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Hubbell JAE, Muir WW, Gorenberg E, Hopster K. A review of equine anesthetic induction: Are all equine anesthetic inductions "crash" inductions? J Equine Vet Sci 2024; 139:105130. [PMID: 38879096 DOI: 10.1016/j.jevs.2024.105130] [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: 04/19/2024] [Revised: 05/29/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
Horses are the most challenging of the common companion animals to anesthetize. Induction of anesthesia in the horse is complicated by the fact that it is accompanied by a transition from a conscious standing position to uncconconscious recumbency. The purpose of this article is to review the literature on induction of anesthesia with a focus on the behavioral and physiologic/pharmacodynamic responses and the actions and interactions of the drugs administered to induce anesthesia in the healthy adult horse with the goal of increasing consistency and predictability.
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Affiliation(s)
| | - William W Muir
- College of Veterinary Medicine, Lincoln Memorial University, Harrogate, Tennessee, USA
| | - Emma Gorenberg
- School of Veterinary Medicine, University of Pennsylvania. Kennett Square, PA, USA
| | - Klaus Hopster
- School of Veterinary Medicine, University of Pennsylvania. Kennett Square, PA, USA
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2
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Petrucci M, de Brot S, Casoni D. Case report: Side effects of etomidate in propylene glycol in five Göttingen Minipigs. Front Vet Sci 2024; 11:1376604. [PMID: 39055863 PMCID: PMC11270138 DOI: 10.3389/fvets.2024.1376604] [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: 01/25/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Etomidate, an agonist of the GABA A receptors, is available for clinical use either in combination with 35% propylene glycol or in a lipid emulsion. Its recognized ability to minimally impact the cardiovascular system made etomidate a suitable option for cardiac-compromised patients. Myoclonus and pain at the injection site are recognized side effects of etomidate in propylene glycol, affecting both human and veterinary species. There is no information available concerning potential side effect in minipigs. In the present case series, we report the side effects related to the use of etomidate in 35% propylene glycol in five Ellegaard Göttingen Minipigs that underwent general anesthesia for cardiac magnetic resonance imaging days or weeks after experimentally induced myocardial infarction. Following intravenous injection of etomidate, laryngeal edema and hyperemia were observed in one case. In another case, tachycardia, apnea, and decreased oxygen saturation, accompanied by laryngeal edema and hyperemia, were observed, which resolved spontaneously in a few minutes. In the arterial or venous samples collected shortly after the induction of general anesthesia, hemolysis was macroscopically visible and subsequently confirmed with a hematological exam in all five cases, as well as hemoglobinuria. Necropsies carried out immediately after euthanasia confirmed macroscopic laryngeal edema, marked diffuse lung alveolar and interstitial edema and hyperemia at histology in one animal, and marked acute lung congestion in another animal. These side effects were not observed when etomidate in a lipid emulsion was injected into another 24 animals. The role played by the different formulations (propylene glycol versus lipidic formulation) has not yet been fully elucidated. Based on our observations, we recommend caution in using the formulation of etomidate in 35% propylene glycol in Göttingen Minipigs.
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Affiliation(s)
- Mariafrancesca Petrucci
- Faculty of Medicine, Experimental Surgery Facility (ESF), Experimental Animal Center (EAC), University of Bern, Bern, Switzerland
- Department for BioMedical Research, Faculty of Medicine, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Science (GCB), University of Bern, Bern, Switzerland
| | - Simone de Brot
- COMPATH, Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - Daniela Casoni
- Faculty of Medicine, Experimental Surgery Facility (ESF), Experimental Animal Center (EAC), University of Bern, Bern, Switzerland
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Redondo JI, Martínez-Taboada F, Viscasillas J, Doménech L, Marti-Scharfhausen R, Hernández-Magaña EZ, Otero PE. Anaesthetic mortality in cats: A worldwide analysis and risk assessment. Vet Rec 2024; 195:e4147. [PMID: 38959210 DOI: 10.1002/vetr.4147] [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: 10/04/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Patient safety is essential in small animal anaesthesia. This study aimed to assess anaesthesia-related deaths in cats worldwide, identify risk and protective factors and provide insights for clinical practice. METHODS A prospective multicentre cohort study of 14,962 cats from 198 veterinary centres across different countries was conducted. Data on anaesthesia-related deaths, from premedication up to 48 hours postextubation, were collected. Logistic regression was used to analyse patient demographics, American Society of Anesthesiologists (ASA) classification, procedure type and anaesthetic drugs. RESULTS The anaesthesia-related mortality was 0.63%, with 74.5% of deaths occurring postoperatively. Cats with cachexia, a higher ASA status or who underwent abdominal, orthopaedic/neurosurgical or thoracic procedures exhibited elevated mortality. Mechanical ventilation use was associated with increased mortality. Mortality odds were reduced by the use of alpha2-agonist sedatives, pure opioids in premedication and locoregional techniques. LIMITATIONS Limitations include non-randomised sampling, potential biases, unquantified response rates, subjective death cause classification and limited variable analysis. CONCLUSIONS Anaesthetic mortality in cats is significant, predominantly postoperative. Risk factors include cachexia, higher ASA status, specific procedures and mechanical ventilation. Protective factors include alpha2-agonist sedatives, pure opioids and locoregional techniques. These findings can help improve anaesthesia safety and outcomes. However, further research is required to improve protocols, enhance data quality and minimise risks.
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Affiliation(s)
- José I Redondo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Fernando Martínez-Taboada
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
- 3A Animal Anaesthesia and Analgesia, Victoria, Australia
| | | | - Luis Doménech
- Departamento de Matemáticas, Física y Ciencias Tecnológicas, Escuela Superior de Enseñanzas Técnicas, Universidad Cardenal Herrera-CEU, Valencia, Spain
| | | | - Eva Z Hernández-Magaña
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Pablo E Otero
- Department of Anaesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Redondo JI, Otero PE, Martínez-Taboada F, Doménech L, Hernández-Magaña EZ, Viscasillas J. Anaesthetic mortality in dogs: A worldwide analysis and risk assessment. Vet Rec 2024; 195:e3604. [PMID: 37953683 DOI: 10.1002/vetr.3604] [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: 06/09/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Ensuring patient safety during small animal anaesthesia is crucial. This study aimed to assess anaesthetic-related deaths in dogs globally, identify risks and protective factors and inform clinical practice. METHODS This prospective cohort multicentric study involved 55,022 dogs from 405 veterinary centres across various countries. Data on anaesthesia-related deaths from premedication to 48 hours post-extubation were collected. Logistic regression was used to analyse patient demographics, American Society of Anesthesiologists (ASA) classification, procedure type and anaesthetic drugs used. RESULTS Anaesthetic-related mortality was 0.69%. Most deaths occurred postoperatively (81%). Age, obesity and a higher ASA classification score were associated with increased mortality. Urgent procedures, non-urgent but unscheduled anaesthesias and short procedures also had higher mortality. Some sedatives, systemic analgesics, hypnotics and the use of locoregional anaesthesia were linked to a decrease in mortality. LIMITATIONS The limitations of the study include the non-randomised sample, potential selection bias, lack of response rate quantification, variable data quality control, subjectivity in classifying causes of death and limited analysis of variables. CONCLUSION Careful patient evaluation, drug selection and monitoring can be associated with reduced mortality. These findings can be used to develop guidelines and strategies to improve patient safety and outcomes. Further research is needed to refine protocols, enhance data quality systems and explore additional risk mitigation measures.
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Affiliation(s)
- José I Redondo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera - CEU, Valencia, Spain
| | - Pablo E Otero
- Department of Anaesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Fernando Martínez-Taboada
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
- 3A Animal Anaesthesia and Analgesia, Victoria, Australia
| | - Luis Doménech
- Departamento de Matemáticas, Física y Ciencias Tecnológicas, Escuela Superior de Enseñanzas Técnicas, Universidad Cardenal Herrera - CEU, Valencia, Spain
| | - Eva Zoe Hernández-Magaña
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera - CEU, Valencia, Spain
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Guo Y, Mao S, Zhou Z. Effects of intramuscular alfaxalone and dexmedetomidine alone and combined on ocular, electroretinographic, and cardiorespiratory parameters in normal cats. Front Vet Sci 2024; 11:1407928. [PMID: 39021405 PMCID: PMC11251925 DOI: 10.3389/fvets.2024.1407928] [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: 04/15/2024] [Accepted: 05/17/2024] [Indexed: 07/20/2024] Open
Abstract
Background This study aimed to determine the effects of intramuscular (IM) administration of alfaxalone with or without dexmedetomidine on short electroretinography (ERG), ocular parameters and cardiorespiratory in healthy cats. Methods Eight healthy female spayed cats were treated with three sedation protocols: IM administration of 5 μg/kg dexmedetomidine (DEX), 5 mg/kg alfaxalone (ALF), and 5 μg/kg dexmedetomidine plus 5 mg/kg alfaxalone (DEX + ALF). The washout period after each treatment was 2 weeks. Physiological parameters, time metrics, intraocular pressure (IOP), Schirmer tear test 1 (STT-1) and a short ERG protocol were recorded. For age data, weight data, time metrics and ERG data, one-way ANOVA with Bonferroni posterior comparisons were performed. For physiological parameters, IOP and STT-1 data, two-way repeated measures ANOVA with Bonferroni posterior comparisons were performed. Statistical significance was set at a p-value <0.05. Results IOPs were increased in all three groups compared to baseline and showed no significant differences among three groups at any time point. STT-1 values were decreased significantly during the process. Significant differences were noticed between a-wave amplitude in the dark-adapted response between DEX and ALF, and a-wave amplitude in light-adapted response between ALF and DEX + ALF. Conclusion This study demonstrates the feasibility of three sedation protocols for short ERG recording in cats. All these treatments resulted in increased IOP values and reduced STT-1 values. But baseline data of ERG was not obtained as a blank control in cats.
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Affiliation(s)
| | | | - Zhenlei Zhou
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
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Santos LCP, Perkins N, Keates H, Goodwin W. Anaesthetic practices and attitudes to patient safety in a sample of Australian veterinary practices. Vet Anaesth Analg 2024:S1467-2987(24)00115-6. [PMID: 39138050 DOI: 10.1016/j.vaa.2024.06.004] [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: 02/20/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE To survey anaesthetic practices and attitudes towards veterinary patient safety in Australia. STUDY DESIGN This was a cross-sectional sample population from Australian veterinary practices, including first opinion small animal, mixed animal and referral small animal practices. The survey included practices' anaesthetic management, monitoring equipment and topics regarding patient safety. RESULTS Responses were obtained from 310/1700 (18%) veterinary practices, with 208 respondents from small animal practices (67%), 71 mixed animal practices (23%) and 31 referral small animal centres (10%). Overall, 61% of respondents reported always having a dedicated staff member monitoring the anaesthetic, who was most commonly a certified veterinary nurse (89%). In 22% of the practices, some of the staff monitoring an anaesthetic did not have any qualification. Completion of anaesthetic plans for each animal prior to an anaesthetic was reported by 24.5% of respondents and labelling of syringes was completed in 80% of practices. Pulse oximetry (98%) and temperature (88%) were the most common clinical variables monitored. The use of capnography (46%) or an electrocardiogram (48%) was also reported by the respondents. Emergency drugs, airway and ventilation equipment are available in 96%, 88% and 59% of practices, respectively. A defibrillator was available in 11% of practices with only 54% respondents being confident in using it. Of the respondents 60% were aware of anaesthesia safety interventions and clinical guidelines regarding patient safety during anaesthesia. CONCLUSIONS AND CLINICAL RELEVANCE Despite practices showing a relative improvement over the years in the standard of anaesthesia care, most of them are still not meeting international guidelines. Areas where changes could lead to improved safety practices could include: a trained person dedicated to monitor anaesthesia, pain scoring evaluation in patients recovering from anaesthesia, an increased use of standardised handover checklists, record keeping and an increase in open discussion of adverse events by the veterinary team.
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Affiliation(s)
- Luiz C P Santos
- School Of Biodiversity, One Health & Veterinary Medicine, The University of Glasgow, Garscube Campus, Glasgow, UK; School of Veterinary Sciences, The University of Queensland, Gatton, QLD, Australia.
| | - Nigel Perkins
- School of Veterinary Sciences, The University of Queensland, Gatton, QLD, Australia
| | - Helen Keates
- School of Veterinary Sciences, The University of Queensland, Gatton, QLD, Australia
| | - Wendy Goodwin
- School of Veterinary Sciences, The University of Queensland, Gatton, QLD, Australia
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Jeong Y, Kim B, Kim SS, Lee K, Yoon H. Changes in echocardiographic indices and left ventricular strain values by two-dimensional speckle-tracking echocardiography following pre-anesthetic oral pimobendan administration compared with intravenous pimobendan in dogs. Front Vet Sci 2024; 11:1394896. [PMID: 38895712 PMCID: PMC11184225 DOI: 10.3389/fvets.2024.1394896] [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: 03/02/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction The effects of pre-anesthetic single-dose oral pimobendan during inhalational anesthesia, including the comparison with the effects of single intravenous pimobendan under anesthesia, remain unexplored. Therefore, this study aimed to determine changes in hemodynamic and echocardiographic parameters induced by pre-anesthetic administration of oral pimobendan under isoflurane general anesthesia and to compare them with those induced by intravenous pimobendan. Methods Thirteen clinically normal dogs (4 laboratory and 9 client-owned dogs) with no clinical signs and not on any medical treatment were included. Anesthesia was performed three times: no pimobendan (Control), oral pimobendan (PIMO PO, 0.3 mg/kg), and intravenous pimobendan (PIMO IV, 0.15 mg/kg). Echocardiographic and hemodynamic parameters were monitored at 30-min intervals in all groups. Results Compared to the Control group, end-systolic volume index (ESVI) and normalized left ventricular internal diameter at end-systole (LVIDSN) were significantly lower, and fractional shortening (FS) and ejection fraction (EF) were significantly higher in the PIMO PO and IV groups (p < 0.001). Global radial strain (GRS) was significantly higher in the PIMO PO and IV groups (p = 0.015). Conclusion Under general anesthesia, oral pimobendan preserved LV systolic and myocardial function in a manner comparable to intravenous pimobendan. Pre-anesthetic administration of oral pimobendan can be used to compensate for cardiac systolic function in dogs who require therapeutic and diagnostic procedures under general anesthesia with potential risk of circulatory failure.
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Affiliation(s)
- Yijin Jeong
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
- VIP Animal Medical Center, Seoul, Republic of Korea
| | - Bumseok Kim
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Sung-Soo Kim
- VIP Animal Medical Center, Seoul, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
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8
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Zanusso F, De Benedictis GM, Bellini L. Exploring oxygen reserve index for timely detection of deoxygenation in canine patients recovering from anesthesia. Res Vet Sci 2024; 173:105268. [PMID: 38631076 DOI: 10.1016/j.rvsc.2024.105268] [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: 12/30/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
Pulse oximetry (SpO2) identifies a decrease in the partial pressure of oxygen (PaO2) when it falls below 80 mmHg, while oxygen reserve index (ORi), a dimensionless index ranging from 0 to 1, detects PaO2 changes between 100 and 200 mmHg. This study investigates the usefulness of ORi in detecting impending deoxygenation before traditional SpO2. Fifty-one dogs undergoing anesthesia were mechanically ventilated maintaining a fraction of inspired oxygen of 0.50 and an ORi of 1. Animals were classified according to their body condition score (BCS) as normal-fit (BCS 4-5/9), overweight (BCS 6-7/9), or obese (BCS 8-9/9). At the end of the procedure, dogs were placed in sternal recumbency, and after 10 min disconnected from the ventilator and maintained in apnea. ORi added warning time was determined at various ORi values as the time difference in reaching SpO2 of 95% from ORi of 0.9 and 0.5, compared to the SpO2 warning time from SpO2 of 98%. During apnea, ORi decreased before noticeable SpO2 changes. An ORi of 0.9 anticipated an SpO2 of 95% in normal-fit dogs by 87 (33-212) [median (range)] seconds or in those with a BCS ≥ 6/9 by 49 (7-161) seconds. Regardless of the BCS class, the median time from ORi of 0.5 to SpO2 of 95% was 30-35 s. ORi declined from 0.9 to 0.0 in 68 compared to 33 s between normal-fit and obese dogs (p < 0.05). In dogs, ORi added warning time could facilitate timely intervention, particularly in obese patients.
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Affiliation(s)
- Francesca Zanusso
- Department of Animal Medicine, Productions and Health, School of Agricultural Sciences and Veterinary Medicine, University of Padova, Legnaro 35020, Padova, Italy
| | - Giulia Maria De Benedictis
- Department of Animal Medicine, Productions and Health, School of Agricultural Sciences and Veterinary Medicine, University of Padova, Legnaro 35020, Padova, Italy
| | - Luca Bellini
- Department of Animal Medicine, Productions and Health, School of Agricultural Sciences and Veterinary Medicine, University of Padova, Legnaro 35020, Padova, Italy.
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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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10
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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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Pinho RH, Nasr-Esfahani M, Pang DSJ. Medication errors in veterinary anesthesia: a literature review. Vet Anaesth Analg 2024; 51:203-226. [PMID: 38570267 DOI: 10.1016/j.vaa.2024.01.003] [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: 04/23/2023] [Revised: 12/18/2023] [Accepted: 01/16/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To provide an overview of medication errors (MEs) in veterinary medicine, with a focus on the perianesthetic period; to compare MEs in veterinary medicine with human anesthesia practice, and to describe factors contributing to the risk of MEs and strategies for error reduction. DATABASES USED PubMed and CAB abstracts; search terms: [("patient safety" or "medication error∗") AND veterin∗]. CONCLUSIONS Human anesthesia is recognized as having a relatively high risk of MEs. In veterinary medicine, MEs were among the most commonly reported medical error. Predisposing factors for MEs in human and veterinary anesthesia include general (e.g. distraction, fatigue, workload, supervision) and specific factors (e.g. requirement for dose calculations when dosing for body mass, using several medications within a short time period and preparing syringes ahead of time). Data on MEs are most commonly collected in self-reporting systems, which very likely underestimate the true incidence, a problem acknowledged in human medicine. Case reports have described a variety of MEs in the perianesthetic period, including prescription, preparation and administration errors. Dogs and cats were the most frequently reported species, with MEs in cats more commonly associated with harmful outcomes compared with dogs. In addition to education and raising awareness, other strategies described for reducing the risk of MEs include behavioral, communication, identification, organizational, engineering and cognitive aids.
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Affiliation(s)
- Renata H Pinho
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
| | - Maryam Nasr-Esfahani
- University of Calgary, Cumming School of Medicine, Department of Obstetrics and Gynecology, Alberta Health Services, Calgary, AB, Canada
| | - Daniel S J Pang
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada; Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Montreal, PQ, Canada
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KuKanich B, KuKanich K, Tzic ADC, Anderson EE. Correlation of opioid antinociception and hypothermia in dogs-An animal welfare refinement. J Vet Pharmacol Ther 2024; 47:73-79. [PMID: 37930056 DOI: 10.1111/jvp.13415] [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: 08/21/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
The purpose of this study was to assess antinociception and correlation of antinociception and hypothermic effects after intravenous opioids in dogs. Nine healthy male Beagles were enrolled in the study. They were acclimated to a thermal nociceptive device, then received three IV treatments (saline, butorphanol 0.4 mg/kg and methadone 0.5 mg/kg) in a randomized complete block design. Rectal temperature and thermal withdrawals were assessed prior to and 0.5-6 h after drug administration. One dog was excluded due to lack of withdrawal to thermal stimuli. Rectal temperatures were not significantly different between treatments at time 0, but significantly decreased from 0.5 to 5 h for both opioids compared to saline. Withdrawals were significantly decreased, compared to saline, from 0.5 to 4 h for butorphanol and 0.5-5 h for methadone. A significant (p = .0005) and moderate (R2 = .43) correlation between antinociception and hypothermia occurred. Based on these data, intravenous butorphanol (0.4 mg/kg) and methadone (0.5 mg/kg) provided 4 and 5 h of antinociception, respectively. Opioid hypothermia can serve as an easy, noninvasive and humane manner for preclinical assessment of opioid antinociception in dogs prior to evaluation in clinical trials. This is a major refinement in animal welfare for assessing novel opioids, opioid doses and dose intervals in dogs.
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Affiliation(s)
- Butch KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Astrid D Carcamo Tzic
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Elayna E Anderson
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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13
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Goich M, Bascuñán A, Faúndez P, Siel D. Comparison of analgesic efficacy of tramadol, morphine and methadone in cats undergoing ovariohysterectomy. J Feline Med Surg 2024; 26:1098612X231224662. [PMID: 38545955 PMCID: PMC10983611 DOI: 10.1177/1098612x231224662] [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] [Indexed: 04/19/2024]
Abstract
OBJECTIVES The aim of this study was to compare the analgesic efficacy and the effect on physiological variables and behavior of the use of tramadol, methadone and morphine as preoperative analgesia in healthy cats undergoing elective ovariohysterectomy. METHODS Cats undergoing ovariohysterectomy were randomly assigned to receive one of the following premedication treatments intramuscularly: methadone (0.2 mg/kg; n = 10); morphine (0.2 mg/kg; n = 10); or tramadol (3 mg/kg; n = 10). Induction of anesthesia was done with propofol, and maintenance of anesthesia was done with isoflurane. Intraoperative heart rate, arterial blood pressure, respiratory rate, end-tidal isoflurane concentration and frequency of rescue analgesia (fentanyl 2.5 µg/kg) were compared between groups. Postoperative analgesia was assessed using the UNESP-Botucatu Multidimensional Composite Pain Scale, and perioperative serum glucose, cortisol concentrations and postoperative rescue analgesia were evaluated. RESULTS Intraoperative rescue analgesia was required in 76.5% of cats at some time during surgery, and 27% of cats required postoperative rescue analgesia up to 6 h after extubation. There were no significant differences between groups with respect to intraoperative and postoperative rescue analgesia, pain scale scores and end-tidal isoflurane concentrations. In the immediate postoperative period, after extubation, most of the patients presented with hypothermia; however, 1-6 h postoperatively, hyperthermia was observed in most of the patients, and was most common in the tramadol group. CONCLUSIONS AND CLINICAL RELEVANCE Under the conditions of this study, methadone, morphine and tramadol produced satisfactory postoperative analgesia in most of the cats undergoing ovariohysterectomy, and the effects lasted up to 6 h postoperatively. Intraoperative analgesia was not sufficient in most cases. Significant cardiovascular or respiratory effects contraindicating the use of these drugs were not found. Postanesthetic hyperthermia occurred with all opioids studied and was more frequent in the tramadol group.
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Affiliation(s)
- Mariela Goich
- Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Alejandra Bascuñán
- Hospital Clínico Veterinario de la Universidad de Chile sede Bilbao, Santiago, Chile
| | - Patricio Faúndez
- Hospital Clínico Veterinario de la Universidad de Chile sede Bilbao, Santiago, Chile
| | - Daniela Siel
- Escuela de Medicina Veterinaria, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Chile
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Guedes PEB, Pinto TM, Corrêa JMX, Niella RV, dos Anjos CM, de Oliveira JNS, Marques CSDC, de Souza SS, da Silva EB, de Lavor MSL. Efficacy of Preemptive Analgesia with Amantadine for Controlling Postoperative Pain in Cats Undergoing Ovariohysterectomy. Animals (Basel) 2024; 14:643. [PMID: 38396611 PMCID: PMC10886337 DOI: 10.3390/ani14040643] [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: 12/12/2023] [Revised: 01/02/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to evaluate the effect of the preemptive administration of amantadine on postoperative analgesia in cats undergoing ovariohysterectomy and its influence on the physiological parameters. Twenty healthy domestic cats scheduled to undergo ovariohysterectomy at the Santa Cruz State University, Ilhéus, were divided into two groups: the control group (Group C; n = 10) and the amantadine group (Group A; n = 10). The cats in Group C received placebo capsules 30 min prior to the standard anesthetic protocol, whereas those in Group A received 5 mg/kg of amantadine orally 30 min prior to the standard anesthetic protocol. Postoperative pain was assessed using the visual analog scale and the UNESP-Botucatu multidimensional scale for the evaluation of postoperative pain in cats. The administration of amantadine had no effect on the physiological parameters evaluated. The pain scores in Group A were lower than those in Group C, indicating that the frequency of rescue analgesic administration cats in Group A was lower. That way, preemptive oral administration of amantadine at a dose of 5 mg/kg was effective at controlling postoperative pain in cats undergoing ovariohysterectomy. Moreover, no adverse effects or alterations in the physiological patterns were observed in the treated animals.
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Affiliation(s)
- Paula Elisa Brandão Guedes
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Taísa Miranda Pinto
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Janaína Maria Xavier Corrêa
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Raquel Vieira Niella
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Carolina Moreira dos Anjos
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Jéssica Natália Silva de Oliveira
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Claire Souza da Costa Marques
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Sophia Saraiva de Souza
- Postgraduate Program in Animal Science, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil; (P.E.B.G.); (T.M.P.); (J.M.X.C.); (R.V.N.); (C.M.d.A.); (J.N.S.d.O.); (C.S.d.C.M.); (S.S.d.S.)
| | - Elisângela Barboza da Silva
- Department of Agricultural and Environmental Sciences, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil;
| | - Mário Sérgio Lima de Lavor
- Department of Agricultural and Environmental Sciences, State University of Santa Cruz (UESC), Ilhéus 45662-900, BA, Brazil;
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Panprom C, Pattanapon N, Petchdee S. The effects of anesthetic drug choice on heart rate variability and echocardiography parameters in cats. Sci Rep 2024; 14:316. [PMID: 38172353 PMCID: PMC10764780 DOI: 10.1038/s41598-024-51162-z] [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: 11/10/2022] [Accepted: 01/01/2024] [Indexed: 01/05/2024] Open
Abstract
Heart rate variability (HRV) is one of the assessments of cardiovascular risk during general anesthesia. This study aimed to assess the effects of an anesthetic drug on HRV in cats and to provide information for clinical applications. Twenty-four healthy client-owned cats of various breeds, 12 females and 12 males scheduled for elective surgery, were enrolled in this study. The cats were premedicated and induced with 4 protocols: protocol 1, diazepam (0.3 mg/kg) and propofol (2-4 mg/kg) IV; protocol 2, diazepam (0.3 mg/kg) and alfaxalone (1-3 mg/kg) IV; protocol 3, diazepam (0.3 mg/kg) and ketamine (3-5 mg/kg) IV; and protocol 4, xylazine (1 mg/kg) and tiletamine/zolazepam (Zoletil) (5 mg/kg) IM. The heart rate and HRV of the 24 cats were collected before and at least 1 h after administering the anesthetic drugs. Echocardiography was performed to evaluate heart function. Oscillometric blood pressure monitoring was used to obtain the mean blood pressure. After anesthetic drug administration, higher heart rates were found in cats premedicated and induced with alfaxalone (p = 0.045) than in the other protocols. The lowest heart rate (HR) values were found in cats in protocol 4 using xylazine and Zoletil. The HRV low frequency (LF) and high frequency (HF) power ratios increased in all protocols except for cats premedicated and intubated with propofol. The standard deviation of the regular sinus beats (SDNN) was higher in cats premedicated and induced with ketamine than in other anesthetic protocols (p = 0.015). An increase in sympathetic activity and reduced HRV is associated with high blood pressure and left atrial dimension. The percentage of fractional shortening (FS) decreased in cats premedicated with ketamine. The results showed that the anesthesia method using diazepam and propofol caused the least disturbance of HRV compared with other anesthesia methods that were used in this study.
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Affiliation(s)
- Chattida Panprom
- Kasetsart University Veterinary Teaching Hospital Kamphaeng Saen Campus, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakorn Pathom, Thailand
| | - Nakrob Pattanapon
- Kasetsart University Veterinary Teaching Hospital Kamphaeng Saen Campus, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakorn Pathom, Thailand
| | - Soontaree Petchdee
- Department of Large Animal and Wildlife Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakorn Pathom, 73140, Thailand.
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Gomes VH, Peixoto AJ, EdosSL Fernandes M, de Souza Campos AC, Coelho CM, da Silva MF. Evaluation of lidocaine administration into the ovarian pedicle for the control of intraoperative and early postoperative pain during ovariohysterectomy in dogs. Vet Anaesth Analg 2024; 51:64-70. [PMID: 37919174 DOI: 10.1016/j.vaa.2023.07.002] [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: 01/30/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate effects of lidocaine 2% administration into the ovarian pedicle on intraoperative nociception and early postoperative pain in dogs undergoing ovariohysterectomy. STUDY DESIGN Prospective, randomized, blinded clinical study. ANIMALS A total of 20 healthy adult female dogs of different breeds. METHODS Dogs were premedicated with acepromazine (0.02 mg kg-1) and morphine (0.5 mg kg-1) intramuscularly, anesthesia induced with propofol and maintained with isoflurane. Dogs were randomly assigned to be administered 2 mL of saline (group S) or lidocaine 2% (group L) into the mesovarium (1 mL each side). Heart rate (HR) and noninvasive systemic arterial pressure were recorded before surgery (T0), before (T1) and during ligation of the right ovarian pedicle (T2), before (T3) and during ligation of the left ovarian pedicle (T4). Rescue treatment (propofol) was administered if HR or systolic arterial pressure (SAP) increased by 20% compared with the previous time point. Pain, assessed with the Glasgow Composite Measure Pain Scale-Short Form (CMPS-SF) was recorded before premedication (baseline) and after extubation. Administration of postoperative rescue analgesia was recorded. RESULTS In group S, HR was higher at T2 than T1 (112 ± 18 versus 89 ± 21 beats minute-1, p = 0.001) There were no significant differences between treatments at any time. SAP was higher at T2 than T1 in group S (110 ± 12 versus 100 ± 10 mmHg, p = 0.031). SAP was higher in group S than group L at T3 (113 ± 12 and 91 ± 10 mmHg, respectively, p = 0.001). No dogs required propofol intraoperatively. All dogs required postoperative rescue analgesia. Compared with baseline, CMPS-SF increased 60 minutes after extubation (group S; p = 0.019, group L; p = 0.043). CONCLUSIONS AND CLINICAL RELEVANCE Administration of lidocaine 2% into the mesovarium did not reduce intraoperative nociception and did not improve postoperative analgesia.
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Affiliation(s)
- Viviane H Gomes
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil.
| | - Anna Jr Peixoto
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Maria EdosSL Fernandes
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Ana Carolina de Souza Campos
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Cassia Mm Coelho
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Marta Fa da Silva
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
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17
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Li Z, Zhu W, Zhang B, Zhang Y, Li H, Lv B, Zhen Q, Liu L, Liu L, Wu Y, Li S. A novel minimally invasive fixation method for flail chest management in a Canine model: an animal research. J Cardiothorac Surg 2023; 18:359. [PMID: 38098070 PMCID: PMC10722814 DOI: 10.1186/s13019-023-02445-5] [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: 01/16/2023] [Accepted: 11/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Multiple rib fractures can lead to flail chest with up to 35% mortality rate due to severe pulmonary complications. Current treatments of flail chest remain controversial. Studies have shown that surgical treatments can improve outcomes and reduce mortality, comparing to non-operative treatments. Current surgical fixation methods focus on stabilization of ribs on the outward facing side, and they require division of intercostal muscles. Damages to surrounding nerves and vessels may lead to chronic pain. This study tests a novel interior fixation method that minimizes neurovascular injuries. METHODS Twelve healthy canines were divided in two surgical operation groups for exterior and interior fixation using titanium metal plates. Osteotomy with oblique fractures was prepared under general anesthesia. Exterior fixation was performed in open surgery. Interior fixation was minimally invasive using custom made tools including a flexible shaft extension screwdriver, solid plate stand, guiding wire loop and metal plates with threaded holes. RESULTS Respiratory and cardiovascular functions (RR, PO2, PCO2, SpO2, and HR) together with body temperature were measured before anesthesia and within 48 h after surgery. The difference in measurements was not statistically significant between the two groups before surgery with P values greater than 0.05. However, the interior group canines had better RR and PO2 values starting from the 24th hour, and better PCO2, SpO2, and HR values starting from the 48th hour. It took longer operation time to complete the minimally invasive interior fixation surgery (P value less than 0.001), but the total blood loss was less than the exterior fixation group (P value less than 0.001). Results also showed that interior group canines suffered less pain, and they had quicker recovery in gastrointestinal and physical mobility. CONCLUSIONS The investigative interior fixation method was safe and effective in rib stabilization on a canine rib fracture model, comparing to the exterior fixation method. The interior fixation was minimally invasive, with less damages to tissues and nerves surrounding the ribs, leading to better postoperative outcomes.
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Affiliation(s)
- Zhe Li
- Department of Thoracic Surgery, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang City, Hebei, 050000, China
- Department of Thoracic Surgery, Shijiazhuang People's Hospital, No. 365 Jianhua South Street, Shijiazhuang City, Hebei, 050031, China
| | - Weiwei Zhu
- Department of Thoracic Surgery, The First Hospital of Shijiazhuang, No. 36, Fanxi Road, Shijiazhuang City, Hebei, 050011, China
| | - Bing Zhang
- Department of Thoracic Surgery, The First Hospital of Shijiazhuang, No. 36, Fanxi Road, Shijiazhuang City, Hebei, 050011, China
| | - Yaxiao Zhang
- Department of Thoracic Surgery, The First Hospital of Shijiazhuang, No. 36, Fanxi Road, Shijiazhuang City, Hebei, 050011, China
| | - Huixian Li
- Department of Thoracic Surgery, The First Hospital of Shijiazhuang, No. 36, Fanxi Road, Shijiazhuang City, Hebei, 050011, China
| | - Baolei Lv
- Department of Thoracic Surgery, The First Hospital of Shijiazhuang, No. 36, Fanxi Road, Shijiazhuang City, Hebei, 050011, China
| | - Qiang Zhen
- Department of Thoracic Surgery, The First Hospital of Shijiazhuang, No. 36, Fanxi Road, Shijiazhuang City, Hebei, 050011, China
| | - Lin Liu
- Hebei General Hospital, No.348 Heping West Road, Shijiazhuang City, Hebei, 050051, China
| | - Lijun Liu
- Department of Thoracic Surgery, Hebei General Hospital, No.348 Heping West Road, Shijiazhuang City, Hebei, 050051, China
| | - Yanxin Wu
- Hebei General Hospital, No.348 Heping West Road, Shijiazhuang City, Hebei, 050051, China
| | - Shujun Li
- Department of Thoracic Surgery, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang City, Hebei, 050000, China.
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Zanusso F, De Benedictis GM, Zemko P, Bellini L. Non-invasive assessment of oxygenation status using the oxygen reserve index in dogs. BMC Vet Res 2023; 19:241. [PMID: 37980491 PMCID: PMC10657143 DOI: 10.1186/s12917-023-03804-z] [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: 08/31/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND The oxygen reserve index (ORi) is a real-time, continuous index measured with multi-wavelength pulse CO-oximetry technology. It estimates mild hyperoxemia in humans, which is defined as a partial pressure of oxygen (PaO2) level between 100 and 200 mmHg. The objectives of this study were to assess the correlation between ORi and PaO2, as well as to determine its ability in detecting mild hyperoxemia in dogs. METHODS This prospective observational study enrolled 37 anaesthetised and mechanically ventilated dogs undergoing elective procedures. Simultaneous measurements of ORi and PaO2 were collected, using a multi-wavelength pulse CO-oximeter with a probe placed on the dog's tongue, and a blood gas analyser, respectively. A mixed-effects model was used to calculate the correlation (r2) between simultaneous measurements of ORi and PaO2. The trending ability of ORi to identify dependable and proportional changes of PaO2 was determined. The diagnostic performances of ORi to detect PaO2 ≥ 150 mmHg and ≥ 190 mmHg were estimated using the area under the receiver operating characteristic curve (AUROC). The effects of perfusion index (PI), haemoglobin (Hb), arterial blood pH and partial pressure of carbon dioxide (PaCO2) on AUROC for PaO2 ≥ 150 mmHg were evaluated. RESULTS A total of 101 paired measurements of ORi and PaO2 were collected. PaO2 values ranged from 74 to 258 mmHg. A strong positive correlation (r2 = 0.52, p < 0.001) was found between ORi and PaO2. The trending ability ORi was 90.7%, with 92% sensitivity and 89% specificity in detecting decreasing PaO2. An ORi value ≥ 0.53 and ≥ 0.76 indicated a PaO2 ≥ 150 and ≥ 190 mmHg, respectively, with ≥ 82% sensitivity, ≥ 77% specificity and AUROC ≥ 0.75. The AUROC of ORi was not affected by PI, Hb, pH and PaCO2. CONCLUSIONS In anaesthetised dogs, ORi may detect mild hyperoxaemia, although it does not replace blood gas analysis for measuring the arterial partial pressure of oxygen. ORi monitoring could be used to non-invasively assess oxygenation in dogs receiving supplemental oxygen, limiting excessive hyperoxia.
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Affiliation(s)
- Francesca Zanusso
- Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Padova, 35020, Italy
| | - Giulia Maria De Benedictis
- Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Padova, 35020, Italy
| | - Polina Zemko
- Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Padova, 35020, Italy
| | - Luca Bellini
- Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Padova, 35020, Italy.
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Brunori L, Dolan C, Elias Santo‐Domingo N. Occurrence and clinical relevance of postoperative hypernatremia in dogs undergoing cholecystectomy. J Vet Intern Med 2023; 37:2171-2177. [PMID: 37682033 PMCID: PMC10658579 DOI: 10.1111/jvim.16847] [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: 02/13/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Patients undergoing cholecystectomy have not been reported previously to develop clinically relevant postoperative hypernatremia. OBJECTIVES Describe the frequency of postoperative hypernatremia in dogs undergoing cholecystectomy and its clinical relevance (duration of hospitalization and survival). ANIMALS Thirty-seven dogs undergoing cholecystectomy at 2 private referral hospitals. METHODS Retrospective study of dogs undergoing cholecystectomy with available preoperative and postoperative serum sodium concentrations. RESULTS Postoperative hypernatremia (>150 mEq/L) was common (56%; 95% confidence interval [CI], 40%-70%) and was associated with significantly higher mortality compared to nonhypernatremic patients (52%; 95% CI, 30%-70% vs 12.5%; 95% CI, 2%-40%; P = .02). Nonsurvivors had higher mean postoperative peak serum sodium concentrations (155 mEq/L; range, 146-172) than survivors (150 mEq/L; range, 142-156; P = .01). Dogs developing hypernatremia within 6 hours after surgery had 7.7 higher odds of nonsurvival (odds ratio [OR], 7.7; 95% CI, 5.9-9.4). A delta value (serum sodium concentration on admission [T0] - serum sodium concentration 6 hours postoperatively [T2]) of ≥10 mEq/L carried 3.3 higher odds of mortality (OR, 3.3; 95% CI, 1.6-5.1). All dogs with a postoperative peak sodium concentration >160 mEq/L did not survive. Admission acute patient physiologic laboratory evaluation fast (APPLEfast ) scores were not different between survivors and nonsurvivors or between postoperative hypernatremic and normonatremic patients. Hospitalization time was no different between hypernatremic and normonatremic patients (6 days vs 4.5 days; P = .15). Dogs with gallbladder mucocele were more likely to develop postoperative hypernatremia and have poorer outcomes. CONCLUSIONS Hypernatremia was a common and clinically relevant postoperative complication in dogs after cholecystectomy. Detection of hypernatremia within 6 hours after surgery may be associated with poorer outcomes.
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Affiliation(s)
- Lara Brunori
- Emergency & Critical Care Specialist ServiceVetsNow 24/7 Pet Emergency & Specialty HospitalGlasgowUnited Kingdom
| | - Cormac Dolan
- Emergency & Critical Care Specialist ServiceVetsNow 24/7 Pet Emergency & Specialty HospitalGlasgowUnited Kingdom
| | - Neus Elias Santo‐Domingo
- Emergency & Critical Care Specialist ServiceVetsNow 24/7 Pet Emergency & Specialty HospitalGlasgowUnited Kingdom
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20
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Goodwin W, Monteiro BP, Grimm K, Steagall PV. Letter to Editor in response to "Acute kidney injury in 18 cats after subcutaneous meloxicam and an update on non-steroidal anti-inflammatory drug usage in feline patients in Australia". Aust Vet J 2023; 101:411-412. [PMID: 37587769 DOI: 10.1111/avj.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/29/2023] [Indexed: 08/18/2023]
Affiliation(s)
- W Goodwin
- Veterinary Anaesthesia and Analgesia Chapter of Australian and New Zealand College of Veterinary Scientists
| | - B P Monteiro
- World Small Animal Veterinary Association Global Pain Council
| | - K Grimm
- American College Veterinary Anesthesia and Analgesia
| | - P V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Rezende BADS, Bottoni NG, Cunha LA, de Oliveira ÂGN, Motta LB, Sartori F, de Carvalho EB. Cervical ultrasound for endotracheal intubation confirmation in dogs by veterinary students: a cadaveric study. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2023; 45:e002623. [PMID: 37705937 PMCID: PMC10497175 DOI: 10.29374/2527-2179.bjvm002623] [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: 06/29/2023] [Accepted: 08/02/2023] [Indexed: 09/15/2023] Open
Abstract
Although endotracheal intubation is usually a simple and fast procedure in dogs, some situations can be challenging and lead to the risk of tube misplacement in the esophagus-a life-threatening complication. Hence, confirming intubation is a cornerstone whenever this procedure is performed. Methods such as direct visualization or capnography present limitations insofar as they may be unreliable or unavailable under some circumstances. Ultrasound has emerged as a promising tool to confirm intubation in medicine. However, so far little research has been done on the subject in veterinary medicine. This study's main goal was to investigate ultrasound performed by veterinary students as a confirmation method for intubation in canine cadavers after a brief training session (25 minutes). A total of 160 exams were performed with a microconvex probe by 20 students in 11 different cadavers on left and right recumbencies. Overall accuracy was 70.6% with a median success rate of 75% and a median time to diagnosis of 25 seconds. The number of correct diagnoses was statistically higher than the wrong ones (p<0.05) without difference between recumbencies. Sensitivity, specificity, and positive and negative predictive values were 72.5%, 68.8%, 69.9%, and 71.4%, respectively. The fastest diagnosis was performed in just 4 seconds, and among the top-performers, one student had 100% accuracy with a mean time to diagnosis of 16.8 seconds, and four students had approximately 88% accuracy. This study showed for the first time that even inexperienced veterinary students can have acceptable accuracy in confirming endotracheal intubation in dogs after a brief training session.
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Affiliation(s)
| | - Nicolle Gouvêa Bottoni
- Undergraduate in Veterinary Medicine, Faculdade de Medicina Veterinária, Universidade de Vassouras. Vassouras, RJ, Brazil.
| | - Loíse Almeida Cunha
- Undergraduate in Veterinary Medicine, Faculdade de Medicina Veterinária, Universidade de Vassouras. Vassouras, RJ, Brazil.
| | | | - Lucas Baptista Motta
- Undergraduate in Veterinary Medicine, Faculdade de Medicina Veterinária, Universidade de Vassouras. Vassouras, RJ, Brazil.
| | - Fabio Sartori
- Veterinarian, MSc. Faculdade de Medicina Veterinária, Universidade de Vassouras. Vassouras, RJ, Brazil.
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22
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Kazmir-Lysak K, Torres-Cantó L, Ingraffia S, Romanelli G, Massari F, Rossanese M, Compagnone K, Pisani G, Cinti F, Montinaro V, Collivignarelli F, Okushima S, Vallefuoco R. Use of wound infusion catheters for postoperative local anaesthetic administration in cats. J Feline Med Surg 2023; 25:1098612X231193534. [PMID: 37713178 PMCID: PMC10812034 DOI: 10.1177/1098612x231193534] [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] [Indexed: 09/16/2023]
Abstract
OBJECTIVES The present study aimed to document the use of the wound infusion catheter (WIC) following a variety of surgical procedures in cats, investigating complications and risk factors associated with catheter placement or local anaesthetic (LA) administration. METHODS A retrospective, multicentric study was performed. Medical databases of eight veterinary referral hospitals from 2010 to 2021 were searched to identify records of cats where WICs were used. Information regarding signalment, type of surgery, size and type of WIC placed, and LA protocol used, as well as postoperative complications, were retrieved. RESULTS One hundred and sixty-six cases fulfilled the inclusion criteria. Feline injection site sarcoma resection was the most common surgery. Overall complications were identified in 22/166 cats (13.2%). Thirteen cats (7.8%) experienced wound-related complications, whereas nine cats (5.4%) experienced drug-delivery complications. The only factor associated with an increased risk of complications was the amount of a single dose of LA delivered through the catheter (P <0.001). An amount higher than 2.5 ml of LA delivered at each administration was associated with an increased risk of complications. All complications were minor and self-limiting. CONCLUSIONS AND RELEVANCE WICs were used for a large variety of surgical procedures with different protocols of LA administration as part of a multimodal analgesic plan in cats. The risk of complications was relatively low and self-limiting, suggesting its safe use in cats. Further prospective studies are required to evaluate efficacy of postoperative analgesia and to determine the suitable protocol for WIC handling and maintenance.
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Affiliation(s)
- Kristina Kazmir-Lysak
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Lucía Torres-Cantó
- Anaesthesia Department, Southern Counties Veterinary Specialists, Ringwood, Hampshire, UK
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23
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Henao-Guerrero N, Ricco-Pereira CH, Paranjape VV. A Comparison of Dobutamine, Norepinephrine, Vasopressin, and Hetastarch for the Treatment of Isoflurane-Induced Hypotension in Healthy, Normovolemic Dogs. Animals (Basel) 2023; 13:2674. [PMID: 37627465 PMCID: PMC10451654 DOI: 10.3390/ani13162674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Isoflurane is a commonly used inhalation anesthetic in species undergoing veterinary care that induces hypotension, impacting organ perfusion, making it imperative to minimize its occurrence or identify effective strategies for treating it. This study evaluated and compared the hemodynamic effects of DOB, NEP, VAS, and HES in twelve isoflurane-anesthetized Beagle dogs. The order of the first three treatments was randomized. HES was administered last. Data were collected before treatments (baseline) and after 10 min of a sustained MAP of <45 mmHg induced by a high end-tidal isoflurane concentration (T0). Once treatment was initiated and the target MAP was achieved (65 to 80 mmHg) or the maximum dose reached, data were collected after 15 min of stabilization (T1) and 15 min after (T2). A 15 min washout period with a MAP of ≥65 mmHg was allowed between treatments. The intravenous dosage regimens started and were increased by 50% every five minutes until the target MAP or maximum dose was reached. The dosages were as follows: DOB, 5-15 μg/kg/min; NEP, 0.1-2 μg/kg/min; VAS, 0.5-5 mU/kg/min; and HET, 6% 1-20 mL/kg/min. DOB improved CO, DO2, and VO2, but reduced SVR. VAS elevated SVR, but decreased CO, DO2, and VO2. HES minimally changed BP and mildly augmented CO, DO2, and VO2. These treatments failed to reach the target MAP. NEP increased the arterial BP, CO, MPAP, and PAWP, but reduced HR. Norepinephrine infusion at 0.44 ± 0.19 μg/kg/min was the most efficient therapy for correcting isoflurane-induced hypotension.
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Affiliation(s)
- Natalia Henao-Guerrero
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA;
| | - Carolina H. Ricco-Pereira
- Department of Veterinary Clinical Sciences, The Ohio State University-College of Veterinary Medicine, Columbus, OH 43210, USA;
| | - Vaidehi V. Paranjape
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA;
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24
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Vullo C, Falcone A, Marino G, Monti S, Tambella AM, Bufalari A, Catone G. Comparison between the effects of epidural lidocaine, tramadol, and lidocaine-tramadol on postoperative pain in cats undergoing elective orchiectomy. Acta Vet Scand 2023; 65:33. [PMID: 37434222 DOI: 10.1186/s13028-023-00696-9] [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: 08/07/2022] [Accepted: 07/05/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND In veterinary clinical practice, orchiectomy is one of the most common surgical procedures for cats and is performed mainly in young animals. The purpose of this study was to compare three different epidural (EP) analgesic protocols used in cats undergoing orchiectomy in order to determine which protocol resulted in superior outcomes in terms of perioperative analgesia. Twenty-one client-owned male cats were premedicated with a combination of dexmedetomidine (10 µg/kg) and midazolam (0.2 mg/kg) injected intramuscularly. Anesthesia was induced intravenously with propofol. Cats were randomly divided in three treatment groups of seven animals each: Group L received EP lidocaine (2 mg/kg), Group T received EP tramadol (1 mg/kg), and Group LT received EP lidocaine (2 mg/kg) plus tramadol (1 mg/kg). The post-operative pain level was assessed using two different scales: the Glasgow Composite Measure Pain Scale-Feline (CMPS-F) and the Feline Grimace Scale (FGS). Rescue analgesia was administered when the CMPS-F total score was ≥5 or the FGS total score was ≥4. RESULTS No adverse effects related to tramadol or lidocaine were observed. Based on post-operative pain assessments, significant differences between groups were observed according to both pain scoring systems. In particular, in Group LT, the CMPS-F and FGS scores decreased significantly in the first six hours following castration. CONCLUSIONS Based on our results, EP lidocaine plus tramadol provided the best post-operative analgesic effects in cats submitted to orchiectomy lasting 6 h and could also be a choice to consider for longer surgical procedures.
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Affiliation(s)
- Cecilia Vullo
- Department of ChiBioFarAm, University of Messina, Viale Ferdinando Stagno d'Alcontres, Messina, 98166, Italy.
- Veterinary Teaching Hospital, University of Messina, Via Palatucci, Messina, 98168, Italy.
| | - Annastella Falcone
- Veterinary Teaching Hospital, University of Messina, Via Palatucci, Messina, 98168, Italy
| | - Gabriele Marino
- Veterinary Teaching Hospital, University of Messina, Via Palatucci, Messina, 98168, Italy
- Department of Veterinary Sciences, University of Messina, Via Palatucci, Messina, 98168, Italy
| | - Salvatore Monti
- Veterinary Teaching Hospital, University of Messina, Via Palatucci, Messina, 98168, Italy
- Department of Veterinary Sciences, University of Messina, Via Palatucci, Messina, 98168, Italy
| | - Adolfo Maria Tambella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, Matelica, 62022, Italy
| | - Antonello Bufalari
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo, Perugia, 06126, Italy
| | - Giuseppe Catone
- Veterinary Teaching Hospital, University of Messina, Via Palatucci, Messina, 98168, Italy
- Department of Veterinary Sciences, University of Messina, Via Palatucci, Messina, 98168, Italy
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25
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Mauthe von Degerfeld M, Serpieri M, Bonaffini G, Ottino C, Quaranta G. Intranasal Atomization of Ketamine, Medetomidine and Butorphanol in Pet Rabbits Using a Mucosal Atomization Device. Animals (Basel) 2023; 13:2076. [PMID: 37443874 DOI: 10.3390/ani13132076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
A non-invasive method of drug delivery, intranasal atomization, has shown positive results in human medicine and in some animal species. The objective of this study was to evaluate the effects of intranasal atomization, compared to intramuscular administration, of a mix of anesthetic drugs in pet rabbits. In total, 104 mixed-breed pet rabbits, undergoing various types of surgery, received a combination of ketamine, medetomidine, and butorphanol (20, 0.4, and 0.2 mg/kg) by intranasal atomization using a Mucosal Atomization Device (Group MAD) or intramuscular administration (Group IM). When required, isoflurane was dispensed through a face mask. At the end of the procedures, atipamezole was administered using the same routes in the respective Groups. There were no differences in time to loss of righting reflex between the groups, while differences were found for the need for isoflurane (higher in Group MAD) and recovery time, occurring earlier in Group MAD. The results suggest that intranasal atomization of a combination of ketamine, medetomidine, and butorphanol produces a lighter depth of anesthesia in pet rabbits, compared to intramuscular administration. Intranasal atomization can be performed to administer sedative and anesthetic drugs, avoiding the algic stimulus related to the intramuscular inoculation of drugs.
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Affiliation(s)
- Mitzy Mauthe von Degerfeld
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Matteo Serpieri
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Giuseppe Bonaffini
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Chiara Ottino
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Giuseppe Quaranta
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
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26
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Kramer BM, Hellyer PW, Rishniw M, Kogan LR. Anesthetic and analgesic techniques used for cats undergoing ovariohysterectomies in general practice in the United States. Vet Anaesth Analg 2023:S1467-2987(23)00080-6. [PMID: 37230820 DOI: 10.1016/j.vaa.2023.04.006] [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: 12/30/2022] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To better document anesthetic and analgesic protocols used by veterinarians in general practice within the United States (US) when performing elective ovariohysterectomy in cats. STUDY DESIGN Cross-sectional survey. POPULATION Veterinary practitioners in the US who are members of the Veterinary Information Network Inc. (VIN). METHODS An online anonymous survey was distributed to VIN members. The survey included questions pertaining to preanesthetic evaluation, premedication, induction, monitoring and maintenance protocols, and postoperative analgesia and sedation protocols when performing ovariohysterectomy in cats. RESULTS A total of 1324 veterinarians completed the survey. Respondents (number; %) reported performing preanesthetic laboratory tests [packed cell volume (256; 19.3%), complete blood cell count (893; 67.4%) and biochemistry panels (1101; 83.2%)] and preanesthetic examinations (1186; 89.6%) on the morning of surgery. The most frequently administered drugs for premedication were dexmedetomidine (353; 26.7%) and buprenorphine (424; 32.0%). The most frequently administered induction agent was propofol (451; 61.3%), and isoflurane (668; 50.4%) was the most common agent for maintenance of anesthesia. The majority of respondents reported placing intravenous catheters (885; 66.8%), administering crystalloid fluids (689; 52.0%) and providing heat support (1142; 86.3%). Participants reported using perioperative and postoperative analgesia including opioids (791; 59.7%), non-steroidal anti-inflammatory drugs (NSAIDs; 697; 52.6%) and NSAIDs dispensed for home use (665; 50.2%). Cats were commonly released home on the day of surgery (1150; 86.9%), and most participants reported contacting owners for follow-up within 1-2 days (989; 74.7%). CONCLUSIONS AND CLINICAL RELEVANCE Anesthetic protocols and management techniques for routine feline ovariohysterectomy differ widely among US veterinarians who are VIN members, and results from this study may be of use to evaluate anesthetic practices from this population of veterinarians.
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Affiliation(s)
- Brittany M Kramer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Peter W Hellyer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Lori R Kogan
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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27
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Paranjape VV, Henao-Guerrero N, Menciotti G, Saksena S, Agostinho M. Agreement between Electrical Cardiometry and Pulmonary Artery Thermodilution for Measuring Cardiac Output in Isoflurane-Anesthetized Dogs. Animals (Basel) 2023; 13:ani13081420. [PMID: 37106987 PMCID: PMC10135226 DOI: 10.3390/ani13081420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
In animals, invasive pulmonary artery thermodilution (PATD) is a gold standard for cardiac output (CO) monitoring, but it is impractical in clinical settings. This study evaluates the agreement between PATD and noninvasive electrical cardiometry (EC) for measuring CO and analyzes the other EC-derived hemodynamic variables in six healthy anesthetized dogs subjected to four different hemodynamic events in a sequential order: (1) euvolemia (baseline); (2) hemorrhage (33% blood volume loss); (3) autologous blood transfusion; and (4) 20 mL/kg colloid bolus. The CO measurements obtained using PATD and EC are compared using Bland-Altman analysis, Lin's concordance correlation (LCC), and polar plot analysis. Values of p < 0.05 are considered significant. The EC measurements consistently underpredict the CO values as compared with PATD, and the LCC is 0.65. The EC's performance is better during hemorrhage, thus indicating its capability in detecting absolute hypovolemia in clinical settings. Even though the percentage error exhibited by EC is 49.4%, which is higher than the standard (<30%), EC displays a good trending ability. Additionally, the EC-derived variables display a significant correlation with the CO measured using PATD. Noninvasive EC may have a potential in monitoring trends in hemodynamics in clinical settings.
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Affiliation(s)
- Vaidehi V Paranjape
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA 24061, USA
| | - Natalia Henao-Guerrero
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA 24061, USA
| | - Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA 24061, USA
| | - Siddharth Saksena
- Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, 750 Drillfield Dr, Blacksburg, VA 24061, USA
| | - Manuela Agostinho
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA 24061, USA
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28
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Gomes VH, Freitas MM, Morais TDN, de Menezes TQ, Stocco AV, da Silva MDOL, Balthazar DDA. Anesthetic effects of isoflurane and fentanyl infusion in capuchin monkeys (Sapajus sp) undergoing salpingectomy or deferentectomy, previously chemically restrained with ketamine-midazolam or ketamine-dexmedetomidine. J Med Primatol 2023; 52:149-155. [PMID: 36914961 DOI: 10.1111/jmp.12639] [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: 11/17/2022] [Revised: 01/24/2023] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND This study evaluated the anesthetic and cardiorespiratory effects of two anesthetic protocols for salpingectomy or deferentectomy in capuchin monkeys (Sapajus sp). MATERIALS AND METHODS Five capuchin monkeys (5 per group) received ketamine (20 mg/kg) combined with midazolam (0.5 mg/kg; group KM) or dexmedetomidine (5 μg/kg; group KD) intramuscularly. Anesthesia is induced with propofol intravenously and maintained with isoflurane. Before the start of surgery, fentanyl 3 μg/kg was administered IV, and continuous infusion (10 μg/kg/min) IV was started. Times and quality of anesthetic recovery were evaluated postoperatively. RESULTS KM and KD resulted in adequate chemical restraint. KD resulted in bradycardia. Intraoperative heart rate and systolic blood pressure were higher in KM than in KD. Both groups had smooth recovery. Time to standing was longer in KM than in KD. CONCLUSION Both protocols allowed the performance of surgeries, with few cardiorespiratory effects. Anesthetic recovery was smooth and shorter in KD group.
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Affiliation(s)
- Viviane Horta Gomes
- Veterinary Institute, Universidade Federal Rural do Rio de Janeiro, Seropédica, Brazil
| | - Mayara Muniz Freitas
- Veterinary Institute, Universidade Federal Rural do Rio de Janeiro, Seropédica, Brazil
| | | | | | - Anieli Vidal Stocco
- Veterinary Institute, Universidade Federal Rural do Rio de Janeiro, Seropédica, Brazil
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29
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Sant Cassia EV, Tordiffe ASW. Agreement of high-definition oscillometry at two cuff locations with invasively measured arterial blood pressures in anaesthetised cheetahs. Vet Anaesth Analg 2023; 50:170-179. [PMID: 36669927 DOI: 10.1016/j.vaa.2022.11.009] [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: 09/15/2021] [Revised: 09/15/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the agreement between high-definition oscillometry (HDO) used on the metatarsus or tail base with invasive arterial blood pressures measured in the dorsal pedal artery in anaesthetised cheetahs. STUDY DESIGN Prospective clinical study. ANIMALS A group of 13 captive adult cheetahs. METHODS Cheetahs were immobilised with medetomidine (32-45 μg kg-1) and tiletamine/zolazepam (0.93-1.39 mg kg-1) administered intramuscularly, and anaesthesia was maintained with either isoflurane in oxygen or continuous propofol infusion. Invasive blood pressure was measured via a 20 gauge intra-arterial catheter in the dorsal pedal artery in the metatarsus and used as a reference method for pressures simultaneously estimated using HDO on the contralateral metatarsus and tail base. Bland-Altman plots (for repeated measurements) and criteria defined by the American College of Veterinary Internal Medicine (ACVIM) were used to compare agreement according to the anatomical location of the cuff, the anaesthetic maintenance agent and magnitude of the blood pressure. RESULTS A total of 147 paired measurements were obtained with HDO on the metatarsus and 135 on the tail. Agreement with invasive pressures was better when HDO was used on the tail (rather than on the metatarsus) with all ACVIM criteria being met. Mean bias (a positive bias meaning that HDO overestimated the invasively measured pressures) ± standard deviation of differences for systolic, diastolic and mean arterial pressures were -7.0 ± 13.9, 4.2 ±12.1 and 4.6 ±11.2 mmHg, respectively, for HDO on the tail, and -11.9 ±15.1, 2.8 ±16.5 and 2.1 ±13.2 mmHg, respectively, for HDO on the metatarsus. Agreement was better during isoflurane anaesthesia than propofol, and at lower blood pressures than at higher. CONCLUSIONS AND CLINICAL RELEVANCE When used on the tail base of anaesthetised cheetahs, HDO met the ACVIM validation criteria for a noninvasive device, as compared to invasively measured pressures in the dorsal pedal artery.
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Affiliation(s)
| | - Adrian S W Tordiffe
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
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30
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Comparison of alfaxalone and propofol on haematological and serum biochemical variables in cats undergoing radiotherapy with sevoflurane maintenance. Vet Anaesth Analg 2023; 50:146-156. [PMID: 36759290 DOI: 10.1016/j.vaa.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/30/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate effects of repeated alfaxalone or propofol administration on haematological and serum biochemical variables in cats undergoing radiotherapy. STUDY DESIGN Prospective, block-randomized, clinical trial. ANIMALS A group of 39 client-owned cats. METHODS After butorphanol (0.2 mg kg-1) and midazolam (0.1 mg kg-1) sedation, cats were randomly assigned to receive either alfaxalone or propofol for induction of anaesthesia and sevoflurane maintenance. Cats were anaesthetized daily with the same induction agent for 10-12 days. Complete blood counts, reticulocytes, Heinz body score and serum biochemistry were performed before the first treatment (T1), at T6, T10 and 3 weeks after the final treatment (T21). Cumulative induction agent dose for each cat at each time point was evaluated for an effect on Heinz body score. Data are shown as mean ± standard deviation; p < 0.05. RESULTS At baseline there were no significant differences in signalment or blood variables between groups. A significant decrease in haematocrit of 2.3% ± 0.77 (p = 0.02) between T1-T6 and T1-T10 [mean 4.1% (± 0.78, p < 0.0001)] was detected, with a significant increase in haematocrit of 2.1% ± 0.80 (p = 0.046) between T6-T21 and 4.0% ± 0.8 (p < 0.001) between T10-T21. Heinz body score significantly increased by 1.86 ± 0.616 (p = 0.013) between T1-T10. In the propofol group, reticulocytes increased significantly between T1-T6 [mean 23,090 μL-1 ± 7670 (p = 0.02)] and T1-T10 [mean 27,440 μL-1 ± 7990 (p = 0.007)]. Mean cumulative dose at T10 was 19.65 mg kg-1 ± 5.3 and 43.4 mg kg-1 ± 14.4 for alfaxalone and propofol, respectively, with no significant effect on Heinz body formation at any time point. CONCLUSIONS AND CLINICAL RELEVANCE Haematocrit decreased in both groups with recovery after 3 weeks. Repeated alfaxalone and propofol administration was not associated with marked haematological or serum biochemistry changes.
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31
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Wun MK, Leister E, King T, Korman R, Malik R. Acute kidney injury in 18 cats after subcutaneous meloxicam and an update on non-steroidal anti-inflammatory drug usage in feline patients in Australia. Aust Vet J 2023; 101:90-98. [PMID: 36470590 DOI: 10.1111/avj.13222] [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: 07/06/2022] [Revised: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Acute kidney injury (AKI) is a well-known but poorly documented adverse effect of non-steroidal anti-inflammatory drugs (NSAIDs) in cats. We aimed to describe instances of NSAID-associated AKI in cats and survey Australian veterinarians on NSAID use in acute settings. METHODS Medical records of cats that developed an AKI subsequent to the administration of meloxicam were obtained by searching the databases of seven practices in Queensland, as well as by contemporaneously contacting select veterinary colleagues of the authors in both general and specialist small animal practice. An online questionnaire was created for the survey, and the URL distributed to Australian practitioners. RESULTS A total of 18 cases were retrieved, all of which received injectable meloxicam. The indication(s) for its use and the dosage prescribed were within the manufacturer's recommendations for Australian veterinarians. The majority of cases (13/18 cats) received the label dose of 0.3 mg/kg subcutaneously (SC) on the day of the procedure. In 12/18 cats, the injection was given in association with general anaesthesia or sedation. Fourteen cats survived to hospital discharge. Of 187 survey respondees, 89% routinely administered NSAIDs for surgery-related analgesia, with 98% prescribing meloxicam and 84% of these giving it SC. Ninety percent of respondees routinely administered NSAIDs for non-surgical-related analgesia, with 99% prescribing meloxicam and 35% of those giving it SC. CONCLUSIONS AND RELEVANCE We strongly recommend that practitioners avoid prescribing meloxicam SC in cats. This recommendation is emphatic in situations where concurrent dehydration and/or hypotension are possible.
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Affiliation(s)
- M K Wun
- Veterinary Specialist Services, Underwood, Australia
- Animal Referral Hospital Brisbane, Sinnamon Park, Australia
| | - E Leister
- Pet Intensive Care Unit, Underwood, Australia
| | - T King
- Veterinary Specialist Services, Underwood, Australia
| | - R Korman
- Veterinary Specialist Services, Underwood, Australia
| | - R Malik
- Centre for Veterinary Education, B22, The University of Sydney, Camperdown, Australia
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Murillo C, Weil AB, Moore GE, Kreuzer M, Ko JC. Electroencephalographic and Cardiovascular Changes Associated with Propofol Constant Rate of Infusion Anesthesia in Young Healthy Dogs. Animals (Basel) 2023; 13:ani13040664. [PMID: 36830451 PMCID: PMC9951736 DOI: 10.3390/ani13040664] [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: 01/11/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
This study aimed to evaluate electroencephalography (EEG) and cardiovascular changes associated with propofol constant rate of infusion (CRI) anesthesia in dogs. Six dogs were each given propofol CRI to induce different anesthetic phases including induction (1 mg/kg/min for 10 min), and decremental maintenance doses of 2.4 mg per kg per min, 1.6 mg per kg per min, and 0.8 mg per kg per minute over 45 min. Processed EEG indices including patient state index (PSI), (burst) suppression ratio (SR), and spectral edge frequency (95%) were obtained continuously until the dogs recovered to sternal recumbency. The dogs were intubated and ventilated. Cardiovascular and EEG index values were compared between anesthetic phases. The PSI, SR, mean arterial blood pressure, and subjective anesthetic depth scores were highly correlated throughout anesthetic depth changes. The PSI decreased from 85.0 ± 17.3 at awake to 66.0 ± 29.0 at induction, and then sharply reduced to 19.7 ± 23.6 during maintenance and returned to 61.5 ± 19.2 at extubation. The SR increased from 15.4 ± 30.9% at induction to 70.9 ± 39.8% during maintenance and decreased to 3.4 ± 8.9% at extubation. We concluded that EEG indices can be used to aid in tracking ongoing brain state changes during propofol anesthesia in dogs.
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Affiliation(s)
- Carla Murillo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Ann B. Weil
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - George E. Moore
- Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Matthias Kreuzer
- Department of Anesthesiology and Intensive Care, School of Medicine, Technical University of Munich, 80333 München, Germany
| | - Jeff C. Ko
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
- Correspondence:
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Stoner CH, Saunders AB. Evaluation of two probes for transesophageal echocardiography in small dogs: imaging capabilities, image quality, and usability. J Vet Cardiol 2023; 45:41-49. [PMID: 36696791 DOI: 10.1016/j.jvc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTIONS Patient size is a limiting factor for transesophageal echocardiography (TEE) in small dogs. The objective of this study was to describe imaging capabilities of two probes for TEE in small dogs. ANIMALS, MATERIALS, AND METHODS Prospective study in 10 client-owned dogs weighing <4 kg with congenital heart disease (CHD). Dogs had TEE performed with a microprobe (10T-D, GE Medical) and intracardiac echocardiography (ICE) catheter-based probe (AcuNav™, Biosense Webster) in the esophagus in alternating order. Ease of placement, ability to acquire images of the CHD, image quality, and probe limitations were recorded. RESULTS Median weight was 2.4 kg (range, 1.0-3.2). Congenital abnormalities included patent ductus arteriosus (n = 9) and pulmonary valve stenosis (n = 1). The 10T-D microprobe was easy to place (n = 8) or achievable with gentle manipulation (n = 2), and image quality of the CHD was optimal (n = 8), adequate (n = 1), or poor (n = 1). The ICE probe was difficult to place in the esophagus even with an external support system (n = 9) or could not be placed (n = 1), and image quality of the CHD was optimal (n = 2), adequate (n = 3), or poor (n = 5). Both probes provided images in a 1.0-kg dog. Probe limitations included lack of lateral motion (microprobe), the need for an external support system (ICE probe) and inability to consistently maintain contact with the esophagus (ICE probe). CONCLUSION The 10T-D microprobe provided high-quality TEE images more consistently than the ICE probe in the majority of dogs in this study; however, the lack of lateral motion can diminish its utility in some dogs.
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Affiliation(s)
- C H Stoner
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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Paran E, Major AC, Warren-Smith C, Hezzell MJ, MacFarlane P. Prevalence of gastroesophageal reflux in dogs undergoing MRI for a thoracolumbar vertebral column pathology. J Small Anim Pract 2023; 64:321-329. [PMID: 36717107 DOI: 10.1111/jsap.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/20/2022] [Accepted: 11/28/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The aims of the study were to investigate the prevalence and extent of gastroesophageal reflux, and the prevalence of regurgitation in dogs undergoing thoracolumbar spine magnetic resonance imaging, and to explore possible associations of reflux and regurgitation with signalment (breed, age, sex, neuter status), bodyweight, body condition score and drugs used in the anaesthetic protocol. MATERIALS AND METHODS The thoracic part of the oesophagus was retrospectively assessed for presence and quantification of fluid on two T2 weighted sequences. Patient breed, age, sex, neuter status, weight and body condition score were recorded. Anaesthetic records were reviewed for the presence of regurgitation and detailed anaesthetic protocols. RESULTS Fifty percent [95% confidence interval (44.99, 56.81)] of included dogs had evidence of gastroesophageal reflux. Reflux was not associated with the individual breed, age, sex, neuter status or body weight. Brachycephalic dogs did not demonstrate significantly higher rates of reflux compared to non-brachycephalic dogs. A larger volume of reflux was associated with a higher chance of regurgitation. CLINICAL SIGNIFICANCE Gastroesophageal reflux is a common finding in dogs undergoing thoracolumbar spine magnetic resonance imaging. Dogs which regurgitated had higher volumes of reflux. Early detection and quantification of the volume of reflux is helpful as it may allow the anaesthetist to take measures which may reduce the risk of associated complications.
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Affiliation(s)
- E Paran
- Langford Vets, Langford House, Langford, Bristol, BS40 5DU, UK.,University of Glasgow Small Animal Hospital, 464 Bearsden Road, Bearsden, Glasgow, G61 1BD, UK
| | - A C Major
- Langford Vets, Langford House, Langford, Bristol, BS40 5DU, UK
| | - C Warren-Smith
- Langford Vets, Langford House, Langford, Bristol, BS40 5DU, UK
| | - M J Hezzell
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, UK
| | - P MacFarlane
- Langford Vets, Langford House, Langford, Bristol, BS40 5DU, UK
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Dhaliwal R, Boynton E, Carrera-Justiz S, Cruise N, Gardner M, Huntingford J, Lobprise H, Rozanski E. 2023 AAHA Senior Care Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2023; 59:1-21. [PMID: 36584321 DOI: 10.5326/jaaha-ms-7343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Veterinary professionals are taught to recognize that "old age is not a disease." However, clients may have the perception that older dogs and cats undergo an unavoidable physical, mental, and behavioral decline attributable simply to old age. The veterinary team's role includes providing medical care and support to senior pets to maintain their quality of life, as well as supporting and educating clients on proper senior animal care and addressing any misconceptions about the aging process. These Guidelines describe a systematic approach to the healthcare of the senior pet that is based on an evidence-guided assessment of both healthy and unhealthy canine and feline patients. By using evidence-guided medicine, which may include conventional and integrative approaches as well as environmental management for the senior pet, the patient's quality of life can be enhanced and potentially extended during this vulnerable life stage. Developing a senior program for the veterinary practice requires appropriate training of the entire healthcare team and includes a robust client education program that focuses on the wellbeing of the senior pet. Palliative and hospice care should be included in the education and information provided for both the veterinary team and the families of senior pets.
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Affiliation(s)
- Ravinder Dhaliwal
- MedVet Silicon Valley Veterinary Specialists, San Jose, California (R.D.)
| | | | | | - Nicole Cruise
- Northcentral Technical College, Wausau, Wisconsin (N.C.)
| | | | | | - Heidi Lobprise
- Cibolo Creek Veterinary Hospital, Kerrville, Texas (H.L.)
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts (E.R.)
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Galosi M, Troisi A, Toniolo P, Pennasilico L, Cicirelli V, Palumbo Piccionello A, Di Bella C. Comparison of the Transdermal and Intravenous Administration of Buprenorphine in the Management of Intra- and Postoperative Pain in Dogs Undergoing a Unilateral Mastectomy. Animals (Basel) 2022; 12:ani12243468. [PMID: 36552388 PMCID: PMC9774767 DOI: 10.3390/ani12243468] [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: 10/31/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
The aim of this prospective clinical study was to evaluate the effectiveness of transdermal patches of buprenorphine as an alternative route for the management of perioperative pain in dogs undergoing a unilateral mastectomy. Our hypothesis was that the transdermal route would allow the obtainment of an analgesic plan comparable to that of the injectable administration. Twelve dogs were divided in two groups. In the BupreP group (six dogs), buprenorphine patches were applied 40 h before the start of the surgery, guaranteeing a dosage of 5−6 μg/kg/h. In the BupreI group (six dogs), 20 μg/kg of buprenorphine was administered intravenously 30 min before the induction of anesthesia, and this was repeated every 6 h for 24 h. The main physiological parameters, sedation scores (0 = no sedation; 11 = deep sedation), and pain scores were monitored from 30 min before the surgery to 24 h after the end of anesthesia. All p values < 0.05 were defined as statistically significant. Thirty minutes before the surgery, the sedation scores were higher in BupreI (score = 10) compared to the BupreP group (score = 1). Moreover, during the mastectomy, the mean arterial pressure significantly increased in both groups even if nobody required additional analgesia. In the postoperative period, the pain scores did not show statistically significant differences between the two groups, maintaining values below the pain threshold at all times of the study. In conclusion, the transdermal administration of buprenorphine could guarantee an analgesic quality equal to that of the injectable route.
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Affiliation(s)
- Margherita Galosi
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Alessandro Troisi
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Pietro Toniolo
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Luca Pennasilico
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Vincenzo Cicirelli
- Department of Veterinary Medicine (DMV), University of Bari Aldo Moro, 70010 Valenzano, Italy
| | | | - Caterina Di Bella
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
- Correspondence: ; Tel.: +39-0737-403460
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Gomes VH, de Carvalho WTS, Pimentel VC, Cappelli N, Mignani BTG, da Silva MFA. Ketamine-dexmedetomidine combined with local anesthesia, with or without different doses of atipamezole in the postoperative period, for orchiectomy in cats. J Am Vet Med Assoc 2022; 261:217-222. [PMID: 36459451 DOI: 10.2460/javma.22.10.0437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To evaluate the anesthetic and cardiopulmonary effects of ketamine-dexmedetomidine combined with local anesthesia, associated or not in the postoperative period with different doses of atipamezole, for orchiectomy in cats. ANIMALS 24 healthy cats. PROCEDURES Cats received ketamine (7 mg/kg) combined with dexmedetomidine (10 µg/kg) IM, and 1 mL of saline (group KDSAL), 25 µg/kg (group KDAT25), or 50 µg/kg (group KDAT50) of atipamezole IV, postoperatively. All cats received local anesthesia (2 mg/kg of lidocaine) intratesticular and SC. Physiologic variables were recorded at baseline and at time points during anesthesia. Ketamine rescue dose (1 mg/kg) was recorded. The quality of recovery, the degree of sedation, and side effects were evaluated postoperatively. RESULTS 2 cats received a single additional bolus of ketamine to perform local anesthesia. Heart rate was lower in KDSAL, KDAT25, and KDAT50 during anesthesia, compared with baseline. Hypertension was observed intraoperatively in all groups. The time to head up, pedal reflex regained time, time to sternal recumbency, and time to standing were shorter in KDAT25 and KDAT50 compared to KDSAL. Lower sedation scores were assigned sooner to KDAT25 and KDAT50 than KDSAL. All groups resulted in low recovery quality scores and no side effects. CLINICAL RELEVANCE At the doses used, ketamine-dexmedetomidine combined with local anesthesia allowed the performance of orchiectomy. Rescue dose of ketamine for performing local anesthesia may be required. This combination can result in hypertension. Both atipamezole doses shortened the anesthetic recovery, without differences among them, and side effects.
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Affiliation(s)
- Viviane H Gomes
- 1Department of Veterinary Medicine, Universidade Castelo Branco, Rio de Janeiro, RJ, Brazil.,2Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
| | - Wagner T S de Carvalho
- 1Department of Veterinary Medicine, Universidade Castelo Branco, Rio de Janeiro, RJ, Brazil
| | - Vitor C Pimentel
- 1Department of Veterinary Medicine, Universidade Castelo Branco, Rio de Janeiro, RJ, Brazil
| | - Naomi Cappelli
- 1Department of Veterinary Medicine, Universidade Castelo Branco, Rio de Janeiro, RJ, Brazil
| | - Bruna T G Mignani
- 1Department of Veterinary Medicine, Universidade Castelo Branco, Rio de Janeiro, RJ, Brazil
| | - Marta F A da Silva
- 2Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
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Methods Used for Endotracheal Tube Cuff Inflation and Pressure Verification in Veterinary Medicine: A Questionnaire on Current Practice. Animals (Basel) 2022; 12:ani12223076. [PMID: 36428304 PMCID: PMC9686819 DOI: 10.3390/ani12223076] [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: 09/10/2022] [Revised: 10/14/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
Endotracheal intubation is a routine procedure in veterinary anaesthesia, yet no consensus guidelines exist for endotracheal tube (ETT) cuff inflation and pressure measurement. The aim of this study was to assess current practice of ETT cuff inflation and seal verification in veterinary medicine. An online questionnaire was distributed among veterinary professionals who administer anaesthesia, comprising six demographic and twelve ETT cuff-related questions per species. N = 348 questionnaires were completed. Cuff pressure was measured by 30% of respondents in cats, 32% in dogs and 9% in both farm animals and horses. Anaesthesia diplomates were not more likely to measure cuff pressure than others, except in cats (OR: 1.8; 95% CI: 1.1−2.9). The most frequently selected recommended range of cuff pressure was 20−30 cm H2O, regardless of species, although >30 cm H2O was selected significantly more often in horses compared to dogs, cats and farm animals. The preferred technique to verify cuff seal was minimal occlusive volume in dogs, cats and farm animals, whereas in horses, the preferred method was verification of normal capnogram waveform. ETT cuff pressure measurement remains uncommon in veterinary anaesthesia. The development of consensus recommendations for cuff inflation, including evidence-based target cuff pressure ranges for various species and different ETT models or materials, can help to improve practice.
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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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Watanabe R, Monteiro BP, Ruel HLM, Cheng A, Marangoni S, Steagall PV. The Effects of Sedation with Dexmedetomidine-Butorphanol and Anesthesia with Propofol-Isoflurane on Feline Grimace Scale © Scores. Animals (Basel) 2022; 12:ani12212914. [PMID: 36359038 PMCID: PMC9656706 DOI: 10.3390/ani12212914] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the effects of sedation and anesthesia on Feline Grimace Scale© (FGS) scores. Twelve healthy cats were included in a prospective, blinded and randomized, cross-over study with a 14 day wash-out. Saline or dexmedetomidine-butorphanol (Dex-But) was administered intramuscularly before an anesthetic induction with propofol and maintenance with isoflurane. Saline or atipamezole (Dex-But) was administered at the end of the general anesthesia. Video-filming/image capturing was performed before and up to 24 h post-anesthesia. A total of 125 images were evaluated by four raters blinded to the treatment groups using the FGS (ear position/orbital tightening/muzzle tension/whiskers change/head position; action units (AU); scores 0−2 for each AU). The effects of the sedation/anesthesia were analyzed (p < 0.05). The total FGS and each AU scores were significantly higher with Dex-But than with saline 20 min post-sedation. In the saline group, the total FGS, orbital tightening, and whiskers and head position scores were significantly higher than baseline at 0.5 h post-anesthesia. In the Dex-But group, the total FGS and each AU scores were significantly higher after sedation, whereas the orbital tightening scores were significantly higher at 0.5 h post-anesthesia when compared with the baseline. None of the other comparisons between or within the groups was significantly different. The sedation with dexmedetomidine-butorphanol and anesthesia with propofol-isoflurane changed the FGS scores on a short-term basis; consequently, they may bias acute pain assessment.
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Affiliation(s)
- Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Beatriz P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Hélène L. M. Ruel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Alice Cheng
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Sabrine Marangoni
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Paulo V. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
- Department of Veterinary Clinical Sciences, Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
- Correspondence:
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Lotti F, Boscan P, Warrit K, Twedt DC. Strongly acidic gastroesophageal reflux and esophageal lumen pH before and after esophageal lavage with water or two bicarbonate concentrations in anesthetized dogs. Am J Vet Res 2022; 83:1-5. [PMID: 36074745 DOI: 10.2460/ajvr.22.05.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To increase acidic esophageal lumen pH in dogs that developed gastroesophageal reflux (GER) during anesthesia. We compared water and 2 different bicarbonate concentrations. ANIMALS 112 healthy, nonbrachycephalic dogs presented for ovariectomy. PROCEDURES Following standard anesthesia and surgery protocols for ovariectomy in all dogs, esophageal lumen impedance and pH were monitored using a dedicated probe. Esophageal impedance indicates the presence of GER whereas pH indicates the acidity level. Dogs with strongly acidic GER and an esophageal lumen pH value < 4.0 were included in the study, and lavage was performed with either tap water, bicarbonate 1%, or bicarbonate 2% until the pH increased to > 4.0. The effect of lavage on esophageal pH was compared using the Kruskal-Wallis and Wilcoxon 2 sample tests. Associations between lavage and pH changes were determined. RESULTS Of 48/112 dogs with strongly acidic GER, 33% neutralized their esophageal pH during surgery. For the 32 dogs that maintained an esophageal lumen pH value < 4, esophageal lavage with water increased the lumen pH to > 4 in 78.6% of dogs, whereas both bicarbonate concentrations increased it in 100% of the dogs to a more neutral pH (P < .0001). The dogs in the water group were more likely to regurgitate after anesthesia (36% vs 0% in both bicarbonate groups, P = .028). CLINICAL RELEVANCE Bicarbonate 1% and 2% increased esophageal lumen pH to more than 4 after strongly acidic GER. Lavage with water was mildly effective, but required large volumes and predisposed to further regurgitation after anesthesia.
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Anesthetic and analgesic techniques used for dogs undergoing ovariohysterectomies in general practice in the United States. Vet Anaesth Analg 2022; 49:556-562. [PMID: 36038461 DOI: 10.1016/j.vaa.2022.07.010] [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: 03/20/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To acquire information about anesthesia and analgesia protocols used by United States (US) veterinarians in primary care practices when performing routine ovariohysterectomy in dogs. STUDY DESIGN Cross-sectional survey. POPULATION Primary care veterinarians in the US. METHODS An online anonymous survey, originally created in New Zealand, was modified with permission and made available to Veterinary Information Network (VIN) members. The survey asked questions about performing ovariohysterectomy in healthy adolescent dogs in the categories of preanesthetic evaluation, premedication and induction protocols, maintenance protocols and monitoring equipment, and postoperative analgesic and sedation protocols and pain assessments. RESULTS A total of 1213 US veterinarians completed the survey. Respondents (n; %) reported performing preoperative laboratory tests [packed cell volume (135; 11%), complete blood cell count (889; 73%) and biochemistry panels (1057; 87%)] and preanesthetic examinations on the morning of surgery (1083; 90%). The most commonly administered drugs for premedication were acepromazine (512; 42%), hydromorphone (475; 39%) or butorphanol (463; 38%), with propofol (637; 67%) for induction of anesthesia and isoflurane (882; 73%) for maintenance of anesthesia. Most veterinarians reported placing intravenous catheters (945; 78%), administering electrolyte solutions (747; 67%) and providing heat support (1160; 96%). Perioperative and postoperative analgesia included local anesthetics (545; 45%), opioids (844; 70%) and non-steroidal anti-inflammatory drugs (NSAIDs) (953; 79%); NSAIDs were dispensed for home use (985; 81%). Dogs were most frequently discharged on the day of surgery (1068; 88%) and the owners were contacted (914; 75%) for follow-up within 1-2 days. CONCLUSIONS AND CLINICAL RELEVANCE Anesthetic management for routine ovariohysterectomy in dogs varies among US veterinary VIN members. Information from this study is useful for all veterinarians for comparison with their practice management and for teachers of veterinary anesthesia to continue to emphasize options for analgesia.
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Dagnall C, Wilson H, Khenissi L. An investigation into the detection of the pulse in conscious and anaesthetised dogs. Vet Anaesth Analg 2022; 49:589-596. [DOI: 10.1016/j.vaa.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/16/2022] [Accepted: 08/13/2022] [Indexed: 11/26/2022]
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Garbin M, Benito J, Ruel HLM, Watanabe R, Monteiro BP, Cagnardi P, Steagall PV. Pharmacokinetics of Bupivacaine Following Administration by an Ultrasound-Guided Transversus Abdominis Plane Block in Cats Undergoing Ovariohysterectomy. Pharmaceutics 2022; 14:pharmaceutics14081548. [PMID: 35893804 PMCID: PMC9331386 DOI: 10.3390/pharmaceutics14081548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023] Open
Abstract
Bupivacaine is commonly used for peripheral nerve block in veterinary medicine. This study described the pharmacokinetics of two doses of bupivacaine following administration by an ultrasound-guided transversus abdominis plane (TAP) block in cats undergoing ovariohysterectomy. Twelve healthy female adult cats were included in a randomized, prospective, blinded clinical trial. Anaesthetic protocol included acepromazine–buprenorphine–propofol–isoflurane–meloxicam. Each cat received 1 mL/kg of bupivacaine 0.2% or 0.25% (BUPI-2 and BUPI-2.5, respectively) via bilateral two-point TAP block before surgery (n = 6/group). Plasma concentrations of bupivacaine were detected using liquid chromatography-mass spectrometry. A one-compartment model and non-compartmental analysis described the pharmacokinetic parameters. Bupivacaine was detected up to 480 min (335 ± 76 in BUPI-2 and 485 ± 198 ng/mL in BUPI-2.5). For BUPI-2 and BUPI-2.5, maximum plasma concentrations were 1166 ± 511 and 1810 ± 536 ng/mL at 33 ± 14 and 47 ± 22 min, clearance was 5.3 ± 1.8 and 4.9 ± 1.5 mL/min/kg, and elimination half-life were 253 ± 55 and 217 ± 52 min, respectively. The two doses of bupivacaine via TAP block produced concentrations below toxic levels in cats. A dose of 2.5 mg/kg bupivacaine was safe to be administered using this block in healthy cats.
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Affiliation(s)
- Marta Garbin
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Javier Benito
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Hélène L. M. Ruel
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Ryota Watanabe
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Beatriz P. Monteiro
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, 26900 Lodi, Italy;
| | - Paulo V. Steagall
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
- Department of Veterinary Clinical Sciences and Centre Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
- Correspondence:
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Downing RA. The One Health vision requires veterinarians and physicians to collaborate to prevent bioethical challenges created by restricted access to ketamine in low- and middle-income countries. J Am Vet Med Assoc 2022; 260:1445-1450. [DOI: 10.2460/javma.22.04.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The One Health approach asserts that the health of animals and people is closely connected. Under this approach, the CDC and AVMA work globally to attain optimal health outcomes for both animals and humans. One facet of optimal health involves access to safe and effective anesthetics and analgesics. The anesthetic and analgesic drug ketamine possesses unique properties that make it particularly important for both veterinary and human patients in low- and middle-income countries (LMICs). These properties include its portability and stability, low cost, ease of administration, and wide therapeutic margin. China advocates regularly to the United Nations for global scheduling of ketamine as a controlled substance. However, this would disproportionately restrict access to ketamine in LMICs, imposing bioethical challenges related to animal patients, human patients, and communities. In alignment with the One Health vision, opposing global scheduling of ketamine in LMICs creates a unique opportunity for collaboration between veterinarians and physicians in LMICs and high-income countries to prevent these bioethical challenges.
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Casoria V, Auckburally A, Rocchi A. Variable‐rate infusion of adrenaline to manage hypotension in an anaesthetised goat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ioannides J, Parker J, Kumaratunga V, Preston J, Donaldson D, McFarlane P, Hartley C. A prospective, masked, randomized, controlled superiority study comparing the incidence of corneal injury following general anesthesia in dogs with two methods of corneal protection. Vet Ophthalmol 2022; 25:291-296. [PMID: 35512022 PMCID: PMC9541710 DOI: 10.1111/vop.12991] [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: 11/01/2021] [Revised: 04/03/2022] [Accepted: 04/16/2022] [Indexed: 11/27/2022]
Abstract
Objective To compare the incidence of corneal injury during general anesthesia (GA) and the immediate post‐operative period in eyes protected with topical ocular lubricant alone with eyes protected with topical lubricant followed by complete eyelid closure using tape. Animals Studied One hundred client‐owned dogs (200 eyes) undergoing GA for MRI scan. Methods Patients had ocular lubricant applied to both eyes upon induction of anesthesia. One eye was taped closed immediately after induction for the duration of anesthesia using Strappal® tape (BSN medical™; treatment group), and the other eye was not taped (control group). Eyes were randomly allocated to a treatment group. Ophthalmic examination was performed before and after anesthesia; the examiner was masked to eye treatment groups. Corneal injury was defined as corneal ulceration or corneal erosion. A McNemar's test was used to compare the incidence of corneal injury between groups. A paired‐samples t‐test was used to compare Schirmer‐1 tear test (STT‐1) readings between groups. Results Sixteen eyes (8%) developed corneal erosion. No corneal ulceration occurred. There was no significant difference between incidence of corneal erosion between groups (p = .454). There was a significant decrease in STT‐1 readings following GA in both groups (p < .001), with no significant difference in STT‐1 between groups (p = .687). No adverse effects of taping the eye closed were observed. Conclusion Taping the eyes closed during GA had no additional benefit to the lubrication protocol used in this study.
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Affiliation(s)
- Joy Ioannides
- Langford Vets, University of Bristol, Langford, UK.,Optivet Referrals Ltd, Havant, Hampshire, UK
| | - Josie Parker
- Langford Vets, University of Bristol, Langford, UK.,The University of Edinburgh Royal Dick School of Veterinary Studies, Roslin, Midlothian, UK
| | - Vim Kumaratunga
- Langford Vets, University of Bristol, Langford, UK.,Department of Clinical Science and Services, The Royal Veterinary College, Queen Mother Hospital for Animals Hatfield, Hertfordshire, UK
| | - Juliette Preston
- Langford Vets, University of Bristol, Langford, UK.,Department of Clinical Science and Services, The Royal Veterinary College, Queen Mother Hospital for Animals Hatfield, Hertfordshire, UK
| | | | | | - Claudia Hartley
- Langford Vets, University of Bristol, Langford, UK.,The University of Edinburgh Royal Dick School of Veterinary Studies, Roslin, Midlothian, UK
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Suzuki R, Yuchi Y, Saito T, Teshima T, Matsumoto H, Koyama H. Investigation of Beraprost Sodium on Cardiac Function and Hemodynamics in Canine Models of Chronic Pulmonary Hypertension. Front Vet Sci 2022; 9:876178. [PMID: 35498754 PMCID: PMC9048895 DOI: 10.3389/fvets.2022.876178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/21/2022] [Indexed: 01/02/2023] Open
Abstract
Pulmonary hypertension (PH) is a life-threatening disease in dogs characterized by increased pulmonary arterial pressure (PAP) and/or pulmonary vascular resistance. No study has evaluated the utility of Beraprost sodium (BPS) in dogs with PH. This study aimed to evaluate the effect of BPS on cardiac function and hemodynamics and examine the optimal dose of BPS in canine models of chronic embolic PH. In this prospective crossover study, three doses of BPS (5, 15, and 25 μg/kg, twice a day) were examined in eight canine models of chronic embolic PH. All model dogs underwent invasive PAP measurement, echocardiography, and non-invasive systemic blood pressure measurement before and after continuous administration of oral BPS for 1 week. No side effects of BPS were observed in any dog during the study. All doses of BPS significantly decreased systolic PAP and pulmonary vascular impedance. Additionally, systemic vascular impedance significantly decreased with 15 and 25 μg/kg of BPS. The right ventricular stroke volume and longitudinal strain significantly decreased with all doses of BPS. The left ventricular stroke volume and circumferential strain decreased with 15 μg/kg BPS. BPS was well-tolerated in this study. A dose-dependent vasodilating effect on pulmonary vessels was observed in canine models of chronic PH. Additionally, 15 μg/kg BPS showed a balanced vasodilating effect on systemic and pulmonary vessels. Furthermore, with a decrease in systemic and pulmonary vascular impedance, the left and right ventricular functions were significantly improved. Our results suggest that BPS may be useful in the treatment of canine PH.
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Kim D, Lee I, Son WG. Modified retrograde intubation through the cricothyroid membrane in a cat with temporomandibular joint ankylosis. Vet Med Sci 2022; 8:1341-1346. [PMID: 35384359 PMCID: PMC9297776 DOI: 10.1002/vms3.789] [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] [Indexed: 11/13/2022] Open
Abstract
A 6‐month‐old, 2.9‐kg, male, Korean short hair cat was referred for inadequate mouth opening (4 mm), and condylectomy was scheduled for ankylosis of the left temporomandibular joint. Retrograde intubation via the cricothyroid membrane was planned since direct visualisation of the larynx was not possible. In dorsal recumbency, the cricothyroid membrane was punctured with an 18‐gauge needle, and a J‐tip guidewire, inserted via the needle, was advanced and identified at the mouth. A 6‐Fr truncated feeding tube was inserted from the mouth to the cricothyroid membrane along the guidewire. The guidewire was removed, and the tip of the feeding tube was advanced as an anterograde guide to the inner trachea. Subsequently, an endotracheal tube was inserted along the feeding tube. Capnography was used to confirm correct intubation. Condylectomy was performed on the left temporomandibular joint, and the patient recovered from anaesthesia uneventfully. Retrograde intubation is less invasive than tracheostomy or cricothyroidotomy, and the cricothyroid membrane has been suggested as a suitable site for guidewire insertion in humans and dogs. However, when resistance is encountered during the advancement of endotracheal tube using the traditional technique without the anterograde guide, it may be difficult to distinguish where the resistance occurred leading to damage or oesophageal displacement in cats with relatively fragile airway. This report suggests that retrograde intubation via the cricothyroid membrane can be performed in cats with limited visualisation of the larynx, and an anterograde guide following the retrograde wire could reduce the potential damage or oesophageal displacement.
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Affiliation(s)
- Dalhae Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Won-Gyun Son
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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Reporting of anaesthesia and pain management in preclinical large animal models of articular cartilage repair - A long way to go. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100261. [DOI: 10.1016/j.ocarto.2022.100261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
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