Comparison of hemodynamic effects of propofol or alfaxalone during induction in dogs.

This randomized prospective clinical study aimed to compare the hemodynamic effects of propofol and alfaxalone for the induction of anesthesia in dogs. Thirty-one healthy dogs undergoing various procedures in a private referral center were premedicated with intramuscular acepromazine (0.015 mg/kg) and methadone (0.15 mg/kg). They then received 5 mg/kg of propofol over 30 s for induction, followed by a maintenance dose of 25 mg/kg/h (Group P), or 2 mg/kg of alfaxalone over 30 s for induction, followed by a continuous rate infusion of 10 mg/kg/h (Group A). Heart rate (HR), mean arterial pressure (MAP), and the velocity time integral (VTI) of the aortic blood flow using transthoracic echocardiography were measured before anesthetic induction and every 15 s for 180 s. Dogs not adequately anaesthetized for intubation were excluded from the hemodynamic evaluation. Events of hypotension (any MAP value lower than 60 mmHg) were also recorded. Statistical analyses utilized ANOVA for repeated measures, two-way repeated measures ANOVA, paired t-tests, or Wilcoxon signed rank-test as appropriate. Significance was set at p < 0.05. Two dogs in Group P (2/14) and 3 in Group A (3/17) were excluded from the study because the anesthesia plane was too light to allow intubation. Treatment P resulted in a significant decrease in MAP between 45 and 75 s during the induction period, with no significant variation in HR, VTI, and VTI*HR. In treatment A, HR increases between 60 and 105 s, VTI decreases at 150-180 s. Analysis between groups did not show any difference in MAP (p = 0.12), HR (p = 0.10), VTI (p = 0.22) and VTI*HR (p = 0.74). During induction, hypotension was detected in 3/12 (25%) dogs in Group P and 1/14 (8%) in Group A. In healthy premedicated dogs, propofol and alfaxalone induction produce similar hemodynamic variations. Propofol induction results in a short-term reduction in MAP, whereas alfaxalone induction preserves MAP and cardiac output by significantly increasing heart rate.

A novel approach to ear pain in the horse: A case report.

Background: During electrochemotherapy (ECT), a chemotherapeutic drug is injected into the tumor and then an electroporation is provided. In horses, ear manipulation may be very painful, and combining a loco-regional technique with sedation might be a good option to avoid anesthesia-related risks. A two-injection-point block of the internal and external pinna and acoustic meatus was described in horse cadavers, and it permitted complete stain of all three branches of the great auricular nerve (GAN), internal auricular nerve branch (IAB), lateral auricular branch (LAB), and caudal auricular nerve (CAN), suggesting a lower risk of intra-parotid injection during the IAB and LAB block. Case Description: An 8-year-old Italian jumping gelding presented for ECT to treat a fibroblastic sarcoid in the left medial pinna. After intravenous sedation with acepromazine, romifidine, and butorphanol, a two-injection-point block was provided as previously described. The block of the GAN was blind, whereas an electrical nerve locator was used for the IAB, LAB, and CAN. A total of 12 ml of 0.5% ropivacaine was injected. The ECT was safely performed without any difficulties. The horse well tolerated the procedure and completely recovered 75 minutes after sedation. No complications were detected. Conclusion: The described approach seems feasible and suitable for the blockade of the sensory innervation of the equine ear in the case of ECT.

Surgical Treatment of Nonmineralized Supraspinatus Tendinopathy in Dogs: A Retrospective Long-Term Follow-Up.

(1) Background: two forms of supraspinatus tendinopathy (ST) have been reported in dogs: mineralized and non-mineralized. Surgical treatment consists of longitudinal incisions (splitting) in the tendon of insertion of the supraspinatus muscle. The purpose of this retrospective study is to describe the diagnostic workout, the surgical procedure and the short and long term follow up of dogs treated for non-mineralized ST. (2) Methods: medical records (2010-2017) of dogs diagnosed with non-mineralized ST that underwent surgical treatment were reviewed. Data retrieved were: signalment, history, clinical signs, orthopaedic examination findings, diagnostic imaging findings, surgical treatment, histopathologic diagnosis and clinical outcome. (3) Results: A total of 27 dogs met the inclusion criteria. The most consistent clinical findings were intermittent lameness accompanied by pain on palpation of the insertion of the supraspinatus. Magnetic resonance imaging (MRI) of 27 shoulders distended sheaths of the biceps tendon (10/27), compression of the biceps brachii tendon sheaths (5/27) and enlargement of the supraspinatus tendon (3/27) were observed. The most prominent histologic finding was severe myxomatous degeneration in all 27 samples. Resolution of lameness was achieved in 80% of the cases surgically treated without any further lameness episodes in the long-term follow-up. (4) Conclusions: the surgical splitting of the non-mineralized supraspinatus tendon is an effective procedure with no intra-operative complications and a low incidence of minor (18%) and major (4%) complications.

Sentinel lymph node mapping with computed tomography lymphography for mast cell tumours and a comparison between regional and sentinel lymph node histological status: Sixty-two cases.

It is known that the regional lymph node (RLN) may not correspond to the sentinel lymph node (SLN) (the first lymph node draining the tumour), and many diagnostic techniques have recently been aimed at its detection. Although lymphoscintigraphy is the gold standard in both human and veterinary medicine for SLN mapping, it is relatively unavailable in veterinary medicine due to costs and difficult management of the radiotracer. This prospective study evaluated, as a first aim, the feasibility and sensitivity of the computed tomography lymphography (CTL) in detecting the SLN in 62 mast cell tumours (MCTs). The second aim was to evaluate the accuracy of the CTL in identifying the most representative lymph node of the patient's lymphatic status; the histological status of the SNL was compared with that of the RLN, to see in how many cases the patient's stage would have changed according to the RLN. When the RLN turned out to be also the SLN it was decided to excise, as a control LN, the one localised in the neighbourhood of the MCT (neighbouring lymph node; NLN). The detection rate was 90%, with failure of SLN identification in six cases. In 18 (32%) of 56 MCTs with a diagnostic CTL, the SLN did not correspond to the RLN. Forty-five MCTs were surgically removed, together with their corresponding SLN and RLN/NLN. Since the clinical stage of the patient would have changed in only 7% of cases, CTL is a reliable method of detecting the SLN and, for staging purposes, there is no need to remove other LNs.

A comparison of 0.375% ropivacaine psoas compartment block and 2% prilocaine spinal anaesthesia in dogs undergoing tibial plateau levelling osteotomy.

BACKGROUND: In dogs undergoing routine elective orthopaedic surgeries carried out as same-day surgeries regional anaesthetic techniques (RATs) should aim to produce analgesia but minimising the postoperative motor dysfunction. Our objective was to compare the perioperative analgesic effects and the time to motor recovery between spinal anaesthesia (SA) with hyperbaric solution of prilocaine 2% (mg = 4 x [0.3 × BW (kg) + 0.05 × SCL (cm)]) and morphine (0.03 mg/kg) and combined ultrasound (US) and electro stimulator-guided psoas compartment and ischiatic nerve block (PB) with ropivacaine 0.375% (0.45 mL/kg). Dogs undergoing tibial plateau levelling osteotomy (TPLO) were randomly assigned to receive either SA or PB. Procedural failure, perioperative rescue analgesia, motor block recovery and complications were recorded. RESULTS: Procedural failure rate (PFR) was 19% (7 out of 36) for SA and 9% (3 out of 32) for PB (p = 0.31). Intraoperative rescue analgesia was administered to 6/29 (21%) SA group dogs and in 15/29 (52%) PB group dogs, respectively (p = 0.03). At 3 h after RAT, percentage of dogs with complete block recovery was 25/29 (86%) and 25/29 (86%) in group SA and PB, respectively (p = 1). Two cases of pruritus and one case of urinary retention were recorded in the SA group. Residual ischiatic nerve block was noted at 12 h after RAT in 2/15 (13%) of dogs in group PB; it completely resolved 24 h after RAT. CONCLUSIONS: SA with prilocaine 2% and PB with ropivacaine 0.37% were found suitable for dogs undergoing same-day TPLO surgery. Pruritus and urinary retention in SA and residual block in both groups might occasionally delay the time of discharge.

A case of priapism following intrathecal morphine injection in a dog.

Background: Priapism refers to prolonged erection unrelated to sexual stimulation, with severe sequelae unless treated. In humans, it is a rare complication associated with epidural or spinal opioid administration. Its pathophysiology is unclear. This is the first report of priapism following neuraxial anesthesia in dog. Case Description: An intrathecal morphine injection (30 mcg/kg) at L5-L6 for postoperative analgesia was given at the end of surgery for removal of cutaneous mastocytomas of the abdomen and left axillary lymphadenectomy. Painless penile erection occurred 2 hours later and lasted 6 hours, before spontaneously resolving 7-8 hours after the injection. No pain or other adverse events (e.g., nausea, urinary retention, and itching) were recorded. Recovery was complete without treatment. Conclusion: Painless, self-resolving priapism is a rare complication associated with intrathecal morphine injection in dogs.

Prognostic impact of bone invasion in canine oral malignant melanoma treated by surgery and anti-CSPG4 vaccination: A retrospective study on 68 cases (2010-2020).

Prognosis of canine oral malignant melanoma encompasses clinical, histological and immunohistochemical parameters. The aim of this study was to evaluate the prognostic impact of bone invasion in oral canine melanoma. Sixty-eight dogs bearing oral melanoma staged II and III that underwent surgery and anti-CSPG4 electrovaccination, with available histological data and a minimum follow up of minimum 1 year, were retrospectively selected. Bone invasion was detected on imaging and/or histology. Median survival time of dogs with evidence of bone invasion (group 1) was 397 days and significantly shorter compared with dogs with oral melanomas not invading the bone (group 2, 1063 days). Dogs with tumours localised at the level of the cheek, lip, tongue and soft palate (soft tissue - group 3) lived significantly longer compared with dogs having tumours within the gingiva of the maxilla or mandible (hard tissue - group 4) with a median survival time of 1063 and 470 days, respectively. Within group 4, the subgroup of dogs with tumours not invading the bone (group 5) showed a significant prolonged survival time (972 days) in comparison with dogs of group 1 (bone invasion group). Similar results were obtained for the disease-free intervals amongst the different groups. Statistical analysis showed that Ki67 and mitotic count were correlated with shorter survival in patients of group 1 (with bone invasion). Bone invasion should always be assessed since it appears to be a negative prognostic factor.

Difference in outcome between curative intent vs marginal excision as a first treatment in dogs with oral malignant melanoma and the impact of adjuvant CSPG4-DNA electrovaccination: A retrospective study on 155 cases.

Canine oral malignant melanoma is locally invasive and highly metastatic. At present, the best option for local control is en bloc excision followed by radiation if excision margins are incomplete. Adjuvantly, the role of chemotherapy is dubious while immunotherapy appears encouraging. This retrospective study evaluated 155 dogs with oral malignant melanomas (24 stage I, 54 stage II, 66 stage III and 11 stage IV) managed in a single institution. The aim was to evaluate the differences in median survival time (MST) and disease-free interval (DFI) between dogs which, at presentation, were treated surgically with a curative intent (group 1) vs those marginally excised only (group 2). MST in group 1 was longer than in group 2 (594 vs 458 days), but no significant difference was found (P = .57); a statistical difference was, however, found for DFI (232 vs 183 days, P = .008). In the subpopulation of vaccinated dogs, the impact of adjuvant anti-CSPG4 DNA electrovaccination was then evaluated (curative intent, group 3, vs marginal, group 4); a significant difference for both MST (1333 vs 470 days, respectively, P = .03) and DFI (324 vs 184 days, respectively, P = .008) was found. Progressive disease was significantly more common in dogs undergoing marginal excision than curative intent excision for both the overall population (P = .03) and the vaccinated dogs (P = .02). This study pointed out that, after staging, wide excision together with adjuvant immunotherapy was an effective approach for canine oral malignant melanoma.

Construction and preliminary characterization of human recombinant proNGF-A variant.

The precursor of Nerve Growth Factor (proNGF) is the predominant form of NGF in the brain, where its tissue levels are increased in neurodegenerative diseases. proNGF exists in two main splicing variants, the long proNGF-A and the short proNGF-B. We demonstrated that proNGF-B is selectively increased in the hippocampus of rats affected by early diabetic encephalopathy and that native, purified proNGFs elicit different responses when used to stimulate PC12 cells. Therefore, the evaluation of the proNGF-B/proNGF-A ratio may be of important diagnostic and prognostic value in pathologies characterized by dysfunctions of NGF system. To date there is not clear pharmacological characterization of the different proNGFs variants, due to the lack of a proper recombinant proNGF-A. Using a bioinformatics approach, we predicted aminoacid sites involved in proNGF-A intracellular cleavage/conversion into proNGF-B, we cloned and expressed non-cleavable proNGF-A in HeLa cells and pursued a first characterization of their secretion modalities. Finally, we studied the biological effects of different proNGF-A mutants, stimulating PC12 cells with conditioned media from transfected HeLa cells. Based on our results, we propose the A73Y mutation as essential to obtaining an intact proNGF-A, limiting its conversion to proNGF-B. proNGF-A A73Y is probably released in an activity dependent manner and, when supplied to PC12 cells, shows a moderate differentiative capacity opposed to high neuroprotective potential. This preliminary study lays the foundation for future research aimed at uncovering the selective biological activities of proNGF-A and proNGF-B, and at developing pharmacological treatments that target the unbalance of proNGF system, induced by neurodegeneration.

Inter-rater and inter-device reliability of mechanical thresholds measurement with the Electronic von Frey Anaesthesiometer and the SMALGO in healthy cats.

OBJECTIVES: The aim of this study was to compare the Electronic von Frey Anaesthesiometer (EVF) and the Small Animal ALGOmeter (SMALGO), used to measure sensory thresholds in 13 healthy cats at both the stifle and the lumbosacral joint, in terms of inter-rater and inter-device reliability. METHODS: Two independent observers carried out the sets of measurements in a randomised order, with a 45 min interval between them, in each cat. The inter-rater and inter-device reliability were evaluated by calculating the inter-rater correlation coefficient (ICC) for each pair of measurements. The Bland-Altman method was used as an additional tool to assess the level of agreement between the two algometers. RESULTS: The mean ± SD sensory thresholds measured with the EVF were 311 ± 116 g and 378 ± 178 g for the stifle and for the lumbosacral junction, respectively, whereas those measured with the SMALGO were 391 ±172 g and 476 ± 172 g. The inter-rater reliability was fair (ICC >0.4) for each pair of measurements except those taken at the level of the stifle with the SMALGO, for which the level of agreement between observers A and B was poor (ICC = 0.01). The inter-device reliability was good (ICC = 0.73; P = 0.001). The repetition of the measurements affected reliability, as the thresholds obtained after the 45 min break were consistently lower than those measured during the first part of the trial (P = 0.02). CONCLUSIONS AND RELEVANCE: The EVF and the SMALGO may be used interchangeably in cats, especially when the area to be tested is the lumbosacral joint. However, when the thresholds are measured at the stifle, the inter-observer reliability is better with the EVF than with the SMALGO. The reliability decreases when the measurements are repeated within a short time interval, suggesting a limited clinical applicability of quantitative sensory testing with both algometers in cats.

Combination of magnesium sulphate and ropivacaine epidural analgesia for hip arthroplasty in dogs.

OBJECTIVE: The aim of this study was to determine whether lumbosacral epidural administration of magnesium sulphate added to ropivacaine prolongs and improves perioperative analgesia, without adverse effects on motor block duration or hind limb neurological function, in dogs undergoing hip arthroplasty. STUDY DESIGN: Investigator-blind, controlled, randomized, prospective clinical trial. ANIMALS: A group of 20 client-owned dogs undergoing hip arthroplasty were allocated randomly to either group C (control, 1 mg kg-1epidural ropivacaine) or group M (magnesium, epidural injection of 1 mg kg-1 ropivacaine and 2 mg kg-1magnesium sulphate). METHODS: All dogs were premedicated with intramuscular acepromazine. General anaesthesia was induced with propofol and maintained with isoflurane in oxygen. Intraoperatively, nociception was assessed based on changes in heart rate, respiratory rate and mean arterial pressure above baseline values. Postoperatively, pain was evaluated with a Sammarco pain score, a Glasgow pain scale and a visual analogue scale (VAS). Tarlov's scale was used to quantify motor block. All dogs were evaluated at recovery and then 1, 2, 3, 4, 5 and 24 hours after that. Rescue analgesia was provided during surgery with fentanyl and, postoperatively, with buprenorphine. Groups were compared using one-way repeated-measure analysis of variance followed by the Holm-Sidak method for multiple comparison or nonparametric tests when appropriate. RESULTS: The two treatment groups did not differ (p > 0.05) with respect to intraoperative physiological variables, rescue analgesia, postoperative pain scores (Sammarco q = 1.00; Glasgow q = 3.10; VAS q = 0.50) and duration of the motor block (Tarlov's q = 2.40). CONCLUSIONS AND CLINICAL RELEVANCE: The addition of epidural magnesium to ropivacaine did not improve or prolong the analgesia provided by ropivacaine alone. Further studies are needed to determine whether an epidural magnesium dose of >2 mg kg-1 would exert better analgesia, without causing adverse effects, in dogs undergoing orthopaedic surgery.

CSPG4-specific immunity and survival prolongation in dogs with oral malignant melanoma immunized with human CSPG4 DNA.

PURPOSE: Due to the many similarities with its human counterpart, canine malignant melanoma (cMM) is a valuable model in which to assess the efficacy of novel therapeutic strategies. The model is herein used to evaluate the immunogenicity, safety, and therapeutic efficacy of a human chondroitin sulfate proteoglycan-4 (hCSPG4) DNA-based vaccine. The fact that homology between hCSPG4 and cCSPG4 amino-acidic sequences stands at more than 80% provides the rationale for using an hCSPG4 DNA vaccine in the cMM model. EXPERIMENTAL DESIGN: Dogs with stage II-III surgically resected CSPG4-positive oral MM were subjected to monthly intramuscular plasmid administration, which was followed immediately by electroporation (electrovaccination) for at least 6, and up to 20, months. The immunogenicity, safety, and therapeutic efficacy of the vaccine have been evaluated. RESULTS: hCSPG4 electrovaccination caused no clinically relevant local or systemic side effects and resulted in significantly longer overall and disease-free survival times in 14 vaccinated dogs as compared with 13 nonvaccinated controls. All vaccinated dogs developed antibodies against both hCSPG4 and cCSPG4. Seven vaccinated dogs were also tested for a cCSPG4-specific T-cell response and only two gave a detectable interferon (IFN)γ response. CONCLUSION: Xenogeneic electrovaccination against CSPG4 is able to overcome host unresponsiveness to the "self" antigen and seems to be effective in treating cMM, laying the foundation for its translation to a human clinical setting.