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Dougherty N, Gartrell B, Walsh V, Chatterton J, Lenting B. SERIAL CHANGES IN METABOLIC ACID-BASE STATUS IN THREE SPECIES OF ANESTHETIZED CAPTIVE LARGE FELID. J Zoo Wildl Med 2024; 55:602-610. [PMID: 39255201 DOI: 10.1638/2022-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 09/12/2024] Open
Abstract
Determination of acid-base status contributes important information about patient health, including for patients under anesthesia. There is a paucity of information about the determinants of acid-base status of large felids managed under anesthesia, and advancement of such knowledge may contribute to patient safety. This study serially monitored the individual metabolic acid-base status of 11 large felids, including lions (Panthera leo), tigers (Panthera tigris), and cheetahs (Acinonyx jubatus), under general anesthesia. We analyzed the contributions of measured strong ions (sodium, chloride, potassium, lactate), weak acids and buffers (albumin, phosphate and bicarbonate), and unmeasured anions to standardized extracellular base excess (SBE). A general linear model assessed for species differences in these parameters, with time since immobilization, SBE, and mean arterial pressure as covariates. By employing a Stewart-based analytical approach, it was possible to separate chloremic and unmeasured anion contributions to metabolic acid base status. This provided a basis for identifying mixed metabolic processes, generating differentials for underlying causes. Using normal acid base parameters for domestic felids, metabolic acidosis was found to be prevalent. Frequent evidence of unmeasured anion accumulation was also found, with unmeasured anions occasionally exceeding 5mmol/L. These findings warrant further inquiry into the drivers and clinical significance of metabolic acidosis and unmeasured anion accumulations in anesthetized large felids, encouraging further anion identity studies to elucidate possible causes. Reference ranges need to be established for acid-base parameters in large felids as a foundation for interpreting more controlled, prospective research into determinants of metabolic acid-base status in these animals under anesthesia.
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Affiliation(s)
- Nigel Dougherty
- Wildbase Hospital, School of Veterinary Science, Massey University, Palmerston North, Manawatū, Aotearoa New Zealand 4410,
| | - Brett Gartrell
- Wildbase Hospital, School of Veterinary Science, Massey University, Palmerston North, Manawatū, Aotearoa New Zealand 4410
| | - Vicki Walsh
- Department of Anesthesia, School of Veterinary Science, Massey University, Palmerston North, Manawatū, Aotearoa New Zealand 4410
| | - James Chatterton
- New Zealand Centre for Conservation Medicine, Auckland Zoo, Western Springs, Auckland, Aotearoa New Zealand
| | - Baukje Lenting
- The Nest Te Kōhanga, Wellington Zoo, Newtown, Wellington, Aotearoa New Zealand 6021
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Margeti C, Kazakos G, Galatos AD, Skampardonis V, Zacharopoulou T, Tsioli V, Tyrnenopoulou P, Loukopoulos E, Papatsiros VG, Flouraki E. The Effect of a Subsequent Dose of Dexmedetomidine or Other Sedatives following an Initial Dose of Dexmedetomidine on Electrolytes, Acid-Base Balance, Creatinine, Glucose, and Cardiac Troponin I in Cats: Part II. Vet Sci 2024; 11:143. [PMID: 38668411 PMCID: PMC11053990 DOI: 10.3390/vetsci11040143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 04/29/2024] Open
Abstract
The administered dose of dexmedetomidine may occasionally fail to produce the anticipated sedative effects. Therefore, a subsequent dose or administration of another sedative may enhance sedation; however, patient safety may be affected. The safety of seven different drugs administered at the following time point after an insufficient dose of dexmedetomidine was evaluated in a crossover, blind, experimental study that included six healthy adult cats. All cats received an initial dose of dexmedetomidine and a subsequent dose of either dexmedetomidine (Group DD), NS 0.9% (DC), tramadol (DT), butorphanol (DBT), buprenorphine (DBP), ketamine (DK), or midazolam (DM). Animal safety was assessed using repeated blood gas analysis and measurement of electrolytes, glucose, cardiac troponin I, and creatinine to evaluate cardiac, respiratory, and renal function. The median values of creatinine, cardiac troponin I, pH, partial pressure of carbon dioxide, potassium, and sodium did not change significantly throughout the study. Heart rate was significantly decreased in all groups after administration of the drug combinations, except for in the DK group. Respiratory rate decreased significantly after administration of the initial dose of dexmedetomidine and in the DBP and DM groups. The partial pressure of oxygen, although normal, decreased significantly after the administration of dexmedetomidine, whereas the median concentration of glucose increased significantly following the administration of dexmedetomidine. The results of our study suggest that the drug combinations used did not alter the blood parameters above normal limits, while cardiac and renal function were not compromised. Therefore, a safe level of sedation was achieved. However, the administration of dexmedetomidine reduced the partial pressure of oxygen; thus, oxygen supplementation during sedation may be advantageous. Additionally, the increase in glucose concentration indicates that dexmedetomidine should not be used in cats with hyperglycaemia, whereas the decrease in haematocrit suggests that dexmedetomidine is not recommended in anaemic cats.
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Affiliation(s)
- Chrysoula Margeti
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
| | - Georgios Kazakos
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece;
| | - Apostolos D. Galatos
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
| | - Vassilis Skampardonis
- Department of Epidemiology, Biostatistics and Animal Health Economics, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece;
| | - Theodora Zacharopoulou
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
| | - Vassiliki Tsioli
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
| | - Panagiota Tyrnenopoulou
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
| | - Epameinondas Loukopoulos
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
| | - Vasileios G. Papatsiros
- Clinic of Medicine, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece
| | - Eugenia Flouraki
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (P.T.); (E.L.)
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Bowen RAR, Esguerra V, Arboleda E, Cheng P, Hu B. Impact of blood collection devices and mode of transportation on peripheral venous blood gas parameters. Clin Chim Acta 2023; 548:117464. [PMID: 37399883 DOI: 10.1016/j.cca.2023.117464] [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: 05/05/2023] [Revised: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Peripheral venous blood (PVB) gas analysis has become an alternative to arterial blood gas (BG) analysis in assessing acid-base balance. This study aimed to compare the effects of blood collection devices and modes of transportation on peripheral venous BG parameters. METHODS PVB-paired specimens were collected from 40 healthy volunteers into blood gas syringes (BGS) and blood collection tubes (BCT), transported by either a pneumatic tube system (PTS) or human courier (HC) to the clinical laboratory, and compared using a two-way ANOVA or Wilcoxon signed-rank test. To determine clinical significance, the PTS and HC-transported BGS and BCT biases were compared to the total allowable error (TEA). RESULTS PVB partial pressure of oxygen (pO2), fractional oxyhemoglobin (FO2Hb), fractional deoxyhemoglobin (FHHb), and oxygen saturation (sO2) showed statistically significant differences between BGS and BCT (p < 0.0001). Compared to HC-transported BGS and BCT, statistically significant increases in pO2, FO2Hb, sO2, oxygen content (only in BCT) (all p < 0.0001), and base excess extracellular (only in BCT; p < 0.0014) concentrations and a statistically significant decrease in FHHb concentration (p < 0.0001) were found in BGS and BCT delivered by PTS. The biases between PTS- and HC-transported BGS and BCT exceeded the TEA for many BG parameters. CONCLUSIONS Collecting PVB in BCT is unsuitable for pO2, sO2, FO2Hb, FHHb, and oxygen content determinations.
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Affiliation(s)
- Raffick A R Bowen
- Department of Pathology, Stanford Health Care, Stanford, CA 94305, United States.
| | - Vanessa Esguerra
- Stanford Hospital and Clinics, Stanford, CA 94305, United States
| | | | - Phil Cheng
- Stanford Hospital and Clinics, Stanford, CA 94305, United States
| | - Bing Hu
- Stanford Hospital and Clinics, Stanford, CA 94305, United States
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Sharp SM, Gomez FM, Meegan JM, Rowles TK, Townsend F, Schwacke LH, Smith CR. Using Blood Gas Analysis and Capnography to Determine Oxygenation Status in Bottlenose Dolphins ( Tursiops truncatus) Following the Deepwater Horizon Oil Spill. TOXICS 2023; 11:toxics11050423. [PMID: 37235238 DOI: 10.3390/toxics11050423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023]
Abstract
Following the Deepwater Horizon (DWH) oil spill in 2010, poor pulmonary health and reproductive failure in bottlenose dolphins (Tursiops truncatus) in the northern Gulf of Mexico were well-documented. One postulated etiology for the increased fetal distress syndrome and pneumonia found in affected perinatal dolphins was maternal hypoxia caused by lung disease. The objective of this study was to evaluate the utility of blood gas analysis and capnography in determining oxygenation status in bottlenose dolphins with and without pulmonary disease. Blood and breath samples were collected from 59 free-ranging dolphins in Barataria Bay, Louisiana (BB), during a capture-release health assessment program, and from 30 managed dolphins from the U.S. Navy Marine Mammal Program in San Diego, CA. The former was the oil-exposed cohort and the latter served as a control cohort with known health histories. Capnography and select blood gas parameters were compared based on the following factors: cohort, sex, age/length class, reproductive status, and severity of pulmonary disease. Animals with moderate-severe lung disease had higher bicarbonate concentrations (p = 0.005), pH (p < 0.001), TCO2 (p = 0.012), and more positive base excess (p = 0.001) than animals with normal-mild disease. Capnography (ETCO2) was found to have a weak positive correlation with blood PCO2 (p = 0.020), with a mean difference of 5.02 mmHg (p < 0.001). Based on these findings, indirect oxygenation measures, including TCO2, bicarbonate, and pH, show promise in establishing the oxygenation status in dolphins with and without pulmonary disease.
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Affiliation(s)
- Sarah M Sharp
- National Marine Mammal Foundation, San Diego, CA 92106, USA
- International Fund for Animal Welfare, Yarmouth Port, MA 02675, USA
| | | | - Jenny M Meegan
- National Marine Mammal Foundation, San Diego, CA 92106, USA
| | - Teresa K Rowles
- Marine Mammal Health and Stranding Response Program, National Oceanographic and Atmospheric Administration, Silver Spring, MD 20910, USA
| | - Forrest Townsend
- College of Veterinary Medicine, Auburn University, Auburn, AL 36832, USA
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5
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Rincon AA, Wurlod VA, Liu CC, Smith MR. Effects of time delay and blood storage methods on analysis of canine venous blood samples with an Element point-of-care analyzer. Vet Clin Pathol 2023; 52:22-29. [PMID: 36573472 DOI: 10.1111/vcp.13177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/09/2022] [Accepted: 06/19/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Manufacturers of point-of-care (POC) analyzers recommend immediate processing and anaerobic collection of blood samples. However, it is not uncommon for clinical scenarios to result in delayed sample processing or room air exposure that could impact the test results. OBJECTIVE To investigate the effect of time delay and sample storage method on key POC analytes in canine venous blood samples processed with an Element POC analyzer. METHODS Blood gas analysis was performed on venous blood samples at times 0 (T0), 15, 30, and 60 minutes after sampling using three different storage methods: preheparinized plastic syringes and two different lithium heparin tubes. To determine clinical relevance, results were compared with allowable total error of the respective parameter. Significance was set at P < 0.05. RESULTS Significant differences between the three storage methods at baseline were found for partial pressure of carbon dioxide (PCO2 ), partial pressure of oxygen (PO2 ), base excess, and total hemoglobin. No significant differences up to T60 were found within collection methods for actual bicarbonate (HCO3 - ), base excess, sodium, potassium, chloride, ionized calcium (iCa), glucose, and BUN. Significant differences within collection methods were found after T0 for creatinine, after 15 minutes for lactate, and after 30 minutes for pH and hematocrit. No significant differences were found for PO2 in samples stored in preheparinized plastic syringes at any time point. CONCLUSIONS These results suggest that HCO3 - , sodium, potassium, chloride, iCa, glucose, and BUN are comparable within the three storage methods for up to 60 minutes after sampling without resulting in clinically relevant changes.
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Affiliation(s)
- Angie A Rincon
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Virginie A Wurlod
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Chin-Chi Liu
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - M Ryan Smith
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
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Barandun MA, Mullins RA, Rytz U. Billroth II procedure for the treatment of spontaneous gastrointestinal perforation in two cats. J Am Vet Med Assoc 2021; 259:1325-1331. [PMID: 34727055 DOI: 10.2460/javma.20.04.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 9-year-old castrated male domestic shorthair cat (cat 1) and a 10-year-old castrated male Maine Coon cat (cat 2) were presented for recurrent feline lower urinary tract disease after receiving outpatient care from their primary veterinarians. CLINICAL FINDINGS Physical examination findings for both cats were initially within reference limits. After a short period of hospitalization, both cats developed peritoneal effusion; results of cytologic analysis of a sample of the fluid were consistent with septic peritonitis. During exploratory laparotomy, perforation of the pylorus or proximal portion of the duodenum secondary to ulceration was identified. TREATMENT AND OUTCOME Both cats underwent partial duodenectomy, partial gastrectomy (pylorectomy), and gastrojejunostomy (Billroth II procedure). The cats recovered from surgery and returned to a normal quality of life; however, each had mild episodes of anorexia but maintained a stable body weight. Cat 2 required additional surgery for trichobezoar removal 7 weeks later but recovered quickly. At 7 months after trichobezoar removal, cat 2 developed intermittent vomiting, but clinicopathologic, abdominal ultrasonographic, and upper gastrointestinal tract endoscopic findings were within reference limits. At 9 (cat 2) and 13 (cat 1) months after the Billroth II procedure, both cats were reported to be in good general health and without gastrointestinal signs. CLINICAL RELEVANCE In both cats, the Billroth II procedure was technically straightforward and associated with a full recovery and good medium- to long-term quality of life. A Billroth II procedure could be considered for treatment of cats with large mural lesions in the pyloroduodenal region.
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7
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Tinsman AE, Bellis TJ. Hyperinsulinemia/euglycemia and intravenous lipid emulsion therapy for the management of severe amlodipine toxicosis in a cat. Clin Case Rep 2021; 9:e05175. [PMID: 34934496 PMCID: PMC8650752 DOI: 10.1002/ccr3.5175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/23/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
Calcium-channel blockers (CCBs) are widely used in people and animals. Overdose can result in cardiovascular collapse and death. Hyperinsulinemia/euglycemia therapy (HIET) and intralipid therapy (ILT) are reported treatment options in people. This is the first report describing HIET and ILT as treatments for amlodipine toxicosis in a cat.
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Affiliation(s)
| | - Tara J. Bellis
- Emergency & Critical CareGarden State Veterinary ServicesIselinNJUSA
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8
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Costa GP, Monteiro ER, Marques ÉJ, Beck RC, Carneiro RK, da Costa FVA, Valle SF. Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial. J Feline Med Surg 2021; 23:540-548. [PMID: 33044122 PMCID: PMC10741301 DOI: 10.1177/1098612x20962754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to compare the sedative effects in cats administered acepromazine-nalbuphine and acepromazine-butorphanol, intramuscularly (IM) and intravenously (IV), and the occurrence of adverse cardiorespiratory effects. METHODS Forty-six cats were randomly divided into four groups and administered acepromazine (0.05 mg/kg) combined with nalbuphine (0.5 mg/kg) or butorphanol (0.4 mg/kg), IV (ACP-NALIV and ACP-BUTIV groups, respectively) or IM (ACP-NALIM and ACP-BUTIM groups, respectively). Sedation scores, ease of intravenous catheter placement (simple descriptive scale [SDS] scores), physiologic variables, venous blood gases and the propofol dose required for anesthetic induction were recorded. RESULTS Mild sedation was observed in all groups approximately 30 mins after treatment administration (timepoint T1, prior to propofol administration). Sedation scores at T1 increased above baseline in all groups (P <0.05), but no significant difference was observed among groups. Dynamic interactive visual analogue scale sedation scores (range 0-100 mm) recorded at T1 were (median [interquartile range]): ACP-NALIM, 12 (10-12); ACP-NALIV, 11 (6-16); ACP-BUTIM, 11 (7-14); and ACP-BUTIV, 12 (7-19). Overall, SDS scores did not change from baseline at T1 and there was no significant difference among groups. The propofol dose did not differ among groups. Blood gases remained within the reference intervals for cats. Significant decreases from baseline were detected for all groups in systolic arterial pressure (SAP). Mean ± SD values at T1 were (mmHg): ACP-NALIM, 108 ± 13; ACP-NALIV, 102 ± 10; ACP-BUTIM, 97 ± 13; and ACP-BUTIV, 98 ± 21. Arterial hypotension (SAP <90 mmHg) was recorded at T1 in 0/11, 1/13, 4/11 and 5/11 cats in groups ACP-NALIM, ACP-NALIV, ACP-BUTIM and ACP-BUTIV, respectively, and was further exacerbated after the induction of anesthesia with propofol. CONCLUSIONS AND RELEVANCE In healthy cats administered acepromazine-nalbuphine and acepromazine-butorphanol, IM and IV, the degree of sedation was mild regardless of the protocol and the route of administration. The main adverse effect observed was a reduction in arterial blood pressure.
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Affiliation(s)
- Gabriela P Costa
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
| | - Eduardo R Monteiro
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
| | - Éder J Marques
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
| | - Rafael C Beck
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
| | - Rafael K Carneiro
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
| | - Fernanda VA da Costa
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
| | - Stella F Valle
- Department of Animal Medicine, Faculty of Veterinary
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS,
Brazil
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Smith P, Tolbert MK, Gould E, Taylor A, Knych H, Messenger K. Pharmacokinetics, sedation and hemodynamic changes following the administration of oral transmucosal detomidine gel in cats. J Feline Med Surg 2020; 22:1184-1190. [PMID: 32643979 PMCID: PMC10814369 DOI: 10.1177/1098612x20917305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe the pharmacokinetics of oral transmucosal (OTM) detomidine gel in healthy cats and assess its effects on sedation and hemodynamic variables. METHODS Eight adult cats weighing 4.12 kg ± 0.72 received 4 mg/m2 detomidine gel onto the buccal mucosa. Level of sedation, heart rate (HR), blood pressure (BP) and respiratory rate (f R) were assessed at predetermined intervals following administration. Blood samples for plasma detomidine concentrations and venous blood gas variables were collected from a medial saphenous catheter. Plasma detomidine concentrations were analyzed using ultra-high-pressure liquid chromatography with mass spectrometry detection, and pharmacokinetic estimates were obtained with compartmental methods. Data were analyzed using ANOVA and paired t-test or appropriate non-parametric tests. RESULTS Sedation occurred in all cats, and was increased from baseline at 30 mins (P <0.001). Decreases in HR occurred from 15-60 mins, ranging from 140 to 165 beats per min (P <0.001). Blood glucose increased from 101 ± 12 mg/dl to 168 ± 27.3 mg/dl at 60 mins (P = 0.004). Systolic blood pressure decreased from baseline (139 ± 14.8 mmHg) to 103 ± 23.0 mmHg at 60 mins (P = 0.023). All changes abated by 120 mins. Emesis occurred in 7/7 cats within 2 mins of gel administration. Geometric mean (coefficient of variation) for clearance was 220.7 ml/min/kg (35.3 ml/min/kg), volume of distribution was 14.9 l/kg (39.9 l/kg) (both a function of bioavailability) and elimination half-life was 46.9 mins (16.0 mins). Maximum plasma concentrations of 10.5 ng/ml (35.5 ng/ml) detomidine occurred at 36.9 mins (21.5 mins). CONCLUSIONS AND RELEVANCE OTM detomidine gel produced moderate sedation with minimal undesirable side effects in healthy cats, although emesis occurred in all cats. The pharmacokinetic profile supports short-term, minimally invasive sedation in this species. Further studies are warranted to assess its safety and feasibility for use in debilitated cats, or prior to general anesthesia.
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Affiliation(s)
- Preston Smith
- Quartet Veterinary Specialty and Emergency Hospital, Cary, NC, USA
| | - M Katherine Tolbert
- Texas A&M University, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA
| | - Emily Gould
- Texas A&M University, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA
| | | | - Heather Knych
- University of California, Davis, California Animal Health and Food Safety Lab Molecular Biosciences, Davis, CA, USA
| | - Kristen Messenger
- North Carolina State University, Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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10
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Coady M, Fletcher DJ, Goggs R. Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats. Front Vet Sci 2019; 6:276. [PMID: 31508432 PMCID: PMC6714612 DOI: 10.3389/fvets.2019.00276] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/06/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Calcium disorders are common in small animals, but few studies have investigated the etiology of ionized hypercalcemia and hypocalcemia in large populations. This study aimed to determine the incidence of ionized calcium disorders in dogs and cats treated at a tertiary referral clinic and to describe the associated diseases. Methods: An electronic database of electrolyte analyses conducted at the Cornell University Hospital for Animals from 2007 to 2017 was searched. Dogs and cats with ionized hypercalcemia or hypocalcemia were identified based on institution reference intervals. Duplicate case entries were removed. Medical records were reviewed to identify the cause of the calcium abnormality. Chi-squared analysis with Bonferroni adjustment was performed to compare frequencies of disease processes between mild and moderate-severe disturbances. Results: The database included 15,277 dogs and 3,715 cats. Hypercalcemia was identified in 1,641 dogs and 119 cats. The incidence of canine and feline hypercalcemia was 10.7 and 3.2%, respectively. Hypocalcemia was identified in 1,467 dogs and 450 cats. The incidence of canine and feline hypocalcemia was 9.6% and 12.1%, respectively. The most common pathologic causes of hypercalcemia in dogs were malignancy-associated (12.9%), parathyroid-dependent (4.6%) and hypoadrenocorticism (1.7%). In cats, malignancy-associated hypercalcemia (22.7%), kidney injury (13.4%) and idiopathic hypercalcemia (12.6%) were most common. Dogs presenting with moderate-severe hypercalcemia vs. mild hypercalcemia were significantly more likely to have hyperparathyroidism, malignancy-associated hypercalcemia or hypervitaminosis D, whereas cats were significantly more likely to have malignancy-associated hypercalcemia or idiopathic hypercalcemia. The most common pathologic causes of hypocalcemia in dogs were critical illness (17.4%), kidney injury (10.4%) and toxicity (7.5%). In cats, kidney injury (21.6%), urethral obstruction (15.1%), and critical illness (14.7%) were most frequent. Dogs presenting with moderate-severe hypocalcemia were significantly more likely to have hypoparathyroidism, kidney injury, eclampsia or critical illness, whereas cats were significantly more likely to have kidney injury, soft tissue trauma or urethral obstruction. Conclusions: Mild calcium disturbances are most commonly associated with non-pathologic or transient conditions. Malignancy-associated hypercalcemia is the most common cause of ionized hypercalcemia in dogs and cats. Critical illness and kidney injury are frequent causes of ionized hypocalcemia in both species.
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Affiliation(s)
- Michelle Coady
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Daniel J Fletcher
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
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11
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Zoff A, Dugdale AHA, Scarabelli S, Rioja E. Evaluation of pulse co-oximetry to determine haemoglobin saturation with oxygen and haemoglobin concentration in anaesthetized horses: a retrospective study. Vet Anaesth Analg 2019; 46:452-457. [PMID: 31196749 DOI: 10.1016/j.vaa.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 12/10/2018] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study compared the values of variables measured by pulse co-oximetry (Masimo Radical 7; Masimo Europe Limited, UK) with those measured by a co-oximeter-enabled blood gas analyser (Siemens Rapid-point 500; Siemens Healthcare Limited, UK) in anaesthetized horses. STUDY DESIGN Retrospective study. ANIMALS A total of 30 anaesthetized horses. METHODS In total, 47 heparinized arterial blood samples were collected for blood gas analysis to determine haemoglobin concentration (tHb, g L-1) and percentage of haemoglobin saturation with oxygen (SaO2). Arterial haemoglobin saturation with oxygen was determined noninvasively by pulse co-oximetry (Masimo SpO2). Pulse co-oximetry also provided arterial haemoglobin concentration (SpHb) and arterial oxygen content (SpCaO2). Arterial oxygen content was calculated (CaO2) in 39 samples using SaO2 and the value of Hüfner's constant used by Masimo Radical 7 (1.3 mL g-1). Data were compared using Bland-Altman analysis, correlation tests, accuracy root mean square (ARMS) statistics and total allowable error, where available. RESULTS Low bias but wide limits of agreement (LoA) were found between Masimo SpO2 and SaO2 (bias = -1.4%, LoA = -4.0 to 1.3%), with an ARMS of 3%. Compared with tHb, SpHb showed low bias (6.2 g L-1) but wide LoA (-39.6 to 52.6 g L-1); its % bias (5.2%) was still within the 7% limits recommended by the Clinical Laboratory Improvement Amendments (CLIA) for humans. When comparing SpCaO2 and CaO2, the bias and LoA were -0.2 mL dL-1 and -6.7 to 6.2 mL dL-1, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Masimo SpO2 was acceptable for current ARMS standards, and SpHb measurements also met CLIA limits. The wide LoA in this study, however, suggest that the Masimo Radical 7 cannot be recommended as a substitute for direct measurements. As blood gas machines, pulse oximeters and co-oximeters use algorithms based on human haemoglobin, no true gold standard exists for horses.
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Affiliation(s)
- A Zoff
- University of Liverpool, Philip Leverhulme Equine Hospital, Institute of Veterinary Science, Leahurst Campus, Liverpool, UK.
| | - A H A Dugdale
- University of Liverpool, Philip Leverhulme Equine Hospital, Institute of Veterinary Science, Leahurst Campus, Liverpool, UK
| | - S Scarabelli
- University of Liverpool, Philip Leverhulme Equine Hospital, Institute of Veterinary Science, Leahurst Campus, Liverpool, UK
| | - E Rioja
- University of Liverpool, Philip Leverhulme Equine Hospital, Institute of Veterinary Science, Leahurst Campus, Liverpool, UK
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Nentwig A, Meli ML, Schrack J, Reichler IM, Riond B, Gloor C, Howard J, Hofmann-Lehmann R, Willi B. First report of Cytauxzoon sp. infection in domestic cats in Switzerland: natural and transfusion-transmitted infections. Parasit Vectors 2018; 11:292. [PMID: 29747680 PMCID: PMC5944068 DOI: 10.1186/s13071-018-2728-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/19/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cytauxzoonosis is an emerging tick-borne disease of domestic and wild felids. Cytauxzoon felis induces severe and often fatal disease in domestic cats. In Europe, clinical and subclinical infections caused by Cytauxzoon sp. are described. We report the first cases of Cytauxzoon sp. infection in domestic cats in Switzerland. METHODS Clinical and laboratory data and results of PCR analyses were collected from Cytauxzoon sp. PCR-positive cats and the cats followed for up to 851 days. RESULTS The cases were three two-month old kittens from the same litter (Cases 1-3) and two adult domestic shorthair cats (Cases 4 and 5). The cats originated from the north-west and west of Switzerland. Cases 1-3 presented with moderate to severe regenerative anaemia and intraerythrocytic inclusions. Cytauxzoon sp. was confirmed by PCR and sequencing. The kittens made a clinical and haematological recovery after blood transfusion and/or treatment with azithromycin and atovaquone, but erythroparasitaemia persisted. Case 4 presented with severe non-regenerative anaemia. Case 5 was healthy and used as a blood donor for Case 4. Following blood transfusion, Case 4 showed intraerythrocytic inclusions, and Cytauxzoon sp. was confirmed in both Cases 4 and 5 using PCR and sequencing. Case 4 achieved clinical and haematological remission after treatment with azithromycin, atovaquone and immunosuppressive drugs. Eight months later, Case 4 was presented again with anaemia but tested Cytauxzoon sp. PCR-negative. Sequencing of 1637 bp of the 18S rRNA gene of Cytauxzoon sp. revealed 100% nucleotide sequence identity among isolates of Cases 1-3 and between isolates of Cases 4 and 5, and 99% sequence identity between isolates of all cases. Phylogenetic analysis revealed the closest relationship of the Swiss isolates to Cytauxzoon sp. isolates from domestic cats and wild felids from France, Spain and Romania and to Cytauxzoon manul from a Pallas's cat. CONCLUSIONS This is the first report of Cytauxzoon sp. infection in domestic cats in Switzerland. It is also the first report of infection in very young kittens and transmission of Cytauxzoon sp. to an adult cat by transfusion of blood from an asymptomatic cat. The cats recovered but some developed chronic asymptomatic erythroparasitaemia for up to 28 months. Domestic cats may act as reservoirs for Cytauxzoon sp. in Europe and blood donor cats should be screened for this agent by PCR.
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Affiliation(s)
- Alice Nentwig
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Marina L Meli
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Johanna Schrack
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Iris M Reichler
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Barbara Riond
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Corinne Gloor
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Judith Howard
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Regina Hofmann-Lehmann
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Barbara Willi
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland. .,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
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