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Paul S, Strelchik A, O'Day J, Guedes AGP, Gordon-Evans WJ. Comparison of bupivacaine liposome injectable solution and fentanyl for postoperative analgesia in dogs undergoing limb amputation. Vet Surg 2024; 53:1102-1110. [PMID: 38349047 DOI: 10.1111/vsu.14080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/12/2024] [Accepted: 01/28/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE The objectives of the study were to compare the clinical efficacy and adverse effects of two analgesic protocols consisting of bupivacaine liposome injectable solution (BLIS) and 0.5% bupivacaine and fentanyl for postsurgical analgesia in dogs undergoing limb amputation. STUDY DESIGN Randomized, double-blind, prospective, controlled, intent-to-treat, clinical noninferiority trial. ANIMALS Forty client-owned dogs. METHODS Dogs undergoing amputation were randomly assigned to either the BLIS or control group. Postoperative pain, sedation, nausea, and amount eaten were assessed using appropriate scales at 6, 12, 18, and 24 h by trained individuals blinded to the treatment protocol. Rescue analgesia was provided for Glasgow composite measure pain scale (short form) (CMPS-SF) scores of 5 or above. Clients were requested to pain score their dogs at home using a visual analogue scale (VAS) for 48 h following discharge. RESULTS Forty dogs completed this study (20 control dogs and 20 BLIS dogs). The BLIS and control groups were equivalent for sedation, nausea, amount eaten, and pain, at all time periods except at 6 h (p < .01), when the BLIS group pain score was lower. CONCLUSION The BLIS provided equivalent analgesia with fewer adverse effects than fentanyl constant rate infusion (CRI) following limb amputation. Rescue analgesia was provided to five dogs in the BLIS group and four in the control group, and there was no statistical difference. Nausea scores did not differ statistically. CLINICAL SIGNIFICANCE As BLIS provides equivalent analgesia, this may allow for decreased reliance on opioids in the immediate postoperative period.
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Affiliation(s)
- Snighdha Paul
- College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Alena Strelchik
- College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Jack O'Day
- College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Alonso G P Guedes
- College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Wanda J Gordon-Evans
- College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
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2
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Schütter A, Chorbadzhieva A, Kästner S. Anwendbarkeit, Wiederholbarkeit und Zuverlässigkeit der deutschen Version der Glasgow Composite Measured Pain Scale - feline während der Einführungsphase in eine KleintierklinikApplicability, reproducibility, and reliability of the German version of the Glasgow composite measured pain scale - feline during implementation into a small animal clinic. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2024; 52:17-24. [PMID: 38412954 DOI: 10.1055/a-2229-3039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE The aim of the study was to evaluate reproducibility and practicality of the German version of the Glasgow composite measured pain scale - feline, during its implementation into a German veterinary hospital. MATERIAL AND METHODS The study comprised of 2 parts. Participation of veterinary professionals was voluntary. During part 1, 15 staff members (all rater=AR) with variable clinical experience (nurses, interns, junior clinician, senior clinicians), from 4 disciplines (anesthesia, internal medicine, surgery, neurology), and one main investigator (AC), pain scored 45 diseased cats and 10 healthy cats. Part 2 was an online survey, evaluating the practical experience of participants during part 1 and asking for suggestions to improve the scale and process of pain assessment. For part 1 normal distribution of data was tested by Shapiro-Wilk-Test and histograms. Intrarater and interrater reliability were evaluated by calculating the intraclass-correlation. Statistical analysis of part 2 used descriptive methods. RESULTS The interrater reliability was moderate (ICC AR : 0.59) and the intrarater reliability was good (ICC AC : 0.88). The pain scores of cats with medical (AR: 3.06±2.33, AC 3.52±2.34) and surgical disease (AR: 3.78±2.38, AC: 4.02±2.72) showed no significant difference. All healthy cats were classified as "not painful" (AR: 0.77±0.67, AC: 1.09±0.83). Clinical experience of the rater did not significantly influence pain scores. The GCMPS-F was judged as easy to use and as helpful tool for cats with unclear pain conditions. CONCLUSION The GCMPS-F had a good acceptance and moderate interrater reliability. CLINICAL RELEVANCE Using the German version of the GCMPS-F, veterinary professionals from different disciplines and with different grades of specialisation can reliably assess pain levels in cats without prior extensive training.
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Affiliation(s)
- Alexandra Schütter
- Abteilung für Anästhesie und Analgesie, Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover
| | - Ana Chorbadzhieva
- Abteilung für Anästhesie und Analgesie, Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover
| | - Sabine Kästner
- Abteilung für Anästhesie und Analgesie, Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover
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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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Tavares IT, Rivero R, Sales‐Luís JP, Vaudano CG, Correia SD, Corbera JA, Jaber JR. Premedication with acetazolamide: Is its use for postoperative pain and stress control after laparoscopic ovariectomy in dogs ruled out? Vet Med Sci 2023; 9:1114-1123. [PMID: 36952262 PMCID: PMC10188092 DOI: 10.1002/vms3.1115] [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: 11/18/2022] [Accepted: 02/19/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Studies in human medicine have concluded that acetazolamide reduces pain associated with carbon dioxide insufflation during laparoscopic surgery. However, there are no published reports regarding the use of acetazolamide for this purpose in companion animals, despite the increasing popularity of laparoscopic techniques in veterinary medicine due to their advantages over open surgeries. OBJECTIVES Thirty mixed-breed female dogs were included in the study and randomly assigned to one of three groups: OVE (median celiotomy ovariectomy; n = 10), OVEL (laparoscopic ovariectomy, n = 10) and OVELA (laparoscopic ovariectomy with acetazolamide preoperative administration; n = 10). Experienced surgeons performed all procedures, and the anaesthetic and analgesic protocols were identical for all animals. Acetazolamide was administered orally (at a dose of 25 mg/kg) 2 h prior to induction in the OVELA group. Postoperative pain was evaluated using serum cortisol, salivary cortisol, and the University of Melbourne Pain Scale (UMPS) Score. RESULTS Any statistical differences were observed in the UMPS scores when the OVELA group was compared to the OVEL group at 1 h after surgery (p = 0.515), 12 h (p = 0.375) and 24 h (p = 0.242). Animals undergoing open surgery (OVE group) had significantly higher pain scores at all times after surgery when compared with OVEL and OVELA groups. A high positive correlation (r = 0.792; p = 0.01) was found between serum and saliva cortisol concentrations. Mean saliva cortisol concentration was not significantly lower for the OVELA group compared to the other groups. CONCLUSIONS This study found evidence that preoperative administration of acetazolamide may be beneficial in managing postoperative pain in dogs after laparoscopic surgeries. However, further research with a larger sample size is needed to confirm this and to determine if acetazolamide should be included in a multimodal postoperative analgesia protocol for laparoscopic ovariectomy in dogs.
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Affiliation(s)
- Inês T. Tavares
- Faculty of Veterinary MedicineLusófona UniversityLisbonPortugal
| | - Ramón Rivero
- Faculty of Veterinary MedicineUniversidad Autónoma de Ciudad JuárezCiudad JuarezMéxico
| | - José P. Sales‐Luís
- Faculty of Veterinary MedicineUniversidade de LisboaAvenida da Universidade TécnicaLisbonPortugal
| | | | - Sérgio D. Correia
- COPELABSDepartamento de ArquiteturaUniversidade Lusofóna de Humanidades e TecnologiasLisbonPortugal
- VALORIZACentro de Investigação para a Valorização de Recursos EndógenosPolytechnic Institute of PortalegrePortalegrePortugal
| | - Juan Alberto Corbera
- Hospital Clínico Veterinario ULPGCFacultad de VeterinariaInstituto Universitario de Investigaciones Biomédicas y SanitariasUniversidad de Las Palmas de Gran CanariaArucasSpain
| | - Jose Raduan Jaber
- Facultad de VeterinariaDepartamento de MorfologíaUniversidad de Las Palmas de Gran CanariaArucasSpain
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Gutierre E, Crosignani N, García‐Carnelli C, di Mateo A, Recchi L. A case report of CBD and THC as analgesic therapy in a cat with chronic osteoarthritic pain. Vet Med Sci 2023; 9:1021-1025. [PMID: 37002652 DOI: 10.1002/vms3.1057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
A 10-year-old mixed breed male cat presented with clinical signs related to chronic orthopaedic pain. Upon physical examination, pain was noted, based on the feline Musculoskeletal Pain Index (FMPI). An analgesic treatment with a full spectrum cannabis oil (1.8% CBD and 0.8% THC) was proposed for 30 days (0,5 mg/kg based on CBD). The FMPI scale score decreased more than 50%. This case reported a satisfactory outcome for the patient and the owner, although this medication could increase ALT. Given the paucity of literature published to date on the treatment of veterinary species with cannabis-based medications, further clinical and pharmacokinetic studies are necessary to study the safety and efficacy of its use.
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Affiliation(s)
- E Gutierre
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
| | - N Crosignani
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
| | - C García‐Carnelli
- Facultad de Química Departamento de Química Orgánica Universidad de la República Montevideo Uruguay
| | - A di Mateo
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
| | - L Recchi
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
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6
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Jones TL, Cediel R, Wolff S, Thomas K, Hofmeister EH. Post-operative Pain Assessment Following Tooth Extraction Using Liposomal Encapsulated Bupivacaine as a Local Anesthetic in Dogs. J Vet Dent 2023:8987564231161226. [PMID: 36922766 DOI: 10.1177/08987564231161226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
The objective of this study was to evaluate owner assessment of appetite, demeanor, and mouth soreness following dental extractions in dogs receiving either bupivacaine hydrochloride (BH) or liposomal encapsulated bupivacaine (LEB) for dental blocks. Thirty healthy, adult dogs requiring dental extractions were enrolled in the study. All procedures were completed with dogs under general anesthesia. A non-steroidal anti-inflammatory drug was administered subcutaneously in the preoperative period. Dogs were randomly assigned to receive BH or LEB. An owner assessment to evaluate appetite, demeanor, and soreness of mouth was completed at the end of both the first and second day after discharge from the hospital. The total of the owner assessments for day 1 and both days combined was significantly lower for dogs receiving LEB (P = .007). There were no differences in the number of extractions (P = .21), time from block to evaluations (P = .07), in-hospital pain assessments (P = .99), or number of dogs requiring rescue analgesia (P = .99). This study concluded, dogs that received LEB for dental blocks had improved appetite and demeanor, and reduced soreness of mouth, as evaluated by the owner two days postoperatively, when compared to dogs who received BH.
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Affiliation(s)
- Teela L Jones
- Department of Specialty Medicine, College of Veterinary Medicine, 3541Midwestern University, Glendale, AZ, USA
| | - Roberto Cediel
- Department of Specialty Medicine, College of Veterinary Medicine, 3541Midwestern University, Glendale, AZ, USA
| | - Stephanie Wolff
- Department of Primary Care, College of Veterinary Medicine, 3541Midwestern University, Glendale, AZ, USA
| | - Kara Thomas
- Department of Primary Care, College of Veterinary Medicine, 3541Midwestern University, Glendale, AZ, USA
| | - Erik H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, 1383Auburn University, Auburn, AL, USA
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Atif O, Lee J, Park D, Chung Y. Behavior-Based Video Summarization System for Dog Health and Welfare Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:2892. [PMID: 36991606 PMCID: PMC10054391 DOI: 10.3390/s23062892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 06/19/2023]
Abstract
The popularity of dogs has been increasing owing to factors such as the physical and mental health benefits associated with raising them. While owners care about their dogs' health and welfare, it is difficult for them to assess these, and frequent veterinary checkups represent a growing financial burden. In this study, we propose a behavior-based video summarization and visualization system for monitoring a dog's behavioral patterns to help assess its health and welfare. The system proceeds in four modules: (1) a video data collection and preprocessing module; (2) an object detection-based module for retrieving image sequences where the dog is alone and cropping them to reduce background noise; (3) a dog behavior recognition module using two-stream EfficientNetV2 to extract appearance and motion features from the cropped images and their respective optical flow, followed by a long short-term memory (LSTM) model to recognize the dog's behaviors; and (4) a summarization and visualization module to provide effective visual summaries of the dog's location and behavior information to help assess and understand its health and welfare. The experimental results show that the system achieved an average F1 score of 0.955 for behavior recognition, with an execution time allowing real-time processing, while the summarization and visualization results demonstrate how the system can help owners assess and understand their dog's health and welfare.
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Affiliation(s)
- Othmane Atif
- Department of Computer and Information Science, Korea University, Sejong City 30019, Republic of Korea
| | - Jonguk Lee
- Department of Computer Convergence Software, Sejong Campus, Korea University, Sejong City 30019, Republic of Korea
| | - Daihee Park
- Department of Computer Convergence Software, Sejong Campus, Korea University, Sejong City 30019, Republic of Korea
| | - Yongwha Chung
- Department of Computer Convergence Software, Sejong Campus, Korea University, Sejong City 30019, Republic of Korea
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Sunghan J, Manmoo S, Suriyasathaporn W, Suriyasathaporn W, Warrit K, Kusolphat P. Comparison of the efficacy and perioperative pain between vessel sealing and suture ligation for median celiotomy in canine ovariohysterectomy. Vet World 2023; 16:386-394. [PMID: 37042013 PMCID: PMC10082707 DOI: 10.14202/vetworld.2023.386-394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/04/2023] [Indexed: 03/06/2023] Open
Abstract
Background and Aim: Vessel sealing (VS) is used widely in human medicine and veterinary practice during laparoscopic surgery; however, few studies have investigated VS in canine ovariohysterectomy (OHE) using the median celiotomy approach. This study aimed to compare the effect of VS and suture ligation (SL) on surgical time, blood loss, and perioperative pain in canine OHE through median celiotomy.
Materials and Methods: Twenty-eight dogs were randomly and equally assigned into two groups that underwent surgery either by SL at both the ovarian pedicle and uterus or using a disposable VS device. The short form of the Glasgow composite pain scale (SF-GCPS) and the Colorado state university canine acute pain scale (CSU-CAP) were used to determine pain pre-operatively (baseline); at 30 min; and at 1, 2, 3, 4, 24, and 72 h post-operatively. Perioperative physiological parameters, surgical duration, and percentage of blood loss were recorded. Repeated measures analysis was performed to determine the differences in all parameters among time-related tasks and between both groups. A significant difference was defined at p < 0.05.
Results: The duration from identification of the first ovary to uterus removal was shorter in VS than in SL (p < 0.05). No clinically relevant differences were found among physiological variables. Both groups showed higher SF-GCPS and CSU-CAP values after surgery compared with baseline. The SF-GCPS in SL at 1 h was higher than in VS (p < 0.05). Two dogs in the SL group required additional post-operative rescue analgesia. No differences were found between the groups in terms of blood loss.
Conclusion: The use of a VS device in dogs undergoing OHE celiotomy decreased post-operative pain and shortened the perioperative time, making it an effective alternative technique for this common surgery. However, the VS device must be applied 2–3 times in the same location during the OHE procedure to prevent technical failure. This disposable device was reused up to 5 times for economic reasons without device failure. Soft tissue damage during OHE using the VS device should be investigated in a future prospective study.
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Affiliation(s)
- Jutapoln Sunghan
- Faculty of Veterinary Science, Prince of Songkla University, Hat Yai, 90110, Thailand
| | - Sareepah Manmoo
- Faculty of Veterinary Science, Prince of Songkla University, Hat Yai, 90110, Thailand
| | - Wanna Suriyasathaporn
- Department of Companion Animal and Wildlife Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; Research Center of Producing and Development of Products and Innovations for Animal Health and Production, Chiang Mai University, Chiang Mai 50100, Thailand
| | - Witaya Suriyasathaporn
- Research Center of Producing and Development of Products and Innovations for Animal Health and Production, Chiang Mai University, Chiang Mai 50100, Thailand; Cambodia Campus, Asian Satellite Campuses Institute, Nagoya University, Nagoya, Japan
| | - Kanawee Warrit
- Department of Companion Animal and Wildlife Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
| | - Pradipa Kusolphat
- Faculty of Veterinary Science, Prince of Songkla University, Hat Yai, 90110, Thailand
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O’Neill DG, Gunn-Moore D, Sorrell S, McAuslan H, Church DB, Pegram C, Brodbelt DC. Commonly diagnosed disorders in domestic cats in the UK and their associations with sex and age. J Feline Med Surg 2023; 25:1098612X231155016. [PMID: 36852509 PMCID: PMC10812063 DOI: 10.1177/1098612x231155016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVES The objectives of this study were to generate a robust evidence base on the prevalence of common disorders in cats and develop a deeper understanding of disorder associations with sex and age that could offer important opportunities for targeted veterinary care to improve feline health and welfare. METHODS A random sample of 18,249 cats was obtained from 1,255,130 cats under primary care during 2019 within VetCompass, an epidemiological research programme based on anonymised primary care veterinary clinical records. All disorders recorded during 2019 were extracted and reported, and associations with sex and age were examined. RESULTS The most prevalent disorders were periodontal disease (n = 2780 [15.2%], 95% confidence interval [CI] 14.72-15.76), obesity (n = 2114 [11.6%], 95% CI 11.12-12.06) and dental disease (n = 1502 [8.2%], 95% CI 7.84-8.64). Compared with male cats, females had an increased prevalence of poor quality of life, postoperative complications and hyperthyroidism, among others. Male cats had a higher prevalence of periodontal disease, road traffic accident (RTA) and obesity. Younger cats (<8 years) had an increased prevalence of cat bite abscess, flea infestation and RTA, while older cats (⩾8 years) had increased prevalence of lameness, cystitis and dental disease, among others. CONCLUSIONS AND RELEVANCE These findings suggest that the veterinary profession needs to engage more effectively in informing owners on common preventable disorders (ie, obesity and dental disease). This new information can contribute to more targeted health surveillance and more effective veterinary interventions to promote improved health and welfare in pet cats. Large-scale collection and analysis of anonymised veterinary clinical records offer an important clinical resource for research.
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Affiliation(s)
- Dan G O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK
| | - Danièlle Gunn-Moore
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | | | - Harriet McAuslan
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK
| | - David B Church
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK
| | - Camilla Pegram
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK
| | - Dave C Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK
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10
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Downing R, Della Rocca G. Pain in Pets: Beyond Physiology. Animals (Basel) 2023; 13:355. [PMID: 36766244 PMCID: PMC9913605 DOI: 10.3390/ani13030355] [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: 11/28/2022] [Revised: 12/25/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Animals do not speak a language humans understand, making it easy to believe that they do not experience pain the way humans do. Despite data affirming that companion animals can and do experience pain much as do humans, there remains a gap between companion animal acute pain management knowledge and its execution. Companion animal pain is not simply a physiological issue. Veterinary clinicians can and should embrace the foundational principles of clinical bioethics-respect for autonomy, nonmaleficence, beneficence, and justice-translated from human medicine for the benefit of their patients. By reframing companion animal pain as a bioethical issue, as described in this paper, veterinarians affirm their commitment to closing the gap between what is known and what is done for painful companion animals. This takes pet pain beyond physiology.
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Affiliation(s)
- Roberta Downing
- The Downing Center for Animal Pain Management, Windsor, CO 80550, USA
| | - Giorgia Della Rocca
- Research Center on Animal Pain, Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy
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11
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Cavaco JS, Otero PE, Ambrósio AM, Neves ICB, Perencin FM, Pereira MAA, Matera JM, Fantoni DT. Analgesic efficacy of ultrasound-guided transversus abdominis plane block in dogs undergoing ovariectomy. Front Vet Sci 2022; 9:1031345. [PMID: 36387373 PMCID: PMC9659733 DOI: 10.3389/fvets.2022.1031345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
Background In medicine, the transversus abdominis plane (TAP) block has been shown as an effective method of analgesia in several surgical procedures. In this context, this prospective, randomized, blinded study aimed to evaluate the analgesic efficacy of TAP block, guided by ultrasound in female dogs submitted to ovariectomy. Methods Therefore, 32 animals randomly assigned in two groups (n = 16) were used. Groups consisted of TAP block control (TBC) which received water injection (0.2 ml kg−1 point), and TAP block bupivacaine (TBB) which received bupivacaine (0.2 ml kg−1 point at 0.25%); both groups were submitted to four-point approach. Animals were pre-medicated with acepromazine (0.03 mg kg−1) and meperidine (2 mg kg−1) IM, propofol was used as anesthetic induction (3–5 mg kg−1) IV, and isoflurane was used to maintain. To standardize groups, the animals received a continuous infusion of remifentanil (0.2μg kg−1 min) and rocuronium (0.6 mg kg−1) IV in the intraoperative period. Variables measured were the heart and respiratory rates, blood pressure, temperature, peripheral oxyhemoglobin saturation, exhaled carbon dioxide concentration, exhaled isoflurane concentration, serum cortisol, analgesia, and sedation. Before the pre-anesthetic medication (Baseline) and 1, 2, 4, 6, and 8 h after extubation, pain and sedation were assessed using a numeric rating scale (NRS), Glasgow composite measure pain scale (GCMPS-SF), and sedation scale. Moreover, serum cortisol was measured at different moments. Results The results show that in the intraoperative period, there was no significant difference between groups. After surgery, in TBC, 13 out of 16 animals required analgesic rescue, whereas, in TBB, this occurred only in one animal. Regarding the measurement of serum cortisol, the TBC group showed a significant difference when compared to the baseline time in the traction of the first ovary (p < 0.0001), 2 h (p = 0.0441), and 8 h (p = 0.0384) after extubation. In TBB, cortisol showed a significant increase only in the traction of the first ovary and 2 h after extubation (p < 0.0001). Conclusion The technique using ultrasound-guided TAP block in two points approach by hemiabdomen with 0.2 ml kg−1 bupivacaine 0.25% was effective in providing post-operative analgesia in dogs undergoing ovariectomy.
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Affiliation(s)
- Jéssica Sperandio Cavaco
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
- *Correspondence: Jéssica Sperandio Cavaco
| | - Pablo Ezequiel Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Aline Magalhães Ambrósio
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Ieda Cristina Boni Neves
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Felipe Montanheiro Perencin
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Marco Aurélio Amador Pereira
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Julia Maria Matera
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Denise Tabacchi Fantoni
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
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12
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Buote NJ, Hayes G, Bisignano J, Rosselli D. Retrospective comparison of open vs minimally invasive cystotomy in 28 cats using a composite outcome score. J Feline Med Surg 2022; 24:1032-1038. [PMID: 34904482 PMCID: PMC10812324 DOI: 10.1177/1098612x211066477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to compare the outcomes of cats undergoing open cystotomy with those undergoing minimally invasive surgery (MIS) for removal of cystic calculi by use of a composite outcome score. METHODS Twenty-eight cats were retrospectively enrolled and divided into two groups: open cystotomy (n = 14) and MIS (n = 14). The primary outcome measure was a composite outcome score, including three variables: pain scores ⩾2 at either 6 or 12 h postoperatively; failure to remove all stones as determined by postoperative radiographs; and postoperative complications requiring a visit to the hospital separate from the planned suture removal appointment. Other data collected included signalment, history, other procedures performed during anesthesia, willingness to eat the day after surgery and the financial cost of the procedures. RESULTS There was no significant difference in age, weight, sex or breed between the two groups. The risk of experiencing the composite outcome was 3/14 (21.4%) in the MIS group and 10/14 (71%) in the open procedure group (P = 0.02). The cats in the open surgery group had 8.3 times greater odds of developing the composite outcome than cats in the MIS group (odds ratio 8.3, 95% confidence interval 1.3-74.4; P = 0.02). In the MIS group, 10/14 cats were eating the day after surgery vs 3/14 in the open procedure group (P = 0.02). The procedural cost was higher in the MIS group, with a median cost of US$945 (interquartile range [IQR] US$872-1021) vs US$623 (IQR US$595-679) in the open group (P <0.01). CONCLUSIONS AND RELEVANCE In this study the composite outcome score provided evidence to support the use of MIS techniques in cats with cystic calculi. The composite outcome score should be considered in future veterinary studies as a promising method of assessing clinically relevant outcomes.
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Affiliation(s)
- Nicole J Buote
- VCA West Los Angeles, Los Angeles, CA, USA
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Galina Hayes
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
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13
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Lovell S, Simon B, Boudreau EC, Mankin J, Jeffery N. Randomized clinical trial comparing outcomes after fentanyl or ketamine-dexmedetomidine analgesia in thoracolumbar spinal surgery in dogs. J Vet Intern Med 2022; 36:1742-1751. [PMID: 35962706 PMCID: PMC9511085 DOI: 10.1111/jvim.16514] [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: 04/06/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Opioids are widely used for perioperative pain control in dogs undergoing spinal surgery, but alternatives may be required because data suggest that opioids exacerbate inflammation in the injured spinal cord and veterinary access to opioids may become more restricted in the future. Objectives To compare recovery of ambulation and other functions between spinal cord‐injured dogs receiving peri‐operative fentanyl and those receiving a ketamine‐dexmedetomidine combination. Animals A total of 102 client‐owned dogs undergoing decompressive surgery for thoracolumbar intervertebral disc herniation. Methods Randomized clinical trial. Dogs were randomized 1:1 to fentanyl or a ketamine‐dexmedetomidine combination for intra and postoperative analgesia. Primary outcome was time to recovery of ambulation; secondary outcomes were the postoperative Colorado Acute Pain Scale, the short‐form Glasgow Composite Measure Pain Scale, time to recovery of voluntary urination and time to unassisted eating. Results No difference was found in time to recovery of ambulation between groups (adjusted sub‐hazard ratio, 0.83; 95% confidence interval [CI], 0.55‐1.24; P = .36) or in pain scores (Colorado: χ2 = 14.74; P = .32; Glasgow: χ2 = 6.61; P = .76). Differences in time to recovery of eating and urination were small but favored ketamine‐dexmedetomidine (adjusted odds ratios, 3.31; 95% CI, 1.53‐7.16; P = .002 and 2.43; 95% CI, 1.00‐5.96; P = .05, respectively). Conclusions and Clinical Importance There was no evidence that, at the doses used, fentanyl impaired ambulatory outcome after surgery for thoracolumbar intervertebral disc herniation in dogs. Pain control appeared similar between groups. Secondary outcomes suggested minor benefits associated with ketamine‐dexmedetomidine. The ketamine‐dexmedetomidine combination appears to be a reasonable alternative to peri‐operative opioids.
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Affiliation(s)
- Stephanie Lovell
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Bradley Simon
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Elizabeth C Boudreau
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Joseph Mankin
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Nicholas Jeffery
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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14
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Pentsou K, Huuskonen V. Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery. Ir Vet J 2022; 75:17. [PMID: 35962415 PMCID: PMC9375286 DOI: 10.1186/s13620-022-00224-7] [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: 12/31/2021] [Accepted: 08/05/2022] [Indexed: 11/26/2022] Open
Abstract
Background Thoracolumbar intervertebral disc extrusion is a common neurologic complaint in dogs and is associated with debilitating pain that requires careful analgesic management to avoid the transition to a chronic pain state. Recently, there has been an increased effort to incorporate regional anaesthetic techniques whenever possible, both for perioperative analgesia management and for prevention of chronic pain. A novel regional anaesthetic technique named retrolaminar block is a fascial plane block where the local anaesthetic is injected directly on top of the dorsal aspect of the vertebral lamina, in the fascial plane between the lamina and the epaxial muscles. The technique was recently described in humans and it is claimed to provide analgesia in patients undergoing thoracic and lumbar procedures. To the authors’ knowledge, the retrolaminar block has not been previously reported in live dogs. Case presentation Seven dogs presented to our hospital for suspected thoracolumbar intervertebral disc extrusion were anaesthetised using an anaesthetic premedication and induction protocol tailored for each individual animal. Once the suspected diagnosis was confirmed, all seven dogs were placed in sternal recumbency, and the target thoracolumbar vertebral spinous process was identified with palpation. A unilateral retrolaminar block was performed in all dogs with 2 mg/kg of 0.25% bupivacaine. Physiologic parameters, as well as responses to nociceptive stimuli, were monitored throughout the anaesthetic event. Intraoperatively, one dog required a bolus of fentanyl to control nociceptive stimulation while the epaxial muscles were retracted. No further intraoperative rescue analgesia was required in any of the cases. The postoperative pain was assessed using the Short Form of Glasgow Composite Measure Pain Scale for dogs every four hours for the duration of the dogs’ hospitalization. The retrolaminar block reduced the intraoperative requirement for systemic opioids and other adjunct analgesic agents and all dogs were comfortable throughout their hospitalization and up until the time of their discharge. Conclusions This case report presents the performance of the retrolaminar block technique as part of multimodal analgesia management in seven dogs undergoing thoracolumbar spinal surgery. Supplementary Information The online version contains supplementary material available at 10.1186/s13620-022-00224-7.
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Affiliation(s)
- Kyratsoula Pentsou
- UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland.
| | - Vilhelmiina Huuskonen
- UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland
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15
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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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16
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Ferro ACZB, Cannolas C, Reginato JC, Luna SPL. Postoperative Acupuncture is as Effective as Preoperative Acupuncture or Meloxicam in Dogs Undergoing Ovariohysterectomy: a Blind Randomized Study. J Acupunct Meridian Stud 2022; 15:181-188. [PMID: 35770548 DOI: 10.51507/j.jams.2022.15.3.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 12/03/2021] [Accepted: 02/16/2022] [Indexed: 11/03/2022] Open
Abstract
Background Acupuncture has the same analgesic effect as non-steroidal antiinflammatory drugs and opioids. It is challenging to perform preoperative acupuncture in unmanageable animals, while the residual postoperative anesthetic effect facilitates the performance of acupuncture postoperatively. Objectives To compare preoperative acupuncture or meloxicam versus postoperative acupuncture for postoperative analgesia after ovariohysterectomy. Methods This is a horizontal prospective positive control blind randomized experimental study. Thirty-six dogs were randomly divided into three groups: GA (preemptive acupuncture), GPA (postoperative acupuncture), and GM (meloxicam 0.2 mg/kg IV preoperatively). After sedation with acepromazine (0.05 mg/kg IM), anesthesia was induced with propofol (5.3 ± 0.3 mg/kg) and maintained with isoflurane/O2. Fentanyl (2 μg/kg, IV) was administered immediately before surgery. Bilateral acupuncture was performed at acupoints Large intestine 4, Spleen 6, and Stomach 36 for 20 minutes, before (GA) or immediately after surgery (GPA). Pain was evaluated by an observer blind to the treatment using the Glasgow scale before and for 24 hours after ovariohysterectomy. Dogs with a score ≥ 6 received rescue analgesia with morphine (0.5 mg/kg IM). Nonparametric data were analyzed by the Kruskal-Wallis test, followed by Dunn's test and parametric data by ANOVA followed by Tukey's test. Results Two GA and one GPA dogs received rescue analgesia once. Two GM dogs received rescue analgesia and one of those was treated again twice. There were no differences in the number of dogs receiving rescue analgesia between groups (p = 0.80). Conclusion Postoperative acupuncture was as effective as preoperative acupuncture or meloxicam in female dogs undergoing ovariohysterectomy.
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Affiliation(s)
- Ana Carla Zago Basilio Ferro
- School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
| | | | | | - Stelio Pacca Loureiro Luna
- School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil
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17
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Ravuri HG, Sadowski P, Noor Z, Satake N, Mills PC. Plasma proteomic changes in response to surgical trauma and a novel transdermal analgesic treatment in dogs. J Proteomics 2022; 265:104648. [PMID: 35691609 DOI: 10.1016/j.jprot.2022.104648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/16/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
Abstract
Assessment of pain responses and inflammation during animal surgery is difficult because traditional methods, such as visual analogue scores, are not applicable while under anaesthesia. Acute phase proteins (APPs), such as C-reactive protein and haptoglobin, that are typically monitored in veterinary research, do not show a significant change until at least 2 h post-surgery and therefore, immediate pathophysiological changes are uncertain. The current study used sequential window acquisition of all theoretical mass spectra (SWATH-MS) to investigate plasma proteome changes that occur immediately following surgery in dogs and also to assess the efficacy of a novel transdermal ketoprofen (TK) formulation. Castration was chosen as surgical model in this study. The procedure was performed on twelve dogs (n = 6 in two groups) and blood samples were collected at 0 h, 1 and 2 h after surgery for proteomic analysis. Following surgery, there was a general downregulation of proteins, including complement C- 3, complement factor B, complement factor D, transthyretin, and proteins associated with lipid, cholesterol, and glucose metabolisms, reflecting the systemic response to surgical trauma. Many of these changes were diminished in the transdermal group (TD) since ketoprofen, a non-steroidal anti-inflammatory drug (NSAID), inhibits prostanoids and the associated chemotactic neutrophil migration to site of tissue injury. SIGNIFICANCE: SWATH-MS Proteomic analysis revealed significant changes in plasma proteins, predominantly involved in early acute phase and inflammatory response at 1 & 2 h after surgery in castrated dogs. Pre-operative application of transdermal ketoprofen formulation had reduced the systemic immune response, which was confirmed by negligible alteration of proteins in transdermal treated group. A key outcome of this experiment was studying the efficacy of a novel transdermal NSAID formulation in dogs.
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Affiliation(s)
- Halley Gora Ravuri
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Pawel Sadowski
- Central Analytical Research Facility, Queensland University of Technology, Brisbane, QLD, Australia
| | - Zainab Noor
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Nana Satake
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Paul C Mills
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia.
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18
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Evidence-Based Complementary and Alternative Orthopedic Veterinary Medicine. Vet Clin North Am Small Anim Pract 2022; 52:925-938. [PMID: 35562224 DOI: 10.1016/j.cvsm.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The use of complementary and alternative veterinary medicine (CAVM) continues to become more widespread, especially for the management of chronic pain conditions such as canine osteoarthritis. Many patients have comorbidities that preclude traditional medical options, have not adequately responded to conventional therapies, or have owners interested in pursuing a complementary approach. Evidence-based CAVM can serve as a safe and effective adjunct to manage chronic pain conditions. There is growing evidence in the veterinary literature for the use of acupuncture and some herbal supplements in the multimodal management of canine osteoarthritis. The majority of evidence supporting chiropractic is limited to equine and human literature.
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19
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Gomez‐Martinez MI, Adams J, Langley‐Hobbs S, Khenissi L. Use of an ultrasound‐guided sciatic and saphenous nerve block as a part of the multimodal analgesic management in a cria for the stabilisation of a left tibial eminence avulsion fracture. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - James Adams
- Farm Animal Practice Langford Vets University of Bristol Bristol UK
| | | | - Latifa Khenissi
- Small Animal Referral Hospital Langford Vets University of Bristol Bristol UK
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20
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Development and implementation of veterinary anesthesia medical quality standards for primary care. Vet Anaesth Analg 2022; 49:233-242. [DOI: 10.1016/j.vaa.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 01/07/2022] [Accepted: 01/28/2022] [Indexed: 11/22/2022]
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21
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Markou M, Anatolitou A. Acute intestinal obstruction after methylene‐diphenyl‐diisocyanate‐based glue ingestion in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.165] [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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22
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Corrêa JMX, Niella RV, Oliveira JNSD, Silva Junior AC, Marques CSDC, Pinto TM, Silva EBD, Beier SL, Silva FL, Lavor MSLD. Antinociceptive and analgesic effect of continuous intravenous infusion of maropitant, lidocaine and ketamine alone or in combination in cats undergoing ovariohysterectomy. Acta Vet Scand 2021; 63:49. [PMID: 34838084 PMCID: PMC8626950 DOI: 10.1186/s13028-021-00615-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Multimodal analgesia consists of the combination of analgesic drugs at low doses to act in different places along the path of pain. Studies with continuous infusion of analgesic drugs in cats are not common. This study aimed to evaluate the analgesic effect of maropitant, lidocaine and ketamine alone or in combination (intravenous bolus + subsequent continuous intravenous infusion) in the management of acute postoperative pain in cats undergoing ovariohysterectomy. Seventy healthy cats undergoing an ovariohysterectomy received a standard anesthetic protocol consisting of acepromazine and morphine, propofol (anesthesia induction), and isoflurane (anesthesia maintenance). The animals were stratified into seven groups (n = 10 in each group): control (CG), maropitant (MG), lidocaine (LG), ketamine (KG), maropitant + lidocaine (LMG), maropitant + ketamine (KMG), and maropitant + lidocaine + ketamine (LKMG). All drugs were injected first as an intravenous bolus and then by continuous intravenous infusion. During surgery, esophageal temperature, respiratory rate, heart rate, oxygen saturation, expired isoflurane concentration, and partial pressure of carbon dioxide at the end of expiration were evaluated at 7 time points. Postoperative pain was evaluated for 6 h after extubation using the visual analogue scale and the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats. Results Adverse effects related to maropitant, lidocaine and ketamine infusion were not observed. Pain scores were lower in the MG, KG and LG groups when compared to the CG group using both scales. Although pain scores were also lower in all combination groups than CG, more animals in these groups required rescue analgesia compared to MG. This indicates that the postoperative analgesic effect of all drugs, either alone or in combination, confers analgesia, although the combinations did not promote greater analgesia. Conclusions Continuous intravenous infusion of maropitant, lidocaine, and ketamine alone induces postoperative analgesic effect in cats undergoing ovariohysterectomy, but combinations of these drugs did not increase the analgesic effect. No adverse effect was observed with any drug or their combination.
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23
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Testa B, Reid J, Scott ME, Murison PJ, Bell AM. The Short Form of the Glasgow Composite Measure Pain Scale in Post-operative Analgesia Studies in Dogs: A Scoping Review. Front Vet Sci 2021; 8:751949. [PMID: 34660773 PMCID: PMC8515184 DOI: 10.3389/fvets.2021.751949] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022] Open
Abstract
The measurement and treatment of acute pain in animals is essential from a welfare perspective. Valid pain-related outcome measures are also crucial for ensuring reliable and translatable findings in veterinary clinical trials. The short form of the Glasgow Composite Measure Pain Scale (CMPS-SF) is a multi-item behavioral pain assessment tool, developed and validated using a psychometric approach, to measure acute pain in the dog. Here we conduct a scoping review to identify prospective research studies that have used the CMPS-SF. We aim to describe the contexts in which it has been used, verify the correct use of the scale, and examine whether these studies are well-designed and adequately powered. We identify 114 eligible studies, indicating widespread use of the scale. We also document a limited number of modifications to the scale and intervention level, which would alter its validity. A variety of methods, with no consensus, were used to analyse data derived from the scale. However, we also find many deficiencies in reporting of experimental design in terms of the observers used, the underlying hypothesis of the research, the statement of primary outcome, and the use of a priori sample size calculations. These deficiencies may predispose to both type I and type II statistical errors in the small animal pain literature. We recommend more robust use of the scale and derived data to ensure success of future studies using the tool ensuring reliable and translatable outcomes.
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Affiliation(s)
- Barbara Testa
- School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Jacqueline Reid
- School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom.,NewMetrica Research, Glasgow, United Kingdom
| | - Marian E Scott
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Pamela J Murison
- School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Andrew M Bell
- School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
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24
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Cicirelli V, Lacalandra GM, Aiudi GG. The effect of splash block on the need for analgesia in dogs subjected to video-assisted ovariectomy. Vet Med Sci 2021; 8:104-109. [PMID: 34647415 PMCID: PMC8788979 DOI: 10.1002/vms3.637] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives The present study aimed to demonstrate the efficacy of splash block using lidocaine to provide additional analgesia during ovariectomy in bitches. To identify an acute intraoperative nociceptive response, three clinical parameters were used: increased blood pressure, heart rate and respiratory rate. Material and Methods Forty healthy bitches were randomly assigned to receive 2% lidocaine (L group) topical application (splash block) on both ovaries (2 mg/kg each), or an equal volume of NaCl 0.9% at the same sites (C group). A fentanyl bolus (2 µg/kg) was administered intraoperatively in response to an increase in blood pressure, heart rate or respiratory rate during surgery (> 30% compared with the pre‐incisional values). Results Local lidocaine administration significantly reduced the need for supplementary fentanyl. Dogs in the L group showed greater intraoperative hemodynamic stability and lower surgical pain than those in the C group. In addition to the routine anaesthetic protocol, the local anaesthesia used in the present study was safe and caused no cardiopulmonary suppression. In addition, it significantly reduced the need for mandatory systemic or rescue analgesia. Clinical Significance Ovariectomy is a common surgical procedure in bitches. Analgesia during this procedure is important because intraoperative pain can cause negative effects that prevent patient recovery. This study aimed to demonstrate the analgesic efficacy of lidocaine splash block in video‐assisted ovariectomy in dogs. The results showed that splash block improved surgical analgesia during canine laparoscopic ovariectomy. Considering its relative simplicity, low cost, and safety, splash block could be used in daily clinical practice.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | | | - Giulio G Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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25
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Wang AY, Malavasi L, Craft R. Evaluation of bupivacaine liposome injectable suspension efficacy in single-use vials over five days of multiple use. Vet Anaesth Analg 2021; 48:956-961. [PMID: 34561182 DOI: 10.1016/j.vaa.2021.08.002] [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: 03/24/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test the anesthetic effect of a bupivacaine liposome injectable suspension (BLIS), used in a multiple-dose manner for up to 5 consecutive days. STUDY DESIGN Prospective, randomized, experimental study. ANIMALS A total of 30 male and female Sprague-Dawley rats (Rattus norvegicus), aged 97 (75-130) days and weighing 337.2 (219.6-465.9) g, mean (range). METHODS Rats were assigned to one of five BLIS vial groups, in which drug was administered from a newly opened vial or 1, 2, 3 and 4 days after the vial was opened. The vials were refrigerated between uses. A 14 gauge needle attached to an injection plug was used to puncture each vial once and was not removed; BLIS was withdrawn from the injection plug in a multiple-dose fashion. A dose rate of 0.4 mL kg-1 was administered subcutaneously into the left pelvic limb paw. Antinociception was evaluated using a paw pressure test on both injected and uninjected paws before (time 0, baseline) and 1, 24, 48 and 72 hours after injection. RESULTS Age of BLIS vial had no significant effect on anesthetic efficacy (p = 0.97). Across all groups, paw withdrawal latency averaged 5.23 ± 0.24 seconds at baseline (before BLIS injection), increased to 16.45 ± 0.65 seconds at 1 hour after BLIS injection, declined to 7.50 ± 0.76 seconds at 24 hours after BLIS injection, and further declined thereafter (p < 0.001). There was no significant change in paw withdrawal latency in the uninjected paw over time. CONCLUSIONS AND CLINICAL RELEVANCE BLIS single-use vials retained efficacy when used up to 5 days in a multiple-dose fashion. Because anesthetic effects declined substantially after 24 hours, multimodal pain management remains important for providing analgesia care.
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Affiliation(s)
- Alison Y Wang
- College of Veterinary Medicine, Washington State University, Pullman, WA, USA.
| | - Lais Malavasi
- Department of Anesthesiology, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Rebecca Craft
- Department of Psychology, College of Arts and Sciences, Washington State University, Pullman, WA, USA
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26
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Roberts C, Armson B, Bartram D, Belshaw Z, Capon H, Cherry G, Gonzalez Villeta L, McIntyre SL, Odeyemi I, Cook AJC. Construction of a Conceptual Framework for Assessment of Health-Related Quality of Life in Dogs With Osteoarthritis. Front Vet Sci 2021; 8:741864. [PMID: 34631862 PMCID: PMC8497798 DOI: 10.3389/fvets.2021.741864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022] Open
Abstract
An owner's ability to detect changes in the behavior of a dog afflicted with osteoarthritis (OA) may be a barrier to presentation, clinical diagnosis and initiation of treatment. Management of OA also relies upon an owner's ability to accurately monitor improvement following a trial period of pain relief. The changes in behavior that are associated with the onset and relief of pain from OA can be assessed to determine the dog's health-related quality of life (HRQOL). HRQOL assessments are widely used in human medicine and if developed correctly can be used in the monitoring of disease and in clinical trials. This study followed established guidelines to construct a conceptual framework of indicators of HRQOL in dogs with OA. This generated items that can be used to develop a HRQOL assessment tool specific to dogs with OA. A systematic review was conducted using Web of Science, PubMed and Scopus with search terms related to indicators of HRQOL in dogs with osteoarthritis. Eligibility and quality assessment criteria were applied. Data were extracted from eligible studies using a comprehensive data charting table. Resulting domains and items were assessed at a half-day workshop attended by experts in canine osteoarthritis and quality of life. Domains and their interactions were finalized and a visual representation of the conceptual framework was produced. A total of 1,264 unique articles were generated in the database searches and assessed for inclusion. Of these, 21 progressed to data extraction. After combining synonyms, 47 unique items were categorized across six domains. Review of the six domains by the expert panel resulted in their reduction to four: physical appearance, capability, behavior, and mood. All four categories were deemed to be influenced by pain from osteoarthritis. Capability, mood, and behavior were all hypothesized to impact on each other while physical appearance was impacted by, but did not impact upon, the other domains. The framework has potential application to inform the development of valid and reliable instruments to operationalize measurement of HRQOL in canine OA for use in general veterinary practice to guide OA management decisions and in clinical studies to evaluate treatment outcomes.
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Affiliation(s)
- Claire Roberts
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Bryony Armson
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - David Bartram
- Outcomes Research, Zoetis, Loughlinstown, County Dublin, Ireland
| | - Zoe Belshaw
- EviVet Research Consultancy, Nottingham, United Kingdom
| | - Hannah Capon
- Canine Arthritis Management, Shoreham-by-Sea, United Kingdom
| | - Georgina Cherry
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | | | - Shona L. McIntyre
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Isaac Odeyemi
- Outcomes Research, Zoetis, Loughlinstown, County Dublin, Ireland
| | - Alasdair J. C. Cook
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
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Selman J, Towle Millard H. Hypertrophic osteodystrophy in dogs: diagnosis and treatment. J Small Anim Pract 2021; 63:3-9. [PMID: 34490906 DOI: 10.1111/jsap.13413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/16/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022]
Abstract
Hypertrophic osteodystrophy is an uncommon orthopaedic disease that affects young, growing dogs. Aetiology is currently unknown; however, several unproven etiologies have been theorised in the literature including canine distemper virus, previous vaccination, hereditary causes and auto-immune disorders. Affected animals often present with varying degrees of lameness, lethargy, pyrexia and/or distal metaphyseal swelling of affected limbs. An index of suspicion is based on clinical signs. Confirmation is obtained with radiographs of the affected limb(s) by the presence of a "double physis," or a radiolucent line that is parallel to the physis. Treatment varies depending on degree affected, but generally consists of anti-inflammatory steroids, pain medications, gastrointestinal support, nutritional management and appropriate supportive care. Critically affected patients require intensive monitoring and more aggressive supportive care for prevention of life-threatening sequalae. Prognosis is very favourable with mildly and moderately affected patients, but good to guarded in severely affected patients.
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Affiliation(s)
- J Selman
- Small Animal Surgery, BluePearl Veterinary Partners, Overland Park, Kansas, USA
| | - H Towle Millard
- Small Animal Surgery, BluePearl Veterinary Partners, Overland Park, Kansas, USA
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Fudge JM, Page B, Lee I. Evaluation of Targeted Bupivacaine, Bupivacaine-lidocaine-epinephrine, Dexamethasone, and Meloxicam for Reducing Acute Postoperative Pain in Cats Undergoing Routine Ovariohysterectomy. Top Companion Anim Med 2021; 45:100564. [PMID: 34314884 DOI: 10.1016/j.tcam.2021.100564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/04/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
This study compared bupivacaine (BUP), bupivacaine-lidocaine-epinephrine (BLE), dexamethasone (DEX), and meloxicam (MEL) targeted at specific, potentially painful sites for reducing acute postoperative pain in cats undergoing elective ovariohysterectomy. One hundred fifty-one cats were included in a prospective, randomized, double-blinded clinical trial. Anesthesia consisted of a standardized protocol including buprenorphine, ketamine, dexmedetomidine, and isoflurane. A ventral midline ovariohysterectomy was performed, and cats were administered targeted injections of 0.5% bupivacaine (2 mg/kg); a combined 0.25% bupivacaine (1 mg/kg), 1% lidocaine (2 mg/kg), and 1:100,000 epinephrine (0.005 mg/kg); dexamethasone (0.125 mg/kg); or meloxicam (0.2 mg/kg) intraoperatively at the ovarian suspensory ligaments, uterine body, and incisional subcutaneous tissues. A 0-10 Numeric Pain Rating Scale (NRS) was used to assess cats postoperatively, 1 hour and 3 hours after anesthesia recovery prior to a same day discharge. Pain scores among evaluators were in good agreement with an overall Intraclass Correlation Coefficient (ICC) of 0.7897 (95% Confidence Interval 0.795-0.8313). In all groups, overall pain scores 1-hour post anesthesia recovery were significantly higher than scores 3 hours post anesthesia recovery (P < .0001). Averaged pain scores compared among treatment groups did not differ at 1 hour post recovery. At 3-hours post anesthesia recovery, MEL group cats had significantly lower pain scores than the BLE group (P = .018). Study results indicate that early postoperative pain scores were similar for cats receiving local infiltrations of BUP, BLE, DEX, and MEL as part of a multimodal pain therapy for routine ovariohysterectomies. MEL showed somewhat better results 3 hours post anesthesia recovery, gaining significance over the BLE group.
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Affiliation(s)
| | | | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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Reader R, Olaitan O, McCobb E. Evaluation of prescribing practices for gabapentin as an analgesic among veterinary professionals. Vet Anaesth Analg 2021; 48:775-781. [PMID: 34275755 DOI: 10.1016/j.vaa.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the prescribing practices for gabapentin as an analgesic within the veterinary community. STUDY DESIGN Anonymous online voluntary survey. POPULATION A total of 718 veterinarians within the United States and Canada, including general practitioners and diplomates of the American Colleges of Veterinary Anesthesia and Analgesia, Emergency and Critical Care, Surgery and Internal Medicine. METHODS An anonymous online survey was used to gather information about individual prescribing practices for gabapentin including frequency of use, reasons for prescribing and procedures for authorizing refill requests. Questions specific to gabapentin covered mechanisms of action, perceptions of efficacy and the potential for abuse in people. Dunn's test for multiple comparisons and pairwise Mann-Whitney U test were used to evaluate relationships between veterinary specialty and survey responses. RESULTS A total of 718 veterinarians responded to the survey, 528 (73.5%) answered all questions of the survey to completion. Frequency of prescribing was high with 365/529 (69.0%) of respondents prescribing gabapentin as an analgesic on a daily or weekly basis. Surgeons and general practitioners used gabapentin significantly more frequently than other groups, with surgeons more likely to prescribe gabapentin for postoperative pain. The most common reason [254/517 (49.1%)] survey respondents prescribed gabapentin as an analgesic was because administration of a non-steroidal anti-inflammatory medication was contraindicated for that animal. The majority of survey respondents [362/527 (68.7%)] considered the abuse potential of gabapentin to be low in people. CONCLUSIONS AND CLINICAL RELEVANCE Veterinary prescribing practices for gabapentin closely mirrored that of human physicians, with gabapentin being prescribed frequently and for uses largely unrelated to its labeled indication. The perception of the potential for abuse of gabapentin is low within the veterinary community.
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Affiliation(s)
- Rebecca Reader
- Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, MA, USA.
| | - Oladapo Olaitan
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, The Albert Sherman Center, Worcester, MA, USA
| | - Emily McCobb
- Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, MA, USA
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Shilo-Benjamini Y, Letz S, Peery D, Abu Ahmad W, Bar-Am Y. Comparison of three regional anaesthetic techniques for infraorbital or maxillary nerve block in cats: a cadaveric study. J Feline Med Surg 2021; 24:322-327. [PMID: 34106793 PMCID: PMC8961245 DOI: 10.1177/1098612x211020163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives The maxillary nerve courses very close to the globe, rendering cats – with their large
eyes – at risk of globe penetration during infraorbital or maxillary nerve blocks.
Therefore, the goals of the study were to compare the distribution and potential
complications of three infraorbital or maxillary regional injection techniques. Methods Twenty-three bilateral maxillae of cat cadavers were used in a randomised blinded
trial. Each maxilla was injected with a 0.2 ml 1:1 mixture of lidocaine 2% and a
contrast medium by one of three injection techniques: infraorbital foramen (IOF;
n = 14); infraorbital canal (IOC; n = 16); or maxillary foramen (MF; transpalpebral
approach; n = 16) using a 25 G 1.6 cm needle. CT imaging of each cadaver head was
performed before and after injections. A radiologist scored injectate distribution (none
[0], mild [1], moderate [2], large [3]) in four locations: rostral, central and caudal
IOC, and at the MF, for which the distribution side was also determined. Comparisons
were performed with ordinal logistic mixed effects (P <0.05). Results The median (range) total distribution score of the IOC and MF technique were
significantly higher compared with the IOF technique (6.5 [4–12], 4 [2–8] and 0 [0–10],
respectively). The total IOC score was also significantly higher compared with the MF
technique. Injectate distribution at the MF was significantly more central following IOC
injection compared with MF injection, which distributed centrolaterally. None of the
techniques resulted in intraocular injection. Conclusions and relevance The IOC and MF techniques produced a satisfactory spread of the mixture that could
result in effective maxillary anaesthesia in cats. Further studies are required to
determine the effectiveness and safety of these techniques.
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Affiliation(s)
- Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Shachar Letz
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dana Peery
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Wiessam Abu Ahmad
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yoav Bar-Am
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Lee NN, Salzer E, Bach FC, Bonilla AF, Cook JL, Gazit Z, Grad S, Ito K, Smith LJ, Vernengo A, Wilke H, Engiles JB, Tryfonidou MA. A comprehensive tool box for large animal studies of intervertebral disc degeneration. JOR Spine 2021; 4:e1162. [PMID: 34337336 PMCID: PMC8313180 DOI: 10.1002/jsp2.1162] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Preclinical studies involving large animal models aim to recapitulate the clinical situation as much as possible and bridge the gap from benchtop to bedside. To date, studies investigating intervertebral disc (IVD) degeneration and regeneration in large animal models have utilized a wide spectrum of methodologies for outcome evaluation. This paper aims to consolidate available knowledge, expertise, and experience in large animal preclinical models of IVD degeneration to create a comprehensive tool box of anatomical and functional outcomes. Herein, we present a Large Animal IVD Scoring Algorithm based on three scales: macroscopic (gross morphology, imaging, and biomechanics), microscopic (histological, biochemical, and biomolecular analyses), and clinical (neurologic state, mobility, and pain). The proposed algorithm encompasses a stepwise evaluation on all three scales, including spinal pain assessment, and relevant structural and functional components of IVD health and disease. This comprehensive tool box was designed for four commonly used preclinical large animal models (dog, pig, goat, and sheep) in order to facilitate standardization and applicability. Furthermore, it is intended to facilitate comparison across studies while discerning relevant differences between species within the context of outcomes with the goal to enhance veterinary clinical relevance as well. Current major challenges in pre-clinical large animal models for IVD regeneration are highlighted and insights into future directions that may improve the understanding of the underlying pathologies are discussed. As such, the IVD research community can deepen its exploration of the molecular, cellular, structural, and biomechanical changes that occur with IVD degeneration and regeneration, paving the path for clinically relevant therapeutic strategies.
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Affiliation(s)
- Naomi N. Lee
- Thompson Laboratory for Regenerative OrthopaedicsUniversity of MissouriColumbiaMissouriUSA
| | - Elias Salzer
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Frances C. Bach
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Andres F. Bonilla
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityColoradoUSA
| | - James L. Cook
- Thompson Laboratory for Regenerative OrthopaedicsUniversity of MissouriColumbiaMissouriUSA
| | - Zulma Gazit
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | | | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Lachlan J. Smith
- Departments of Neurosurgery and Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrea Vernengo
- AO Research Institute DavosDavosSwitzerland
- Department of Chemical EngineeringRowan UniversityGlassboroNew JerseyUSA
| | - Hans‐Joachim Wilke
- Institute of Orthopaedic Research and BiomechanicsUniversity Hospital UlmUlmGermany
| | - Julie B. Engiles
- Department of Pathobiology, New Bolton Center, School of Veterinary MedicineUniversity of PennsylvaniaKennett SquarePennsylvaniaUSA
| | - Marianna A. Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
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Glucosamine and Chondroitin Sulfate: Is There Any Scientific Evidence for Their Effectiveness as Disease-Modifying Drugs in Knee Osteoarthritis Preclinical Studies?-A Systematic Review from 2000 to 2021. Animals (Basel) 2021; 11:ani11061608. [PMID: 34072407 PMCID: PMC8228516 DOI: 10.3390/ani11061608] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Osteoarthritis is the most common progressive joint disease diagnosed in companion animals and its management continues to be a significant challenge. Nutraceuticals have been widely investigated over the years in the treatment of osteoarthritis and among them, glucosamine and chondroitin sulfate treatments are probably the most common therapies used in veterinary management. However, heterogeneous results were obtained among animal studies and the evidence of their efficacy is still controversial. Animal models have a crucial role in studying the histological changes and evaluating the therapy efficacy of different drugs. Consequently, we consider it may be of interest to evaluate the effectiveness of the most representative nutraceuticals in experimental animal studies of osteoarthritis. In this systematic review, we found a large inconsistency among the experimental protocols, but a positive cartilage response and biochemical modulation were observed in half of the evaluated articles, mainly associated with pre-emptive administrations and with some therapies’ combinations. Even though some of these results were promising, additional data are needed to draw solid conclusions, and further studies evaluating their efficacy in the long term and focusing on other synovial components may be needed to clarify their function. Abstract Glucosamine and chondroitin sulfate have been proposed due to their physiological and functional benefits in the management of osteoarthritis in companion animals. However, the scientific evidence for their use is still controversial. The purpose of this review was to critically elucidate the efficacy of these nutraceutical therapies in delaying the progression of osteoarthritis, evaluating their impact on the synovial knee joint tissues and biochemical markers in preclinical studies by systematically reviewing the last two decades of peer-reviewed publications on experimental osteoarthritis. Three databases (PubMed, Scopus and, Web of Science) were screened for eligible studies. Twenty-two articles were included in the review. Preclinical studies showed a great heterogeneity among the experimental designs and their outcomes. Generally, the evaluated nutraceuticals, alone or in combination, did not seem to prevent the subchondral bone changes, the synovial inflammation or the osteophyte formation. However, further experimental studies may be needed to evaluate their effect at those levels. Regarding the cartilage status and biomarkers, positive responses were identified in approximately half of the evaluated articles. Furthermore, beneficial effects were associated with the pre-emptive administrations, higher doses and, multimodality approaches with some combined therapies. However, additional studies in the long term and with good quality and systematic design are required.
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Vullo C, Tambella AM, Falcone A, Marino G, Catone G. Constant Rate Infusion of Lidocaine, Tumescent Anesthesia and Their Combination in Dogs Undergoing Unilateral Mastectomy. Animals (Basel) 2021; 11:ani11051280. [PMID: 33946987 PMCID: PMC8146467 DOI: 10.3390/ani11051280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
Tumescent anesthesia (TUM) is a technique that was initially used to perform liposuction under local anesthesia, which consists of the injection of such large volumes of local anesthetic until to produce swelling and firmness (tumescence) of the surgical area. The aim of this study was to compare the intraoperative analgesic efficacy of lidocaine (LID) constant rate infusion (CRI), of TUM, or their combination (LID/TUM) and the postoperative pain and analgesic requirement in dogs undergoing unilateral mastectomy. Twenty-four dogs were premedicated with dexmedetomidine (3 μg/kg) and methadone (0.2 mg/kg) intravenously (IV). After induction with propofol IV to effect, dogs were randomly allocated to receive a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min (Group LID) in addition to an equivalent volume of lactated Ringer's solution instead of local TUM; a loading dose of lactated Ringer's solution followed by a CRI of Ringer's solution in addition to TUM (Group TUM); a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min in addition to TUM (Group LID/TUM). Anesthesia was maintained with isoflurane in oxygen. Postoperative pain scores were assessed once the dogs had fully recovered from the sedative effects, and following 15, 30, 45 and 60 min. The results of the current study allow us to assert that all three treatments provided satisfactory intraoperative antinociceptive effects but administration of LID/TUM induced greater inhibition on sympathetic stimulating effect up to 60 min from recovery, thus, providing better early postoperative pain relief in dogs undergoing mastectomy.
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Affiliation(s)
- Cecilia Vullo
- Department of ChiBioFarm, University of Messina, 98168 Messina, Italy
- Correspondence:
| | - Adolfo Maria Tambella
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy;
| | - Annastella Falcone
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
| | - Gabriele Marino
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
| | - Giuseppe Catone
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
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Pumphrey SA, Reader RC, Rosenstein DS, Mouser PJ, Wetmore LA. Iatrogenic ocular trauma associated with infraorbital block performed for rhinoscopy in a cat: case report and preliminary imaging findings. JFMS Open Rep 2021; 7:20551169211011456. [PMID: 33996139 PMCID: PMC8108087 DOI: 10.1177/20551169211011456] [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: 11/16/2022] Open
Abstract
Objectives This paper describes a case of endophthalmitis in a feline patient caused by globe penetration during an infraorbital block performed to provide analgesia during rhinoscopy, and presents additional imaging and dissection data demonstrating risk of iatrogenic ocular trauma during infraorbital blocks in cats when the infraorbital canal is entered. Methods Case records and accompanying histopathologic reports were reviewed for the feline patient. Separately, two feline cadavers were imaged using CT following placement of 5/8" 25 G needles or 1" 22 G over the needle catheters in the infraorbital canal. Infraorbital blocks with injection of trypan blue dye followed by dissection were performed in two further feline cadavers to assess the potential for globe penetration and to provide preliminary information regarding the potential efficacy of infraorbital blocks for analgesia during rhinoscopy. Results Clinical and histopathologic findings support inadvertent globe penetration during infraorbital block as the cause for endophthalmitis in the feline patient described. CT imaging and dye injection studies further demonstrate the risks involved with this local anesthetic technique in cats. Conclusions and relevance Further study is needed to assess the safety and efficacy of infraorbital blocks performed for rhinoscopy in cats. Catheters may be safer anesthetic delivery devices than needles. Extreme caution should be used when entering the infraorbital canal in cats.
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Affiliation(s)
- Stephanie A Pumphrey
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Rebecca C Reader
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | | | | | - Lois A Wetmore
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
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della Rocca G, Gamba D. Chronic Pain in Dogs and Cats: Is There Place for Dietary Intervention with Micro-Palmitoylethanolamide? Animals (Basel) 2021; 11:952. [PMID: 33805489 PMCID: PMC8065429 DOI: 10.3390/ani11040952] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022] Open
Abstract
The management of chronic pain is an integral challenge of small animal veterinary practitioners. Multiple pharmacological agents are usually employed to treat maladaptive pain including opiates, non-steroidal anti-inflammatory drugs, anticonvulsants, antidepressants, and others. In order to limit adverse effects and tolerance development, they are often combined with non-pharmacologic measures such as acupuncture and dietary interventions. Accumulating evidence suggests that non-neuronal cells such as mast cells and microglia play active roles in the pathogenesis of maladaptive pain. Accordingly, these cells are currently viewed as potential new targets for managing chronic pain. Palmitoylethanolamide is an endocannabinoid-like compound found in several food sources and considered a body's own analgesic. The receptor-dependent control of non-neuronal cells mediates the pain-relieving effect of palmitoylethanolamide. Accumulating evidence shows the anti-hyperalgesic effect of supplemented palmitoylethanolamide, especially in the micronized and co-micronized formulations (i.e., micro-palmitoylethanolamide), which allow for higher bioavailability. In the present paper, the role of non-neuronal cells in pain signaling is discussed and a large number of studies on the effect of palmitoylethanolamide in inflammatory and neuropathic chronic pain are reviewed. Overall, available evidence suggests that there is place for micro-palmitoylethanolamide in the dietary management of chronic pain in dogs and cats.
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Affiliation(s)
- Giorgia della Rocca
- Department of Veterinary Medicine, Centro di Ricerca sul Dolore Animale (CeRiDA), Università degli Studi di Perugia, 06123 Perugia, Italy
| | - Davide Gamba
- Operational Unit of Anesthesia, Centro Veterinario Gregorio VII, 00165 Roma, Italy;
- Freelance, DG Vet Pain Therapy, 24124 Bergamo, Italy
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Sliusarenko DV, Ilnitskiy МG, Bilyi DD, Bobrytska OM, Kovalova LO. Regional anesthesiological support for the implementation of surgical interventions in the abdomen of dogs. REGULATORY MECHANISMS IN BIOSYSTEMS 2021. [DOI: 10.15421/022108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Widespread use of surgical interventions in the abdomen of dogs determines the relevance of the study. The research tested the influence of therapeutic epidural blockade with 0.2% bupivacaine after surgical interventions on the background of potentiated local anaesthesia on the body of clinically healthy dogs undergoing ovariohysterectomy. In the control group postoperative analgesia was performed with the nonsteroidal anti-inflammatory drug rimadyl on the background of potentiated thiopental anaesthesia. Wound healing rates were determined in 10 animals of both control and experimental groups; blood counts and the level of inflammatory response were indicated in 5 animals of each group. The dynamics of reparative processes and complete wound healing in dogs of the experimental group occurred earlier than in animals of the control group, which confirmed the fact that the use of bupivacaine had a beneficial effect on tissue regeneration. The results of morphological and biochemical parameters of blood in animals of the experimental group manifested only an increase of leukocytes by 1.58 times, fibrinogen by 2.02 times, while in dogs of the control group the level of erythrocytes, haemoglobin and hematocrit decreased, leukocytes increased by 1.74 times, platelets decreased by 2.87 times and fibrinogen increased by 1.72 times. Among the stress response markers in the control group there was a 1.94 times increase in glucose level after surgery. In the experimental group there was a decrease in the intensity of the inflammatory reaction in dogs, accompanied by an increase of anti-inflammatory interleukin 4 (IL-4) only on the seventh day – 1.86 times, while in the control group the level of anti-inflammatory interleukin 1 receptor antagonist (IL-1RA) after three days increased by 2.30 times, after seven days – by 2.48 times, and the level of proinflammatory interleukin 6 (IL-6) after surgery increased by 2.57 times. It will be promising to conduct further research on the influence of therapeutic blockades with bupivacaine in animals in cases of various surgical interventions and pathological conditions, which will lead to faster recovery of animals and alleviate pathological processes.
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Tomsič K, Rakinić K, Sokolov C, Seliškar A. A survey study on the recognition and treatment of pain in dogs and cats by Slovenian veterinarians. Vet Anaesth Analg 2021; 48:334-343. [PMID: 33741262 DOI: 10.1016/j.vaa.2020.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/04/2020] [Accepted: 11/14/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To obtain information on pain management in dogs and cats by Slovenian veterinarians, and to compare it with reports from other countries. STUDY DESIGN Prospective online survey. METHODS The questions were uploaded using open source survey software and pertained to demographic data, self-evaluation of acquired and current knowledge, attitude towards pain and evaluation of actual knowledge, assessment of chronic and acute pain and pain due to surgery or medical conditions, and the use of analgesics. Descriptive statistics were used to summarize frequency distribution. Wilcoxon signed rank test, Mann-Whitney U test and Spearman's rho were applied where appropriate. RESULTS The response rate was 11%. From 680 registered members of the Veterinary Chamber of Slovenia, 73 veterinarians completed the survey. Most of the respondents were women (71.2%) working in small (60.3%) or mixed (21.9%) animal practices. A more recent year of graduation was positively correlated to the self-reporting of knowledge acquired during undergraduate studies (rs = 0.339, p = 0.003) and to current knowledge about the topic (rs = 0.293, p = 0.012). Cats were assigned higher scores than dogs for signs of acute (p < 0.001) pain. Female respondents assigned higher scores than male respondents for chronic pain in dogs. Dogs were assigned higher pain scores than cats for surgical procedures and medical conditions. The most frequently used non-steroidal anti-inflammatory drugs (NSAIDs) in dogs and cats were meloxicam and carprofen, and butorphanol was the most commonly used opioid. The choice of NSAID was influenced by perceived effectiveness, experience with use and anti-inflammatory effect. Opioid use was influenced by experience with use and perceived effectiveness. CONCLUSIONS AND CLINICAL RELEVANCE Slovenian veterinarians acknowledged the importance of pain management as reported for other European countries. However, the use of multimodal analgesia is limited, and inadequacies remain in the pain management of cats.
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Affiliation(s)
- Katerina Tomsič
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Cvetka Sokolov
- Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Alenka Seliškar
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia.
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Dion L, Le Lous M, Nyangoh Timoh K, Levêque J, Arnaud A, Henri-Malbert C, Foucher F, Boudjema K, Bendavid C, Vigneau C, Legembre P, Val-Laillet D, Lavoué V. Single bilateral ovarian venous return in uterine transplant: Validation in an orthotopic auto-transplant model in the Yucatan minipig. J Gynecol Obstet Hum Reprod 2021; 50:102059. [PMID: 33421624 DOI: 10.1016/j.jogoh.2021.102059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/12/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Uterine transplant (UT) represents an opportunity to treat absolute uterine infertility. However, the use of uterine veins for venous return, in addition to ovarian veins, significantly increases the risk of ureteral wounds in the living donor and UT time for the recipient. Our aim was to demonstrate that dual ovarian venous return is sufficient for graft viability and survival. METHODS Uterine orthotopic auto-transplant was performed under general anaesthesia in six Yucatan minipig sows. The uterus graft was implanted with termino-lateral anastomoses between the ovarian and external iliac veins, and between the uterine and external iliac arteries, respectively. RESULTS The macroscopic physical aspect of the graft was adequate in 83 % of the sows (5/6) 30 min after reperfusion with a surgical time of 439±54 min (mean anastomosis time: 153±49 min). Two sows died the day after surgery. In the four remaining sows, two uteri were necrotic and two were adequately vascularized on Day 7. CONCLUSIONS the learning curve was relatively fast, the sole use of bilateral ovarian venous return is possible and might reduce post-surgery morbidity in human living donors as well as UT time for the recipient.
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Affiliation(s)
- Ludivine Dion
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France; INSERM, U1242, COS, Rennes, France.
| | - Maela Le Lous
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France
| | | | - Jean Levêque
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France; INSERM, U1242, COS, Rennes, France
| | - Alexis Arnaud
- Rennes University Hospital, Department of Paediatrics, Hôpital Sud, France; INRA, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer (NuMeCan), Rennes, St Gilles, France
| | | | - Fabrice Foucher
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France
| | - Karim Boudjema
- Rennes University Hospital, Departement of Hepatobile Surgery and Liver Transplantation, Pontchaillou, France
| | - Claude Bendavid
- Rennes University Hospital, Departement of Biochemistry, Pontchaillou, France
| | - Cécile Vigneau
- Rennes University Hospital, Departement of Nephrology, Pontchaillou, France
| | | | - David Val-Laillet
- INRA, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer (NuMeCan), Rennes, St Gilles, France
| | - Vincent Lavoué
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France; INSERM, U1242, COS, Rennes, France
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Di Salvo A, Chiaradia E, Nannarone S, Della Rocca G. Intra-articular use of analgesic/antinflammatory drugs in dogs and horses. Res Vet Sci 2020; 134:159-170. [PMID: 33387756 DOI: 10.1016/j.rvsc.2020.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/24/2020] [Accepted: 12/22/2020] [Indexed: 12/27/2022]
Abstract
Joint pain is a major cause of lameness in animals such as horses and dogs, and it may affect their athletic performance and quality of life. The intra-articular administration of analgesic/antinflammatory drugs is a common practice in veterinary medicine, for both lameness diagnosis and joint pain management. It is used either perioperatively, such as in animals undergoing arthroscopy/arthrotomy, and in osteoarthritic animals. However, evidence regarding efficacy and safety of each drug is limited, and controversies persist in these areas. In particular, it is often uncertain whether a defined treatment is effective by simply relieving the symptomatic pain associated with the joint disease, or whether it has a positive effect on the joint environment. Moreover, there is still much hesitation about treatments for joint diseases, related to the time of their application for the best outcome, and to any possible deleterious side effects. This article includes a review of the literature concerning the main analgesic/antinflammatory drugs used intra-articularly for managing acute and chronic joint pain/inflammation in dogs and horses. Three main issues for each class of drugs are considered, including clinical efficacy, pharmacokinetics, and local cytotoxic effects.
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Affiliation(s)
- Alessandra Di Salvo
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy; Department of Veterinary Medicine, Research Center on Animal Pain, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy
| | - Elisabetta Chiaradia
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy
| | - Sara Nannarone
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy; Department of Veterinary Medicine, Research Center on Animal Pain, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy.
| | - Giorgia Della Rocca
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy; Department of Veterinary Medicine, Research Center on Animal Pain, University of Perugia, Via San Costanzo, 4, 06126 Perugia, Italy
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Grubb T, Sager J, Gaynor JS, Montgomery E, Parker JA, Shafford H, Tearney C. 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2020; 56:59-82. [PMID: 32078360 DOI: 10.5326/jaaha-ms-7055] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Risk for complications and even death is inherent to anesthesia. However, the use of guidelines, checklists, and training can decrease the risk of anesthesia-related adverse events. These tools should be used not only during the time the patient is unconscious but also before and after this phase. The framework for safe anesthesia delivered as a continuum of care from home to hospital and back to home is presented in these guidelines. The critical importance of client communication and staff training have been highlighted. The role of perioperative analgesia, anxiolytics, and proper handling of fractious/fearful/aggressive patients as components of anesthetic safety are stressed. Anesthesia equipment selection and care is detailed. The objective of these guidelines is to make the anesthesia period as safe as possible for dogs and cats while providing a practical framework for delivering anesthesia care. To meet this goal, tables, algorithms, figures, and "tip" boxes with critical information are included in the manuscript and an in-depth online resource center is available at aaha.org/anesthesia.
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Affiliation(s)
- Tamara Grubb
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
| | - Jennifer Sager
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
| | - James S Gaynor
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
| | - Elizabeth Montgomery
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
| | - Judith A Parker
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
| | - Heidi Shafford
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
| | - Caitlin Tearney
- From Washington State University College of Veterinary Medicine, Pullman, Washington (T.G.); University of Florida Veterinary Hospitals, Gainesville, Florida (J.S.); Peak Performance Veterinary Group, Breckenridge, Colorado (J.S.G.); University of California, Davis, School of Veterinary Medicine, Davis, California (E.M.); Pima Pet Clinic, Tucson, Arizona (J.A.P.); Veterinary Anesthesia Specialists, Clackamas, Oregon (H.S.); and Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (C.T.)
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Portela DA, Romano M, Zamora GA, Garcia-Pereira F, Pablo LS, Gatson BJ, Johnson AN, Otero PE. The effect of erector spinae plane block on perioperative analgesic consumption and complications in dogs undergoing hemilaminectomy surgery: a retrospective cohort study. Vet Anaesth Analg 2020; 48:116-124. [PMID: 33277182 DOI: 10.1016/j.vaa.2020.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/06/2020] [Accepted: 10/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the perioperative use of analgesics and complication rates in dogs administered an erector spinae plane (ESP) block or a traditional opioid-based (OP) treatment as part of analgesic management during hemilaminectomy. STUDY DESIGN Retrospective cohort study. ANIMALS Medical records of 114 client-owned dogs. METHODS General data included demographics, duration of procedure, number of laminae fenestrated, perioperative use of steroid and non-steroidal anti-inflammatory drugs. Intra- and postoperative analgesics used in 48 hours and complications rates were compared between groups. Opioid use was expressed in morphine equivalents [ME (mg kg-1)]. Continuous data were compared using the Mann-Whitney U test and incidence of events with a Fisher's exact tests. Multiple linear regression was used to evaluate association between perioperative ME consumption (dependent variable) with other independent variables. Data are presented as median (range). Differences were considered significant when p < 0.05. RESULTS Group ESP comprised 42 dogs and group OP 72 dogs. No differences were observed in the general data. Intraoperative ME was 0.65 (0.20-3.74) and 0.79 (0.19-5.60) mg kg-1 in groups ESP and OP, respectively (p = 0.03). Intraoperative infusion of lidocaine was administered intravenously (IV) to 23.8% and 68% of groups ESP and OP, respectively (p < 0.0001). Intraoperative infusion of ketamine was administered IV to 21% and 40% of groups ESP and OP, respectively (p = 0.04). Regression analysis revealed the ESP block as the only independent variable affecting the perioperative ME consumption. Pharmacological intervention to treat cardiovascular complications was administered to 21.4% and 47.2% of dogs in groups ESP and OP, respectively (p = 0.008). There were no differences in postoperative complication rates. CONCLUSIONS AND CLINICAL RELEVANCE ESP block was associated with reduced perioperative opioid consumption, intraoperative adjuvant analgesic use and incidence of pharmacological interventions to treat cardiovascular complications in dogs undergoing hemilaminectomy.
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Affiliation(s)
- Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Gustavo A Zamora
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | | | - Luisito S Pablo
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Bonnie J Gatson
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Alana N Johnson
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Reader RC, McCarthy RJ, Schultz KL, Volturo AR, Barton BA, O'Hara MJ, Abelson AL. Comparison of liposomal bupivacaine and 0.5% bupivacaine hydrochloride for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy. J Am Vet Med Assoc 2020; 256:1011-1019. [PMID: 32301662 DOI: 10.2460/javma.256.9.1011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare liposome-encapsulated bupivacaine (LEB) and (nonliposomal) 0.5% bupivacaine hydrochloride (0.5BH) for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy (TPLO). ANIMALS 33 client-owned dogs. PROCEDURES In a randomized clinical trial, dogs undergoing TPLO received LEB (5.3 mg/kg [2.4 mg/lb]) or 0.5BH (1.5 mg/kg [0.68 mg/lb]) by periarticular soft tissue injection. All dogs received carprofen (2.2 mg/kg [1 mg/lb], SC, q 12 h) beginning at extubation. Signs of pain were assessed at extubation and predetermined times up to 48 hours later with the Colorado State University-Canine Acute Pain Scale and Glasgow Composite Pain Scale-Short Form. A pressure nociceptive threshold device was used at the affected stifle joint before surgery and at 5 postoperative time points. Methadone (0.1 mg/kg [0.05 mg/lb], IV) was administered if the Colorado State University pain scale score was ≥ 2 (scale, 0 to 4). Surgical variables; pain scores; pressure nociceptive thresholds; times to first administration of rescue analgesic, first walk, and first meal consumption; and total opioid administration were compared between treatment groups. RESULTS 28 dogs completed the study. Dogs administered LEB were less likely to require rescue analgesia and received lower amounts of opioids than dogs administered 0.5BH. There were no significant intergroup differences in other measured variables. CONCLUSIONS AND CLINICAL RELEVANCE The LEB appeared to provide adequate analgesia after TPLO with lower requirements for opioid treatments, which may allow dogs to be discharged from the hospital earlier than with traditional pain management strategies.
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Gugliandolo E, Peritore AF, Impellizzeri D, Cordaro M, Siracusa R, Fusco R, D’Amico R, Di Paola R, Schievano C, Cuzzocrea S, Crupi R. Dietary Supplementation with Palmitoyl-Glucosamine Co-Micronized with Curcumin Relieves Osteoarthritis Pain and Benefits Joint Mobility. Animals (Basel) 2020; 10:ani10101827. [PMID: 33049960 PMCID: PMC7601140 DOI: 10.3390/ani10101827] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Canine osteoarthritis is a chronic degenerative joint disease and a major cause of elective euthanasia. The disorder increasingly limits joint motion, might cause lameness as well as pain, and impacts quality of life. An unmet need remains for safe and effective therapies for osteoarthritis. Palmitoyl-glucosamine and curcumin are used in animal nutrition. A co-micronized formulation, with the two substances being jointly processed to reduce their particle size and increase the extent to which they can be absorbed, is currently available on the European market. The present study investigated if this formulation could relieve joint pain and benefit mobility. Two well-established rat models of inflammation and osteoarthritis pain were used. Results from the first set of experiments showed that the dietary supplement relieved experimentally induced paw edema, infiltration of inflammatory cells, and decreased sensitivity to painful stimuli (thermal hyperalgesia). In the osteoarthritis model, the supplement proved to protect joint cartilage against degradation and successfully address neuropathic pain (i.e., pain from normally non-painful stimuli). Locomotor function recovered by 45% under supplement administration. The present findings suggest that the dietary supplement with palmitoyl-glucosamine co-micronized with curcumin might help manage osteoarthritis. Abstract Chronic mixed pain and orthopedic dysfunction are the most frequently associated consequences of canine osteoarthritis (OA). An unmet need remains for safe and effective therapies for OA. Palmitoyl-glucosamine (PGA) and curcumin are safe and naturally occurring compounds whose use is limited by poor bioavailability. Micronization is an established technique to increase bioavailability. The aim of this study was to investigate if the dietary supplementation with PGA co-micronized with curcumin (PGA-Cur, 2:1 ratio by mass) could limit pathologic process in two well-established rat models of inflammation and OA pain, i.e., subplantar carrageenan (CAR) and knee injection of sodium monoiodoacetate (MIA), respectively. In CAR-injected animals, a single dose of PGA-cur significantly reduced paw edema and hyperalgesia, as well as tissue damage and neutrophil infiltration. The repeated administration of PGA-Cur three times per week for 21 days, starting the third day after MIA injection resulted in a significant anti-allodynic effect. Protection against cartilage damage and recovery of locomotor function by 45% were also recorded. Finally, PGA-cur significantly counteracted MIA-induced increase in serum levels of TNF-α, IL-1β, NGF, as well as metalloproteases 1, 3, and 9. All the effects of PGA-Cur were superior compared to the compounds used singly. PGA-Cur emerged as a useful dietary intervention for OA.
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Affiliation(s)
- Enrico Gugliandolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Alessio Filippo Peritore
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Daniela Impellizzeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Marika Cordaro
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Rosalba Siracusa
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Ramona D’Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Rosanna Di Paola
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
| | - Carlo Schievano
- Innovative Statistical Research srl, Prato Della Valle 24, I-35123 Padova, Italy;
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (E.G.); (A.F.P.); (D.I.); (M.C.); (R.S.); (R.F.); (R.D.); (R.D.P.)
- Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, Saint Louis, MO 63104, USA
- Correspondence:
| | - Rosalia Crupi
- Department of Veterinary Science, University of Messina, 98168 Messina, Italy;
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Shihadih DS, Harris TR, Kodani SD, Hwang SH, Lee KSS, Mavangira V, Hamamoto B, Guedes A, Hammock BD, Morisseau C. Selection of Potent Inhibitors of Soluble Epoxide Hydrolase for Usage in Veterinary Medicine. Front Vet Sci 2020; 7:580. [PMID: 33005645 PMCID: PMC7479175 DOI: 10.3389/fvets.2020.00580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
The veterinary pharmacopeia available to treat pain and inflammation is limited in number, target of action and efficacy. Inhibitors of soluble epoxide hydrolase (sEH) are a new class of anti-inflammatory, pro-resolving and analgesic drugs being tested in humans that have demonstrated efficacy in laboratory animals. They block the hydrolysis, and thus, increase endogenous concentrations of analgesic and anti-inflammatory signaling molecules called epoxy-fatty acids. Here, we screened a library of 2,300 inhibitors of the sEH human against partially purified feline, canine and equine hepatic sEH to identify inhibitors that are broadly potent among species. Six very potent sEH inhibitors (IC50 < 1 nM for each enzyme tested) were identified. Their microsomal stability was then measured in hepatic extracts from cat, dog and horse, as well as their solubility in solvents suitable for the formulation of drugs. The trans-4-{4-[3-(4-trifluoromethoxy-phenyl)-ureido]-cyclohexyloxy}-benzoic acid (t-TUCB, 1,728) appears to be the best compromise between stability and potency across species. Thus, it was selected for further testing in veterinary clinical trials of pain and inflammation in animals.
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Affiliation(s)
- Diyala S. Shihadih
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Todd R. Harris
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Sean D. Kodani
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Sung-Hee Hwang
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Kin Sing Stephen Lee
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
- Department of Pharmacology and Toxicology and Department of Chemistry, Michigan State University, East Lansing, MI, United States
| | - Vengai Mavangira
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Briana Hamamoto
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Alonso Guedes
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, United States
| | - Bruce D. Hammock
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Christophe Morisseau
- Department of Entomology and Nematology, U.C. Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
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Tomacheuski RM, Taffarel MO, Cardoso GS, Derussi AAP, Ferrante M, Volpato R, Luna SPL. Postoperative Analgesic Effects of Laserpuncture and Meloxicam in Bitches Submitted to Ovariohysterectomy. Vet Sci 2020; 7:vetsci7030094. [PMID: 32708066 PMCID: PMC7559566 DOI: 10.3390/vetsci7030094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background: This prospective, randomised and blind study investigated the efficacy of laserpuncture for postoperative pain management in dogs. Method: Sixteen bitches were sedated with acepromazine and randomly treated before ovariohysterectomy with meloxicam 0.2 mg·kg−1 intramuscular or laserpuncture (wavelength 904 mm, frequency 124 Hz, potency 10 Joules, 100 s in each acupoint). Anaesthesia was performed with propofol, isoflurane/O2, and fentanyl. The Glasgow Composite Measure Pain Scale (GCMPS) and Dynamic Interactive Visual Analog Scale (DIVAS) were used to evaluate postoperative pain before and for 24 h after surgery. Morphine was administrated as rescue analgesia when pain scores were ≥3.33 (GCMPS). Differences between treatments, time points, and amount of rescue analgesia between groups were investigated by the Mann–Whitney test and the area under the curve (AUC) for GCMPS, Friedman, and Chi-squared tests, respectively (p < 0.05). Results: Dogs treated with laserpuncture presented lower GCMPS AUC for 24 h and lower GCMPS scores at 2 and 4 h postoperatively (p = 0.04). Three dogs treated with meloxicam required postoperatively rescue analgesia against none treated with laserpuncture. Conclusions: In this preliminary study, laserpuncture mitigated postoperative pain in dogs following ovariohysterectomy, and the technique is a promising adjunct to perioperative pain management in dogs undergoing soft tissue surgery.
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Affiliation(s)
- Rubia M. Tomacheuski
- Department of Anesthesiology, Medical School, São Paulo State University (Unesp), Botucatu 18618687, Brazil;
| | - Marilda O. Taffarel
- Department of Veterinary Medicine, Maringá State University (UEM), Umuarama 87502970, Brazil;
| | - Guilherme S. Cardoso
- Department of Veterinary Clinics, Londrina State University (UEL), Londrina 86057970, Brazil;
| | - Ana A. P. Derussi
- Department of Animal Reproduction, José do Rosário Vellano University (UNIFENAS), Alfenas 37131587, Brazil;
| | - Marcos Ferrante
- Department of Veterinary Medicine, Federal University of Lavras (UFLA), Lavras 37200900, Brazil;
| | - Rodrigo Volpato
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu 18618000, Brazil;
| | - Stelio P. L. Luna
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu 18618000, Brazil;
- Correspondence: ; Tel.: +55-14-996275212
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Zidan N, Medland J, Olby N. Long-term postoperative pain evaluation in dogs with thoracolumbar intervertebral disk herniation after hemilaminectomy. J Vet Intern Med 2020; 34:1547-1555. [PMID: 32462728 PMCID: PMC7379041 DOI: 10.1111/jvim.15800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/14/2020] [Accepted: 05/01/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Chronic neuropathic pain is a common complication in people with spinal cord injury (SCI) but has not been investigated in dogs. OBJECTIVE To determine the reliability of measuring spinal mechanical sensory thresholds (MSTs) in dogs and to compare MSTs of healthy dogs and dogs with SCI caused by acute thoracolumbar intervertebral disk extrusion after hemilaminectomy over a 1-year period. STUDY DESIGN Prospective study. ANIMALS Thirty-two healthy and 40 SCI dogs. METHODS Dogs were divided into group 1 (healthy Dachshunds), group 2 (healthy dogs including several breeds), and SCI group. The MSTs were measured using algometry at an incision (thoracolumbar) and control site. Dogs in group 1 were tested once; those in group 2 were tested for 5 consecutive days; and SCI dogs were tested on days 7, 14, 28, 42, 180, and 365 postoperatively. The MSTs were compared among days in healthy and SCI dogs and between SCI and healthy dogs using mixed effect models. P < .05 was considered significant. RESULTS At the incision site of SCI dogs, MST was significantly lower than in healthy dogs for 42 days postoperatively, but not subsequently. However, 4/27 dogs had control site MST below the reference range 1 year after surgery. CONCLUSIONS AND CLINICAL IMPORTANCE Mechanical sensory thresholds normalize by 6 months after surgery in most dogs with SCI. Approximately 15% of SCI dogs may develop chronic neuropathic pain. Improving long-term pain assessment of SCI dogs is important for offering treatment options and advising owners.
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Affiliation(s)
- Natalia Zidan
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Julia Medland
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Natasha Olby
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
- Comparative Medicine InstituteNorth Carolina State UniversityRaleighNorth CarolinaUSA
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Shilo-Benjamini Y, Slav SA, Kahane N, Kushnir Y, Sarfaty H, Ofri R. Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs. J Am Vet Med Assoc 2020; 255:1255-1262. [PMID: 31730436 DOI: 10.2460/javma.255.11.1255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs. ANIMALS 20 client-owned dogs undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation. RESULTS At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.
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Černá P, Gardiner H, Sordo L, Tørnqvist-Johnsen C, Gunn-Moore DA. Potential Causes of Increased Vocalisation in Elderly Cats with Cognitive Dysfunction Syndrome as Assessed by Their Owners. Animals (Basel) 2020; 10:E1092. [PMID: 32599838 PMCID: PMC7341261 DOI: 10.3390/ani10061092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/23/2020] [Accepted: 06/22/2020] [Indexed: 11/16/2022] Open
Abstract
The objectives of this study were to explore owner perception of the causes of increased vocalisation in cats diagnosed with cognitive dysfunction syndrome (CDS) and consider what impact this vocalisation may have on the cat's household. Owners of cats diagnosed with CDS that presented with increased vocalisation were invited to complete an online survey. The survey consisted of 28 questions including the cat's signalment, its medical history, and questions pertaining to the owner's perception of what motivated their cat´s increased vocalisation. This was determined by looking at the cat's behaviour when vocalising, where it was looking when it was vocalising, and if the vocalisation stopped when the owner interacted with it, e.g., petting or feeding it. The owners were also asked how stressful they found their cat's vocalisation. There were 37 responses. The majority of owners reported that the main cause of their cat's vocalisation appeared to be disorientation (40.5%) or attention seeking (40.5%). Seeking a resource such as food was reported in 16.2%, and pain was perceived to be the cause in only 2.7% of cats. However, the majority of owners (64.8%) believed there was >1 cause of their cat's increased vocalisation. Importantly, when owners were asked how stressful they found their cat's increased vocalisation, 40.5% scored ≥3 (where 1 = not stressful; 5 = significantly stressful). This study provides novel insight into owner perception of feline CDS, as well as potential causes for increased vocalisation; this will allow veterinarians to better advise owners on how to manage their cat with CDS.
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Affiliation(s)
- Petra Černá
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh EH25 9RG, UK; (L.S.); (C.T.-J.); (D.A.G.-M.)
- Small Animal Clinic, The University of Veterinary and Pharmaceutical Sciences Brno, 251 61 Brno, Czech Republic
| | - Hannah Gardiner
- The Beaumont Veterinary Group—Kidlington branch, Kidlington OX5 1EA, UK;
| | - Lorena Sordo
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh EH25 9RG, UK; (L.S.); (C.T.-J.); (D.A.G.-M.)
| | - Camilla Tørnqvist-Johnsen
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh EH25 9RG, UK; (L.S.); (C.T.-J.); (D.A.G.-M.)
| | - Danièlle A. Gunn-Moore
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh EH25 9RG, UK; (L.S.); (C.T.-J.); (D.A.G.-M.)
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DiMarco AF, Kowalski KE. Activation of the expiratory muscles via lower thoracic high frequency spinal cord stimulation in awake animals. Respir Physiol Neurobiol 2020; 276:103360. [PMID: 32045702 DOI: 10.1016/j.resp.2019.103360] [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: 10/23/2019] [Revised: 12/03/2019] [Accepted: 12/14/2019] [Indexed: 11/28/2022]
Abstract
Lower thoracic spinal cord stimulation is an effective method of restoring an effective cough in participants with complete spinal cord injury. The high voltage requirements however significantly limits this application in subjects with intact lower chest wall sensation. In anesthetized animals, we have shown that the expiratory muscles can also be effectively activated with low stimulus currents (1 mA) but with high stimulus frequencies (HF-SCS -500 Hz). In 3 intact, awake pigs the responses to HF-SCS, were evaluated. HF-SCS was associated with marked expansion of the abdominal wall and external oblique EMG activity without any associated changes in heart rate or vocalization. During a terminal procedure under general anesthesia, responses to HF-SCS were re-assessed. Abdominal movement and EMG were similar to that observed in the awake state. HF-SCS (1.5 mA) resulted in an airway pressure of 65 ± 2cmH2O. Our results indicate that lower thoracic HF-SCS may be a useful method to restore an effective cough in patients with intact chest wall sensation.
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Affiliation(s)
- Anthony F DiMarco
- Department of Physical Medicine and Rehabilitation, Cleveland, OH, USA; Department of Research, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA.
| | - Krzysztof E Kowalski
- Department of Medicine, Cleveland, OH, USA; Department of Research, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA; Research Service, Louis Stokes Cleveland VA Medical Center, 10701, East Boulevard, Cleveland, OH, USA.
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Fudge JM, Page B, Mackrell A, Lee I. Evaluation of targeted bupivacaine for reducing acute postoperative pain in cats undergoing routine ovariohysterectomy. J Feline Med Surg 2020; 22:91-99. [PMID: 30720395 PMCID: PMC10814562 DOI: 10.1177/1098612x19826700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES This study sought to determine if bupivacaine targeted at specific, potentially painful sites could enhance postoperative analgesia in routine feline ovariohysterectomies. A secondary objective was to assess the utility of multiple acute pain scales for cats in a high-volume surgery setting. METHODS Two hundred and twelve cats were included in a prospective, randomized, double-blinded, placebo-controlled clinical trial. Anesthesia included buprenorphine, ketamine, dexmedetomidine and isoflurane. A ventral midline ovariohysterectomy was performed and cats were administered bupivacaine (2 mg/kg), placebo control (0.9% saline) or sham control (observation only) intraoperatively at the ovarian suspensory ligaments and vessels, uterine body and incisional subcutaneous tissues. Two pain scales were used to assess cats postoperatively. Initially, a multidimensional composite pain scale (MCPS) and a 0-10 numeric pain rating scale (NRS) were used. Subsequently, the MCPS was replaced with a modified Colorado State University Feline Acute Pain Scale (mCSU). Pain scores for the test groups were compared using a one-way ANOVA and a Holm-Bonferroni post hoc analysis when a difference was found (P <0.05). RESULTS Pain for the bupivacaine group was lower than the control groups at 1 h post-recovery and discharge, attaining significance with higher body weights. The P values were 0.008 and 0.004 for 1 h post-recovery and discharge, respectively. Pain scores between evaluators for the MCPS and NRS correlated poorly with r values for 1 h post-recovery and discharge of -0.08 and 0.22, respectively. Additionally, the MCPS proved difficult to use and time consuming, especially for feral and fractious patients, and was replaced with the mCSU. CONCLUSIONS AND RELEVANCE Targeted bupivacaine reduced early postoperative pain scores following routine feline ovariohysterectomies. The technique used was simple, requiring just over a minute to perform at minimal additional cost. The MCPS was not ideal for use in a high-volume spay setting.
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Affiliation(s)
| | | | | | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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