Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study.

OBJECTIVE: To assess the use of adrenaline (0.00198%) in a bilateral maxillary nerve block to reduce intraoperative hemorrhage in dogs undergoing staphylectomy for the treatment of brachycephalic obstructive airway syndrome (BOAS). STUDY DESIGN: Prospective, randomized, double-blinded controlled study. SAMPLE POPULATION: A total of 32 client owned, clinically affected dogs undergoing a cut and sew sharp staphylectomy for treatment of BOAS. A total of 16 dogs randomly assigned to adrenaline (A) group and 16 to no-adrenaline (NA) group. METHODS: A bilateral maxillary nerve block was performed in all dogs prior to staphylectomy using lidocaine alone (group NA) or a combination of lidocaine and adrenaline (group A). Total hemorrhage was measured by weighing cotton-tipped applicators and swabs used on precision scales. In addition, a semi-quantitative hemorrhage score (1-5) was determined. Dogs were monitored for intraoperative hemodynamic stability during the procedure. RESULTS: Total hemorrhage was significantly (p = .013) lower in group A compared with group NA. The median semi-quantitative hemorrhage score was significantly lower for group A (p = .029) compared with group NA. No significant adverse effects were noted due to adrenaline usage. CONCLUSION: This study demonstrated that the use of adrenaline in a bilateral maxillary nerve block results in significantly lower intraoperative hemorrhage during cut and sew sharp staphylectomy and appeared safe to use. CLINICAL SIGNIFICANCE: Potential clinical advantages include improved visualization, prevention of unnecessary blood loss and reduction in risk of blood aspiration.

Estimation of the intraoperative blood loss in dogs undergoing enucleation.

PURPOSE: To quantify the surgical blood loss during canine enucleation and to investigate the relationship between this and any patient, surgical, and anesthetic factors. METHODS: A prospective observational analysis was conducted on 121 client-owned dogs (130 eyes) undergoing enucleation at a referral ophthalmology clinic. Blood loss was estimated by the gravimetric method (weight difference between dry and blood-containing surgical materials) to provide absolute blood loss (ABL) in milliliters, expressed as a percentage of circulating blood volume, to establish relative blood loss (RBL). RESULTS: Median ABL was 12 ml (1.6-116 ml), and median RBL was 1.3% (0.1%-6.7%). A higher RBL was associated with the following: use of a bupivacaine splash block versus retrobulbar nerve block (1.9 vs. 1%; p < .001), transpalpebral versus subconjunctival approach (2.2 vs. 1.3%; p = .003), and small versus large breed dogs (1.7% vs. 1.1%; p = .001). Both ABL and RBL differed significantly between surgeons. There was no significant difference in hemorrhage associated with the presence of ocular hypertension, systemic illness, surgical time, administration of meloxicam or choice of pre-medicant (acepromazine vs medetomidine). No dog required supportive intervention in response to surgical hemorrhage. CONCLUSIONS: This study has established a surgical blood loss estimate for dogs undergoing enucleation at an ophthalmology referral centre. Subconjunctival enucleation may be preferred for patients at greater risk of haemodynamic complications.

Comparison of conventional methods with commercially available topical hemostat surgical snow (oxidized cellulose) for achieving hemostasis in canine model of partial splenectomy.

Spleen is highly vascularized organ and bleeding control during partial splenectomy is a big challenge. In this study conventional methods of electrocautery, absorbable suturing and advance methods of topical hemostat Surgicel® were compared to control bleeding during partial splenec- tomy. Twelve healthy dogs (n=4) were divided in A, B and C groups. After partial splenectomy Surgicel®, electrocautery and absorbable horizontal mattress sutures were used to control hemor- rhages in group A, B and C respectively. Bleeding time and loss of blood volume was evaluated during surgery. In addition, blood samples were taken on day 0 pre-surgery and on days 3, 10 and 17 post-surgery to evaluate changes in biochemical parameters after the application of dif- ferent hemostatic techniques. Ultrasonography was also performed at alternative days to check any gross changes in the spleen. Dogs in group A showed minimum bleeding time and loss of blood volume as compared to group B and C. Drop in red blood cells count was compared be- tween group A, B and C showing significant change (p≤0.05) at day 3, 10 and 17, while a sig- nificant decline in hemoglobin was found in group C followed by groups B and A at 3rd and 10th day. There was no difference between platelet counts in various groups. Ultrasonography showed no significant changes in the spleen parenchyma. It was concluded that Surgicel® was an effective material for controlling hemorrhage in veterinary patients.

Equine colic associated with small intestinal epiploic foramen entrapment.

Intestinal epiploic foramen entrapment (EFE) is an important differential diagnosis in horses with colic, but disappointing short- and long-term outcomes are reported in the scientific literature. Many horses are euthanased during surgery due to a predicted poor prognosis or due to uncontrollable intraoperative haemorrhage. The ileum is involved in the majority of cases. Several risk factors for the development of EFE are described; crib-biting/windsucking being the most important one. The recurrence rate of EFE is low despite the described risk factors, probably due to spontaneous closure of the EF after EFE colic surgery in about 40% of the cases. Safe laparoscopic techniques to obliterate the EF preventively in horses at risk or as part of surgical management of EFE at laparotomy are described. Methods for improved outcomes including utilising recently gained anatomical insights of the region while manipulating entrapped intestines, critical revision of anastomosis techniques and avoiding the occurrence of post-operative reflux are discussed.

Development and assessment of a pictorial guide to improve accuracy of visual estimation of blood loss of small animals.

OBJECTIVE: To investigate the accuracy of visual blood loss estimation from small animals among veterinary staff and final-year veterinary students, and the development and utility of a pictorial guide to improve estimation, in a veterinary hospital. STUDY DESIGN: Online anonymous voluntary survey. METHODS: A two-part online survey was circulated to voluntary participants at the University Veterinary Teaching Hospital Sydney, The University of Sydney, including students, nurses, interns, residents, general practitioners and specialists. The survey consisted of visual and brief descriptive depictions of blood loss scenarios involving small animals, principally including images of common surgical items and receptacles containing a bloodlike substance. Each participant estimated the blood volume (in millilitres) for each scenario two times, initially [Pre-Guide (PGD)] and then with the aid of a pictorial guide [With-Guide (WGD)]. The pictorial guide used similar images labelled with corresponding volumes. Data were analysed for normality with the Shapiro-Wilk test, corrected to absolute error and compared for statistical significance using the Wilcoxon signed-rank test or the Kruskal-Wallis test as appropriate (p < 0.05). RESULTS: A total of 59 participants provided 288 responses. The raw median PGD error was -16 mL (range -105 to 443 mL), indicating a tendency towards underestimation of the actual volume. The WGD median error was 18 mL (range -91 to 191 mL), indicating a tendency towards overestimation when using a pictorial guide (p < 0.0001). Data corrected to absolute error showed a PGD median error of 34 mL (range 0-443 mL) and WGD median error of 23 mL (range 0-191 mL; p < 0.0001). There were differences between the participant roles in the PGD phase but not when using the pictorial guide. CONCLUSIONS: and clinical relevance Participants generally underestimated surgical blood loss, with a wide variation, when visually estimating scenarios involving small animals. A pictorial guide improved estimation by reducing the absolute median error and narrowing the range.

Use of a vessel-sealing device versus conventional hemostatic techniques in dogs undergoing thyroidectomy because of suspected thyroid carcinoma.

OBJECTIVE: To compare use of a vessel-sealing device (VSD) versus conventional hemostatic techniques in dogs undergoing thyroidectomy because of suspected thyroid carcinoma. DESIGN: Retrospective cohort study. ANIMALS: 42 client-owned dogs undergoing thyroidectomy because of suspected thyroid carcinoma. PROCEDURES: Medical records of dogs treated at 4 referral centers from 2010 through 2016 were reviewed, and information was obtained on patient signalment, surgical technique, tumor-specific factors, and operative duration. Postoperative hospitalization time and complications were compared between dogs grouped on the basis of hemostatic technique. RESULTS: Thyroidectomy was performed with a VSD in 23 dogs and with conventional hemostatic techniques (ie, ligatures, hemoclips, or electrocautery) in 19 dogs. Hemostatic technique (ie, use of a VSD vs conventional hemostatic techniques) was the only factor significantly associated with operative duration (median time, 28 vs 41 minutes). Postoperative hospitalization times and complication rates did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that use of a VSD, rather than conventional hemostatic techniques, in dogs undergoing thyroidectomy because of suspected thyroid carcinoma resulted in shorter operative times without significantly affecting complication rates or postoperative hospitalization times.

Comparison of two vessel-sealing devices for laparoscopic-assisted ovariohysterectomy in dogs. / Vergleich zweier Instrumente zur Gefäßversiegelung bei der laparaskopisch-assistierten Ovariohysterektomie der Hündin.

OBJECTIVE: The study aimed to compare two different vessel-sealing devices (VSD) for laparoscopic-assisted ovariohysterectomy in dogs. MATERIAL AND METHODS: In this randomized, prospective clinical trial 12 consecutive, client-owned, healthy, intact female dogs of different breeds were included. The dogs had been admitted for elective laparoscopic-assisted ovariohysterectomy and were randomly assigned to one of two treatment groups. The LigaSure™ was used in one group (n = 6), and the other group was operated using the Caiman® (n = 6). Recorded variables were duration of all surgical steps, number of seals required for transection of each ovarian pedicle, number of previous uses of the VSD, and complications related to each VSD. RESULTS: Transection of the ovarian pedicles using the Caiman® required significantly fewer seals per ovary. However, overall surgical time was not significantly reduced. Intraoperative hemorrhage occurred in both groups but was more common in the LigaSure™ group. Emergency conversion to laparotomy was not required in any case. CONCLUSION AND CLINICAL RELEVANCE: The Caiman® can be safely used for laparoscopic-assisted ovariohysterectomy in dogs. In comparison with the Liga Sure™, the Caiman® requires fewer seals to transect ovarian pedicles, owing to the advantages of a longer working length and the first-tip closure mechanism.

Electrolyte and acid/base changes in dogs undergoing autologous blood transfusion via a cell salvage device.

This study reports electrolyte and acid/base disturbances observed in clinical cases receiving autologous transfusion of blood processed by a cell salvage device. The records of 12 client-owned dogs that received an autologous transfusion via a cell salvage device with pre- and post-autologous transfusion blood work available were reviewed. Blood work from the 12 case dogs was compared to blood work from 12 control dogs with similar diseases. Control dogs received similar surgical treatment and were administered a similar volume per kg of packed red blood cells as case dogs, but did not undergo autologous transfusion. Case dogs that received autologous transfusion via a cell salvage device were significantly more likely to experience a decrease in ionized calcium and magnesium levels post-transfusion than were control dogs. Calcium and magnesium levels should be closely monitored during and after autologous transfusion. Calcium and/or magnesium supplementation may be required.

Changements électrolytiques et acido-basiques chez les chiens subissant une transfusion sanguine autologue à l'aide d'un dispositif de récupération des cellules. Cette étude signale les perturbations électrolytiques et acido-basiques observées dans des cas cliniques recevant une transfusion de sang autologue traitée à l'aide d'un dispositif de récupération des cellules. On a évalué les dossiers de 12 chiens, appartenant à des propriétaires, qui avaient reçu une transfusion autologue à l'aide d'un dispositif de récupération des cellules et avaient subi des analyses sanguines avant et après la transfusion autologue. Les analyses sanguines des 12 chiens ont été comparées aux analyses de 12 chiens témoins atteints de maladies semblables. Les chiens témoins ont reçu des traitements chirurgicaux semblables et un volume semblable par kg de concentré de globules rouges que les chiens du cas, mais n'ont pas subi la transfusion autologue. Il était significativement plus probable que les chiens du cas qui avaient reçu une transfusion autologue à l'aide d'un dispositif de récupération des cellules subissent une baisse du niveau de calcium ionisé et de magnésium après la transfusion que les chiens témoins. Le niveau de calcium et de magnésium devrait être étroitement surveillé durant et après la transfusion autologue. Des suppléments de calcium et/ou de magnésium pourront être requis.(Traduit par Isabelle Vallières).

Efficacy of a half-grip technique using a fine tip LigaSure™, Dolphin Tip Sealer/Divider, on liver dissection in swine model.

BACKGROUND: Recently, a lot of energy devices in the surgical field, especially in the liver surgery, have been developed, and a fine tip LigaSure™, Dolphin Tip Sealer/Divider (DT-SD) also has been used frequently to dissect liver parenchyma as well as ultrasonically activated device (USAD). However, the utility of this instrument for liver dissection (LD) is still unknown. Moreover, to reduce bleeding during LD, a half-grip technique (HGT) was contrived. We herein report an experimental study in swine model to evaluate the feasibility and effectiveness of HGT using DT-SD for LD. METHODS: The swine model experiment was carried out under general anesthesia by veterinarians. LD was performed repeatedly by DT-SD with the HGT (Group A, n = 6), or the conventional clamp-crush technique (CCT) (Group B, n = 6), and by variable mode USAD (Group C, n = 6). The dissection length and depth (cm) as well as bleeding volume (g) were measured carefully, and the dissection area (cm(2)) and speed (cm(2)/min) were calculated precisely. Histological examinations of the dissection surfaces were also executed. Mann-Whitney's U test was used for Statistical analyses with variance at a significance level of 0.05. RESULTS: Among the three groups, the three averages of dissection lengths were unexpectedly equalized to 8.3 cm. The dissection area (cm(2)) was 9.9 ± 5.1 in Group A, 9.8 ± 4.7 in Group B, and 9.9 ± 4.5 in Group C. The mean blood loss during LD was 10.6 ± 14.8 g in Group A, 41.4 ± 39.2 g in Group B, and 34.3 ± 39.2 g in Group C. For Group A, the bleeding rate was the least, 0.9 ± 1.0 g/cm(2), and the average depth of coagulation was the thickest, 1.47 ± 0.29 mm, among the three groups (p < 0.05). The dissection speed in Group A (1.3 ± 0.3 cm(2)/min) was slower, than that in Group C (p < 0.05). CONCLUSIONS: This report indicates firstly that the HGT using DT-SD bring the least blood loss when compared with CCT or USAD. Although the HGT is feasible and useful for LD, to popularize the HGT, further clinical studies will be needed.

Cardiovascular function during maintenance of anaesthesia with isoflurane or alfaxalone infusion in greyhounds experiencing blood loss.

OBJECTIVE: To compare adequacy of oxygen delivery and severity of shock during maintenance of anaesthesia with isoflurane or alfaxalone infusion in greyhounds experiencing blood loss. STUDY DESIGN: Prospective, randomised study. ANIMALS: Twenty-four greyhounds (ASA I). METHODS: All greyhounds were premedicated with methadone (0.2 mg kg(-1) ) intramuscularly. Anaesthesia was induced with alfaxalone 2.5 mg kg(-1) intravenously. Following endotracheal intubation, the dogs were connected to an anaesthetic circle circuit delivering oxygen. Dogs were allocated to receive inhaled isoflurane or an intravenous infusion of alfaxalone for maintenance of anaesthesia. Isoflurane was initially administered to achieve an end-tidal concentration of 1.4% and alfaxalone was initially administered at 0.13 mg kg(-1)  minute(-1) . The dose of isoflurane or alfaxalone was adjusted during instrumentation to produce a clinically equivalent depth of anaesthesia. All dogs were mechanically ventilated to normocapnia (Pa CO2 35-40 mmHg; 4.67-5.33 kPa). Passive warming maintained core body temperature between 37 and 38 °C. Measured and calculated indices of cardiovascular function, including mean arterial blood pressure (MAP), cardiac index (CI), systemic vascular resistance index (SVRI), oxygen delivery index (D˙O2I), oxygen consumption index (V˙O2I) and oxygen extraction ratio (OER), were determined at baseline (60 minutes after start of anaesthesia) and after removal of 32 mL kg(-1) and 48 mL kg(-1) of blood. RESULTS: In all dogs, blood loss resulted in a significant decrease in MAP, CI, D˙O2 , and a significant increase in SVRI, V˙O2I , and OER. The changes in each of the indices did not differ significantly between dogs receiving isoflurane and dogs receiving alfaxalone. CONCLUSION AND CLINICAL RELEVANCE: No difference in oxygen delivery or severity of shock was observed when either inhaled isoflurane or intravenous alfaxalone infusion was used for maintenance of anaesthesia in greyhounds experiencing blood loss. There appears to be no clinical advantage to choosing one anaesthetic agent for maintenance of anaesthesia over the other in a dog experiencing blood loss.

Intraoperative bleeding in dogs from Grenada seroreactive to Anaplasma platys and Ehrlichia canis.

BACKGROUND: Frequent exposure of Grenadian dogs to Rhipicephalus sanguineus results in Anaplasma platys, and Ehrlichia canis seroreactivity. During elective surgeries, substantial intraoperative hemorrhage occurs in some seroreactive dogs. OBJECTIVES: To assess hemostatic parameters and bleeding tendencies as well as prevalence of PCR positivity in apparently healthy A. platys and E. canis seroreactive and seronegative free-roaming dogs from Grenada. ANIMALS: Forty-seven elective surgery dogs allocated to 4 groups: Seronegative control (n = 12), A. platys (n = 10), E. canis (n = 14) and A. platys, and E. canis (n = 11) seroreactive. METHODS: Preoperatively, hemostasis was assessed by platelet count, prothrombin time, activated partial thromboplastin time, and buccal mucosal bleeding time. Intra- and postoperative bleeding scores were subjectively assigned. Blood, spleen, bone marrow, and lymph node aspirates were tested by PCR. RESULTS: Bleeding scores in dogs coseroreactive for A. platys and E. canis were higher (P = .015) than those of seronegative dogs. A. platys DNA was amplified from 7/21 (33%) A. platys seroreactive dogs and from 1 E. canis seroreactive dog; E. canis DNA was amplified from 21/25 (84%) E. canis seroreactive dogs. E. canis DNA was amplified most often from blood, whereas A. platys DNA was amplified most often from bone marrow. CONCLUSIONS AND CLINICAL IMPORTANCE: Apparently healthy, free-roaming dogs coseropositive for A. platys and E. canis may have increased intraoperative bleeding tendencies despite normal hemostatic parameters. Future investigations should explore the potential for vascular injury as a cause for bleeding in these dogs. Improved tick control is needed for dogs in Grenada.

Autologous blood transfusion following red blood cell salvage for the management of blood loss in 3 dogs with hemoperitoneum.

OBJECTIVE: To describe the use of autologous transfusion using a red blood cell salvage device for the management of large volume hemorrhage in 3 dogs with hemoperitoneum. CASE SERIES SUMMARY: Three dogs were managed for large volume hemorrhage by autologous transfusion of red blood cells after cell salvage. In all cases, blood was salvaged from the abdominal cavity during surgery. The causes of hemorrhage included testicular arterial hemorrhage after castration, hepatic parenchymal hemorrhage following hepatic dissection for intrahepatic portosystemic shunt ligation, and intra-abdominal serosal hemorrhage associated with Angiostrongylus vasorum infection. In all cases, autologous transfusion was not associated with any identified complications and contributed to improved cardiovascular stability and packed cell volume. NEW OR UNIQUE INFORMATION PROVIDED: This case series is the first to describe the use of a semiautomated red blood cell salvage system for the clinical management of acute hemorrhage in dogs. This case series provides evidence that this procedure can be used safely and effectively for the management of clinical hemorrhage. On this basis, further veterinary evaluation can be justified.

Complications of laparoscopic cholecystectomy and its prevention: a review and experience of 400 cases.

In the present era laparoscopic cholecystectomy (LC) has become the gold standard treatment of choice for gallstone disease. This technique has made a new revolution in minimal invasive surgery, but also the spectrum of complications has changed. In this paper we shared our personal experience of LC in 400 hundred cases from January 2007 to December 2010, its complications and prevention. According to our experience the complications were liver bed injury (n=32, 8%), spilled gall stones (n=29, 7.25%), port site infection (n=11, 2.75%), vascular injury (n=18, 4.5%), conversion to open surgery (n=16, 4%), biliary leak (n=10, 2.5%), bowel injury (n=3, 0.75%), CBD stricture (n=4, 1%) and umbilical port hernia (n=2, 0.5%). Before the procedure, patient consent and awareness to all possible complications which may occur intra-operatively is very important. A good surgical team and experience in this procedure seems to prevent hazardous complications.

[Intraoperative sonography for examination of intervertebral disk extrusion in the dog]. / Einsatz der intraoperativen Sonographie zur Untersuchung des Bandscheibenvorfalls beim Hund. Eine intraoperative Studie.

OBJECTIVE: It has been shown that the components of the vertebral canal (dura mater, pia mater, subarachnoid space, spinal cord parenchyma and central canal) can be visualized intraoperatively with the help of ultrasonography. This study was conducted to document the intraoperative sonographical findings of disc extrusion and to determine imaging criteria for the localisation of the extrusion and the consecutive changes of the spinal cord parenchyma. MATERIAL AND METHODS: 43 dogs of different breeds with a diagnosed disc extrusion were sonographically examined immediately after establishing the surgical decompression (hemilaminectomy, laminectomy, ventral slot) (examination 1) and again after removal of disc material (examination 2). RESULTS: In all 34 patients the extruded disc material could be imaged sonographically appearing as inhomogenous, hyperechoic areas of moderate echogenicity. There was a distal shadowing dependent on the grade of calcification in 53% of the patients in examination 1 and in 79% at examination 2. Furthermore, a tendency towards a central localisation of the disc prolapse (67.6% in examination 1 and 57.1% examination 2) was observed. Intraoperative identification of disc extrusion could be accomplished in 79% of the cases. Intraoperative haemorrhage highly significantly impaired the assessment of the spinal cord (p<0.0001). CONCLUSION: Intraoperative spinal ultrasonography using a linear probe with a frequency from 5 to 10 MHz is a valuable tool for the visualization of spinal structures. It provides information for intraspinal navigation and evaluation of the extent of spinal lesions as well as the state of decompression. Bleeding has a negative influence on the visualization of the spinal canal.

Effects of 6% hetastarch (600/0.75) or lactated Ringer's solution on hemostatic variables and clinical bleeding in healthy dogs anesthetized for orthopedic surgery.

OBJECTIVE: To evaluate and compare hemostatic variables and clinical bleeding following the administration of 6% hetastarch (600/0.75) or lactated Ringer's solution (LRS) to dogs anesthetized for orthopedic surgery. STUDY DESIGN: Randomized blinded prospective study. ANIMALS: Fourteen, healthy adult mixed-breed hound dogs of either sex, aged 11-13 months, and weighing 20.8±1.2 kg. METHODS: The dogs were randomly assigned to receive a 10 mL kg(-1) intravenous (i.v.) bolus of either 6% hetastarch (600/0.75) or LRS over 20 minutes followed by a maintenance infusion of LRS (10 mL kg(-1)  hour(-1)) during anesthesia. Before (Baseline) and at 1 and 24 hours after bolus administration, packed cell volume (PCV), total protein concentration (TP), prothrombin time (PT), activated partial thromboplastin time (APTT), von Willebrand's factor antigen concentration (vWF:Ag), factor VIII coagulant activity (F VIII:C), platelet count, platelet aggregation, colloid osmotic pressure (COP) and buccal mucosal bleeding time (BMBT) were measured. In addition a surgeon who was blinded to the treatments assessed bleeding from the incision site during the procedure and at 1 and 24 hours after the bolus administration. RESULTS: Following hetastarch or LRS administration, the PCV and TP decreased significantly 1-hour post-infusion. APTT did not change significantly compared to baseline in either treatment group, but the PT was significantly longer at 1-hour post-infusion than at 24 hours in both groups. No significant change was detected for vWF:Ag, FVIII:C, platelet aggregation or clinical bleeding in either group. The BMBT increased while platelet count decreased significantly at 1-hour post-infusion in both groups. The COP decreased significantly in both treatment groups 1-hour post-infusion but was significantly higher 1-hour post-infusion in the hetastarch group compared to the LRS group. CONCLUSIONS AND CLINICAL RELEVANCE: At the doses administered, both hetastarch and LRS can alter hemostatic variables in healthy dogs. However, in these dogs undergoing orthopedic surgery, neither fluid was associated with increased clinical bleeding.

Comparison of 5 surgical techniques for partial liver lobectomy in the dog for intraoperative blood loss and surgical time.

OBJECTIVE: To compare surgical time and intraoperative blood loss for 5 partial liver lobectomy techniques in the dog. STUDY DESIGN: Experimental in vivo study. ANIMALS: Dogs (n=10). METHODS: Five surgical techniques (SurgiTie(™) ; LigaSure(™) ; Ultracision(®) Harmonic Scalpel [UAS]; Suction+Clip; Suction+thoracoabdominal stapler [TA]) for partial liver lobectomy in dogs were evaluated and compared for total surgical time and intraoperative blood loss. Body weight, activated clotting time (ACT), heart rate, and intraoperative blood pressure (BP) were recorded. Blood loss was determined by adding the weight of the blood soaked sponges during surgery (1 g=1 mL) to the amount of suctioned blood (mL). Surgical time (in seconds) was determined from the start of the lobectomy until cessation of bleeding from the stump. Mean surgical time and mean blood loss for each technique were compared using a Tukey's multiple comparison test. RESULTS: No significant differences were found between dogs for weight, ACT, heart rate, and intraoperative BP. No complications were seen with the SurgiTie(™) technique in 9 of 10 cases. There was no significant difference in surgical time between techniques however there was a significant difference for blood loss; the Suction+Clip method had significantly more blood loss than the other techniques. CONCLUSIONS: Skeletonization of the lobar vessels before individually clipping them (Suction+Clip) resulted in a higher blood loss than using Suction+TA, UAS, SurgiTie(™) or the LigaSure(™) device. The SurgiTie(™) appears to be an acceptable method for partial liver lobectomy. CLINICAL RELEVANCE: Although skeletonization and individually clipping the vessels had the highest blood loss, it still was <7.5% of total blood volume. All 5 techniques should be safe for clinical use in small to medium sized dogs up to 26 kg.

Endothelin receptor subtype A blockade does not affect the haemodynamic recovery from haemorrhage during xenon/remifentanil or isoflurane/remifentanil anaesthesia in dogs.

OBJECTIVE: To test the compensatory role of endothelin-1 when acute blood loss is superimposed on anaesthesia, by characterizing the effect of systemic endothelin receptor subtype A (ET(A)) blockade on the haemodynamic and hormonal responses to haemorrhage in dogs anaesthetized with xenon/remifentanil (X/R) or isoflurane/remifentanil (I/R). STUDY DESIGN: Prospective experimental randomized controlled study. ANIMALS: Six female Beagle dogs, 13.4 +/- 1.3 kg. METHODS: Animals were anaesthetized with remifentanil 0.5 microg kg(-1) minute(-1) plus either 0.8% isoflurane (I/R) or 63% xenon (X/R), with and without (Control) the systemic intravenous endothelin receptor subtype A antagonist atrasentan (four groups, n = 6 each). After 60 minutes of baseline anaesthesia, the dogs were bled (20 mL kg(-1)) over 5 minutes and hypovolemia was maintained for 1 hour. Continuous haemodynamic monitoring was performed via femoral and pulmonary artery catheters; vasoactive hormones were measured before and after haemorrhage. RESULTS: In Controls, systemic vascular resistance (SVR), vasopressin and catecholamine plasma concentrations were higher with X/R than with I/R anaesthesia at pre-haemorrhage baseline. The peak increase after haemorrhage was higher during X/R than during I/R anaesthesia (SVR 7420 +/- 867 versus 5423 +/- 547 dyne seconds cm(-5); vasopressin 104 +/- 23 versus 44 +/- 6 pg mL(-1); epinephrine 2956 +/- 310 versus 177 +/- 99 pg mL(-1); norepinephrine 862 +/- 117 versus 195 +/- 33 pg mL(-1), p < 0.05). Haemorrhage reduced central venous pressure from 3 +/- 1 to 1 +/- 1 cm H(2)O (I/R, ns) and from 8 +/- 1 to 5 +/- 1 cm H(2)O (X/R, p < 0.05), but did not reduce mean arterial pressure, nor cardiac output. Atrasentan did not alter the haemodynamic and hormonal response to haemorrhage during either anaesthetic protocol. CONCLUSIONS AND CLINICAL RELEVANCE: Selective ET(A) receptor blockade with atrasentan did not impair the haemodynamic and hormonal compensation of acute haemorrhage during X/R or I/R anaesthesia in dogs.

Comparison of a method using the HemoCue near patient testing device with a standard method of haemorrhage estimation in dogs undergoing spinal surgery.

OBJECTIVE: To compare an estimate of blood loss obtained using measurements from the Hemocue photometer with a standard estimate in dogs undergoing spinal surgery. STUDY DESIGN: Prospective clinical study. ANIMALS: Twenty-nine client-owned dogs. METHODS: During surgery, blood and all lavage fluids were collected in the suction container and on to swabs. To prevent blood clot formation in the suction container, 10 mL citrate-phosphate dextrose adenine (CPDA) was added. At the end of the procedure, the total volume in the suction container was recorded. It was shaken to ensure uniformity and a 5 mL sample tested with the HemoCue photometer. Blood loss in the suction container was calculated as follows: Blood in suction (mL) = volume in bottle (mL) x [suction haemoglobin (Hb) concentration (g dL(-1))/pre-operative Hb concentration (g dL(-1))]. This volume was added to the estimated volume of blood on the swabs (weight of soaked swabs minus that of dry swabs) to provide the Hemocue estimate of total blood loss. A standard haemorrhage estimate was performed using the volume of fluid in the suction container at the end of surgery in excess of the total volume of lavage fluid available, minus 10 mL CPDA. This volume was added to the estimated volume of blood on the swabs to provide the standard estimate of total blood loss. Data were analyzed with a paired t-test. Retrospective power calculations demonstrated an 80% power to detect a mean difference of 25 mL between the two methods with a level of significance of 0.05. RESULTS: There was no significant difference in calculated blood loss between the two methods (p = 0.8, mean difference: -2 mL, 95% CI: -20 to 16 mL). CONCLUSIONS AND CLINICAL RELEVANCE: The HemoCue may be used to help estimate blood loss in dogs undergoing spinal surgery.