Effects of Alfaxalone or Propofol on Giant-Breed Dog Neonates Viability During Elective Caesarean Sections

Comparison of Propofol and Alfaxalone as Anesthesic Drugs in Bitches Undergoing Ovariohysterectomies (Healthy Bitches and with Pyometra) and Cesarean Sections

This study evaluated the efficacy and safety of two anesthetic agents, alfaxalone and propofol, on maternal physiological parameters (heart and respiratory rates, blood pressure, and temperature) on either ovariohysterectomies or cesarean sections in bitches. A total of 34 healthy and pyometra-affected females (classified as ASA II), were induced with IV propofol (4 mg/kg), while 35 females, both healthy and pyometra affected, were induced with IV alfaxalone (1 mg/kg). For cesarean sections, females (ASA II) were induced with propofol (n = 14) or alfaxalone (n = 14). Additionally, the neonatal viability and modified Apgar score were recorded at 5, 60, and 120 min post-delivery. There were no significant differences in the physiological parameters when comparing the use of propofol and alfaxalone in bitches undergoing ovariohysterectomies, regardless of their health status, nor when comparing cesarean sections. It was observed that bitches induced with propofol occasionally required an additional dose for maintenance of the anesthesia. Neonatal mortality rates were similar for both groups; however, alfaxalone was associated with higher neonatal viability as indicated by the Apgar scores. The findings suggest that both anesthetic protocols are effective and safe for use in canine reproductive surgeries, with no major differences in basic physiological parameters' alteration or neonatal outcomes between the two agents.

Apgar scores in puppies following the induction of etomidate compared with alfaxalone or propofol for cesarean section

Background and Aim

The Apgar score is a useful assessment of neonatal viability in dogs. The Apgar score in puppies born by cesarean section can be lower than vaginal delivery because all anesthetic drugs can cross the placenta. Therefore, anesthetic drugs with minimal cardiorespiratory effect and rapid elimination are recommended for cesarean section. The present study aimed to compare Apgar scores in puppies born after the induction of etomidate, alfaxalone or propofol, and those maintained with isoflurane inhalation during cesarean section.

Materials and Methods

Thirty-six bitches were equally divided in the three anesthetic drug groups. Modified Apgar scores were assessed at 5, 15, and 60 min after delivery. Intraoperative vital signs and Apgar scores were compared using a linear mixed model and adjusted pairwise comparisons using Bonferroni analysis.

Results

A total of 125 puppies were included in this study. Age, body weight, litter size, type of surgery, delivery time, anesthetic and surgical duration, and intraoperative vital signs did not significantly differ between the groups. Puppies in the alfaxalone and propofol groups had significantly higher Apgar scores than the etomidate group in both elective and emergency surgery. In elective surgery, Apgar scores at 5 min after delivery did not differ significantly between groups. At 15 and 60 min after delivery, Apgar scores in the etomidate group were significantly lower than those in the other groups. In emergency surgery, Apgar scores were significantly lower in the etomidate group than in the alfaxalone group at all time points.

Conclusion

Induction with alfaxalone and propofol resulted in better outcomes with higher Apgar scores and neonatal viability than etomidate. Therefore, alfaxalone and propofol should be used as anesthetic induction drugs in both elective and emergency cesarean sections.

Canine Neonatal Health

This article provides a high-level overview of canine neonatal health for clinicians to use as a mental framework so that when presented with a canine neonate it is easier to construct a logical and systematic clinical approach that is less overwhelming. As early detection of the at-risk neonate results in earlier intervention, and improved health outcomes, there will be a focus on pro-active care. Where appropriate, other articles in this issue will be mentioned for a more in-depth discussion of specific areas. Key points will be highlighted throughout the text.

Canine Cesarean Section: Emergency and Elective

Canine Cesarean Section (CS) is primarily performed to increase survival of newborns and less commonly to save the life or reproductive future of the dam. Conducting proper ovulation timing to accurately predict the due date will allow a planned, elective CS as an excellent alternative to a high-risk natural whelping, and possible dystocia, for certain breeds and situations. Techniques for ovulation timing, anesthesia, and surgery tips are provided.

Biochemical factors affecting newborn survival in dogs and cats

The importance and implications of small animal neonatology were underestimated until recent times. Despite the recent increasing interest for this branch of veterinary medicine, however, perinatal mortality rates in canine and feline species remain high, representing an important challenge for the clinician. In this perspective, the prompt identification of newborns requiring additional and tailored assistance becomes a key to reduce the perinatal losses in small animals. To achieve this goal, clinical and laboratory findings must be carefully evaluated. This paper focuses on biochemical parameters and their reported influence on neonatal survival, guiding through the evaluation of canine and feline newborn laboratory analyses, with a thorough discussion about the use of different biological material in these subjects. Beside blood, other biological material, such as urines and fetal fluids proved to be interesting for the identification of possible prognostic markers, thanks also to their easy and safe collection. However, the correct reading-through the results must consider many variables such as type of delivery, anesthesia protocol in case of Caesarean section, age of the newborn at samples collection, and for blood analysis, also the type of blood, site of collection, modality of collection and storage must be considered. Notwithstanding the recent progress in literature, for most of the parameters more research is needed to define cut-off values with certainty.

Insights from one thousand cloned dogs

Animal cloning has been popularized for more than two decades, since the birth of Dolly the Sheep 25 years ago in 1996. There has been an apparent waning of interest in cloning, evident by a reduced number of reports. Over 1500 dogs, representing approximately 20% of the American Kennel Club’s recognized breeds, have now been cloned, making the dog (Canis familiaris) one of the most successfully cloned mammals. Dogs have a unique relationship with humans, dating to prehistory, and a high degree of genome homology to humans. A number of phenotypic variations, rarely recorded in natural reproduction have been observed in in these more than 1000 clones. These observations differ between donors and their clones, and between clones from the same donor, indicating a non-genetic effect. These differences cannot be fully explained by current understandings but point to epigenetic and cellular reprograming effects of somatic cell nuclear transfer. Notably, some phenotypic variations have been reversed through further cloning. Here we summarize these observations and elaborate on the cloning procedure.

Clinical review of the pharmacological and anaesthetic effects of alfaxalone in dogs

This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic-pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio-respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered.

Influence of maternal, anesthetic, and surgical factors on neonatal survival after emergency cesarean section in 78 dogs: A retrospective study (2002 to 2020)

Neonatal mortality rate (NMR) may be affected by maternal physical condition, anesthesia, and uterine incision or en-bloc neonate removal. The association of selected factors with number of dogs with dead puppies at hospital discharge was evaluated using 78 records. Data obtained at admittance for emergency cesarean section included: age, small or large body size, rectal temperature, packed cell volume, serum total protein, blood urea nitrogen, glucose, puppy in pelvic canal, and heart rate. Administration of opioids, propofol, alfaxalone, isoflurane, and sevoflurane, and anesthesia/surgical times and surgical technique were evaluated using Fisher's exact tests. There were 238 live puppies and 38 dogs had 58 dead puppies; the NMR was 19.6%. Mortality was associated with puppy in the pelvic canal (P = 0.003) and duration of anesthesia > 80 minutes (P = 0.029). Age > 8 years (P = 0.054) and induction time to start of surgery > 30 minutes (P = 0.17) may be associated with mortality. Expedient cesarean section with obstructive dystocia and an induction time to start of surgery < 30 minutes are important for puppy survival.

Effect of Delivery by Emergency or Elective Cesarean Section on Nitric Oxide Metabolites and Cortisol Amniotic Concentrations in at Term Normal Newborn Dogs: Preliminary Results

Simple Summary

The high perinatal mortality rates in dogs are partly attributable to stress at parturition, with the production of cortisol (C), and related to the type of delivery, that is elective or emergency cesarean sections (ELCS and EMCS). Nitric oxide metabolites (NOs) are also related to the type of parturition (ELCS or EMCS), because of the different emotional and physical stresses experienced by the bitch in these two scenarios. The study aimed to assess the concentrations of C and NOs in the amniotic fluid of puppies delivered by ELCS or EMCS. In the amniotic fluid of the 32 puppies delivered by ELCS, C, and NOs concentrations were significantly lower than those found in the amniotic fluid of the 22 puppies delivered by EMCS. Lower C concentrations were found at increasing newborn viability assessed by Apgar score. Higher amniotic NOs concentrations were associated to increasing mother’s parity, puppies’ birthweight, and time of labor within the EMCS group. Due to the possible concurrence of several compartments (maternal, maybe placental, and fetal) to the final amniotic fluid composition, the definition of the role played by the three compartments in the higher C and NOs concentrations found in amniotic fluids collected from puppies delivered by EMCS than ELCS needs further clarifications.

Abstract

The neonatal response to stress was reported to be related to the type of delivery, that is elective or emergency cesarean sections (ELCS and EMCS, respectively). Nitric oxide (NO) is also reported to be related to uterine inertia, and high levels of NO metabolites (NOs) are associated with physical and emotional stress. The study aimed to assess the concentrations of cortisol (C) and NOs in the amniotic fluid of puppies delivered by ELCS or EMCS. In total, 32 puppies were delivered by ELCS and 22 by EMCS. ANCOVA showed an effect of the ELCS vs. EMCS on both amniotic NOs (p < 0.001) and C (p < 0.001) concentrations. Lower amniotic C concentrations were found at increasing Apgar score (p < 0.001). Higher amniotic NOs concentrations were associated to increasing mother’s parity (p < 0.001), puppies’ birthweight (p < 0.001), and time of labor within the EMCS group (p < 0.05). A positive correlation between birthweight and amniotic NOs concentrations was also found (p < 0.05) in the EMCS group. Due to the possible concurrence of several compartments (maternal, maybe placental, and fetal) to the final amniotic fluid composition, the definition of the role played by the three compartments in the higher C and NOs concentrations found in amniotic fluids collected from puppies delivered by EMCS than ELCS needs further clarification.

Pre- and Probiotics to Increase the Immune Power of Colostrum in Dogs

Wide differences in Ig concentration in canine colostrum have been reported. Thus, some litters can be at risk of passive immune transfer failure. Present study evaluated if supplementation with MOS, FOS, E. faecium and L. acidophilus along pregnancy increases colostrum quality. Twenty Great Dane bitches were divided into 4 groups. Control group (CG) received standard diet, only. Diet was supplemented with pre- and probiotics in other 3 study groups during: the last (1WG), last 2 (2WG), and last 4 (4WG) weeks of pregnancy, until parturition. Serum samples were collected at estrous (T0), supplementation beginning (T1), and parturition (T2). Colostrum was collected at C-section end. The IgG, IgM, and IgA were assayed on both matrices. In serum, IgG were higher at T0 than at parturition in all study groups and they significantly lowered from T0 to T1 in all groups. In colostrum, IgG and IgM were significantly higher in 4WG, while IgA already increased in 2WG group. Four-week pre- and probiotic supplementation resulted in the best immune properties of colostrum, as by the higher IgG, IgM, and IgA colostrum levels found in 4WG. Further studies would verify the exact mechanisms involved: pre-partum IgG mammary accumulation and B-cells GALT proliferation and mammary transfer. Further trials would verify whether these beneficial effects of pre- and probiotics on colostrum also lead to improved clinical conditions and immunological functions of newborns and puppies.

Investigation of Variables Associated with Surgical Site Infection following the Management of Canine Cranial Cruciate Ligament Rupture with a Lateral Fabellotibial Suture

OBJECTIVE

 This study investigated variables associated with surgical site infection (SSI) in dogs with cranial cruciate ligament rupture managed with stifle joint examination and lateral fabellotibial suture stabilization.

STUDY DESIGN

 A retrospective study of dogs that had stifle arthroscopy, stifle arthrotomy, or a combination of both, followed by lateral fabellotibial suture stabilization for cranial cruciate ligament rupture. All cases had a minimum follow-up of 90 days. Lameness grades were recorded preoperatively, and at 6-week and final follow-up.

RESULTS

 One hundred fifty procedures in 130 dogs met the inclusion criteria. Overall, SSI rate was 17.3% and removal of the lateral fabellotibial suture was performed in 53% of SSI. Multivariable analysis showed significant association between SSI and bodyweight (p = 0.013), and induction using propofol (p = 0.029). Multilevel ordinal logistic regression analysis showed a greater proportion of dogs had a higher lameness grade at 6-week (p = 0.021) and final follow-up (p = 0.002) assessments in the infected compared with non-infected dogs.

CONCLUSION

 Our study demonstrated a higher SSI incidence than previously reported in dogs undergoing a lateral fabellotibial suture for cranial cruciate ligament rupture. Bodyweight and induction with propofol were identified as significant risk factors for postoperative SSI. Owners could be advised of an increased SSI risk in larger dogs and consideration should be given to selection of induction agent. Dogs that develop an SSI have a worse lameness grade at 6-week and final follow-up.

A Biotic Support During Pregnancy to Strengthen the Gastrointestinal Performance in Puppies

Up to 60% of neonates can be affected by gastroenteritis due to specific pathogens or aspecific polymicrobial interactions. The present study evaluated if a dietary supplementation with MOS, FOS, E. faecium and L. acidophilus in pregnancy may reduce gastroenteritis in puppies. Fifteen Great Danes were divided in 3 groups. The control group (CG) ate a standard diet. In 2 study groups, the diet was supplemented with pre- and probiotics during the last (1WG) and the last 4 pregnancy weeks (4WG). Up to 9 weeks, puppies were checked daily to identify first- or second- presentation gastroenteritis. Data were processed by χ² (P < 0.05). First-presentation gastroenteritis was more frequent in CG than in 1WG than in 4WG. Second-presentation gastroenteritis was more frequent in CG than in 1 and 4WG. Puppies from pre- and probiotics supplemented bitches were less prone to gastroenteritis. 1 or 4WG equally reduced second-presentation gastroenteritis in puppies, but 4WG was better than 1WG on first-presentation gastroenteritis. By entero-mammary link, supplemented bitches produced higher immune quality colostrum, thus puppies faced immunitary challenges better; moreover, maternal microbiota, positively altered by supplementation, was transferred to newborns, becoming more resistant to gastroenteritis. This information can be useful in clinical practice with the goal of preventing gastroenteritis in puppies and reducing its prevalence and severity.

Urinalysis in Great Dane Puppies from Birth to 28 Days of Age

Simple Summary

Still, nowadays, small animal perinatology is quite an unknown field of veterinary medicine. To help decrease the high mortality rates reported for canine newborns, veterinary practitioners should become more aware of neonatal physiology and pathology, focusing their attention on metabolic balance. It is impossible to discriminate healthy puppies from pathological littermates in the absence of reference ranges for specific parameters, which are obviously different from those of adults. Since blood samples are more difficult and dangerous to collect from newborns, practitioners could rely on urinary samples, easily gathered by the stimulation of the somato-vesical spinal reflex. The present research, based on 624 urine samples, offers results that can be used as references for the first-line evaluation of newborn Great Danes by dipstick rapid urinalysis. In healthy puppies, specific gravity and pH vary from birth to 28 days of age, while glucosuria and proteinuria are never reported. The present results, derived from a sample of single-breed puppies, can represent the starting point for a further multi-breed evaluation.

Abstract

Urinalysis, a common test in infants, could represent a suitable non-invasive clinical tool in puppies. In dog neonates, urine is easily collected by stimulating the somato-vesccal reflex. Information on urine characteristics during the neonatal period is missing. Beside instrumental laboratory analyses, the dipstick was proven useful for rapid urinalysis to evaluate specific gravity (SG), pH, leukocytes, nitrites, glucose, proteins, ketones, urobilinogen, bilirubin, and blood. The present study aimed to describe urinalysis features by the dipstick test and refractometer along the neonatal period. Urine samples (n = 624) were collected by manual stimulation from 48 healthy Great Danes, daily from birth to seven days, then twice a week until 28 days, to assess age-related changes (ANOVA, p < 0.05) and the possible effects of gender and litter (T-test, p < 0.05). The SG and pH significantly changed during the neonatal period. Other parameters did not vary significantly in relation to age. No significant differences were observed either among litters or between genders. The present study confirmed that canine kidneys are able to concentrate urine from the second week of age when the urinary SG started to be similar to adults, while pH still increased towards the typical values of adults at 28 days. Significant glucosuria and proteinuria were never detected. Dipstick urinalysis represents a useful first-line complementary tool in newborns clinical examination, providing information about systemic homeostasis.