evj.12442] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/08/2015] [Indexed: 12/22/2022]
Abstract
Reasons for performing study Buprenorphine, a μ‐agonist opioid, has recently been licensed for equine use, but butorphanol, a κ‐agonist opioid, is more commonly used in horses. The effect of the 2 opioids has not previously been compared in a large clinical study. Objectives To compare post operative analgesia and physiological variables in horses undergoing elective surgery following premedication with either buprenorphine or butorphanol in a conventional clinical setting. Study design Multicentre, prospective, randomised, blinded clinical investigation. Methods Eighty‐nine healthy horses admitted for elective surgery to one of 6 UK equine veterinary clinics were premedicated with acepromazine, a nonsteroidal anti‐inflammatory drug, and romifidine followed by intravenous (i.v.) buprenorphine or butorphanol. Anaesthesia was induced with diazepam/ketamine and maintained with isoflurane in oxygen. A range of surgical procedures were performed and supplementary anaesthetic agents given as required. Physiological variables were monitored during anaesthesia and pain, ataxia, sedation and vital function were assessed post operatively. Data were analysed using t‐tests, ANOVA, Mann–Whitney U‐test and Chi‐squared test as appropriate and P<0.05 was regarded as significant, except for multiple comparisons, when P<0.01 was used. Results Surgery was carried out successfully in all cases and no mortality or serious morbidity occurred. Physiological variables remained within normal limits and all horses recovered successfully, most standing within 1 h of ceasing anaesthesia. There were no significant differences between groups in any variable except post operative pain when scores (simple descriptive scale) between 3 and 6 h were significantly lower after buprenorphine than after butorphanol. Conclusions Horses experienced less post operative pain after buprenorphine than after butorphanol premedication. Compared with butorphanol, buprenorphine did not cause any different effects on vital function.
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Affiliation(s)
- P M Taylor
- Taylor Monroe, Little Downham, Cambridgeshire, UK
| | - H R Hoare
- School of Veterinary Medicine and Science, Nottingham University, Sutton Bonington, Leicestershire, UK
| | - A de Vries
- Animal Health Trust, Newmarket, Suffolk, UK
| | - E J Love
- Equine First Opinion and Referral Clinic, University of Bristol, Langford, Bristol, UK
| | | | - K L White
- School of Veterinary Medicine and Science, Nottingham University, Sutton Bonington, Leicestershire, UK
| | - J C Murrell
- School of Veterinary Science, University of Bristol, Langford, Bristol, UK
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Carregaro AB, Freitas GC, Ribeiro MH, Xavier NV, Dória RGS. Physiological and analgesic effects of continuous-rate infusion of morphine, butorphanol, tramadol or methadone in horses with lipopolysaccharide (LPS)-induced carpal synovitis. BMC Vet Res 2014; 10:966. [PMID: 25528353 PMCID: PMC4297404 DOI: 10.1186/s12917-014-0299-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 12/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Continuous-rate infusion (CRI) of drugs results in more stable plasma drug concentrations than administration of intermittent boluses, thus providing greater stability of physiological parameters. The aim of this study was to evaluate the physiologic and analgesic effects of the administration of morphine, butorphanol, tramadol or methadone by CRI in horses with induced synovitis of the radiocarpal joint. RESULTS Increased values of cardiorespiratory parameters and body temperature were observed in all groups after initiation of opioid administration, and these increases were sustained throughout the CRI period. Morphine, butorphanol and methadone each caused a reduction in gut sounds, and this effect was greatest in animals that received morphine. Administration of morphine or methadone reduced the degree of lameness after the end of intravenous infusion. Administration of tramadol did not alter the degree of lameness in the animals. CONCLUSIONS CRI of morphine or methadone, but not butorphanol or tramadol, provided analgesia in horses with carpal synovitis. All of these opioids increased cardiovascular and respiratory parameters and reduced gut sounds during CRI.
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Affiliation(s)
- Adriano B Carregaro
- Department of Veterinary Medicine, University of São Paulo, Duque de Caxias Norte ave 225, Pirassununga, ZIP 13635-900, SP, Brazil.
| | - Gabrielle C Freitas
- College of Veterinary Medicine, Federal University of South Border, Realeza, PR, Brazil.
| | - Martina H Ribeiro
- Department of Veterinary Medicine, University of São Paulo, Duque de Caxias Norte ave 225, Pirassununga, ZIP 13635-900, SP, Brazil.
| | - Nathalia V Xavier
- Department of Veterinary Medicine, University of São Paulo, Duque de Caxias Norte ave 225, Pirassununga, ZIP 13635-900, SP, Brazil.
| | - Renata G S Dória
- Department of Veterinary Medicine, University of São Paulo, Duque de Caxias Norte ave 225, Pirassununga, ZIP 13635-900, SP, Brazil.
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Rigotti C, De Vries A, Taylor PM. Buprenorphine provides better anaesthetic conditions than butorphanol for field castration in ponies: results of a randomised clinical trial. Vet Rec 2014; 175:623. [PMID: 25262056 DOI: 10.1136/vr.102729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A prospective, randomised, blinded, clinical trial in 47 ponies compared butorphanol and buprenorphine administered intravenously with detomidine prior to castration under anaesthesia. Detomidine 12 μg/kg intravenously was followed by butorphanol 25 μg/kg (BUT) or buprenorphine 5 μg/kg (BUP) before induction of anaesthesia with intravenous ketamine and diazepam. Quality of sedation, induction and recovery from anaesthesia, response to tactile stimulation, and surgical conditions were scored. If anaesthesia was inadequate 'rescue' was given with intravenous ketamine (maximum three doses) followed by intravenous thiopental and detomidine. Time from induction to first rescue, total ketamine dose and number of rescues were recorded. Postoperative locomotor activity was scored and abnormal behaviour noted. Simple descriptive scales were used for all scoring. Data were analysed using two-way analysis of variance, t tests, Mann-Whitney or Fisher's exact tests as appropriate; P<0.05 was considered statistically significant. Cryptorchid animals did not undergo surgery, but castration was successfully completed in 18 BUT and 20 BUP. More incremental ketamine (P=0.0310) and more rescue drugs (P=0.0165) were required in BUT and more postoperative locomotor activity occurred in BUP (P=0.0001). There were no other differences between groups. Both opioids were suitable for premedication prior to castration but buprenorphine appeared to provide better intraoperative analgesia.
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Affiliation(s)
- C Rigotti
- School of Veterinary Science University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - A De Vries
- Davies Veterinary Specialists, Higham Gobion, UK
| | - P M Taylor
- Taylor Monroe, Gravel Head Farm, Downham Common, Ely CB6 2TY, UK
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Martin-Flores M, Campoy L, Kinsley MA, Mohammed HO, Gleed RD, Cheetham J. Analgesic and gastrointestinal effects of epidural morphine in horses after laparoscopic cryptorchidectomy under general anesthesia. Vet Anaesth Analg 2014; 41:430-7. [DOI: 10.1111/vaa.12133] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 06/21/2013] [Indexed: 11/29/2022]
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Benmansour P, Husulak ML, Bracamonte JL, Beazley SG, Withnall E, Duke-Novakovski T. Cardiopulmonary effects of an infusion of remifentanil or morphine in horses anesthetized with isoflurane and dexmedetomidine. Vet Anaesth Analg 2014; 41:346-56. [DOI: 10.1111/vaa.12149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 07/30/2013] [Indexed: 11/29/2022]
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Sanchez LC, Robertson SA. Pain control in horses: What do we really know? Equine Vet J 2014; 46:517-23. [DOI: 10.1111/evj.12265] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 03/07/2014] [Indexed: 01/15/2023]
Affiliation(s)
- L. C. Sanchez
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville USA
| | - S. A. Robertson
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; Michigan State University; East Lansing USA
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Milner PI, Bardell DA, Warner L, Packer MJ, Senior JM, Singer ER, Archer DC. Factors associated with survival to hospital discharge following endoscopic treatment for synovial sepsis in 214 horses. Equine Vet J 2014; 46:701-5. [DOI: 10.1111/evj.12212] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 11/03/2013] [Indexed: 11/28/2022]
Affiliation(s)
- P. I. Milner
- Institute of Ageing and Chronic Disease University of Liverpool Neston UK
| | - D. A. Bardell
- School of Veterinary Science Institute of Learning and Teaching University of Liverpool Neston UK
| | - L. Warner
- School of Veterinary Science Institute of Learning and Teaching University of Liverpool Neston UK
| | - M. J. Packer
- School of Veterinary Science Institute of Learning and Teaching University of Liverpool Neston UK
| | - J. M. Senior
- Institute of Infection and Global Health University of Liverpool Neston UK
| | - E. R. Singer
- Institute of Ageing and Chronic Disease University of Liverpool Neston UK
| | - D. C. Archer
- Institute of Infection and Global Health University of Liverpool Neston UK
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Nelson BB, Lordan EE, Hassel DM. Risk factors associated with gastrointestinal dysfunction in horses undergoing elective procedures under general anaesthesia. Equine Vet J 2013:8-14. [DOI: 10.1111/evj.12162] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 07/10/2013] [Indexed: 11/28/2022]
Affiliation(s)
- B. B. Nelson
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; USA
| | - E. E. Lordan
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; USA
| | - D. M. Hassel
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; USA
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Gozalo-Marcilla M, Steblaj B, Schauvliege S, Duchateau L, Gasthuys F. Comparison of the influence of two different constant-rate infusions (dexmedetomidine versus morphine) on anaesthetic requirements, cardiopulmonary function and recovery quality in isoflurane anaesthetized horses. Res Vet Sci 2013; 95:1186-94. [DOI: 10.1016/j.rvsc.2013.09.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 08/28/2013] [Accepted: 09/26/2013] [Indexed: 11/16/2022]
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Love EJ, Taylor PM, Whay HR, Murrell J. Postcastration analgesia in ponies using buprenorphine hydrochloride. Vet Rec 2013; 172:635. [DOI: 10.1136/vr.101440] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- E. J. Love
- School of Clinical Veterinary Science; University of Bristol; Langford Bristol BS40 5DU UK
| | - P. M. Taylor
- Taylor Monroe; Little Downham; Ely Cambridgeshire CB6 2TY UK
| | - H. R. Whay
- School of Clinical Veterinary Science; University of Bristol; Langford Bristol BS40 5DU UK
| | - J. Murrell
- School of Clinical Veterinary Science; University of Bristol; Langford Bristol BS40 5DU UK
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Senior JM. Morbidity, Mortality, and Risk of General Anesthesia in Horses. Vet Clin North Am Equine Pract 2013; 29:1-18. [DOI: 10.1016/j.cveq.2012.11.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Patipa LA, Sherlock CE, Witte SH, Pirie GD, Berghaus RD, Peroni JF. Risk factors for colic in equids hospitalized for ocular disease. J Am Vet Med Assoc 2012; 240:1488-93. [PMID: 22657933 DOI: 10.2460/javma.240.12.1488] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the incidence of colic and risk factors for colic in equids hospitalized for ocular disease. DESIGN Retrospective observational study. Animals-337 equids (317 horses, 19 ponies, and 1 donkey) hospitalized for ocular disease. PROCEDURES Medical records of equids hospitalized for > 24 hours for treatment of ocular disease between January 1997 and December 2008 were reviewed. Information from only the first hospitalization was used for equids that were hospitalized for ocular disease on more than 1 occasion. Information gathered included the signalment, the type of ocular lesion and the treatment administered, and any colic signs recorded during hospitalization as well as the severity, presumptive diagnosis, and treatment of the colic. Statistical analysis was used to identify any risk factors for colic in equids hospitalized for ocular disease. RESULTS 72 of 337 (21.4%) equids hospitalized for ocular disease had signs of colic during hospitalization. Most equids (59.7% [43/72]) had mild signs of colic, and most (87.5% [63/72]) were treated medically. Ten of 72 (13.9%) equids with colic had a cecal impaction. Risk factors for colic in equids hospitalized for ocular disease were age (0 to 1 year and ≥ 21 years) and an increased duration of hospitalization (≥ 8 days). CONCLUSIONS AND CLINICAL RELEVANCE There was a high incidence of colic in equids hospitalized with ocular disease in this study. Findings from this study may help identify equids at risk for development of colic and thereby help direct implementation of prophylactic measures.
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Affiliation(s)
- Leah A Patipa
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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Figueiredo JP, Muir WW, Sams R. Cardiorespiratory, gastrointestinal, and analgesic effects of morphine sulfate in conscious healthy horses. Am J Vet Res 2012; 73:799-808. [DOI: 10.2460/ajvr.73.6.799] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Payne RJ, Compston PC. Short- and long-term results following standing fracture repair in 34 horses. Equine Vet J 2012; 44:721-5. [PMID: 22506811 DOI: 10.1111/j.2042-3306.2012.00569.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow-up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. OBJECTIVES To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. METHOD Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedation and local anaesthesia up until June 2011, were retrieved. Hospital records, owner/trainer telephone questionnaire and the Racing Post website were used to evaluate follow-up. RESULTS Thirty-four horses satisfied the inclusion criteria. Fracture sites included the proximal phalanx (incomplete sagittal fracture, n = 14); the third metacarpal bone (lateral condyle, n = 12, and medial condyle, n = 7); and the third metatarsal bone (lateral condyle, n = 1). One horse required euthanasia due to caecal rupture 10 days post operatively. Twenty horses (66.7% of those with available follow-up) have returned to racing. Where available, mean time from operation to return to racing was 226 days (range 143-433 days). CONCLUSIONS Standing fracture repair produced similar results to fracture repair under general anaesthesia in terms of both the number of horses that returned to racing and the time between surgery and race. POTENTIAL RELEVANCE Repair of lower limb fracture in the horse under standing sedation is a procedure that has the potential for tangible benefits, including avoidance of the inherent risks of general anaesthesia. The preliminary findings in this series of horses are encouraging and informative when discussing options available prior to fracture repair.
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Affiliation(s)
- R J Payne
- Rossdales Equine Hospital, Exning, Newmarket, UK
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Love EJ, Taylor PM, Murrell J, Whay HR. Effects of acepromazine, butorphanol and buprenorphine on thermal and mechanical nociceptive thresholds in horses. Equine Vet J 2011; 44:221-5. [PMID: 21696438 DOI: 10.1111/j.2042-3306.2011.00412.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY To investigate the antinociceptive effects of buprenorphine administered in combination with acepromazine in horses and to establish an effective dose for use in a clinical environment. OBJECTIVES To evaluate the responses to thermal and mechanical stimulation following administration of 3 doses of buprenorphine compared to positive (butorphanol) and negative (glucose) controls. METHODS Observer blinded, randomised, crossover design using 6 Thoroughbred geldings (3-10 years, 500-560 kg). Thermal and mechanical nociceptive thresholds were measured 3 times at 15 min intervals. Horses then received acepromazine 0.05 mg/kg bwt with one of 5 treatments i.v.: 5% glucose (Glu), butorphanol 100 µg/kg bwt (But) buprenorphine 5 µg/kg bwt (Bup5), buprenorphine 7.5 µg/kg bwt (Bup7.5) and buprenorphine 10 µg/kg bwt (Bup10). Thresholds were measured 15, 30, 45, 60, 90, 120, 150, 180, 230 min, 4, 5, 6, 7, 8, 9, 10, 11, 12 and 24 h post treatment administration. The 95% confidence intervals for threshold temperature (ΔT) for each horse were calculated and an antinociceptive effect defined as ΔT, which was higher than the upper limit of the confidence interval. Duration of thermal antinociception was analysed using a within-subjects ANOVA and peak mechanical thresholds with a general linear model with post hoc Tukey tests. Significance was set at P<0.05. RESULTS Mean (± s.d.) durations of thermal antinociception following treatment administration were: Glu 0.5 (1.1), But 2.9 (2.0), Bup5 7.4 (2.3), Bup7.5 7.8 (2.7) and Bup10 9.4 (1.1) h. B5, B7.5 and B10 were significantly different from Glu and But. No serious adverse effects occurred, although determination of mechanical thresholds was confounded by locomotor stimulation. CONCLUSIONS Administration of acepromazine and all doses of buprenorphine produced antinociception to a thermal stimulus for significantly longer than acepromazine and either butorphanol or glucose. POTENTIAL RELEVANCE This study suggests that buprenorphine has considerable potential as an analgesic in horses and should be examined further under clinical conditions and by investigation of the pharmacokinetic/pharmacodynamic profile.
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Affiliation(s)
- E J Love
- Department of Clinical Veterinary Science, University of Bristol, Langford House Taylor Monroe, Little Downham, Ely, Cambridgeshire, UK.
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Sano H, Martin-Flores M, Santos LCP, Cheetham J, Araos JD, Gleed RD. Effects of epidural morphine on gastrointestinal transit in unmedicated horses. Vet Anaesth Analg 2011; 38:121-6. [DOI: 10.1111/j.1467-2995.2010.00588.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Senior JM, Pinchbeck GL, Allister R, Dugdale AHA, Clark L, Clutton RE, Coumbe K, Dyson S, Clegg PD. Post anaesthetic colic in horses: a preventable complication? Equine Vet J 2010; 38:479-84. [PMID: 16986610 DOI: 10.2746/042516406778400673] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY There is little information on the prevalence of, and risk factors associated with, post anaesthetic colic (PAC) in horses undergoing nonabdominal operations. OBJECTIVES To undertake the first prospective study of prevalence of PAC and identify risk factors in its development in nonabdominal procedures. METHODS A multicentre prospective case-control study was conducted, on every horse undergoing anaesthesia for a nonabdominal procedure between April 2004 and June 2005. Colic cases were defined as any horse with recognised signs of abdominal pain within 72 h of general anaesthesia that could not be attributed to any concurrent disease. Five control horses per case were selected randomly from the study population at all hospitals. Multivariable logistic regression analysis was used to examine the relationship between predictor variables and the risk of developing PAC. RESULTS The estimated mean prevalence of PAC in the study population was 5.2% (95% CI, 2.8, 8.0). However, the prevalence of colic varied between each centre. The most commonly diagnosed cause of colic was impaction. Multivariable analyses showed that the centre involved and the type of surgery performed were associated with an increased risk of PAC. Preoperative food deprivation and the use of opioid drugs were confounding factors. CONCLUSIONS Prevalence of PAC varied significantly between the 4 hospitals studied; there may be hospital-related covariates that account for this. The type of surgery performed influenced the risk of PAC. POTENTIAL RELEVANCE Identifying the risk factors for PAC is a prerequisite for its prevention. This study indicates horses at increased risk of PAC that might benefit from a more critical evaluation of post anaesthetic gastrointestinal function and/or the provision of preventative measures. Further investigation is required to explain the variation in prevalence of PAC between centres.
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Affiliation(s)
- J M Senior
- Institutes of Evolution, Immunology and Infection Research, University of Edinburgh, UK
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Andersen MS, Clark L, Dyson SJ, Newton JR. Risk factors for colic in horses after general anaesthesia for MRI or nonabdominal surgery: absence of evidence of effect from perianaesthetic morphine. Equine Vet J 2010; 38:368-74. [PMID: 16866208 DOI: 10.2746/042516406777749263] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASON FOR PERFORMING STUDY Post anaesthetic colic is a recognised risk of general anaesthesia (GA), but causes are poorly understood. OBJECTIVES To identify risk factors for development of colic following GA for magnetic resonance imaging (MRI) or nonabdominal surgery and to test whether the use of perianaesthetic morphine was associated with an increased risk of post anaesthetic colic. METHODS A total of 553 anaesthetic and clinical records of 500 horses anaesthetised at the Animal Health Trust were analysed, 342 (62%) involved MRI and 211 (38%) nonabdominal, predominantly orthopaedic surgery. Multivariable logistic regression analysis was used to examine the association between post anaesthetic colic and explanatory variables, including use of perianaesthetic morphine. RESULTS Twenty horses (3.6%) developed colic within 7 days of GA. A significantly larger (P = 0.001) proportion of the surgical cases developed post anaesthetic colic (7.1%) compared with MRI cases (1.5%). Having controlled for the effect of MRI/surgeon, there was evidence for a significantly increased risk of colic associated with maintenance of anaesthesia with isoflurane and administration of benzyl penicillin and/or ceftiofur. A reduction in risk of colic was associated with premedication with romifidine, longer duration of anaesthesia and sedation within 2 days of GA. Perianaesthetic morphine administration was not associated with increased risk. CONCLUSIONS This study identified apparently novel risk factors for colic in horses following GA. Use of morphine was not found, after controlling for other MRI and surgery related risk factors, to be associated with an increased risk. The low prevalence of colic after GA and resulting low study power mean that further larger, multicentre collaborative studies are warranted to corroborate findings in this study. POTENTIAL RELEVANCE Better knowledge of risk factors should lead to achievable measures to reduce frequency of occurrence.
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Abstract
Surgical manipulation of the intestines activates intestinal macrophages that release cytokines and nitric oxide, which results in inhibition of intestinal motility. Subsequent infiltration of circulating leukocytes into the intestinal wall contributes to cytokine and nitric oxide release and exacerbates ileus. Other factors contributing to ileus are endotoxemia; edema of the intestine wall subsequent to excessive fluid therapy; hypocalcemia; and long abdominal incisions. Because treatment of ileus with prokinetic drugs has not proven to be very effective, efforts should be directed at reducing its severity. Strategies which reduce the severity of ileus include pretreatment with a nonsteroidal anti-inflammatory drug, minimizing the length of the abdominal incision, reducing intestinal manipulation, intraoperative lidocaine infusion, correction of hypocalcemia, limiting the volume of intravenous fluids to prevent intestinal edema, and administration of alpha(2) antagonists.
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Affiliation(s)
- Thomas J Doherty
- Department of Large Animal Clinical Sciences, The University of Tennessee College of Veterinary Medicine, 2407 River Drive, Knoxville, TN 37996, USA.
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Hackett ES, Hassel DM. Colic: Nonsurgical Complications. Vet Clin North Am Equine Pract 2008; 24:535-55, viii. [DOI: 10.1016/j.cveq.2008.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Arguedas M, Hines M, Papich M, Farnsworth K, Sellon D. Pharmacokinetics of Butorphanol and Evaluation of Physiologic and Behavioral Effects after Intravenous and Intramuscular Administration to Neonatal Foals. J Vet Intern Med 2008; 22:1417-26. [DOI: 10.1111/j.1939-1676.2008.0200.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Driessen B, Scandella M, Zarucco L. Development of a technique for continuous perineural blockade of the palmar nerves in the distal equine thoracic limb. Vet Anaesth Analg 2008; 35:432-48. [DOI: 10.1111/j.1467-2995.2008.00405.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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