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Alza Salvatierra DN, Motta L, Redondo JI, du Toit M, Pompermaier E, Martinez M. Retrospective case-control non-inferiority analysis of ultrasound-guided erector spinae plane block in dogs undergoing mini-hemilaminectomy for intervertebral disc disease. J S Afr Vet Assoc 2024; 95:109-120. [PMID: 39248351 DOI: 10.36303/jsava.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024] Open
Abstract
BACKGROUND Veterinary medicine has seen significant advancements in locoregional anaesthesia and pain management, including the emergence of the erector spinae plane (ESP) block. However, limited clinical evidence exists on its efficacy and safety. OBJECTIVES This study compares ultrasound-guided ESP block (ESP group) with an intraoperative intravenous ketamine infusion analgesic protocol (CRI group) in dogs undergoing thoracolumbar mini-hemilaminectomy, focusing on intraoperative opioid consumption, cardiovascular response to surgical stimulation (CR), postoperative pain scores (PS), and postoperative opioid consumption. METHODS Retrospective, case-control, non-inferiority study conducted in a single centre. Data collected included demographics, bupivacaine dose, ESP block operator, intraoperative recorded variables (haemodynamic variables, CR, complications, rescue analgesia), pre- and postoperative analgesia, 24-hour PS and opioid administration, first food intake post-extubation and postoperative complications. Univariate and multiple regression analyses were applied. RESULTS One-hundred dogs were included, 75 in the ESP group and 25 in the CRI group. Univariate analysis revealed no significant differences between treatment groups in terms of CR, PS, postoperative rescue analgesia, intraoperative and postoperative opioid consumption, or time to first meal intake. However, the multivariate regression analysis indicated that dogs receiving ketamine infusion had higher CR suspected to be nociception-related (p = 0.036), and higher postoperative opioid consumption (p = 0.013). CONCLUSION Our study suggests that ultrasound-guided ESP block is as effective as intraoperative ketamine infusion providing perioperative analgesia in dogs undergoing thoracolumbar mini-hemilaminectomy for intervertebral disc disease. ESP group showed significantly lower CR suspected to be nociception-related intraoperatively and lower postoperative opioid consumption within the initial 24 hours.
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Affiliation(s)
| | - L Motta
- Northwest Veterinary Specialists, Linnaeus Veterinary Limited, United Kingdom
| | - J I Redondo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Spain
| | - M du Toit
- Northwest Veterinary Specialists, Linnaeus Veterinary Limited, United Kingdom
| | - E Pompermaier
- Wear Referrals, Linnaeus Veterinary Limited, United Kingdom
| | - M Martinez
- ChesterGates Veterinary Specialists, CVS Group public limited company, United Kingdom
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Sasaki K, Kawada T, Matsushita H, Yokota S, Kakuuchi M, Yokoi A, Yoshida Y, Morita H, Sato K, Nishikawa T, Kutter APN, Kataoka Y, Alexander J, Saku K, Ishikawa T, Uemura K. Computer-controlled closed-loop norepinephrine infusion system for automated control of mean arterial pressure in dogs under isoflurane-induced hypotension: a feasibility study. Front Vet Sci 2024; 11:1374356. [PMID: 38881786 PMCID: PMC11177754 DOI: 10.3389/fvets.2024.1374356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/30/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Intra-operative hypotension is a common complication of surgery under general anesthesia in dogs and humans. Computer-controlled closed-loop infusion systems of norepinephrine (NE) have been developed and clinically applied for automated optimization of arterial pressure (AP) and prevention of intra-operative hypotension in humans. This study aimed to develop a simple computer-controlled closed-loop infusion system of NE for the automated control of the mean arterial pressure (MAP) in dogs with isoflurane-induced hypotension and to validate the control of MAP by the developed system. Methods NE was administered via the cephalic vein, whereas MAP was measured invasively by placing a catheter in the dorsal pedal artery. The proportional-integral-derivative (PID) controller in the negative feedback loop of the developed system titrated the infusion rate of NE to maintain the MAP at the target value of 60 mmHg. The titration was updated every 2 s. The performance of the developed system was evaluated in six laboratory Beagle dogs under general anesthesia with isoflurane. Results In the six dogs, when the concentration [median (interquartile range)] of inhaled isoflurane was increased from 1.5 (1.5-1.5)% to 4 (4-4)% without activating the system, the MAP was lowered from 95 (91-99) to 41 (37-42) mmHg. In contrast, when the concentration was increased from 1.5 (1.0-1.5)% to 4 (4-4.8)% for a 30-min period and the system was simultaneously activated, the MAP was temporarily lowered from 92 (89-95) to 47 (43-49) mmHg but recovered to 58 (57-58) mmHg owing to the system-controlled infusion of NE. If the acceptable target range for MAP was defined as target MAP ±5 mmHg (55 ≤ MAP ≤65 mmHg), the percentage of time wherein the MAP was maintained within the acceptable range was 96 (89-100)% in the six dogs during the second half of the 30-min period (from 15 to 30 min after system activation). The median performance error, median absolute performance error, wobble, and divergence were - 2.9 (-4.7 to 1.9)%, 2.9 (2.0-4.7)%, 1.3 (0.8-1.8)%, and - 0.24 (-0.34 to -0.11)%·min-1, respectively. No adverse events were observed during the study period, and all dogs were extubated uneventfully. Conclusion This system was able to titrate the NE infusion rates in an accurate and stable manner to maintain the MAP within the predetermined target range in dogs with isoflurane-induced hypotension. This system can be a potential tool in daily clinical practice for the care of companion dogs.
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Affiliation(s)
- Kazumasu Sasaki
- Akita Cerebrospinal and Cardiovascular Center, Research Institute for Brain and Blood Vessels, Akita, Japan
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
- Sendai Animal Care and Research Center, Sendai, Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hiroki Matsushita
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shohei Yokota
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Midori Kakuuchi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Aimi Yokoi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuki Yoshida
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hidetaka Morita
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kei Sato
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takuya Nishikawa
- Department of Research Promotion and Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Annette P N Kutter
- Section of Anesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Yasuyuki Kataoka
- Medical and Health Informatics, NTT Research, Inc., Sunnyvale, CA, United States
| | - Joe Alexander
- Medical and Health Informatics, NTT Research, Inc., Sunnyvale, CA, United States
| | - Keita Saku
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
- NTTR-NCVC Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tatsuya Ishikawa
- Akita Cerebrospinal and Cardiovascular Center, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Kazunori Uemura
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Japan
- NTTR-NCVC Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Suita, Japan
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Quinn CT. What is the best treatment for hypotension in healthy dogs during anaesthesia maintained with isoflurane? Aust Vet J 2024; 102:264-273. [PMID: 38343013 DOI: 10.1111/avj.13318] [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: 12/16/2021] [Revised: 01/05/2024] [Accepted: 01/21/2024] [Indexed: 04/30/2024]
Abstract
Hypotension is a common and potentially life-threatening complication of general anaesthesia in dogs. Due to the combination of cardiovascular side effects of many anaesthetic, sedative and analgesic drugs used peri-operatively hypotension is frequently reported even in healthy dogs undergoing elective procedures. Several treatment options for hypotension have been advocated. Potential treatments include rapid administration of either crystalloid or colloid fluids; pharmacological treatments to increase cardiac output and/or systemic vascular resistance; or reduction in the delivery of the volatile anaesthetic agents. This critical appraisal considers the current evidence for which treatment is the best option for treating hypotension in healthy euvolemic dogs undergoing general anaesthesia maintained with isoflurane. Fourteen relevant studies were appraised, including 12 laboratory studies and two small clinical trials. One study demonstrated that reduction in the delivery of isoflurane may correct hypotension, but this treatment may not always be feasible. In general, rapid administration of fluids did not increase blood pressure and failed to correct hypotension. Synthetic colloids demonstrated some efficacy, but results were inconsistent between studies and large volumes may be required. Infusion of dopamine appears to be the most reliable pharmacological option consistently increasing blood pressure, cardiac output and correcting hypotension.
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Affiliation(s)
- C T Quinn
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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Miller L, Duncan JC, Handel IG, Shaw DJ, McKenzie HE, Greenhalgh SN. Association between body mass and hypotension in dogs under general anaesthesia. J Small Anim Pract 2023; 64:687-695. [PMID: 37770103 DOI: 10.1111/jsap.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/19/2023] [Accepted: 08/08/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To investigate the association between body mass and hypotension during general anaesthesia in dogs undergoing surgical and diagnostic procedures within a referral hospital. MATERIALS AND METHODS Retrospective evaluation of the anaesthetic records of 1789 dogs was performed. Data on signalment, anaesthetic protocol and physiological variables, including mean arterial pressure, were collected. A multivariable generalised linear model was used to identify associations between explanatory variables, including body mass, and hypotension. RESULTS In the population studied, increasing body mass (per 10 kg) was significantly associated with decreasing odds of hypotension (odds ratio 0.68; 95% confidence interval: 0.60 to 0.77). Additional variables associated with a decreased odds of hypotension were pre-anaesthetic medication with alpha-2 agonists (odds ratio 0.63; 95% confidence interval 0.48 to 0.82) and increased body temperature (per 1°C) during general anaesthesia (odds ratio 0.77; 95% confidence interval 0.67 to 0.88). Brachycephaly (odds ratio 1.72; 95% confidence interval 1.25 to 2.38), ASA physical status classification >3 (odds ratio 2.03; 95% confidence interval 1.16 to 3.56), undergoing a surgical procedure (versus diagnostic) (odds ratio 1.57; 95% confidence interval 1.10 to 2.23) and bradycardia (odds ratio 1.37; 95% confidence interval 1.05 to 1.80) were independently associated with increased odds of hypotension. CLINICAL SIGNIFICANCE Dogs of lower body mass and brachycephalic breeds may be at higher risk of hypotension during general anaesthesia or alternatively represent subpopulations in which accurate blood pressure measurement presents a greater challenge. Monitoring blood pressure accurately in these groups requires particular attention and provisions for treating hypotension should be readily accessible.
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Affiliation(s)
- L Miller
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - J C Duncan
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - I G Handel
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - D J Shaw
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - H E McKenzie
- PDSA, Whitechapel Way, Priorslee, Telford, Shropshire, TF2 9PQ, UK
| | - S N Greenhalgh
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
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Kojima K, Ishizuka T, Sasaki N, Nakamura K, Takiguchi M. Cardiovascular effects of dose escalating of norepinephrine in healthy dogs anesthetized with isoflurane. Vet Anaesth Analg 2021; 48:654-662. [PMID: 34332897 DOI: 10.1016/j.vaa.2021.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the systemic cardiovascular effects of dose escalating administration of norepinephrine in healthy dogs anesthetized with isoflurane. STUDY DESIGN Experimental study. ANIMALS A total of six adult laboratory Beagle dogs, 10.5 (9.2-12.0) kg [median (range)]. METHODS Each dog was anesthetized with isoflurane at an end-tidal concentration of 1.7%, mechanically ventilated and administered a continuous rate infusion of rocuronium (0.5 mg kg-1 hour-1). Each dog was administered incremental dose rates of norepinephrine (0.05, 0.125, 0.25, 0.5, 1.0 and 2.0 μg kg-1 minute-1), and each dose was infused for 15 minutes. Cardiovascular variables were recorded before administration and at the end of each infusion period. RESULTS Norepinephrine infusion increased mean arterial pressure (MAP), cardiac output (CO) and oxygen delivery in a dose-dependent manner. Systemic vascular resistance did not significantly change during the experiment. Stroke volume increased at the lower dose rates and heart rate increased at the higher dose rates. Oxygen consumption and lactate concentrations did not significantly change during infusions. CONCLUSIONS In dogs anesthetized with isoflurane, norepinephrine increased MAP by increasing the CO. CO increased with a change in stroke volume at lower dose rates of norepinephrine. At higher dosage, heart rate also contributed to an increase in CO. Norepinephrine did not cause excessive vasoconstriction that interfered with the CO during this study. CLINICAL RELEVANCE Norepinephrine can be useful for treating hypotension in dogs anesthetized with isoflurane.
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Affiliation(s)
- Kazuki Kojima
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Tomohito Ishizuka
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Noboru Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kensuke Nakamura
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mitsuyoshi Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
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Kent M, Barber RM, Glass EN, Arnold SA, Bibi KF, Stewart GV, Ruby JL, Perlini M, Platt SR. Poliomyelomalacia in three dogs that underwent hemilaminectomy for intervertebral disk herniation. J Am Vet Med Assoc 2021; 257:397-405. [PMID: 32715880 DOI: 10.2460/javma.257.4.397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION 3 dogs were examined because of a sudden onset of signs of pain (1 dog) or paraparesis (2 dogs). CLINICAL FINDINGS Neurologic findings consisted of myelopathy affecting the lumbar intumescence (1 dog) and T3-L3 myelopathy (2 dogs). In all dogs, MRI revealed spinal cord compression caused by L3-4 disk herniation. All dogs underwent routine surgical decompression of the intervertebral disk herniation. During MRI and decompressive surgery, physiologic variables were monitored. Immediately after surgery, all dogs were paraplegic with pelvic limb neurologic dysfunction consistent with myelopathy affecting the L4 through caudal spinal cord segments. TREATMENT AND OUTCOME Within 24 hours after surgery, repeated MRI in all dogs revealed hyperintensity in the spinal cord gray matter of the lumbar intumescence on T2-weighted images. In the absence of neurologic improvement, dogs were euthanized at 3, 91, and 34 days after surgery. Postmortem microscopic examination of each dog's spinal cord at the lumbar intumescence revealed necrosis of the gray matter with relative white matter preservation suggestive of an ischemic injury. CLINICAL RELEVANCE Dramatic neurologic deterioration following decompressive surgery for intervertebral disk herniation in dogs may be associated with the development of poliomyelomalacia secondary to ischemia. In these 3 dogs, ischemia developed despite probable maintenance of normal spinal cord blood flow and perfusion during anesthesia. To exclude other causes, such as compression or hemorrhage, MRI was repeated and revealed hyperintensity of the spinal cord gray matter on T2-weighted images, which microscopically corresponded with ischemic neurons and neuronal loss.
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7
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Sedgwick S, Lorenzutti AM, Araos JB, Gleed RD, Martin-Flores M. Evaluation of an oscillometric blood pressure monitor in anesthetized dogs: Agreement with direct measurements and ability to detect hypotension. Res Vet Sci 2021; 135:162-166. [PMID: 33524826 DOI: 10.1016/j.rvsc.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
We evaluated the agreement between oscillometric and direct blood pressure monitors in anesthetized dogs and evaluated the ability of the oscillometric method to detect MAP <60 mmHg. Forty client-owned dogs, three months to 14 years old, 4.6-50.2 kg, under general anesthesia were studied. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were measured directly via an arterial catheter and with an oscillometric cuff (Cardell Touch monitor). Paired values were compared with mixed effect models. Bias and limits of agreement (LOA) were calculated. The sensitivity and false negative rate to detect hypotension (invasive MAP <60 mmHg) using an oscillometric MAP <60 and < 70 mmHg were calculated. A receiver operating characteristics (ROC) curve was constructed and the area under the curve calculated. SAP and DAP differed between methods (both P < 0.001), but MAP did not (P = 0.5). Bland-Altman plots showed small biases but wide LOA for all variables. The sensitivity to detect hypotension was 40% with a false negative rate of 60% when using an oscillometric MAP <60 mmHg, and 68% and 32%, respectively, with a MAP <70 mmHg. The area under the ROC curve for MAP was 0.82. While the oscillometric MAP did not differ from invasive values, the device failed to recognize hypotensive events when 60 mmHg was used as the threshold to detect hypotension. Higher MAP values increased the ability to correctly recognize hypotension, but at the expense of a higher incidence of false positives.
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Affiliation(s)
- Samantha Sedgwick
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Augusto M Lorenzutti
- Catedra de Farmacologia y Toxicologia, Facultad de Ciencias Agropecuarias, Universidad Catolica de Cordoba, Argentina
| | - Joaquin B Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Robin D Gleed
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
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Fenn J, Ru H, Jeffery ND, Moore S, Tipold A, Soebbeler FJ, Wang-Leandro A, Mariani CL, Early PJ, Muñana KR, Olby NJ. Association between anesthesia duration and outcome in dogs with surgically treated acute severe spinal cord injury caused by thoracolumbar intervertebral disk herniation. J Vet Intern Med 2020; 34:1507-1513. [PMID: 32418346 PMCID: PMC7379036 DOI: 10.1111/jvim.15796] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 04/19/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022] Open
Abstract
Background Retrospective research recently identified a possible relationship between duration of surgery and outcome in severely affected dogs treated surgically for acute thoracolumbar intervertebral disk herniation (TL‐IVDH). Hypothesis That increased duration of surgery is associated with poorer outcome in dogs with absent pain perception treated surgically for TL‐IVDH. Animals Two hundred ninety‐seven paraplegic dogs with absent pain perception surgically treated for acute TL‐IVDH. Methods Retrospective cohort study. Medical records of 5 institutions were reviewed. Inclusion criteria were paraplegia with absence of pain perception, surgical treatment of TL‐IVDH, and 1‐year postoperative outcome (ambulatory: yes or no). Canine data, outcome, and surgery and total anesthesia duration were retrieved. Results In this study, 183/297 (61.6%) dogs were ambulatory within 1 year, 114 (38.4%) dogs failed to recover, including 74 dogs (24.9%) euthanized because of progressive myelomalacia. Median anesthesia duration in dogs that regained ambulation within 1 year of surgery (4.0 hours, interquartile range [IQR] 3.2‐5.1) was significantly shorter than those that did not (4.5 hours, IQR 3.7‐5.6, P = .01). Multivariable logistic regression demonstrated a significant negative association between both duration of surgery and total anesthesia time and ambulation at 1 year when controlling for body weight and number of disk spaces operated on. Conclusions and Clinical Importance Findings support a negative association between increased duration of anesthesia and outcome in this group of dogs. However, the retrospective nature of the data does not imply a causal relationship.
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Affiliation(s)
- Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom.,The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Hongyu Ru
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, USA
| | - Nick D Jeffery
- The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Sarah Moore
- The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Andrea Tipold
- The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Franz J Soebbeler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Adriano Wang-Leandro
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Christopher L Mariani
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Peter J Early
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Karen R Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Natasha J Olby
- The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Guo S, Lu D, Pfeiffer S, Pfeiffer DU. Non-ambulatory dogs with cervical intervertebral disc herniation: single versus multiple ventral slot decompression. Aust Vet J 2020; 98:148-155. [PMID: 32090324 DOI: 10.1111/avj.12908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/23/2019] [Accepted: 12/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the proportion of non-ambulatory dogs with cervical intervertebral disc herniation (IVDH) in a private clinic and to compare signalment and outcome between those that underwent single or multiple ventral slot decompression (VSD). DESIGN Retrospective cohort study. METHODS After screening 43,378 medical records (January 2010-September 2016), those of 185 dogs with non-ambulatory tetraparesis or tetraplegia along with cervical IVDH that had undergone single (123) or multiple (62) VSD were included in this study. Data on signalment, preoperative neurological status, location of affected intervertebral disc(s), time to ambulation and short-term outcome were compared between single and multiple VSD groups. RESULTS The proportion of non-ambulatory dogs with IVDH was 35.3%. The prevalence of non-ambulation was higher in male dogs (0.56%) than in female dogs (0.26%; P < 0.001) and in neutered dogs than in unneutered dogs (0.51% and 0.27%, respectively, P < 0.001). After surgery, 96.2% of the dogs reached ambulatory status. Dogs with multiple IVDH were older than those with single IVDH. Sex, neutering status or size did not affect the outcome or ambulation status postsurgery. The Pekingese was the most commonly affected breed in both groups. There was no difference in the time to reach ambulation and the presence of neurological deficits after surgery between dogs that underwent single and multiple VSD. CONCLUSIONS In this cohort, dogs undergoing multiple VSD had a good postoperative outcome, and their short-term functional recovery was equal to that of dogs undergoing single ventral slot compression.
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Affiliation(s)
- S Guo
- CityU Veterinary Medical Centre, Sham Shui Po, Hong Kong
| | - D Lu
- CityU Veterinary Medical Centre, Sham Shui Po, Hong Kong
| | - S Pfeiffer
- Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - D U Pfeiffer
- Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Kowloon Tong, Hong Kong
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10
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Barnes KH, Aulakh KS, Liu C. Retrospective evaluation of prazosin and diazepam after thoracolumbar hemilaminectomy in dogs. Vet J 2019; 253:105377. [PMID: 31685135 DOI: 10.1016/j.tvjl.2019.105377] [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: 04/16/2018] [Revised: 08/27/2019] [Accepted: 09/10/2019] [Indexed: 11/26/2022]
Abstract
Management of urinary retention after spinal cord injury in dogs is often needed and can include use of medications to relax the urethral sphincter. This was a retrospective study evaluating two such medications, prazosin and diazepam, and whether dogs treated with these medications had different lengths of hospitalization, urinary continence levels, or development of bacteriuria compared to dogs not receiving these medications after thoracolumbar hemilaminectomy for intervertebral disc herniation (IVDH). Electronic medical records were searched for dogs that underwent CT or MRI followed by a hemilaminectomy between the 3rd thoracic and 3rd lumbar vertebra for treatment of IVDH. Dogs were grouped based on whether or not they received a medication to aid in urethral sphincter relaxation (either prazosin, diazepam, or both medications). The total length of hospitalization, urinary continence at the time of discharge, and presence of bacteriuria were recorded from the medical file. Medical records from 71 dogs were included in the analysis. There were no significant associations between administration of prazosin and/or diazepam and length of hospitalization or urinary continence scores at the time of discharge from the hospital (P > 0.05).
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Affiliation(s)
- K H Barnes
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803, USA.
| | - K S Aulakh
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - C Liu
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803, USA
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Bruniges N, Rioja E. Intraoperative anaesthetic complications in dogs undergoing general anaesthesia for thoracolumbar hemilaminectomy: a retrospective analysis. Vet Anaesth Analg 2019; 46:720-728. [PMID: 31547961 DOI: 10.1016/j.vaa.2019.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To establish the incidence of intraoperative anaesthetic complications in dogs undergoing general anaesthesia (GA) for thoracolumbar hemilaminectomy (TH), to determine whether GA duration affects incidence of intraoperative complications and to identify associations between intraoperative complications. STUDY DESIGN Retrospective observational study. ANIMALS A total of 224 client-owned dogs of various breeds undergoing TH for intervertebral disc extrusion. METHODS Anaesthetic records of dogs undergoing TH at a university teaching hospital between 2010 and 2016 were analysed. Data recorded included breed, sex, body weight, GA duration, magnetic resonance imaging (MRI) under the same GA, pharmacological intervention to increase heart rate (PIHR), hypotension (mean arterial blood pressure < 60 mmHg for ≥ 10 minutes), mechanical ventilation (MV) for inadequate ventilation, hypothermia (oesophageal temperature < 37 °C), oesophageal temperature ≥ 39 °C (T ≥ 39 °C), temperature trend, regurgitation and use of alpha-2 adrenoreceptor agonists, acepromazine, ketamine or lidocaine. Multivariate logistic regression models were fitted for hypothermia, T ≥ 39 °C, hypotension and PIHR with forced inclusion of GA duration. RESULTS Hypothermia was the most common complication (63.8% incidence), followed by MV implementation (63.4%), hypotension (33.9%), PIHR (24.6%), T ≥ 39 °C (20.5%) and regurgitation (4.9%). Multivariate models revealed that MRI and hypotension were associated with an increased risk of hypothermia, whilst increasing body weight, alpha-2 adrenoreceptor agonists and MV were associated with a reduced risk. Alpha-2 adrenoreceptor agonists and GA duration were associated with an increased risk of T ≥ 39 °C, whilst hypotension was associated with a reduced risk. Hypothermia and PIHR were associated with an increased risk of hypotension, whereas increased body weight was associated with a reduced risk. MV and hypothermia were associated with an increased risk of PIHR, whereas increased body weight was associated with a reduced risk. CONCLUSIONS AND CLINICAL RELEVANCE Increasing GA duration was associated with increased risk of T ≥ 39 °C, but not any other intraoperative complications.
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Affiliation(s)
- Natalie Bruniges
- School of Veterinary Science, Liverpool University, Liverpool, UK.
| | - Eva Rioja
- Optivet Referrals, Havant, Hampshire, UK
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12
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Yanke AB, Miller MA, Fulkerson CV, Bohn K, Bentley RT. Remission after complete excision of an intramedullary hemangioma with an identifiable tumor plane in a dog. Vet Surg 2019; 48:1507-1513. [PMID: 31179565 DOI: 10.1111/vsu.13238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/04/2019] [Accepted: 04/27/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the use of an identifiable tumor plane (ITP) during myelotomy to excise an intramedullary hemangioma in a dog and report the outcome. STUDY DESIGN Case report. ANIMALS One 5.5-year-old 42.9-kg spayed female Leonberger dog. METHODS Clinical signs included progressive proprioceptive deficits of both pelvic limbs. Magnetic resonance imaging was consistent with a dorsal intramedullary mass at L3-L4. A laminectomy of the third and fourth lumbar vertebrae provided access for dorsal myelotomy. A clear surgical ITP was identified between the intramedullary mass and the spinal cord facilitating complete surgical resection. RESULTS Histopathological examination was consistent with a hemangioma. Postoperative MRI was consistent with complete excision of the mass. No evidence of recurrence was found by MRI at 3 months and at 22 months after surgery. Mild proprioceptive deficits persisted in the right pelvic limb. CONCLUSION A clear ITP was present, and gross-total resection (GTR) was achieved without significant morbidity. Persistent clinical remission resulted from surgery as the sole therapy. CLINICAL SIGNIFICANCE For an intramedullary tumor, GTR is the absence of visible tumor on intraoperative inspection combined with the absence of intramedullary contrast enhancement on postoperative MRI. When an ITP is present, GTR and resultant long-term remission may be more likely.
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Affiliation(s)
- Amy B Yanke
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana.,Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Margaret A Miller
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - Caroline V Fulkerson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - Kendra Bohn
- Neurology Service, Pittsburgh Veterinary Specialty & Emergency Center, Pittsburgh, Pennsylvania
| | - R Timothy Bentley
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
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13
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Jeffery ND, Harcourt-Brown TR, Barker AK, Levine JM. Choices and Decisions in Decompressive Surgery for Thoracolumbar Intervertebral Disk Herniation. Vet Clin North Am Small Anim Pract 2018; 48:169-186. [DOI: 10.1016/j.cvsm.2017.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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