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Margeti C, Kazakos G, Skampardonis V, Galatos AD, Zacharopoulou T, Tsioli V, Loukopoulos E, Tyrnenopoulou P, Papatsiros VG, Flouraki E. The Effect of a Subsequent Dose of Dexmedetomidine or Other Sedatives following an Initial Dose of Dexmedetomidine on Sedation and Quality of Recovery in Cats: Part I. Vet Sci 2024; 11:186. [PMID: 38787158 PMCID: PMC11126131 DOI: 10.3390/vetsci11050186] [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: 04/20/2024] [Indexed: 05/25/2024] Open
Abstract
Dexmedetomidine is an a2-agonist commonly used in veterinary practice. Occasionally, the administered dose of dexmedetomidine may result in insufficient sedation, and an additional dose or drug may be required. The sedative effects of seven different drugs administered at subsequent time points after an initial, insufficient dose of dexmedetomidine were evaluated. Seven adult cats participated in this crossover, blind, randomised study. The groups consisted of two consecutive doses of dexmedetomidine (15 + 10 μg/kg) (DD) or a dose of dexmedetomidine (15 μg/kg) followed by either NS 0.9% (DC-control group), tramadol 2 mg/kg (DT), butorphanol 0.2 mg/kg (DBT), buprenorphine 20 μg/kg (DBP), ketamine 2 mg/kg (DK), or midazolam 0.1 mg/kg (DM). Sedation was evaluated using the Grint sedation scale. In all groups, atipamezole was administered at the end of the evaluation, and recovery was assessed using the Lozano and Sams recovery scales. The DC and DM groups exhibited minimal sedative effects. The maximum sedative effect was observed in the DD and DK groups, while sedation in the DD and DK groups was significantly higher compared to the DC group. Recovery in all groups was uneventful, except in the DM group, where it was prolonged and difficult, although no statistically significant difference was detected. Therefore, insufficient sedation with dexmedetomidine can be enhanced by a subsequent dose of dexmedetomidine, ketamine, or butorphanol, whereas the addition of midazolam reduces sedation and prolongs recovery.
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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.); (E.L.); (P.T.)
| | - Georgios Kazakos
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece;
| | - 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;
| | - 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.); (E.L.); (P.T.)
| | - 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.); (E.L.); (P.T.)
| | - 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.); (E.L.); (P.T.)
| | - 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.); (E.L.); (P.T.)
| | - 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.); (E.L.); (P.T.)
| | - 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.); (E.L.); (P.T.)
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Sun Y, Darmani NA. A Comparative Study of the Antiemetic Effects of α 2-Adrenergic Receptor Agonists Clonidine and Dexmedetomidine against Diverse Emetogens in the Least Shrew ( Cryptotis parva) Model of Emesis. Int J Mol Sci 2024; 25:4603. [PMID: 38731821 PMCID: PMC11083949 DOI: 10.3390/ijms25094603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
In contrast to cats and dogs, here we report that the α2-adrenergic receptor antagonist yohimbine is emetic and corresponding agonists clonidine and dexmedetomidine behave as antiemetics in the least shrew model of vomiting. Yohimbine (0, 0.5, 0.75, 1, 1.5, 2, and 3 mg/kg, i.p.) caused vomiting in shrews in a bell-shaped and dose-dependent manner, with a maximum frequency (0.85 ± 0.22) at 1 mg/kg, which was accompanied by a key central contribution as indicated by increased expression of c-fos, serotonin and substance P release in the shrew brainstem emetic nuclei. Our comparative study in shrews demonstrates that clonidine (0, 0.1, 1, 5, and 10 mg/kg, i.p.) and dexmedetomidine (0, 0.01, 0.05, and 0.1 mg/kg, i.p.) not only suppress yohimbine (1 mg/kg, i.p.)-evoked vomiting in a dose-dependent manner, but also display broad-spectrum antiemetic effects against diverse well-known emetogens, including 2-Methyl-5-HT, GR73632, McN-A-343, quinpirole, FPL64176, SR141716A, thapsigargin, rolipram, and ZD7288. The antiemetic inhibitory ID50 values of dexmedetomidine against the evoked emetogens are much lower than those of clonidine. At its antiemetic doses, clonidine decreased shrews' locomotor activity parameters (distance moved and rearing), whereas dexmedetomidine did not do so. The results suggest that dexmedetomidine represents a better candidate for antiemetic potential with advantages over clonidine.
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Affiliation(s)
| | - Nissar A. Darmani
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA;
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Schimites PI, Mangini LT, Gasparotto JC, Franco IG, Alves TS, Biaggio ML, Mangini NP, Freitas GC, Floriano BP, Soares AV. Sedative and cardiorespiratory effects of dexmedetomidine alone or combined with acepromazine in healthy cats. Vet J 2024; 304:106099. [PMID: 38462168 DOI: 10.1016/j.tvjl.2024.106099] [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: 09/21/2023] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
The purpose of this study was to assess sedation, emesis and cardiovascular effects of dexmedetomidine alone or combined with acepromazine in healthy cats. Fourteen male cats aged 0.9 ± 0.5 years and weighing 3.7 ± 0.7 kg were randomly assigned to one of two experimental groups: GD, dexmedetomidine 5 µg/kg; and GDA, dexmedetomidine 5 µg/kg with acepromazine 0.03 mg/kg, all intramuscularly. Measurements were recorded at baseline, at 20 minutes and then at 10-minute intervals following sedation and included heart rate (HR), respiratory rate (FR), systolic arterial pressure (SAP), rectal temperature (RT), number of episodes of emesis and sedation score (0-4). Data were compared using ANOVA for repeated measures followed by Šídák and Dunnet test. Sedation scores were compared between groups at T20 using Mann-Whitney test. Significance was considered when P <0.05. At T20, HR was significantly lower in GDA (99 ± 14 beats/min) compared with GD (133 ± 19 beats/min) and SAP was significantly lower in both groups compared with baseline (126 ± 14 vs. 148 ± 26 and 111 ± 13 vs. 144 ± 17 mmHg in GD and GDA, respectively). Duration of sedation was similar between groups, although sedation scores differed significantly at T20, with 1 (0-4) in GD and 4 (4-4) in GDA. More episodes of emesis were recorded in GD compared with GDA. The combination of dexmedetomidine and acepromazine produced more profound sedation with faster onset and lower incidence of emesis compared with dexmedetomidine alone in healthy cats.
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Affiliation(s)
- P I Schimites
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil.
| | - L T Mangini
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - J C Gasparotto
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - I G Franco
- University Center of Ourinhos, Ourinhos, São Paulo State, Brazil
| | - T S Alves
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - M L Biaggio
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - N P Mangini
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - G C Freitas
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - B P Floriano
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
| | - A V Soares
- Federal University of Santa Maria (UFSM), Post-Graduation Program in Veterinary Medicine, Center of Rural Sciences, Department of Small Animal Clinic, Santa Maria, Rio Grande do Sul State 97105-900, Brazil
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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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Sanches MC, Bessi WH, Rusch E, Schaffhausser MB, Cassoli AA, Freitas SH, Gehrcke MI, Carregaro AB. Cardiopulmonary and propofol-sparing effects of dexmedetomidine in total intravenous anesthesia in cats undergoing ovariohysterectomy. J Feline Med Surg 2022; 24:e490-e497. [PMID: 36409556 PMCID: PMC10812347 DOI: 10.1177/1098612x221130036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study aimed to assess the effect of dexmedetomidine on the propofol-based anesthesia of cats subjected to ovariohysterectomy. METHODS Twenty-eight cats were randomly allocated to four groups (seven cats in each) and premedicated with either 5 µg/kg dexmedetomidine (groups Dex 1, Dex 3 and Dex 5) or 0.05 ml saline (Prop group) intramuscularly. After the induction of anesthesia with propofol, total intravenous anesthesia was initiated with 300 µg/kg/min propofol plus 3 ml/kg/h NaCl 0.9% (Prop), or 200 µg/kg/min propofol plus dexmedetomidine at the rates of 1 µg/kg/h (Dex 1), 3 µg/kg/h (Dex 3) or 5 µg/kg/h (Dex 5). Cardiorespiratory variables were assessed 5 mins after induction and every 10 mins thereafter, until the end of anesthesia. The propofol infusion rate was adjusted every 10 mins (± 50 µg/kg/min) to maintain anesthetic depth. The times to extubation, sternal recumbency, ambulation and total recovery were recorded. Pain scoring was performed 1, 2, 4, 8, 12 and 24 h after the end of anesthesia. RESULTS Dexmedetomidine produced a propofol-sparing effect of 72.8%, 71.1% and 74.6% in the Dex 1, Dex 3 and Dex 5 groups, respectively. Cats in the Prop group maintained higher heart rate values than the other groups, and the mean arterial pressure remained higher in the Dex 3 and Dex 5 groups. Rescue intraoperative analgesia (fentanyl bolus) was most frequent in the Prop group. There was no significant difference in the time of extubation. Cats in the Dex 1 and Dex 3 groups had a faster anesthetic recovery, with shorter times to achieving sternal recumbency, regaining ambulation and reaching full recovery. Cats in the Dex 1 and Dex 5 groups presented the best recovery quality scores, with 4 (range 4-5) and 4 (range 3-5), respectively, while the Prop group scored 1 (range 1-3), the worst anesthetic recovery score among the groups. CONCLUSIONS AND RELEVANCE The use of dexmedetomidine as a total intravenous anesthesia adjuvant, especially at doses of 1 and 3 µg/kg/h, reduces propofol consumption and improves cardiorespiratory stability and intraoperative analgesia, while promoting a better and quicker recovery from anesthesia.
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Affiliation(s)
- Mariana C Sanches
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
| | - Wellington H Bessi
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
| | - Elidiane Rusch
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
| | - Marianna B Schaffhausser
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
| | - Ana A Cassoli
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
| | - Silvio H Freitas
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
| | - Martielo I Gehrcke
- Departament of Veterinary Clinics, Federal University of Pelotas, Pelotas, Brazil
| | - Adriano B Carregaro
- Department of Veterinary Medicine, School of Animal Science and Food Engineering, University of São Paulo, São Paulo, Brazil
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Côté E, Zwicker LA, Anderson EL, Stryhn H, Yu J, Andersen E. Effects of dexmedetomidine and its reversal with atipamezole on echocardiographic measurements and circulating cardiac biomarker concentrations in normal cats. J Am Vet Med Assoc 2022; 260:1-9. [PMID: 35175929 DOI: 10.2460/javma.21.06.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of dexmedetomidine (DXM) and its subsequent reversal with atipamezole (APM) on the echocardiogram and circulating concentrations of cardiac biomarkers in cats. ANIMALS 14 healthy cats. PROCEDURES Cats underwent echocardiography and measurements of circulating cTn-I and NT-proBNP concentrations before (PRE) and during (INTRA) DXM sedation (40 µg/kg IM) and 2 to 4 (2H POST) and 24 (24H POST) hours after reversal with APM. RESULTS Administering DXM significantly decreased heart rate, right ventricular and left ventricular (LV) outflow tract velocities, and M-mode-derived LV free-wall thickness; increased LV end systolic diameter and volume; and caused valvar regurgitation. While sedative effects resolved within 25 minutes of APM reversal, the evolution of echocardiographic changes was mixed: LV ejection fraction and mitral valvar regurgitation score were different at 2H POST than at both INTRA and PRE (partial return toward baseline), LV end-diastolic volume was different PRE to INTRA and INTRA to 2H POST but not different PRE to 2H POST (full return toward baseline), and M-mode-derived LV free-wall thickness was significantly different from PRE to INTRA and PRE to 2H POST (no return toward baseline). Serum cTn-I and plasma NT-proBNP concentrations increased significantly with DXM, which remained significant 2H POST. CLINICAL RELEVANCE Administration of DXM and APM reversal produced changes in echocardiographic results and in circulating cTn-I and NT-proBNP concentrations. Understanding these changes could help veterinarians differentiate drug effects from cardiac disease.
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Affiliation(s)
- Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Lesley A Zwicker
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Erin L Anderson
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Henrik Stryhn
- Department Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Jenny Yu
- Department Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Erin Andersen
- Veterinary Teaching Hospital, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
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Bouillon J, Duke T, Focken AP, Snead EC, Cosford KL. Effects of dexmedetomidine on glucose homeostasis in healthy cats. J Feline Med Surg 2020; 22:344-349. [PMID: 31090471 PMCID: PMC10814663 DOI: 10.1177/1098612x19847282] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Alpha(α)2-agonist administration has been documented to increase blood glucose concentrations in many species. The aim of this study was to further describe the effect of dexmedetomidine on glucose and its regulatory hormones in healthy cats. METHODS A randomized crossover study using eight healthy cats with a 14 day washout period was used to assess the effect of dexmedetomidine (10 μg/kg IV) and saline on glucose, cortisol, insulin, glucagon and non-esterified fatty acid (NEFA) concentrations at 0, 20, 60, 120 and 180 mins post-administration. Glucose:insulin ratios were calculated for each time point. RESULTS Within the dexmedetomidine group, significant differences (P <0.05) were detected: increased median (range) blood glucose concentrations at 60 mins (11.55 mmol/l [5.9-16.6 mmol/l]) and 120 mins (12.0 mmol/l [6.1-13.8 mmol/l]) compared with baseline (6.05 mmol/l [4.8-13.3 mmol/l]); decreased glucagon concentrations at 120 mins (3.8 pmol/l [2.7-8.8 pmol/l]) and 180 mins (4.7 pmol/l [2.1-8.2 pmol/l]) compared with baseline (11.85 pmol/l [8.3-17.2 pmol/l]); decreased NEFA concentrations at 60 mins (0.281 mmol/l [0.041-1.357 mmol/l]) and 120 mins (0.415 mmol/l [0.035-1.356 mmol/l]) compared with baseline (0.937 mmol/l [0.677-1.482 mmol/l]); and significantly larger (P <0.05) glucose:insulin ratios at 60 mins compared with baseline. Insulin and cortisol concentrations were not significantly changed after dexmedetomidine administration. CONCLUSIONS AND RELEVANCE Feline practitioners should be aware of the endocrine effects associated with the use of α2-agonists, particularly when interpreting blood glucose concentrations. The transient effects of dexmedetomidine on glucose homeostasis are unlikely to significantly affect clinical practice.
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Affiliation(s)
- Juliette Bouillon
- Small Animal Clinical Sciences, Western College of Veterinary Medicine/University of Saskatchewan, Saskatoon, Canada
| | - Tanya Duke
- Small Animal Clinical Sciences, Western College of Veterinary Medicine/University of Saskatchewan, Saskatoon, Canada
| | - Alexandra P Focken
- Small Animal Clinical Sciences, Western College of Veterinary Medicine/University of Saskatchewan, Saskatoon, Canada
| | - Elisabeth C Snead
- Small Animal Clinical Sciences, Western College of Veterinary Medicine/University of Saskatchewan, Saskatoon, Canada
| | - Kevin L Cosford
- Small Animal Clinical Sciences, Western College of Veterinary Medicine/University of Saskatchewan, Saskatoon, Canada
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Nystrom MR, Odunayo A, Okafor CC. Assessment of hydromorphone and dexmedetomidine for emesis induction in cats. J Vet Emerg Crit Care (San Antonio) 2019; 29:360-365. [PMID: 31240797 DOI: 10.1111/vec.12866] [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: 02/20/2017] [Revised: 06/21/2017] [Accepted: 06/21/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the efficacy of hydromorphone and dexmedetomidine at inducing emesis in cats. DESIGN Prospective, blinded, randomized crossover study. SETTING Veterinary university teaching hospital. ANIMALS 12 healthy purpose-bred cats. INTERVENTIONS Cats were randomly assigned to receive hydromorphone (0.1 mg/kg, subcutaneously) or dexmedetomidine (7 μg/kg, IM). Following administration, the incidences of emesis, number of emetic events, signs of nausea (hypersalivation, lip licking), temperature, heart rate, respiratory rate, and sedation score were recorded for 6 hours. MEASUREMENTS AND MAIN RESULTS Emesis was successful in 9 of 12 (75%) cats when treated with hydromorphone and in 7 of 12 (58%) cats when treated with dexmedetomidine (P = 0.67). Dexmedetomidine was more likely to cause sedation than hydromorphone (P < 0.001). Heart rate in cats was significantly decreased at 1 and 2 hours post-hydromorphone (P = 0.003, 0.014, respectively) and at 1, 2, 3, 5, 6 hours post-dexmedetomidine (P = 0.001, 0.003, 0.038, 0.013, 0.001, respectively). Cats were more likely to develop an increase in body temperature with hydromorphone administration although this was not clinically significant. CONCLUSIONS Results of the present study indicate that hydromorphone is an effective alternative to dexmedetomidine for the induction of emesis in cats. Hydromorphone appears to cause less sedation and less decrease in heart rate. Further investigation into the most adequate dose of hydromorphone for optimizing emesis is warranted.
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Affiliation(s)
- Michael R Nystrom
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - Chika C Okafor
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
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Lawrence YA, Rodrigues-Hoffmann A, Steiner JM, Suchodolski JS, Shankar S, Klemashevich CL, Lidbury JA. Development, validation, and application of a liquid chromatography-tandem mass spectrometry method for quantitative determination of trans-4-hydroxy-l-proline concentration in the serum of dogs with chronic hepatitis. Am J Vet Res 2019; 80:434-440. [PMID: 31034276 DOI: 10.2460/ajvr.80.5.434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To develop and analytically validate a liquid chromatography-tandem mass spectrometry method for measurement of endogenous trans-4-hydroxy-l-proline concentrations in canine serum and to assess serum trans-4-hydroxy-l-proline concentrations in dogs with chronic hepatitis. SAMPLE Serum samples obtained from 20 dogs with histopathologically confirmed chronic hepatitis and 20 healthy control dogs. PROCEDURES A liquid chromatography-tandem mass spectrometry method for quantification of trans-4-hydroxy-l-proline concentration was developed and assessed for analytic sensitivity, linearity, accuracy, precision, and reproducibility. Serum concentration of trans-4-hydroxy-l-proline in dogs with chronic hepatitis and healthy control dogs was measured. RESULTS Observed-to-expected ratios for dilutional parallelism ranged from 72.7% to 111.5% (mean ± SD, 91.3 ± 19.6%). Intra-assay and interassay coefficients of variation ranged from 2.1% to 3.0% and 3.2% to 5.3%, respectively. Relative error ranged from -2.3% to 7.8%. Trans-4-hydroxy-l-proline concentrations were significantly lower in serum obtained from dogs with chronic hepatitis (median, 0.24 ng/mL; range, 0.06 to 1.84 ng/mL) than in serum obtained from healthy control dogs (median, 0.78 ng/mL; range, 0.14 to 4.90 ng/mL). CONCLUSIONS AND CLINICAL RELEVANCE The method described here for the quantification of trans-4-hydroxy-l-proline concentration in canine serum was found to be sensitive, specific, precise, accurate, and reproducible. Dogs with chronic hepatitis had significantly lower serum trans-4-hydroxy-l-proline concentrations than did healthy control dogs, possibly as a result of altered hepatic metabolism of amino acids.
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Zatroch KK, Sakai DM, Parry S, Campoy L, Martin-Flores M. Evaluation of atipamezole as a treatment for dexmedetomidine-induced cardiovascular depression in anesthetized cats. Am J Vet Res 2019; 80:455-460. [PMID: 31034277 DOI: 10.2460/ajvr.80.5.455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the cardiovascular effects of atipamezole administered at half the volume or the same volume as dexmedetomidine to isoflurane-anesthetized cats. ANIMALS 6 adult (1 to 2 years old) domestic shorthair cats (body weight, 3 to 6 kg). PROCEDURES Each cat was anesthetized with isoflurane and rocuronium 3 times; there was a 1-week washout period between successive anesthetic procedures. For each anesthetic procedure, dexmedetomidine (5 μg/kg) was administered IV. Five minutes after dexmedetomidine was administered, atipamezole (25 or 50 μg/kg) or saline (0.9% NaCl) solution was administered IM. Pulse rate, mean arterial blood pressure (MAP), cardiac output (CO), and systemic vascular resistance (SVR) were measured during anesthesia before dexmedetomidine administration (baseline), after dexmedetomidine administration, and 15, 30, 60, and 120 minutes after administration of atipamezole or saline solution. Pulse rate and MAP were also recorded when MAP was at its lowest value. Hemodynamic variables were compared among treatments at baseline, after dexmedetomidine administration, and after administration of atipamezole or saline solution. Effects of treatment and time on all variables were assessed with mixed-effects models. RESULTS Both doses of atipamezole resulted in a significantly lower MAP than did saline solution. Pulse rate, CO, and SVR were not significantly different among treatments after atipamezole or saline solution were administered. CONCLUSIONS AND CLINICAL RELEVANCE Atipamezole administered IM at half the volume or the same volume as dexmedetomidine was ineffective at increasing pulse rate or CO in anesthetized cats that received dexmedetomidine. However, atipamezole caused short-lasting but severe arterial hypotension.
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Carvalho ER, Champion T, Vilani RGDC, Freitas GC, Ambrosini F, Silva GA, Gonçalves KS, Fischborn JCJ. Sedative and electrocardiographic effects of low dose dexmedetomidine in healthy cats. PESQUISA VETERINÁRIA BRASILEIRA 2019. [DOI: 10.1590/1678-5150-pvb-5823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT: In feline veterinary practice sedation is often needed to perform diagnostic or minimally invasive procedures, minimize stress, and facilitate handling. The mortality rate of cats undergoing sedation is significantly higher than dogs, so it is fundamental that the sedatives provide good cardiovascular stability. Dexmedetomidine (DEX) is an α2-adrenergic receptor agonist utilized in cats to provide sedation and analgesia, although studies have been utilized high doses, and markedly hemodynamic impairments were reported. The aim of this study was to prospectively investigate how the sedative and electrocardiographic effects of a low dose of DEX performing in cats. Eleven healthy cats were recruited; baseline sedative score, systolic arterial pressure, electrocardiography, and vasovagal tonus index (VVTI) were assessed, and repeated after ten minutes of DEX 5μg/kg intramuscularly (IM). A smooth sedation was noticed, and emesis and sialorrhea were common adverse effects, observed on average seven minutes after IM injection. Furthermore, electrocardiographic effects of a low dose of DEX mainly include decreases on heart rate, and increases on T-wave amplitude. The augmentation on VVTI and appearance of respiratory sinus arrhythmia, as well as sinus bradycardia in some cats, suggesting that DEX enhances parasympathetic tonus in healthy cats, and therefore will be best avoid in patients at risk for bradycardia.
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Cremer J, Riccó CH. Cardiovascular, respiratory and sedative effects of intramuscular alfaxalone, butorphanol and dexmedetomidine compared with ketamine, butorphanol and dexmedetomidine in healthy cats. J Feline Med Surg 2018; 20:973-979. [PMID: 29192545 PMCID: PMC11129238 DOI: 10.1177/1098612x17742289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives The aim of the study was to evaluate the cardiorespiratory effects, quality of sedation and recovery of intramuscular alfaxalone-dexmedetomidine-butorphanol (ADB) and ketamine-dexmedetomidine-butorphanol (KDB), in cats. Methods Nine adult, healthy cats (6.63 ± 1.42 kg) were enrolled in a blinded, randomized, crossover experimental design. Cats were sedated twice intramuscularly, once with ADB (alfaxalone 1 mg/kg, dexmedetomidine 0.005 mg/kg, butorphanol 0.2 mg/kg), and once with KDB (ketamine 5 mg/kg, dexmedetomidine 0.005 mg/kg, butorphanol 0.2 mg/kg), in random order. Data collected included heart rate (HR), arterial blood pressure and blood gas analysis, respiratory rate and sedation score. Analysis of variance with Bonferroni post-hoc correction was used for parametric data, and a Wilcoxon signed rank test was used for non-parametric data. Significance was set at P <0.05. Results Total sedation time was shorter for ADB (90.71 ± 15.12 mins vs 147.00 ± 47.75 mins). Peak sedation was observed within 15 mins in both groups. Quality of recovery was excellent in both groups. HR decreased over time in both groups. Diastolic and mean arterial pressure decreased over time for ADB, becoming significant after 30 mins. All cardiovascular variables were within the clinically acceptable range in both groups. Arterial partial pressure of oxygen was significantly decreased from baseline for KDB at all time points (73 ± 2.5 mmHg [9.7 ± 0.3 kPa] vs ADB 83 ± 2.6 mmHg [11 ± 0.3 kPa]). Hypoventilation was not observed. Conclusions and relevance Both protocols produced acceptable cardiovascular stability. Sedation and recovery quality were good, albeit sedation was shorter with ADB. Although oxygenation was better maintained in the ADB group, all sedated cats should receive oxygen supplementation.
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Affiliation(s)
- Jeannette Cremer
- School of Veterinary Medicine, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - Carolina H Riccó
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, OH, USA
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Martin-Flores M, Sakai DM, Honkavaara J, Campoy L, Portela DA, Gleed RD. Hemodynamic effects of MK-467 following intravenous administration to isoflurane-anesthetized cats concurrently receiving dexmedetomidine. Am J Vet Res 2018; 79:711-717. [DOI: 10.2460/ajvr.79.7.711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Martin-Flores M, Sakai DM, Honkavaara J, Campoy L. Hemodynamic effects of low-dose atipamezole in isoflurane-anesthetized cats receiving an infusion of dexmedetomidine. J Feline Med Surg 2018; 20:571-577. [PMID: 28766985 PMCID: PMC11104072 DOI: 10.1177/1098612x17722265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives The objective of this study was to evaluate the cardiovascular effects of low-dose atipamezole administered intravenously to isoflurane-anesthetized cats receiving dexmedetomidine. We hypothesized that atipamezole would increase heart rate (HR) and reduce arterial blood pressure in isoflurane-anesthetized cats receiving dexmedetomidine. Methods Six healthy adult domestic shorthair cats were anesthetized with isoflurane and instrumented for direct arterial pressures and cardiac output (CO) measurements. The cats received a target-controlled infusion of dexmedetomidine (target plasma concentration 10 ng/ml) for 30 mins before administration of atipamezole. Two sequential doses of atipamezole (15 and 30 μg/kg IV) were administered at least 20 mins apart, during dexmedetomidine administration. The effects of dexmedetomidine and each dose of atipamezole on HR, mean arterial blood pressure (MAP), CO and systemic vascular resistance (SVR) were documented. Results Dexmedetomidine reduced the HR by 22%, increased MAP by 78% (both P ⩽0.01), decreased CO by 48% and increased SVR by 58% (both P ⩽0.0003). Administration of atipamezole 15 and 30 μg/kg intravenously increased HR by 8% ( P = 0.006) and 4% ( P = 0.1), respectively. MAP decreased by 39% and 47%, respectively (both P ⩽0.004). Atipamezole 30 μg/kg returned CO and SVR to baseline values. Conclusions and relevance Low doses of atipamezole (15 and 30 μg/kg) administered intravenously to anesthetized cats decreased arterial blood pressure with only marginal increases in HR. Atipamezole 30 μg/kg restored CO and SVR to baseline values before dexmedetomidine administration.
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Affiliation(s)
- Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Daniel M Sakai
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Juhana Honkavaara
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland
| | - Luis Campoy
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Lemos V, Sande J, Barbosa V, Costa Neto J, Martins Filho E, Iwassa C. Avaliação da dexmedetomidina e do tramadol, associados ao midazolam, em gatas anestesiadas com isoflurano e submetidas à ovário-histerectomia. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se comparar as alterações cardiorrespiratórias e a analgesia pós-operatória promovidas pela dexmedetomidina e pelo tramadol, quando associados ao midazolam, em felinas. Para tal, foram selecionadas 18 gatas hígidas, divididas em dois grupos randomizados: GDM, tratadas com dexmedetomidina (10µg/kg) e GTM, tratadas com tramadol (2mg/kg), ambos associados a midazolam (0,2mg/kg,) IM. Após 15 minutos, procedeu-se à indução anestésica com propofol (1,46±0,79mL), mantendo-se a anestesia com isoflurano. As felinas foram submetidas à ovário-histerectomia, registrando-se as variáveis cardiorrespiratórias 15 minutos após a MPA (M0), 15 minutos após a indução (M15) e sequencialmente a cada cinco minutos, até o término do procedimento cirúrgico (M20, M25, M30, M35 e M40). A avaliação da dor iniciou-se 30 minutos após o término do procedimento cirúrgico (MP30) e sequencialmente em intervalos de 30 minutos (MP60, MP90, MP120). A partir do MP120, as avaliações foram registradas a cada hora (MP180, MP240 e MP360). A associação dexmedetomidina-midazolam infere diminuição inicial de frequência cardíaca (FC) sem significado clínico e está relacionada à sedação mais pronunciada, à analgesia menor e menos duradoura e a episódios de êmese, quando comparada à associação tramadol-midazolam. Ambos os protocolos denotaram estabilidade cardiorrespiratória e podem ser considerados seguros em felinas submetidas à ovário-histectomia.
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Siao KT, Pypendop BH, Honkavaara J, Ilkiw JE. Hemodynamic effects of dexmedetomidine, with and without MK-467, following intramuscular administration in cats anesthetized with isoflurane. Vet Anaesth Analg 2017; 44:1101-1115. [DOI: 10.1016/j.vaa.2017.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/17/2017] [Accepted: 02/18/2017] [Indexed: 12/16/2022]
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Raekallio MR, Virtanen M, Happonen I, Vainio OM. Adverse reactions of α 2-adrenoceptor agonists in cats reported in 2003-2013 in Finland. Vet Anaesth Analg 2017; 44:803-810. [PMID: 28733105 DOI: 10.1016/j.vaa.2016.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/14/2016] [Accepted: 07/06/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To describe suspected adverse drug reactions in cats associated with use of α2-adrenoceptor agonists. STUDY DESIGN Retrospective study. ANIMALS A total of 90 cats. METHODS Data were collected from reports on adverse reactions to veterinary medicines sent to the Finnish Medicines Agency during 2003-2013. All reports of suspected adverse reactions associated with use of α2-adrenoceptor agonists in cats were included. Probable pulmonary oedema was diagnosed based on post mortem or radiological examination, or presence of frothy or excess fluid from the nostrils or trachea. If only dyspnoea and crackles on auscultation were reported, possible pulmonary oedema was presumed. RESULTS Pulmonary oedema was suspected in 61 cases. Of these cats, 37 were categorised as probable and 24 as possible pulmonary oedema. The first clinical signs had been noted between 1 minute and 2 days (median, 15 minutes) after α2-adrenoceptor agonist administration. Many cats probably had no intravenous overhydration when the first clinical signs were detected, as either they presumably had no intravenous cannula or the signs appeared before, during or immediately after cannulation. Of the 61 cats, 43 survived, 14 died and for four the outcome was not clearly stated. CONCLUSIONS AND CLINICAL RELEVANCE Pulmonary oedema is a perilous condition that may appear within minutes of an intramuscular administration of sedative or anaesthetic agent in cats. The symptoms were not caused by intravenous overhydration, at least in cats having no venous cannula when the first clinical signs were detected.
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Affiliation(s)
- Marja R Raekallio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
| | | | | | - Outi M Vainio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Pypendop BH, Honkavaara J, Ilkiw JE. Pharmacokinetics of dexmedetomidine, MK-467 and their combination following intramuscular administration in male cats. Vet Anaesth Analg 2017; 44:823-831. [DOI: 10.1016/j.vaa.2017.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
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The impact of MK-467 on sedation, heart rate and arterial blood pressure after intramuscular coadministration with dexmedetomidine in conscious cats. Vet Anaesth Analg 2017; 44:811-822. [DOI: 10.1016/j.vaa.2016.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 07/30/2016] [Accepted: 08/24/2016] [Indexed: 12/28/2022]
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Fernandez-Parra R, Adami C, Dresco T, Donnelly TM, Zilberstein L. Dexmedetomidine-methadone-ketamine versus dexmedetomidine-methadone-alfaxalone for cats undergoing ovariectomy. Vet Anaesth Analg 2017; 44:1332-1340. [PMID: 29150087 DOI: 10.1016/j.vaa.2017.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 02/13/2017] [Accepted: 03/14/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the duration, quality of anaesthesia and analgesia, and quality of recovery of dexmedetomidine and methadone combined with either ketamine or alfaxalone. STUDY DESIGN Randomized, prospective clinical trial. ANIMALS A group of 44 healthy client-owned cats presenting for ovariectomy. METHODS Cats were randomly assigned to one of the two treatment groups: DAM (n=22), which was administered intramuscularly (IM) dexmedetomidine (15 μg kg-1), methadone (0.3 mg kg-1) and alfaxalone (3 mg kg-1), and DKM (n=22), which was administered IM dexmedetomidine (15 μg kg-1), methadone (0.3 mg kg-1) and ketamine (3 mg kg-1). During anaesthesia, heart rate, respiratory rate and systolic arterial pressure were measured every 5 minutes. Cats that moved or had poor muscle relaxation were administered an additional 1 mg kg-1 of either alfaxalone (DAM) or ketamine (DKM) intravenously (IV). In cases of increased autonomic responses to surgical stimulation, fentanyl (2 μg kg-1) was administered IV. At the end of the surgery, atipamezole (75 μg kg-1) was administered IM, and the times to both sternal recumbency and active interaction were recorded. Quality of recovery was evaluated with a simple descriptive scale. The UNESP-Botucatu multidimensional composite pain scale and a visual analogue scale were used to evaluate postoperative analgesia at the return of active interaction and 1, 2 and 3 hours later. RESULTS The additional anaesthesia and rescue fentanyl requirements were similar between groups. The quality of recovery was better in the DAM group than in the DKM group [simple descriptive scale scores: 0 (0-1) and 1 (0-3), respectively; p=0.002]. Postoperative pain scores decreased progressively over time in both groups, with no significant differences (p=0.08) between them. CONCLUSIONS AND CLINICAL RELEVANCE Both protocols provided comparable quality of anaesthesia and analgesia and were suitable for cats undergoing ovariectomy. In combination with methadone and dexmedetomidine, alfaxalone and ketamine showed comfortable and reliable recoveries.
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Affiliation(s)
- Rocio Fernandez-Parra
- Department of Veterinary Anesthesiology and Critical Care, Ecole Nationale Vétérinaire d'Alfort, Paris, France.
| | - Chiara Adami
- Department of Clinical Sciences and Services, Royal Veterinary College, Hatfield, UK
| | - Thomas Dresco
- Department of Veterinary Anesthesiology and Critical Care, Ecole Nationale Vétérinaire d'Alfort, Paris, France
| | - Thomas M Donnelly
- Department of Veterinary Anesthesiology and Critical Care, Ecole Nationale Vétérinaire d'Alfort, Paris, France
| | - Luca Zilberstein
- Department of Veterinary Anesthesiology and Critical Care, Ecole Nationale Vétérinaire d'Alfort, Paris, France
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Pypendop BH, Honkavaara J, Ilkiw JE. Cardiovascular effects of dexmedetomidine, with or without MK-467, following intravenous administration in cats. Vet Anaesth Analg 2017; 44:52-62. [DOI: 10.1111/vaa.12397] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/20/2016] [Indexed: 12/26/2022]
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Honkavaara J, Pypendop B, Turunen H, Ilkiw J. The effect of MK-467, a peripheral α2-adrenoceptor antagonist, on dexmedetomidine-induced sedation and bradycardia after intravenous administration in conscious cats. Vet Anaesth Analg 2017; 44:42-51. [DOI: 10.1111/vaa.12385] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/15/2016] [Indexed: 12/16/2022]
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Bruniges N, Taylor PM, Yates D. Injectable anaesthesia for adult cat and kitten castration: effects of medetomidine, dexmedetomidine and atipamezole on recovery. J Feline Med Surg 2016; 18:860-867. [PMID: 26265737 PMCID: PMC11132223 DOI: 10.1177/1098612x15598550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objectives Rapid recovery from injectable anaesthesia benefits cat shelter neutering programmes. The effects of medetomidine, dexmedetomidine and atipamezole on recovery were evaluated in adult cats and kittens (⩽6 months old). Methods One hundred healthy male cats (age range 2-66 months, weight range 0.7-5.3 kg) admitted forneutering were randomly allocated to groups of 25. Anaesthesia was induced with 60 mg/m2 ketamine, 180 µg/m2 buprenorphine, 3 mg/m2 midazolam and either 600 µg/m2 medetomidine (groups M and MA) or 300 µg/m2 dexmedetomidine (groups D and DA) intramuscularly (IM). Groups MA and DA also received 1.5 mg/m2 atipamezole IM after 40 mins. Preparation time, surgical time, and times to sternal recumbency and standing were recorded. Data were analysed using the Kruskall-Wallis test, unpaired t-tests and ANOVA. Statistical significance was deemed to be P ⩽0.05. Results Groups did not differ significantly in age, body weight, preparation or surgical time. The time to sternal recumbency in group MA (64 ± 34 mins) was less than in group M (129 ± 32 mins), and in group DA it was less than in group D (54 ± 6 mins vs 110 ± 27 mins) ( P <0.001). There were no differences in duration of recovery to sternal recumbency between groups M and D or MA and DA. The time to standing in group MA (79 ± 51 mins) was less than in group M (150 ± 38 mins) ( P <0.001), and in group DA it was less than in group D (70 ± 22 mins vs 126 ± 27 mins) ( P <0.01). Time to standing in group D (126 ± 27 mins) was less than in group M (150 ± 38 mins) (P <0.05). Time to standing in groups DA and MA were not different. Kittens recovered faster than adults after atipamezole. Minimal adverse effects were seen. Conclusions and relevance Atipamezole reliably reduced recovery time after anaesthesia incorporating either dexmedetomidine or medetomidine; however, the choice of dexmedetomidine or medetomidine had little effect. Recovery was faster in kittens.
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Affiliation(s)
| | | | - David Yates
- RSPCA Greater Manchester Animal Hospital, Salford, UK
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COMPARISON BETWEEN DEXMEDETOMIDINE-S-KETAMINE AND MIDAZOLAM-S-KETAMINE IN IMMOBILIZATION OF ONCILLA (LEOPARDUS TIGRINUS). J Zoo Wildl Med 2016; 47:17-24. [PMID: 27010260 DOI: 10.1638/2013-0304.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Established immobilization protocols are required for safe procedures on wildlife and zoo animals. This study evaluated the cardiovascular, respiratory, and anesthetic effects of dexmedetomidine (40 μg/kg) with S-ketamine (5 mg/kg) and midazolam (0.5 mg/kg) with S-ketamine (5 mg/kg) in 12 specimens of oncilla (Leopardus tigrinus) at Quinzinho de Barros Municipal Zoo Park in Sorocaba, São Paulo, Brazil, between January and March 2010. Each animal underwent both protocols, totaling 24 anesthetic procedures. The dexmedetomidine-S-ketamine group (DK) showed a decrease in heart rate compared to initial values and significantly lower heart rate and oxyhemoglobin saturation values compared to Midazolam-S-Ketamine Group (MK). Four animals in DK had episodes of sinus pauses. Systemic blood pressure, respiratory frequency, and rectal temperature showed no significant differences between groups. The dexmedetomidine-S-ketamine group showed a greater degree of muscle relaxation and allowed for more thorough and longer oral evaluations. The dexmedetomidine-S-ketamine group had a shorter period of recumbency, longer period to return of muscle tone, and shorter recovery time. Two animals in MK did not reach recumbency. The dexmedetomidine-S-ketamine group had better qualities of induction and recovery. It may be concluded that both protocols can be safely used in oncillas. Midazolam-S-ketamine promotes effective chemical restraint for quick and minimally invasive procedures and dexmedetomidine-S-ketamine promotes effective chemical restraint for prolonged and more invasive procedures.
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Rodrigo-Mocholí D, Belda E, Bosmans T, Laredo FG. Clinical efficacy and cardiorespiratory effects of intramuscular administration of alfaxalone alone or in combination with dexmedetomidine in cats. Vet Anaesth Analg 2016; 43:291-300. [DOI: 10.1111/vaa.12304] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 05/22/2015] [Indexed: 01/15/2023]
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Cattai A, Pilla T, Cagnardi P, Zonca A, Franci P. Evaluation and optimisation of propofol pharmacokinetic parameters in cats for target-controlled infusion. Vet Rec 2016; 178:503. [PMID: 27044652 DOI: 10.1136/vr.103560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 11/04/2022]
Abstract
The aim of this study was to develop and evaluate a pharmacokinetic model-driven infusion of propofol in premedicated cats. In a first step, propofol (10 mg/kg) was administered intravenously over 60 seconds to induce anaesthesia for the elective neutering of seven healthy cats, premedicated intramuscularly with 0.3 mg/kg methadone, 0.01 mg/kg medetomidine and 2 mg/kg ketamine. Venous blood samples were collected over 240 minutes, and propofol concentrations were measured via a validated high-performance liquid chromatography assay. Selected pharmacokinetic parameters, determined by a three-compartment open linear model, were entered into a computer-controlled infusion pump (target-controlled infusion-1 (TCI-1)). In a second step, TCI-1 was used to induce and maintain general anaesthesia in nine cats undergoing neutering. Predicted and measured plasma concentrations of propofol were compared at specific time points. In a third step, the pharmacokinetic parameters were modified according to the results from the use of TCI-1 and were evaluated again in six cats. For this TCI-2 group, the median values of median performance error and median absolute performance error were -1.85 per cent and 29.67 per cent, respectively, indicating that it performed adequately. Neither hypotension nor respiratory depression was observed during TCI-1 and TCI-2. Mean anaesthesia time and time to extubation in the TCI-2 group were 73.90 (±20.29) and 8.04 (±5.46) minutes, respectively.
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Affiliation(s)
- A Cattai
- Department of Animal Medicine, Production and Health, Università degli Studi di Padova, Padua 35020, Italy
| | - T Pilla
- AHP-Animal Hospital PostojnaÂ, 6230 Postojna, Slovenia Centro Veterinario di Diagnostica per Immagini, Udine 0432, Italy
| | - P Cagnardi
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan 20133, Italy
| | - A Zonca
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan 20133, Italy
| | - P Franci
- Department of Animal Medicine, Production and Health, Università degli Studi di Padova, Padua 35020, Italy
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Pypendop BH, Honkavaara J, Ilkiw JE. Pharmacokinetics of dexmedetomidine, MK-467, and their combination following intravenous administration in male cats. J Vet Pharmacol Ther 2016; 39:460-8. [DOI: 10.1111/jvp.12302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 01/29/2016] [Indexed: 01/11/2023]
Affiliation(s)
- B. H. Pypendop
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - J. Honkavaara
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
| | - J. E. Ilkiw
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
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Abstract
OBJECTIVES The objectives were to review systematically the range of assessment tools used in cats to detect the behavioural expression of pain and the evidence of their quality; and to examine behavioural metrics (considering both the sensory and affective domains) used to assess pain. METHODS A search of PubMed and ScienceDirect, alongside articles known to the authors, from 2000 onwards, for papers in English was performed. This was followed by a manual search of the references within the primary data sources. Only peer-reviewed publications that provided information on the assessment tool used to evaluate the behavioural expression of pain in cats, in conscious animals (not anaesthetised cats), were included. RESULTS No previous systematic reviews were identified. One hundred papers were included in the final assessment. Studies were primarily related to the assessment of pain in relation to surgical procedures, and no clear distinction was made concerning the onset of acute and chronic pain. Ten broad types of instrument to assess pain were identified, and generally the quality of evidence to support the use of the various instruments was poor. Only one specific instrument (UNESP-Botucatu scale) had published evidence of validity, reliability and sensitivity at the level of a randomised control trial, but with a positive rather than placebo control, and limited to its use in the ovariohysterectomy situation. The metrics used within the tools appeared to focus primarily on the sensory aspect of pain, with no study clearly discriminating between the sensory and affective components of pain. CONCLUSIONS AND RELEVANCE Further studies are required to provide a higher quality of evidence for methods used to assess pain in cats. Furthermore, a consistent definition for acute and chronic pain is needed. Tools need to be validated that can detect pain in a range of conditions and by different evaluators (veterinary surgeons and owners), which consider both the sensory and emotional aspects of pain.
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Affiliation(s)
| | - Daniel S Mills
- School of Life Sciences, University of Lincoln, Lincoln, UK
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Thawley VJ, Drobatz KJ. Assessment of dexmedetomidine and other agents for emesis induction in cats: 43 cases (2009–2014). J Am Vet Med Assoc 2015; 247:1415-8. [DOI: 10.2460/javma.247.12.1415] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Papastefanou AK, Galatos AD, Pappa E, Lymperis AG, Kostoulas P. The effect of butorphanol on the incidence of dexmedetomidine-induced emesis in cats. Vet Anaesth Analg 2015; 42:608-13. [DOI: 10.1111/vaa.12260] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/16/2014] [Indexed: 11/29/2022]
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Jena B, Das J, Nath I, Sardar KK, Sahoo A, Beura SS, Painuli A. Clinical evaluation of total intravenous anaesthesia using xylazine or dexmedetomidine with propofol in surgical management of canine patients. Vet World 2014. [DOI: 10.14202/vetworld.2014.671-680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Quandt J. Analgesia, Anesthesia, and Chemical Restraint in the Emergent Small Animal Patient. Vet Clin North Am Small Anim Pract 2013; 43:941-53. [DOI: 10.1016/j.cvsm.2013.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Selleri P, Di Girolamo N, Melidone R. Cystoscopic sex identification of posthatchling chelonians. J Am Vet Med Assoc 2013; 242:1744-50. [DOI: 10.2460/javma.242.12.1744] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hunt JR, Grint NJ, Taylor PM, Murrell JC. Sedative and analgesic effects of buprenorphine, combined with either acepromazine or dexmedetomidine, for premedication prior to elective surgery in cats and dogs. Vet Anaesth Analg 2012; 40:297-307. [PMID: 23279623 DOI: 10.1111/vaa.12003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/19/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine, administered as premedication to cats and dogs undergoing elective surgery. STUDY DESIGN Prospective, randomized, blinded clinical study. ANIMALS Forty dogs and 48 cats. METHODS Animals were assigned to one of four groups, according to anaesthetic premedication and induction agent: buprenorphine 20 μg kg(-1) with either dexmedetomidine (dex) 250 μg m(-2) or acepromazine (acp) 0.03 mg kg(-1), followed by alfaxalone (ALF) or propofol (PRO). Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane. Physiological measures and assessments of pain, sedation and mechanical nociceptive threshold (MNT) were made before and after premedication, intraoperatively, and for up to 24 hours after premedication. Data were analyzed with one-way, two-way and mixed between-within subjects anova, Kruskall-Wallis analyses and Chi squared tests. Results were deemed significant if p ≤ 0.05, except where multiple comparisons were performed (p ≤ 0.005). RESULTS Cats premedicated with dex were more sedated than cats premedicated with acp (p < 0.001) and ALF doses were lower in dex cats (1.2 ± 1.0 mg kg(-1) ) than acp cats (2.5 ± 1.9 mg kg(-1)) (p = 0.041). There were no differences in sedation in dogs however PRO doses were lower in dex dogs (1.5 ± 0.8 mg kg(-1) ) compared to acp dogs (3.3 ± 1.1 mg kg(-1) ) (p < 0.001). There were no differences between groups with respect to pain scores or MNT for cats or dogs. CONCLUSION Choice of dex or acp, when given with buprenorphine, caused minor, clinically detectable, differences in various characteristics of anaesthesia, but not in the level of analgesia. CLINICAL RELEVANCE A combination of buprenorphine with either acp or dex, followed by either PRO or ALF, and then isoflurane, accompanied by an NSAID, was suitable for anaesthesia in dogs and cats undergoing elective surgery. Choice of sedative agent may influence dose of anaesthetic induction agent.
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Affiliation(s)
- James R Hunt
- Morley Veterinary Centre, Taunton, Somerset, UK.
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