Neutrophil extracellular traps and active myeloperoxidase concentrate in lamellar tissue of equids with naturally occurring laminitis.

Laminitis is a pathology of the equine digit ultimately leading to a failure of the dermo-epidermal interface. Neutrophil activation is recognized as a major factor in SIRS-associated laminitis and has recently been described in induced endocrinopathic laminitis evidenced by the presence of myeloperoxidase (MPO). Neutrophil extracellular traps (NET) are released with neutrophil activation. This study aimed to investigate the presence and activity of MPO and NET in the lamellar tissue of equids presented with naturally occurring laminitis. Samples of lamellar tissue of five horses and five donkeys presented with laminitis, as well as eight control horses without laminitis, were collected. Lamellar tissue extracts were submitted to ELISA and specific immuno-extraction followed by enzymatic detection (SIEFED) assays to confirm the presence and activity of both MPO and NET. Lamellar sections were also immunohistopathologically stained for MPO and NET. Analysis of lamellar tissue extracts revealed that laminitis cases had significantly higher levels of total MPO concentration, MPO activity, and NET-bound MPO activity in comparison to control horses. Moreover, a strong correlation was identified between the activity of NET-bound MPO and the total MPO activity, which suggests that MPO activity partly originates from NET-bound MPO. Immunohistochemical staining showed that MPO and NET labelling in laminitis cases was moderate to marked, primarily in the epidermis and in inflammatory infiltrates containing neutrophils, while labelling in control horses was minimal. This article constitutes the first indication of the presence and activity of NET-bound MPO in the lamellar tissue of horses and donkeys with naturally occurring laminitis. Targeting these substances may provide new treatment possibilities for this debilitating disease.

Perioperative analgesic efficacy of lumbar erector spinae plane block in dogs undergoing hemilaminectomy: a randomized blinded clinical trial.

OBJECTIVE: To evaluate the perioperative analgesic effect of the unilateral lumbar erector spinae plane block (ESPBL) in dogs undergoing hemilaminectomy. STUDY DESIGN: Randomized, blinded clinical study. ANIMALS: A total of 30 client-owned dogs undergoing thoracolumbar or lumbar hemilaminectomy for intervertebral disc extrusion (IVDE). METHODS: Dogs were randomly assigned to receive a unilateral ESPBL, performed either with 0.4 mL kg-1 ropivacaine 0.5% [group ROPI (n = 15)] or with saline solution [CNT group (n = 15)]. Dogs were premedicated intravenously (IV) with acepromazine 5 µg kg-1 and methadone 0.2 mg kg-1, general anaesthesia was induced by administering IV midazolam 0.2 mg kg-1 and propofol to effect and maintained with isoflurane. Fentanyl was administered as rescue analgesia. Bradycardia [heart rate (HR) < 60 beats minute-1] with hypotension was treated with atropine IV. The Short-Form of the Glasgow Composite Pain Scale was used pre- and postoperatively at 1, 2, 4, 8, 12, 16, 20 and 24 hours after extubation, and methadone 0.2 mg kg-1 was administered IV when pain score was ≥ 5/20. HR and end-tidal concentration of isoflurane (Fe'Iso) were compared between groups with anova combined with a Dunnet's post hoc test. Time to the first rescue methadone and total dose of fentanyl (FENtot, µg kg-1 hour-1) and methadone (METtot, mg kg-1) in the first 24 postoperative hours were compared using unpaired Student's t test. Postoperative pain scores were compared with the Mann-Whitney test and atropine administration with a Fisher's exact test; p < 0.05. RESULTS: HR, Fe'Iso, FENtot, METtot and atropine administration were significantly lower in group ROPI compared to CNT. Postoperative analgesic effect was significantly longer, and pain scores were significantly lower in group ROPI for all time points. CONCLUSIONS AND CLINICAL RELEVANCE: Unilateral ESPBL with ropivacaine reduced perioperative opioid consumption and the occurrence of bradycardia in dogs undergoing hemilaminectomy.

Free Radical Inhibition Using a Water-Soluble Curcumin Complex, NDS27: Mechanism Study Using EPR, Chemiluminescence, and Docking.

There is a growing interest in the use of natural compounds to tackle inflammatory diseases and cancers. However, most of them face the bioavailability and solubility challenges to reaching cellular compartments and exert their potential biological effects. Polyphenols belong to that class of molecules, and numerous efforts have been made to improve and overcome these problems. Curcumin is widely studied for its antioxidant and anti-inflammatory properties as well as its use as an anticancer agent. However, its poor solubility and bioavailability are often a source of concern with disappointing or unexpected results in cellular models or in vivo, which limits the clinical use of curcumin as such. Beside nanoparticles and liposomes, cyclodextrins are one of the best candidates to improve the solubility of these molecules. We have used lysine and cyclodextrin to form a water-soluble curcumin complex, named NDS27, in which potential anti-inflammatory effects were demonstrated in cellular and in vivo models. Herein, we investigated for the first time its direct free radicals scavenging activity on DPPH/ABTS assays as well as on hydroxyl, superoxide anion, and peroxyl radical species. The ability of NDS27 to quench singlet oxygen, produced by rose bengal photosensitization, was studied, as was the inhibiting effect on the enzyme-catalyzed oxidation of the co-substrate, luminol analog (L012), using horseradish peroxidase (HRP)/hydrogen peroxide (H2O2) system. Finally, docking was performed to study the behavior of NDS27 in the active site of the peroxidase enzyme.

Postoperative Analgesic Effect of Bilateral Quadratus Lumborum Block (QLB) for Canine Laparoscopic Ovariectomy: Comparison of Two Concentrations of Ropivacaine.

The aim of this study was to evaluate the effect of the transverse quadratus lumborum block (QLBLQL-T) on time to the first postoperative rescue analgesia in dogs submitted to laparoscopic ovariectomy. A total of twenty-three female dogs were included. Dogs were randomly assigned to receive a bilateral QLBLQL-T, performed either with 0.3 mL kg-1 ropivacaine 0.5% [group QLB0.5% (n = 8)] or with ropivacaine 0.33% [group QLB0.33% (n = 8)] or a fentanyl-based protocol [group No-QLB (n = 7)]. Dogs were premedicated intravenously (IV) with fentanyl 5 mcg kg-1, general anesthesia was induced IV with propofol and maintained with sevoflurane. Invasive mean arterial pressure (MAP) values were recorded five minutes before and five minutes after performing the QLBLQL-T. The short-form of the Glasgow composite measure pain scale was used every hour after extubation, and methadone 0.2 mg kg-1 was administered IV when pain score was ≥5/24. Kolmogorov-Smirnov test, ANOVA test combined with Tukey post hoc test, Student's T-test and Chi-square test were used to analyze data; p < 0.05. Time from QLBLQL-T to the first rescue analgesia was significantly longer in QLB0.5% than in group QLB0.33% and No-QLB. MAP pre- and post-block decreased significantly only in group QLB0.33%.

Renal Agenesis, Extramural Ectopic Ureter, and Nonfunctioning Urinary Bladder: A Difficult Clinical Case with an Innovative Approach.

Summary. A 7-month-old female Jack Russell Terrier weighing 4.6 kg was referred to a veterinary hospital for persistent urinary incontinence. Blood test results and vital signs were within the normal range. Computed tomography allowed the diagnosis of extramural ectopic ureter and unilateral renal agenesis. After the first neoureterocystostomy surgery, the dog had severe complications, such as hydroureter and hydronephrosis, so a second surgery was performed. A commercial ureteral stent was not an option, and it was decided to fabricate a homemade stent to avoid euthanasia. The stent used was a soft, DEHP-free PVC tube with a lumen of 3 × 4.1 mm and a length of approximately 40 mm that connected the ureter to the urinary bladder. Two years after surgery, the dog is in good general condition, and the results of regularly performed blood and urine tests are within the normal range for dogs.

Bioactive surface coating for preventing mechanical heart valve thrombosis.

BACKGROUND: Prosthetic heart valves are the only treatment for most patients with severe valvular heart disease. Mechanical valves, made of metallic components, are the most long-lasting type of replacement valves. However, they are prone to thrombosis and require permanent anticoagulation and monitoring, which leads to higher risk of bleeding and impacts the patient's quality of life. OBJECTIVES: To develop a bioactive coating for mechanical valves with the aim to prevent thrombosis and improve patient outcomes. METHODS: We used a catechol-based approach to produce a drug-releasing multilayer coating adherent to mechanical valves. The hemodynamic performance of coated Open Pivot valves was verified in a heart model tester, and coating durability in the long term was assessed in a durability tester producing accelerated cardiac cycles. Coating antithrombotic activity was evaluated in vitro with human plasma or whole blood under static and flow conditions and in vivo after surgical valve implantation in a pig's thoracic aorta. RESULTS: We developed an antithrombotic coating consisting of ticagrelor- and minocycline-releasing cross-linked nanogels covalently linked to polyethylene glycol. We demonstrated the hydrodynamic performance, durability, and hemocompatibility of coated valves. The coating did not increase the contact phase activation of coagulation, and it prevented plasma protein adsorption, platelet adhesion, and thrombus formation. Implantation of coated valves in nonanticoagulated pigs for 1 month efficiently reduced valve thrombosis compared with noncoated valves. CONCLUSION: Our coating efficiently inhibited mechanical valve thrombosis, which might solve the issues of anticoagulant use in patients and the number of revision surgeries due to valve thrombosis despite anticoagulation.

Analytical Performance Evaluation of the New GEM® Premier™ 5000 in Comparison to the Epoc® Blood Gas Analyzer in Horses.

Different blood gas analyzers are used in equine practice. Every machine needs to be validated, as they have not been designed for use in horses. The aim of this study was to compare the newly marketed GEM5000 machine to the formerly validated epoc machine for blood gas analysis in horses. In this prospective, non-blinded, comparative laboratory analyzer study, 43 equine blood samples were analyzed on both analyzers and values were compared between the two machines via Lin's concordance analysis, Passing-Bablok regression analysis and Bland-Altman plots. Duplicate measurements were conducted on the GEM5000 machine to evaluate precision. The GEM5000 failed to achieve the required precision for tHb, Hct and iCa2+, but achieved acceptable precision for all other parameters. Concordance correlation analysis revealed poor correlation for Na+, Cl-, iCa2+, K+, Hct and tHb, while there was an at least moderate agreement for all other parameters. Passing-Bablok regression revealed significant constant bias for pCO2, pO2, Cl-, and iCa2+ and significant proportional bias for pCO2, iCa2+ and SO2. Bland-Altman analysis revealed significant systematic bias for Na+, Cl-, iCa2+, K+, Hct, tHb and SO2. This study shows that while precision of the GEM5000 is good, values should not be used interchangeably with data obtained from other blood gas analyzers.

Effects of perineural dexmedetomidine combined with ropivacaine on postoperative methadone requirements in dogs after tibial plateau levelling osteotomy: a two-centre study.

OBJECTIVE: To evaluate the efficacy of a perineural injection of dexmedetomidine combined with ropivacaine for reducing postoperative methadone requirements in dogs after tibial plateau levelling osteotomy (TPLO). STUDY DESIGN: A prospective, clinical, randomized and blinded trial. ANIMALS: A total of 58 client-owned dogs. METHODS: Ultrasound-guided midfemoral sciatic and inguinal femoral nerve blocks with ropivacaine (1 mg kg-1 per nerve block) combined with either dexmedetomidine (0.5 µg kg-1 per nerve block; group DEX) or the same volume of saline (group CON) were performed in dogs undergoing TPLO. Pain was assessed 30 minutes, 2 hours and then every 4 hours for 24 hours after surgery with a validated pain scale (4AVet). Meloxicam (0.15 mg kg-1) was administered intravenously (IV) at recovery. Rescue methadone (0.2 mg kg-1 IV) was administered if a score ≥ 6 (maximal score 18) was recorded and the number of postoperative doses was analysed by Fisher exact tests. The study was performed in parallel at a Veterinary Teaching Hospital (VTH) and a private Veterinary Referral Centre (VRC). RESULTS: Dogs received a total of 22 and 31 postoperative doses of methadone in groups DEX (14 doses at VRC, eight doses at VTH) and CON (28 doses at VRC, three doses at VTH), respectively. Overall, there was no difference in the postoperative rescue analgesia requirements between groups (p = 0.244). At the VRC, dogs received less methadone (p = 0.026) in group DEX compared with group CON, whereas at the VTH, there was no difference between groups (p = 0.216). CONCLUSIONS AND CLINICAL RELEVANCE: Perineural dexmedetomidine combined with ropivacaine did not reduce postoperative methadone requirements in dogs after TPLO, but results may differ from one centre to another. This discrepancy might be linked to variations in clinical practices and questions the validity of results obtained from single-centre randomized controlled trials but applied to different clinical settings.

Effects of a Single Opioid Dose on Gastrointestinal Motility in Rabbits (Oryctolagus cuniculus): Comparisons among Morphine, Butorphanol, and Tramadol.

The aim of this study was to evaluate and compare the effects of single doses of butorphanol, morphine, and tramadol on gastrointestinal motility in rabbits (Oryctolagus cuniculus) using non-invasive imaging methods, such as radiographic barium follow through and ultrasonographic contraction counts. Time-lapse radiographic and ultrasound examinations were performed before and after a single intramuscular dose of 5 mg kg-1 butorphanol, 10 mg kg-1 morphine, or 10 mg kg-1 tramadol. Pyloric and duodenal contraction counts by ultrasonography and radiographic repletion scores for the stomach and caecum were analysed using a mixed linear model. No significant effect was noted on ultrasound examinations of pyloric and duodenal contractions after administration of an opioid treatment. Morphine had a significant effect on the stomach and the caecum repletion scores, whereas butorphanol had a significant effect only on the caecum repletion score. Tramadol had no significant effect on the stomach or caecum repletion scores. The present findings suggest that a single dose of 5 mg kg-1 butorphanol or 10 mg kg-1 morphine temporarily slows gastrointestinal transit in healthy rabbits, preventing physiological progression of the alimentary bolus without the induction of ileus. In contrast, a single dose of 10 mg kg-1 tramadol has no such effects.

Magnets and a self-retractable wire for endoscopic septotomies: from concept to first-in-human use.

BACKGROUND: A medical device that allows simple and safe performance of an endoscopic septotomy could have several applications in the gastrointestinal (GI) tract. We have developed such a device by combining two magnets and a self-retractable wire to perform a progressive septotomy by compression of the tissues. We describe here the concept, preclinical studies, and first clinical use of the device for the treatment of symptomatic epiphrenic esophageal diverticulum (EED). METHODS: The MAGUS (MAgnetic Gastrointestinal Universal Septotome) device was designed based on previous knowledge of compression anastomosis and currently unmet needs. After initial design, the feasibility of the technique was tested on artificial septa in pigs. A clinical trial was then initiated to assess the feasibility and safety of the technique. RESULTS: Animal studies showed that the MAGUS can perform a complete septotomy at various levels of the GI tract. In two patients with a symptomatic EED, uneventful complete septotomy was observed within 28 and 39 days after the endoscopic procedure. CONCLUSIONS: This new system provides a way of performing endoluminal septotomy in a single procedure. It appears to be effective and safe for managing symptomatic EED. Further clinical applications where this type of remodeling of the GI tract could be beneficial are under investigation.

Neuromuscular blockade effects of cisatracurium in 11 cats undergoing ophthalmological surgery anaesthetised with isoflurane.

CASE SERIES SUMMARY: This case series describes the neuromuscular blockade (NMB) following 0.15 mg/kg intravenous (IV) cisatracurium administration in 11 cats undergoing ophthalmological surgery and anaesthetised with isoflurane. Anaesthetic records were analysed retrospectively. Neuromuscular function was assessed by a calibrated train-of-four (TOF) monitor. Cats were 73 ± 53 months old, weighed 4 ± 1 kg and were of American Society of Anesthesiologists' physical classification 2. Duration of anaesthesia and surgery were 144 ± 27 and 94 ± 24 mins, respectively. The lowest TOF count was zero in four cats, four in six cats and for one cat the TOF ratio never decreased below 31%. The time of onset was between 1 and 6 mins after the administration of cisatracurium and the mean duration of action was 20.4 ± 10.1 mins. RELEVANCE AND NOVEL INFORMATION: Cisatracurium at a dose of 0.15 mg/kg IV did not consistently induce a TOF count of zero in all cats. The dose used in these cats did not produce any remarkable cardiovascular side effects. Although the NMB was not complete, the dose given was sufficient to produce central eyeball position, which was the goal of the ophthalmic surgeries.

Comparison of single-breath continuous positive airway pressure manoeuvre with inhaled salbutamol to improve oxygenation in horses anaesthetized for laparotomy.

OBJECTIVE: To compare the efficacy of single-breath continuous positive airway pressure manoeuvre (CPAP-M) with inhaled salbutamol, and a combination of both. STUDY DESIGN: Randomized, clinical study. ANIMALS: A total of 62 client-owned horses (American Society of Anesthesiologists status III-V) anaesthetized for laparotomy. METHODS: Horses were premedicated with intravenous (IV) xylazine (0.4-0.6 mg kg-1), anaesthesia was induced with midazolam (0.06 mg kg-1 IV) and ketamine (2.2 mg kg-1 IV) and maintained with isoflurane in oxygen using volume-controlled ventilation without positive end-expiratory pressure. If PaO2 was < 100 mmHg (13.3 kPa), either a CPAP-M (50 cmH2O for 45 seconds) or salbutamol (0.002 mg kg-1) was administered. The intervention was considered successful if PaO2 reached 100 mmHg (13.3 kPa). If PaO2 remained < 100 mmHg (13.3 kPa), treatments were switched. PaO2/FiO2 ratio and estimated shunt fraction (F-shunt) were derived from data obtained from arterial blood gas measurements. Dynamic compliance (Cdyn) was calculated from variables recorded at the moment of arterial blood analysis. Fisher's exact tests compared success rates between treatments, and linear models were performed to test whether the treatment modified the values of the measurements; p < 0.05. RESULTS: Salbutamol was the first intervention in 28 horses and was effective in 22 horses. CPAP-M was the first intervention in 34 horses and was effective in 26 horses. CPAP-M after salbutamol was performed in six horses, with four responders, and salbutamol after CPAP-M was administered to eight horses, with one responder. Salbutamol, but not CPAP-M, significantly decreased F-shunt. Both salbutamol and CPAP-M significantly increased Cdyn. CONCLUSIONS AND CLINICAL RELEVANCE: Salbutamol and CPAP-M were comparably effective in improving oxygenation and Cdyn in anaesthetized horses with PaO2 < 100 mmHg (13.3 kPa). Whether combining both treatments might be beneficial needs to be confirmed on a larger number of horses.

Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses.

Controversy continues to surround the use of opioids in equine anaesthesia, with variable effects reported. This blinded clinical study aimed to investigate the influence of a low-dose fentanyl continuous rate infusion (CRI) on isoflurane requirements, parasympathetic tone activity (PTA), and anaesthetic parameters in horses during general anaesthesia. All of the twenty-two horses included in the research underwent a standard anaesthetic protocol. Eleven horses in the fentanyl group (Group F) received a loading dose of fentanyl at 6 µg/kg, followed by a CRI of 0.1 µg/kg/min during anaesthesia. A further 11 horses in the control group (Group C) received equivalent volumes of normal saline. Anaesthetic parameters and PTA index were recorded during anaesthesia. The achieved mean fentanyl plasma concentration was 6.2 ± 0.83 ng/mL. No statistically significant differences between groups were found in isoflurane requirements, MAP values, and mean dobutamine requirements. However, horses in Group F required a significantly lower dose of additional ketamine to maintain a sufficient depth of anaesthesia. Significantly higher PTA values were found in the fentanyl group. Further research is warranted to determine the limitations of PTA monitoring, and the influence of various anaesthetics on its values.

Optimization and assessment of a novel gastric electrode anchoring system designed to be implanted by minimally invasive surgery.

A novel electrode anchoring design and its implantation procedure, aiming for a minimally invasive solution for gastric electrical stimulation, are presented. The system comprises an anchor made of a flexible body embedding two needle-shaped electrodes. The electrodes can easily switch from a parallel position - to pierce the stomach - to a diverging position - enabling them to remain firmly anchored into the muscular layer of the stomach. Key device parameters governing anchoring stability were assessed on a traction test bench, and optimal values were derived. The device was then implanted in six dogs by open surgery to assess its anchoring durability in vivo. Computed tomography images showed that the electrodes remained well placed within the dogs' gastric wall over the entire assessment period (more than one year). Finally, a prototype of a surgical tool for the minimally invasive device placement was manufactured, and the anchoring procedure was tested on a dog cadaver, providing the proof of concept of the minimally invasive implantation procedure. The use of our electrode anchoring system in long-term gastric electrical stimulation is promising in terms of implantation stability (the anchor withstands a force up to 0.81 N), durability (the anchor remains onto the stomach over one year) and minimal invasiveness of the procedure (the diameter of the percutaneous access is smaller than 12 mm). Moreover, the proposed design could have clinical applications in other hollow organs, such as the urinary bladder.

Effects of perineural administration of ropivacaine combined with perineural or intravenous administration of dexmedetomidine for sciatic and saphenous nerve blocks in dogs.

OBJECTIVE: To evaluate the effects of using ropivacaine combined with dexmedetomidine for sciatic and saphenous nerve blocks in dogs. ANIMALS: 7 healthy adult Beagles. PROCEDURES: In phase 1, dogs received each of the following 3 treatments in random order: perineural sciatic and saphenous nerve injections of 0.5% ropivacaine (0.4 mL/kg) mixed with saline (0.9% NaCl) solution (0.04 mL/kg; DEX0PN), 0.5% ropivacaine mixed with dexmedetomidine (1 µg/kg; DEX1PN), and 0.5% ropivacaine mixed with dexmedetomidine (2 µg/kg; DEX2PN). In phase 2, dogs received perineural sciatic and saphenous nerve injections of 0.5% ropivacaine and an IV injection of diluted dexmedetomidine (1 µg/kg; DEX1IV). For perineural injections, the dose was divided equally between the 2 sites. Duration of sensory blockade was evaluated, and plasma dexmedetomidine concentrations were measured. RESULTS: Duration of sensory blockade was significantly longer with DEX1PN and DEX2PN, compared with DEX0PN; DEX1IV did not prolong duration of sensory blockade, compared with DEX0PN. Peak plasma dexmedetomidine concentrations were reached after 15 minutes with DEX1PN (mean ± SD, 348 ± 200 pg/mL) and after 30 minutes DEX2PN (816 ± 607 pg/mL), and bioavailability was 54 ± 40% and 73 ± 43%, respectively. The highest plasma dexmedetomidine concentration was measured with DEX1IV (1,032 ± 415 pg/mL) 5 minutes after injection. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that perineural injection of 0.5% ropivacaine in combination with dexmedetomidine (1 µg/kg) for locoregional anesthesia in dogs seemed to balance the benefit of prolonging sensory nerve blockade while minimizing adverse effects.

Opioid requirements after locoregional anaesthesia in dogs undergoing tibial plateau levelling osteotomy: a pilot study.

OBJECTIVE: To determine the intraoperative and early postoperative opioid requirement after ultrasound-guided sciatic and/or femoral nerve block or epidural anaesthesia in dogs undergoing tibial plateau levelling osteotomy (TPLO). STUDY DESIGN: Prospective, masked, pilot, randomized, clinical trial. ANIMALS: A total of 40 client-owned dogs undergoing TPLO. METHODS: Each dog was randomly assigned to group SF (combined sciatic and femoral nerve block), group S (sciatic nerve block), group F (femoral nerve block) or group E (epidural anaesthesia). A total of 0.3 mL kg-1 of ropivacaine 0.5% was administered to each nerve or in the epidural space. Intraoperatively, fentanyl (2 µg kg-1) was administered intravenously when heart rate, mean arterial pressure or respiratory rate increased by >30% compared with baseline values. Postoperatively, a visual analogue scale (VAS) and a modified German version of the French pain scale (4AVet) were used to assess pain every 30 minutes for 150 minutes and again once the morning after surgery. Methadone (0.1 mg kg-1) was administered intravenously if the VAS was ≥ 4 cm [maximal value 10 cm; median (interquartile range)] or the composite pain score was ≥5 [maximal value 15; median (interquartile range)]. Significance was defined as p ≤ 0.05. RESULTS: Groups SF and E required less total intraoperative and early postoperative opioid doses compared with groups S and F (p = 0.031). No dogs in group SF had a block failure or required postoperative methadone. A reduced methadone requirement was found in group SF compared with all the other groups up to 150 minutes after recovery (p = 0.041). CONCLUSIONS AND CLINICAL RELEVANCE: Combined sciatic and femoral nerve block and epidural anaesthesia lead to less cumulative consumption of perioperative opioids than single nerve blockade. Sciatic or femoral nerve block alone might be insufficient to control nociception and early postoperative pain in dogs undergoing TPLO.

Clinical safety of computed tomography-guided injection of autologous muscle-derived mesenchymal stem cells in the intervertebral disc in dogs.

Background: Pre-clinical randomized controlled animal trials have been conducted to evaluate the effect of mesenchymal stem cell (MSCs) transplantation on intervertebral disc (IVD) degeneration. MSCs can be obtained from different tissues, but systematic studies concerning the effects of muscle-derived MSCs injections on canine naturally degenerated IVD are still lacking. The aim of this study is the assessment of the clinical safety of this technique and its effects on the imaging features of the lumbosacral IVD. Methods: Eight adult healthy Beagle dogs were used in this study. In the preliminary phase, viability of muscle-derived MSCs in presence of contrast medium was assessed. In the clinical assessment phase, MSCs were injected in the lumbosacral IVD by computed-tomography (CT) guidance, after the injection of contrast medium to assess the correct intradiscal needle position. Regular clinical examinations were performed and pre- and post-injections (CT) and magnetic resonance imaging (MRI) features of the IVD were assessed. Results: The percentage of viability of MSCs in the presence of contrast medium ranged from 90 to 98%. 3x106 MSCs were obtained from six dogs and injected in the IVD. No major or minor complications were reported during the procedure and no abnormalities were noticed during the clinical examinations. No statistically significant variations were noticed between the pre- and post-injections imaging features. Conclusion: This technique is clinically safe and it is not associated with any progression of the IVD degeneration, detected by CT and MRI imaging.

Effects of fentanyl-lidocaine-ketamine versus sufentanil-lidocaine-ketamine on the isoflurane requirements in dogs undergoing total ear canal ablation and lateral bulla osteotomy.

OBJECTIVE: To compare the isoflurane-sparing effects of sufentanil-lidocaine-ketamine (SLK) and fentanyl-lidocaine-ketamine (FLK) infusions in dogs undergoing total ear canal ablation and lateral bulla osteotomy (TECA-LBO). STUDY DESIGN: Randomized blinded clinical study. ANIMALS: A group of 20 client-owned dogs undergoing TECA-LBO. METHODS: Intravenous (IV) administration of lidocaine (3 mg kg-1) and ketamine (0.6 mg kg-1) with fentanyl (5.4 µg kg-1; n = 10; FLK group) or sufentanil (0.72 µg kg-1; n = 10; SLK group) was immediately followed by the corresponding constant rate infusion (CRI) (lidocaine 3 mg kg-1 hour-1; ketamine 0.6 mg kg-1 hour-1; either fentanyl 5.4 µg kg-1 hour-1 or sufentanil 0.72 µg kg-1 hour-1). Anaesthesia was induced with propofol 3-5 mg kg-1 IV and was maintained with isoflurane. End-tidal isoflurane concentration (Fe'Iso) was decreased in 0.2% steps every 15 minutes until spontaneous movements were observed (treated with propofol 1 mg kg-1 IV) or an increase of > 30% in heart rate or mean arterial pressure from baseline occurred (treated with rescue fentanyl or sufentanil). Quality of recovery and pain were assessed at extubation using the short-form Glasgow Composite Pain Scale (SF-GCPS), Colorado State University Canine Acute Pain scale (CSU-CAP), and visual analogue scale (VAS). Data were analysed with analysis of variance, t tests, Fisher test and Spearman coefficient (p < 0.05). RESULTS: Fe'Iso decreased significantly in SLK group (45%; p = 0.0006) but not in FLK (15%; p = 0.1135) (p = 0.0136). SLK group had lower scores for recovery quality (p = 0.0204), SF-GCPS (p = 0.0071) and CSU-CAP (p = 0.0273) than FLK at extubation. Intraoperative rescue analgesia and VAS were not significantly different between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with FLK infusion, CRI of SLK at these doses decreased isoflurane requirements, decreased pain scores and improved recovery quality at extubation in dogs undergoing TECA-LBO.

Mesh closure of epiploic foramen by ventral laparotomy in 17 horses with entrapment.

BACKGROUND: Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed. METHODS: This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up. RESULTS: In the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases and enterotomy in 4 other cases. Fifteen of these survived to discharge. Long-term follow-up (one to three years, median three years) was favourable in all 15 horses not showing recurrence of EFE nor other related signs of colic. Laparoscopic evaluation of the EF was performed in two cases and showed integration of the mesh. One horse was euthanased 3.5 years after mesh placement for an unrelated cause and the mesh was well adherent obliterating the EF. CONCLUSION: Mesh closure of EF during emergency coeliotomy did not cause short-term complications even in horses with resection or enterotomy and may reduce the risk of recurrence of EFE in horses.