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Arslan HN, Çelik SŞ. Nonpharmacological Nursing Interventions in Postoperative Nausea and Vomiting: A Systematic Review. J Perianesth Nurs 2024; 39:142-154. [PMID: 37865902 DOI: 10.1016/j.jopan.2023.06.096] [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: 11/12/2022] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV). DESIGN This is a systematic review. METHODS MEDLINE, Web of Science, ScienceDirect, Tübitak-ULAKBİM, and TRDizin databases were searched for the following search terms, including "Postoperative Nausea and Vomiting," "Nurse," "Nursing," and "Nonpharmacological Interventions" to identify nonpharmacological nursing interventions for PONV. A systematic review of English and Turkish articles published in the period between January 1, 2012 and June 1, 2023 was conducted. The PICOT-SD method was used to determine the compatibility of the pieces with the eligibility criteria. FINDINGS Fifty-eight of 3,874 articles obtained from databases fulfilled the eligibility criteria. This study demonstrated that acupuncture, aromatherapy, the oral intake of ginger, listening to music, education, and visits to patients decreased the incidence of nausea and vomiting and increased the quality of life. Additionally, it was found that patients' quality of life tended to improve along with reductions in postoperative complications. CONCLUSIONS The results of this study support previous findings in the literature and demonstrate that nonpharmacological nursing interventions help reduce and prevent PONV. Based on our results, we suggest that nonpharmacological nursing interventions can be employed for the management of PONV in patients undergoing surgery.
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Andrews PLR, Golding JF, Sanger GJ. An assessment of the effects of neurokinin 1 receptor antagonism against nausea and vomiting: Relative efficacy, sites of action and lessons for future drug development. Br J Clin Pharmacol 2023; 89:3468-3490. [PMID: 37452618 DOI: 10.1111/bcp.15852] [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: 05/12/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
A broad-spectrum anti-vomiting effect of neurokinin1 receptor antagonists (NK1 RA), shown in pre-clinical animal studies, has been supported by a more limited range of clinical studies in different indications. However, this review suggests that compared with vomiting, the self-reported sensation of nausea is less affected or possibly unaffected (depending on the stimulus) by NK1 receptor antagonism, a common finding for anti-emetics. The stimulus-independent effects of NK1 RAs against vomiting are explicable by actions within the central pattern generator (ventral brainstem) and the nucleus tractus solitarius (NTS; dorsal brainstem), with additional effects on vagal afferent activity for certain stimuli (e.g., highly emetogenic chemotherapy). The central pattern generator and NTS neurones are multifunctional so the notable lack of obvious effects of NK1 RAs on other reflexes mediated by the same neurones suggests that their anti-vomiting action is dependent on the activation state of the pathway leading to vomiting. Nausea requires activation of cerebral pathways by projection of information from the NTS. Although NK1 receptors are present in cerebral nuclei implicated in nausea, and imaging studies show very high receptor occupancy at clinically used doses, the variable or limited ability of NK1 RAs to inhibit nausea emphasizes: (i) our inadequate understanding of the mechanisms of nausea; and (ii) that classification of a drug as an anti-emetic may give a false impression of efficacy against nausea vs. vomiting. We discuss the potential mechanisms for the differential efficacy of NK1 RA and the implications for future development of drugs that can effectively treat nausea, an area of unmet clinical need.
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Affiliation(s)
- Paul L R Andrews
- Division of Biomedical Sciences, St George's University of London, London, UK
| | | | - Gareth J Sanger
- Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Marques ÉJ, Monteiro ER, Herrera-Becerra JR, Tomazeli D, Rovaris IB, de Oliveira TF, Valle SDF, Alievi MM. Influence of Constant Rate Infusions of Fentanyl Alone or in Combination With Lidocaine and Ketamine on the Response to Surgery and Postoperative Pain in Isoflurane Anesthetized Dogs Undergoing Unilateral Mastectomy: A Randomized Clinical Trial. Top Companion Anim Med 2023; 52:100759. [PMID: 36587868 DOI: 10.1016/j.tcam.2022.100759] [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: 07/18/2022] [Revised: 10/03/2022] [Accepted: 12/24/2022] [Indexed: 12/30/2022]
Abstract
The aim of this study was to compare the effects of constant rate infusions (CRI) of fentanyl alone or combined with lidocaine and ketamine (FLK), on physiological parameters, isoflurane requirements and the number of postoperative analgesic rescues in dogs undergoing unilateral mastectomy. Twenty-two dogs were premedicated with acepromazine 0.02 mg/kg and morphine 0.5 mg/kg and anesthetized with propofol and isoflurane. Dogs were randomly assigned to 1 of 2 groups: Fentanyl group (fentanyl 5 µg/kg loading dose [LD] and 9 µg/kg/h CRI; n = 11); FLK group (fentanyl [same doses]; lidocaine 2 mg/kg LD and 3 mg/kg/h CRI; ketamine 1.0 mg/kg LD and 0.6 mg/kg/h CRI; = 11). Intraoperative evaluations were performed before the start of surgery and administration of the treatments (T0); three minutes after the LD (T1); during incision and tissue divulsion (T2); during closure of the surgical wound (T3). Meloxicam (0.1 mg/kg) was administered at T3. Blood samples were collected for determination of plasma concentrations of fentanyl, lidocaine and ketamine. Pain scores and the number of postoperative analgesic rescues with morphine (0.5 mg/kg) were evaluated for 24 hours postoperatively using the short form of the Glasgow Composite Measure Pain Scale. Compared to T0, significant decreases in heart rate (from 84 ± 28 to 53 ± 16 bpm in the Fentanyl group and from 93 ± 16 to 63 ± 15 bpm in FLK) and mean arterial pressure (from 61 ± 5 to 49 ± 10 mmHg in Fentanyl and from 59 ± 3 to 38 ± 6 mmHg in FLK) were observed at T1. Arterial hypotension was transient, with normalization of values at T2 and T3. The expired fraction of isoflurane did not differ significantly between the groups. Plasma concentrations of fentanyl, lidocaine and ketamine remained within the therapeutic range. Postoperatively, the number of dogs requiring analgesic rescue was significantly lower in the FLK (0/11, 0%) than in the Fentanyl group (5/11, 45%). In dogs administered morphine and meloxicam as part of the anesthesia protocol, an intraoperative CRI of FLK abolished the requirement for postoperative analgesic rescue for 24 hours in dogs undergoing mastectomy.
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Affiliation(s)
- Éder J Marques
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eduardo R Monteiro
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - José R Herrera-Becerra
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Débora Tomazeli
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Inácio B Rovaris
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tiago F de Oliveira
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Stella de F Valle
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcelo M Alievi
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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Henze L, Foth S, Meller S, Twele F, Charalambous M, Kenward H, Elliott J, Pelligand L, Volk HA. Ondansetron in dogs with nausea associated with vestibular disease: A double-blinded, randomized placebo-controlled crossover study. Vet Med (Auckl) 2022; 36:1726-1732. [PMID: 35906792 PMCID: PMC9511069 DOI: 10.1111/jvim.16504] [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: 03/17/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022]
Abstract
Background Nausea and emesis can be, among other signs, common manifestations of acute vestibular system dysfunction in dogs. Currently, antiemetic drugs, such as maropitant and metoclopramide, are used commonly, but do not appear to control nausea. A non‐placebo‐controlled preliminary study suggested good efficacy of 5‐HT3‐receptor antagonists, such as ondansetron, against nausea in dogs with vestibular syndrome. Objectives To assess and confirm the effect of ondansetron on behavior suggestive of nausea in dogs with vestibular syndrome. Animals Fourteen dogs with vestibular syndrome and clinical signs of nausea presented to a neurology service. Methods Placebo‐controlled, double‐blinded, crossover study. Behavioral assessment was performed hourly for 4 hours using an established numerical rating scale. The criteria salivation, lip licking, vocalization, restlessness, lethargy, and general nausea were scored. The occurrence of emesis was recorded. After scoring at T0 (pre‐dose) and T2 (2 hours post‐dose) either ondansetron (0.5 mg/kg) or placebo was injected IV. Two hours post‐dose, treatments were switched. Blood samples were collected to measure serum arginine vasopressin (AVP) concentration, which previously has been shown to correlate with clinical signs of nausea. Results Clinical resolution of nausea was observed 1 hour after administration of ondansetron, whereas serum AVP concentration decreased 4 hours after ondansetron administration. Conclusion and Clinical Importance Administration of ondansetron IV is beneficial for dogs with nausea secondary to acute vestibular syndrome. Ondansetron substantially and rapidly decreased clinical signs of nausea behavior and stopped emesis.
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Affiliation(s)
- Lea Henze
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sarah Foth
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Friederike Twele
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Marios Charalambous
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Hannah Kenward
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Ludovic Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Foth S, Meller S, Kenward H, Elliott J, Pelligand L, Volk HA. The use of ondansetron for the treatment of nausea in dogs with vestibular syndrome. BMC Vet Res 2021; 17:222. [PMID: 34154584 PMCID: PMC8218477 DOI: 10.1186/s12917-021-02931-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/07/2021] [Indexed: 12/12/2022] Open
Abstract
Background Vestibular syndrome is often accompanied by nausea. Drugs currently approved for its treatment have been developed to stop vomiting but not nausea. The efficacy of 5-HT3 receptor antagonists to reduce nausea has been described for chemotherapy, but not for nausea secondary to vestibular disorders. Methods Sixteen dogs with vestibular syndrome-associated nausea were included in the open-label, multicentre study. The intensity of nausea-like behaviour was analysed before ondansetron administration (0.5 mg/kg i.v.) and 2 h afterwards, using a validated 5-point-scale. The occurrence and frequency of salivation, lip licking, restlessness, vocalisation, lethargy, and vomiting were assessed. Results All dogs initially showed signs of nausea, whereas only 31% showed vomitus. The intensity of nausea was significantly reduced in all dogs (p ≤ 0.0001) 2 h after ondansetron administration, including the clinical signs of nausea analysed in 11 dogs (salivation [p = 0.0078], lip licking [p = 0.0078], restlessness [p = 0.0039], and lethargy [p = 0.0078]) except for vocalisation (p > 0.9999). Conclusions The results provide preliminary evidence of the potential benefit of ondansetron in the treatment of nausea, which was present in all examined dogs. Vomiting was only observed in 5 dogs indicating that nausea can occur separately and should not be perceived only as a preceding stimulation of the vomiting centre. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-02931-9.
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Affiliation(s)
- S Foth
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - S Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - H Kenward
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, Hatfield, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hertfordshire, Hatfield, UK
| | - L Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, Hatfield, UK
| | - H A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
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Alimi OA, Abubakar AA, Yakubu AS, Aliyu A, Abulkadir SZ. Veterinary acutherapy in management of musculoskeletal disorders: An eye-opener to the developing countries' veterinarians. Open Vet J 2020; 10:252-260. [PMID: 33282695 PMCID: PMC7703614 DOI: 10.4314/ovj.v10i3.2] [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: 02/28/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022] Open
Abstract
Traditional Chinese medicine practitioners believed that the maintenance of the health status of any individual or animal is by the harmonious flow of Chi (life force) along a pathway known as the meridian. Interruption or blockage of Chi brings about disorders, pain, and diseases. Acutherapy, therefore, aims at correcting the interruption or blockage of the harmonious flow of Chi along the meridian to restore the healthy condition of the body system. This correction could be accomplished by either acupuncture or acupressure, and are both collectively referred to as acutherapy. This form of therapy has been used in both humans and animals for several decades. It is, however, just gaining popularity in the treatment of humans and is still not yet in practice among veterinarians for animal patients in most developing countries like Nigeria. This review, therefore, is aimed at exposing veterinarians from the developing countries to the general application of acutherapy with emphasis on the musculoskeletal system and associated pain where it is most applied. It is highly recommended that the universities, where Veterinary Medicine is studied in developing countries, should endeavor to train their veterinary surgeons in this area and see to how acutherapy can be included in the curriculum.
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Affiliation(s)
- Olawale Alimi Alimi
- Department of Veterinary Surgery and Radiology, University of Ilorin, Ilorin, Nigeria.,Department of Veterinary Surgery and Radiology, Usmanu Danfodiyo University Sokoto, Sokoto, Nigeria
| | - Adamu Abdul Abubakar
- Department of Veterinary Surgery and Radiology, Usmanu Danfodiyo University Sokoto, Sokoto, Nigeria
| | - Abubakar Sadiq Yakubu
- Department of Veterinary Surgery and Radiology, Usmanu Danfodiyo University Sokoto, Sokoto, Nigeria
| | - Abdullahi Aliyu
- Department of Veterinary Surgery and Radiology, University of Ilorin, Ilorin, Nigeria
| | - Salman Zubairu Abulkadir
- Department of Veterinary Surgery and Radiology, University of Ilorin, Ilorin, Nigeria.,Department of Veterinary Surgery and Radiology, Usmanu Danfodiyo University Sokoto, Sokoto, Nigeria
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Kirchofer KS, Block G, Johnson JA. Efficacy of intravenous administration of apomorphine for removal of gastric foreign material in dogs: 495 cases (2010-2015). J Am Vet Med Assoc 2020; 255:459-465. [PMID: 31355726 DOI: 10.2460/javma.255.4.459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy of IV administration of apomorphine for removal of gastric foreign bodies in dogs. ANIMALS 495 dogs with gastric foreign bodies. PROCEDURES Records of a veterinary hospital were searched to identify dogs that received an injectable formulation of apomorphine between January 1, 2010, and July 30, 2015. Dogs with a gastric foreign body that received an IV injection of apomorphine were included in the study. Information extracted from the record of each dog included signalment, type of foreign material ingested, duration between foreign material ingestion and emesis, dose and number of doses of apomorphine administered, and whether emesis occurred and did or did not result in successful removal of the foreign body. Descriptive data were compared between dogs with and without successful foreign body removal. RESULTS Emesis with successful foreign body removal was achieved in 363 and 11 dogs after administration of 1 and 2 doses of apomorphine, respectively. Successful removal was more likely for young dogs and dogs that had ingested fabric, leather, or bathroom waste. Successful removal was less likely as the duration between foreign body ingestion and emesis increased and for dogs that received opioids, sedatives, or antiemetics before apomorphine administration. Minor adverse effects were recorded for only 4 dogs. CONCLUSIONS AND CLINICAL RELEVLANCE IV administration of apomorphine was a viable alternative for induction of emesis and removal of gastric foreign bodies in dogs. Dogs should be examined as soon as possible after foreign body ingestion and should not receive any medications that might affect apomorphine efficacy.
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Kraus BLH, Cazlan C. Assessment of Dog Owner Concern Regarding Peri-operative Nausea and Vomiting and Willingness to Pay for Anti-emetic Treatment. Front Vet Sci 2019; 6:264. [PMID: 31508429 PMCID: PMC6714863 DOI: 10.3389/fvets.2019.00264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/29/2019] [Indexed: 12/02/2022] Open
Abstract
Objective: The objective of this study was to assess dog owners' concern regarding peri-operative nausea and vomiting, and their willingness to pay for treatment. Design: Descriptive survey. Sample: A survey was administered to 104 dog owning clients with non-emergent surgical (52) or non-surgical (52) appointments at a University teaching hospital. Procedure: Descriptive statistics were calculated. A Mann-Whitney U test was used to detect differences between clients expecting their pet to undergo elective general anesthesia and those that did not. A Spearman's Rank Co-efficient was used to correlate predictive data. Results: Ninety-seven (93%) dog owners had at least some worry regarding their dog experiencing nausea associated with opioid analgesics and anesthesia, with 39/104 (37.5%) moderately to very worried. Forty-one owners (39%) would definitely and 59/104 (56.7%) would likely choose treatment to decrease or prevent signs of nausea. Ninety-four owners (90.4%) had at least some worry regarding vomiting, and 48/104 (46%) indicated they were moderately to very worried. Fifty-three owners (51.4%) would definitely and 49/103 (47.6%) would likely choose treatment to prevent vomiting. The median and mean amount owners were willing to pay was 50 and 76.47 USD, respectively. Ninety-five (91.3%) were likely or very likely to opt for treatment if required to arrive 1 h earlier for their appointment. There was no correlation between age, income, or owner's PONV experience with likelihood of choosing treatment but there was a significant positive correlation with the owner's level of education. Conclusion: Canine owners are concerned with their pets experiencing nausea and vomiting in relation to opioid analgesics and anesthesia and are willing to pay and stay the required time for effective treatment.
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Affiliation(s)
- Bonnie L Hay Kraus
- Department of Veterinary Clinical Sciences, Lloyd Veterinary Medical Center, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Callie Cazlan
- Department of Veterinary Clinical Sciences, Lloyd Veterinary Medical Center, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
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Shmalberg J, Xie H, Memon MA. Canine and Feline Patients Referred Exclusively for Acupuncture and Herbs: A Two-Year Retrospective Analysis. J Acupunct Meridian Stud 2019; 12:160-165. [PMID: 31028973 DOI: 10.1016/j.jams.2019.04.002] [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] [Received: 12/11/2018] [Revised: 03/10/2019] [Accepted: 04/03/2019] [Indexed: 12/20/2022] Open
Abstract
Acupuncture and the administration of herbal supplements are increasingly used in veterinary practice, but no retrospective studies have examined patient characteristics and treatment interventions in a population of dogs and cats presenting exclusively for such therapies. This two-year retrospective analysis of 161 referrals to an integrative medicine service at an academic teaching hospital found that dogs were more frequently treated than cats (91.9% vs. 8.1%, respectively) and that small animal patients most frequently were presented for musculoskeletal (26.7%), neurologic (16.8%), oncologic (14.9%), and dermatologic (10.6%) conditions. Cats were older than treated dogs (12.7 ± 3.7 vs. 9.5 ± 4.3 years) and more likely to be treated for oncologic complaints (odds ratio = 5.6). Patients received acupuncture (95.4%), herbal supplements (76.4%), acupuncture with percutaneous electrical nerve stimulation (electroacupuncture, 26.1%), and/or cyanocobalamin injections in acupuncture points (pharmacopuncture, 23.6%). Some differences were detected between treatment groups. This retrospective analysis provides a foundation for designing future prospective studies using acupuncture and herbs in dogs and cats.
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Affiliation(s)
- Justin Shmalberg
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16 Ave, Gainesville, FL 32608, USA
| | - Huisheng Xie
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16 Ave, Gainesville, FL 32608, USA
| | - Mushtaq A Memon
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16 Ave, Gainesville, FL 32608, USA.
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Hassen KM, Posner LP, Campbell NB. The effect of aquapuncture at Pericardium 6 (PC-6) on dexmedetomidine-induced nausea and vomiting in cats. Vet Anaesth Analg 2019; 46:308-314. [PMID: 30982710 DOI: 10.1016/j.vaa.2019.01.004] [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: 08/15/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the effect of aquapuncture at acupuncture point Pericardium 6 (PC-6) on the incidence of dexmedetomidine-induced vomiting and nausea in cats. STUDY DESIGN Randomized, prospective, crossover study. ANIMALS A group of 22 cats, 14 females and eight males, aged 1-12 years and weighing 3.8-5.9 kg. METHODS Each cat was administered treatments in random order at ≥1 week intervals. For treatment (DEX-A), cats were administered PC-6 stimulation by aquapuncture (0.25 mL/250 μg vitamin B12 injection subcutaneously at PC-6). After 30 minutes, dexmedetomidine (10 μg kg-1) was administered intramuscularly (IM). For control treatment (DEX), cats were administered only dexmedetomidine (10 μg kg-1) IM. Incidence of vomiting, number of vomiting episodes and time to first vomiting were recorded by an observer unaware of treatment allocation. At 30 minutes after dexmedetomidine administration, atipamezole (0.1 mg kg-1) was injected IM. Behavior was video recorded and later scored by two observers for clinical signs of nausea. A regression model (analysis of covariance) was used to detect the influence of aquapuncture on vomiting and nausea. Significance was set at p < 0.05. RESULTS Of 21 cats, 18 (85%) and 16 cats (76%) vomited in DEX-A and DEX, respectively. There was no significant difference in the incidence of vomiting (p = 0.55), number of vomiting episodes (p = 0.55), mean time to vomit (p = 0.88) or nausea score (p = 0.51) between DEX-A and DEX. CONCLUSIONS AND CLINICAL RELEVANCE PC-6 aquapuncture did not reduce the incidence of dexmedetomidine-induced vomiting or severity of nausea in cats.
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Affiliation(s)
- Kimberly M Hassen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
| | - Lysa P Posner
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Radkey DI, Writt VE, Snyder LBC, Jones BG, Johnson RA. Gastrointestinal effects following acupuncture at Pericardium-6 and Stomach-36 in healthy dogs: a pilot study. J Small Anim Pract 2018; 60:38-43. [PMID: 30281151 DOI: 10.1111/jsap.12935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To quantify changes in gastric and intestinal emptying times in the conscious dog following gastrointestinal acupoint stimulation. MATERIALS AND METHODS In a randomised, blinded crossover study, six dogs were fed 30×1.5 mm barium-impregnated polyethylene spheres and underwent: (1) no acupuncture (Control); (2) stimulation of target points PC6 and ST36 (Target) and (3) stimulation of non-target points LU7 and BL55 (Sham). Abdominal radiographs were assessed immediately after feeding the spheres and every hour for 12 hours and their number in the stomach and large intestines was counted. RESULTS The number of barium-impregnated polyethylene spheres found distal to the stomach was less in the Target group compared to the Control and Sham groups between hours 2 and 4, but no differences between groups were seen for the remainder of the treatment period. The number of spheres found within the colon/rectum was less in the Target group compared to the Control and Sham groups between hours 4 and 6, and compared to the Sham group only at hour 7 but no differences between groups were seen after hour 8. CLINICAL SIGNIFICANCE Acupuncture targeted at the gastrointestinal tract of dogs was associated briefly with slowed gastric emptying and gastrointestinal transit time. This foundational study lays the groundwork for additional studies of acupuncture effects associated with altered physiologic states.
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Affiliation(s)
- D I Radkey
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, 53706, USA
| | - V E Writt
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, 53706, USA
| | - L B C Snyder
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, 53706, USA
| | - B G Jones
- Anetech Imaging Services, Fountain Valley, California, 92708, USA
| | - R A Johnson
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, 53706, USA
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Brioschi FA, Gioeni D, Jacchetti A, Carotenuto AM. Effect of metoclopramide on nausea and emesis in dogs premedicated with morphine and dexmedetomidine. Vet Anaesth Analg 2018; 45:190-194. [PMID: 29409803 DOI: 10.1016/j.vaa.2017.09.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/16/2017] [Accepted: 09/20/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate whether subcutaneous (SC) metoclopramide (0.2 mg kg-1) administered 30 minutes prior to (T30) or simultaneously with (T0) intramuscular (IM) morphine (0.2 mg kg-1) and dexmedetomidine (0.003 mg kg-1) reduces the incidence of nausea and emesis in healthy dogs. STUDY DESIGN Prospective, randomized and blinded study. ANIMALS A total of 45 dogs scheduled for elective procedures. METHODS Dogs were assigned randomly to three groups to be administered SC metoclopramide (0.2 mg kg-1) 30 minutes before (group M30) or simultaneously (group M0) to IM morphine (0.2 mg kg-1) and dexmedetomidine (0.003 mg kg-1). Dogs in the control group (group C) were administered SC saline at T30 and T0. Dogs were observed for 30 minutes after premedication to evaluate signs of nausea (continuous lip-licking and sialorrhoea) and emesis. Signs of pain or discomfort caused by SC injections were also recorded. RESULTS There were no statistical differences amongst groups for age, body weight and sex. More dogs developed continuous lip-licking in group C (12/15, 80.0%) compared to dogs in group M30 (1/15, 6.7%) and dogs in group M0 (5/15, 33.3%; p = 0.0001 and p = 0.01, respectively). More dogs developed sialorrhoea in group M0 (8/15, 53.3%) and in group C (10/15, 66.7%) compared to dogs in group M30 (2/15, 13.3%; p = 0.03 and p = 0.004, respectively). More dogs vomited in group M0 (4/15, 26.7%) and in group C (9/15, 60.0%) compared to dogs in group M30 (0/15, 0.0%; p = 0.05 and p = 0.0003, respectively). None of the dogs demonstrated signs of pain or discomfort during SC metoclopramide injection. CONCLUSIONS AND CLINICAL RELEVANCE Subcutaneous metoclopramide at 0.2 mg kg-1 may reduce IM morphine and dexmedetomidine-induced nausea and emesis if administered 30 minutes in advance. It is effective in reducing lip-licking even when administered concurrently with IM morphine-dexmedetomidine.
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Yang T, Shmalberg J, Hochman L, Miscioscia E, Brumby M, McKenna K, Roth A. Comparison of Point Placement by Veterinary Professionals with Different Levels of Acupuncture Training in a Canine Cadaver Model. J Acupunct Meridian Stud 2017; 10:360-370. [PMID: 29078972 DOI: 10.1016/j.jams.2017.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/08/2017] [Indexed: 11/15/2022] Open
Abstract
Veterinary acupuncture is becoming increasingly implemented for various disease processes, with growing numbers of veterinarians pursuing advanced training to meet the rising demand for this relatively new intervention. Accurate acupoint placement remains challenging, with individual practitioners relying on varying methods of point identification, often compounded by the transpositional nature of points for companion animals. The aim of this study was to assess for differences in acupuncture needle placement of select points between veterinary professionals with three different levels of acupuncture training in an academic teaching environment. Seven participants placed a total of six acupoints on a canine cadaver. Digital radiography was used to document each participant's point placement. Each participant's point location was then compared to a control "correct" point, and the distance between the two points was measured. A significant difference in placement accuracy was identified between the participants when grouped by training level (p = 0.03). These results indicate that veterinary patients receiving acupuncture treatment from veterinarians with different levels of training may subsequently experience varying effects, although further studies are warranted on more specific acupoint description as well as the clinical implications of needle placement accuracy.
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Affiliation(s)
- Toni Yang
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Justin Shmalberg
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Lindsay Hochman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Erin Miscioscia
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Meghan Brumby
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Kelsey McKenna
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Amber Roth
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Hay Kraus BL. Spotlight on the perioperative use of maropitant citrate. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2017; 8:41-51. [PMID: 30050855 PMCID: PMC6042506 DOI: 10.2147/vmrr.s126469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neurokinin-1 (NK-1) receptors are present in both the central nervous system and peripheral tissues. Substance P (SP) is the major ligand and is involved in multiple processes including pain transmission, vasodilation, modulation of the inflammatory response, as well as the sensory neuronal transmission involved in stress, anxiety, and emesis. The involvement of NK-1 and SP in the vomiting reflex has led to the development of NK-1 antagonists to prevent and treat vomiting in human and veterinary medicine. Maropitant is a potent, selective neurokinin (NK-1) receptor antagonist that blocks the pharmacologic action of SP in the central nervous system. Maropitant is available in both an injectable and tablet formulation and approved for use in dogs and cats for the treatment and prevention of vomiting from a variety of clinical causes and motion sickness. When administered prior to anesthetic premedication, maropitant prevents or significantly decreases the incidence of opioid-induced vomiting and signs of nausea in dogs and cats. Maropitant has also been shown to improve postoperative return to feeding and food intake in dogs. The minimum alveolar concentration of sevoflurage is decreased in both dogs and cats by maropitant, indicating a potential role as an adjunct analgesic, especially for visceral pain. This article will review the background information and literature, including clinical recommendations with respect to the perioperative use of maropitant in canine and feline veterinary patients.
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Affiliation(s)
- Bonnie L Hay Kraus
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA,
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16
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Yalcin E, Keser GO. Comparative efficacy of metoclopramide, ondansetron and maropitant in preventing parvoviral enteritis-induced emesis in dogs. J Vet Pharmacol Ther 2017; 40:599-603. [PMID: 28198032 PMCID: PMC7166845 DOI: 10.1111/jvp.12396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 12/19/2016] [Indexed: 12/01/2022]
Abstract
The aim of the study was to evaluate the efficiencies of selected anti‐emetic drugs (metoclopramide, ondansetron and maropitant) in preventing vomiting in the treatment of canine parvoviral enteritis. We designed a randomized, prospective clinical study. PVE quick ELISA test‐positive dogs between 4 and 12 months of age were included in the study. Each of metoclopramide, ondansetron, maropitant and control group had 8 dogs. Metoclopramide and ondansetron were administered as 0.5 mg/kg doses three times a day via intravenous route, and maropitant was administered as 1 mg/kg doses once a day subcutaneously. The number and severity of daily vomitings were recorded. All dogs were treated and monitored for five days; treatments were continued until all animals healed. Metoclopramide, ondansetron and maropitant decreased the severity of vomiting from the first day and the vomiting numbers from the third day in PVE treatment. Obtained results showed that maropitant can be used successfully such as metoclopramide and ondansetron, which are frequently used for PVE treatment. At the same time, it was discovered that metoclopramide, ondansetron and maropitant were equally effective in reducing the frequency and severity of vomiting.
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Affiliation(s)
- E Yalcin
- Department of Internal Medicine, Faculty of Veterinary Medicine, Uludag University, Bursa, Turkey
| | - G O Keser
- Department of Internal Medicine, Faculty of Veterinary Medicine, Uludag University, Bursa, Turkey
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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18
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Scallan EM, Simon BT. The effects of acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting in healthy dogs. Vet Anaesth Analg 2016; 43:495-501. [DOI: 10.1111/vaa.12347] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 12/21/2015] [Indexed: 11/30/2022]
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19
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Memon MA, Shmalberg J, Adair HS, Allweiler S, Bryan JN, Cantwell S, Carr E, Chrisman C, Egger CM, Greene S, Haussler KK, Hershey B, Holyoak GR, Johnson M, Jeune SL, Looney A, McConnico RS, Medina C, Morton AJ, Munsterman A, Nie GJ, Park N, Parsons-Doherty M, Perdrizet JA, Peyton JL, Raditic D, Ramirez HP, Saik J, Robertson S, Sleeper M, Dyke JV, Wakshlag J. Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges. Open Vet J 2016; 6:44-56. [PMID: 27200270 PMCID: PMC4824037 DOI: 10.4314/ovj.v6i1.7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/04/2016] [Indexed: 12/13/2022] Open
Abstract
Integrative veterinary medicine (IVM) describes the combination of complementary and
alternative therapies with conventional care and is guided by the best available
evidence. Veterinarians frequently encounter questions about complementary and
alternative veterinary medicine (CAVM) in practice, and the general public has
demonstrated increased interest in these areas for both human and animal health.
Consequently, veterinary students should receive adequate exposure to the principles,
theories, and current knowledge supporting or refuting such techniques. A proposed
curriculum guideline would broadly introduce students to the objective evaluation of
new veterinary treatments while increasing their preparation for responding to
questions about IVM in clinical practice. Such a course should be evidence-based,
unbiased, and unaffiliated with any particular CAVM advocacy or training group. All
IVM courses require routine updating as new information becomes available.
Controversies regarding IVM and CAVM must be addressed within the course and
throughout the entire curriculum. Instructional honesty regarding the uncertainties
in this emerging field is critical. Increased training of future veterinary
professionals in IVM may produce an openness to new ideas that characterizes the
scientific method and a willingness to pursue and incorporate evidence-based medicine
in clinical practice with all therapies, including those presently regarded as
integrative, complementary, or alternative.
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Affiliation(s)
- M A Memon
- Department of Clinical Science, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - J Shmalberg
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - H S Adair
- Department of Small Animal Clinical Sciences (Egger) and Department of Large Animal Clinical Sciences (Adair), College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - S Allweiler
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - J N Bryan
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - S Cantwell
- Medicine Wheel Veterinary Services, Ocala, FL, USA
| | - E Carr
- Department of Small Animal Clinical Sciences (Robertson) and Department of Large Animal Clinical Sciences (Carr), College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - C Chrisman
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - C M Egger
- Department of Small Animal Clinical Sciences (Egger) and Department of Large Animal Clinical Sciences (Adair), College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - S Greene
- Department of Clinical Science, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - K K Haussler
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - B Hershey
- Integrative Veterinary Oncology, Phoenix, AZ, USA
| | - G R Holyoak
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - M Johnson
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - S Le Jeune
- Veterinary Medical Teaching Hospital (Peyton) and Department of Surgical and Radiological Sciences (Le Jeune), School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - R S McConnico
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - C Medina
- Coral Springs Animal Hospital, Coral Springs, FL, USA
| | - A J Morton
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - A Munsterman
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - G J Nie
- Angel Animal Hospital, Springfield, MO, USA
| | - N Park
- Integrative Ophthalmology for Pets, Los Angeles, CA, USA
| | | | | | - J L Peyton
- Veterinary Medical Teaching Hospital (Peyton) and Department of Surgical and Radiological Sciences (Le Jeune), School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - H P Ramirez
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - J Saik
- Winterville Animal Clinic, Winterville, GA, USA
| | - S Robertson
- Department of Small Animal Clinical Sciences (Robertson) and Department of Large Animal Clinical Sciences (Carr), College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - M Sleeper
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - J Van Dyke
- Canine Rehabilitation Institute, Wellington, FL, USA
| | - J Wakshlag
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Lorenzutti AM, Martín-Flores M, Litterio NJ, Himelfarb MA, Zarazaga MP. Evaluation of the antiemetic efficacy of maropitant in dogs medicated with morphine and acepromazine. Vet Anaesth Analg 2016; 43:195-8. [DOI: 10.1111/vaa.12286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 03/31/2015] [Indexed: 11/29/2022]
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A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions. Vet Med Int 2015; 2015:983621. [PMID: 26798552 PMCID: PMC4699059 DOI: 10.1155/2015/983621] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/16/2015] [Indexed: 12/31/2022] Open
Abstract
Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions). The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.). Older neutered or spayed dogs (mean age = 9.0 years) and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients). Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P < 0.05). The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented.
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Davies JA, Fransson BA, Davis AM, Gilbertsen AM, Gay JM. Incidence of and risk factors for postoperative regurgitation and vomiting in dogs: 244 cases (2000–2012). J Am Vet Med Assoc 2015; 246:327-35. [DOI: 10.2460/javma.246.3.327] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hay Kraus BL. Effect of dosing interval on efficacy of maropitant for prevention of hydromorphone-induced vomiting and signs of nausea in dogs. J Am Vet Med Assoc 2014; 245:1015-20. [DOI: 10.2460/javma.245.9.1015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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