The Effect of a Subsequent Dose of Dexmedetomidine or Other Sedatives following an Initial Dose of Dexmedetomidine on Electrolytes, Acid-Base Balance, Creatinine, Glucose, and Cardiac Troponin I in Cats: Part II.

The administered dose of dexmedetomidine may occasionally fail to produce the anticipated sedative effects. Therefore, a subsequent dose or administration of another sedative may enhance sedation; however, patient safety may be affected. The safety of seven different drugs administered at the following time point after an insufficient dose of dexmedetomidine was evaluated in a crossover, blind, experimental study that included six healthy adult cats. All cats received an initial dose of dexmedetomidine and a subsequent dose of either dexmedetomidine (Group DD), NS 0.9% (DC), tramadol (DT), butorphanol (DBT), buprenorphine (DBP), ketamine (DK), or midazolam (DM). Animal safety was assessed using repeated blood gas analysis and measurement of electrolytes, glucose, cardiac troponin I, and creatinine to evaluate cardiac, respiratory, and renal function. The median values of creatinine, cardiac troponin I, pH, partial pressure of carbon dioxide, potassium, and sodium did not change significantly throughout the study. Heart rate was significantly decreased in all groups after administration of the drug combinations, except for in the DK group. Respiratory rate decreased significantly after administration of the initial dose of dexmedetomidine and in the DBP and DM groups. The partial pressure of oxygen, although normal, decreased significantly after the administration of dexmedetomidine, whereas the median concentration of glucose increased significantly following the administration of dexmedetomidine. The results of our study suggest that the drug combinations used did not alter the blood parameters above normal limits, while cardiac and renal function were not compromised. Therefore, a safe level of sedation was achieved. However, the administration of dexmedetomidine reduced the partial pressure of oxygen; thus, oxygen supplementation during sedation may be advantageous. Additionally, the increase in glucose concentration indicates that dexmedetomidine should not be used in cats with hyperglycaemia, whereas the decrease in haematocrit suggests that dexmedetomidine is not recommended in anaemic cats.

First-Intention Incisional Wound Healing in Dogs and Cats: A Controlled Trial of Dermapliq and Manuka Honey.

This study aimed to compare incisional wound healing in cats and dogs after the topical application of Μanuka honey and a new medical device, Dermapliq. Comparisons were made between each treatment and control, between the two treatments, and between dogs and cats. Twelve cats and twelve dogs were included in this study, and the impact of the two substances was examined through cosmetic, clinical, ultrasonographical, and histological evaluation. The use of Dermapliq in first-intention wound healing achieved a significantly better cosmetic evaluation score and better total clinical score at days 20-41, compared to the control, in both dogs and cats. The ultrasonographically estimated wound area was smaller with Dermapliq compared to the control. Wounds treated with Dermapliq showed histologically less inflammation compared to the control. The use of Manuka honey did not show a significantly better cosmetic score compared to the control. Skin thickening was significantly higher after using Manuka honey compared to the control and so was the total clinical score. However, the median wound area, as was evaluated ultrasonographically, was significantly smaller when wounds were treated with Manuka honey, the difference being more apparent in dogs. Dermapliq was proven to be a better choice in achieving favorable wound healing than Manuka honey in dogs and cats in first-intention healing. In our study, cats had a statistically better cosmetic score and less skin thickening and scar width compared to dogs. Histologically, cats showed significantly less edema, higher inflammation and angiogenesis scores, and lower fibroblast and epidermis thickening scores when compared to dogs.

Effect of Classical Music on Depth of Sedation and Induction Propofol Requirements in Dogs.

The main objective of this prospective, randomized, blind, cross-over experimental study was to evaluate the effect of classical music on the depth of sedation and propofol requirements for the induction of anaesthesia in dogs. Twenty dogs were involved, and each was subjected to three different treatments with a 3-month gap: Chopin music, Mozart music, and no music, via loudspeakers. The dogs were premedicated with acepromazine and butorphanol by intramuscular injection, and anaesthesia was induced using propofol intravenously. To compare the depth of sedation and propofol requirements for the induction of anaesthesia among the different treatments, we utilized non-parametric tests (Kruskal-Wallis test) for the depth of sedation due to a slight deviation from the normal distribution and parametric (ANOVA) for propofol requirements. When exposed to music (Chopin or Mozart), dogs exhibited deeper sedation and required less propofol for their intubation compared to the no-music treatment (p < 0.05). Exposure to classical music had a positive impact on the level of sedation, and more profound central nervous system depression seemed to contribute to approximately 20% lower propofol dose requirements for tracheal intubation. Therefore, classical music during the preoperative period appeared to exert a beneficial effect, at least when applying the specific pre-anaesthetic medications used in the present study.

Use of a semitendinosus myocutaneous flap for the coverage of hindlimb full-thickness skin defects in cats.

BACKGROUND: The management of feline hindlimb full-thickness skin defects is challenging. On the other hand, the use of a semitendinosus (ST) myocutaneous flap for their coverage has not been reported. OBJECTIVES: To describe the ST flap and compare it with second intention healing for managing hindlimb full-thickness skin defects. METHODS: In 12 purpose-bred laboratory domestic short-haired cats, two wounds were made on each tibia. The wounds in group A (n = 12) were covered with ST flaps, and those in group B (n = 12) were left to heal by second intention. In both groups, clinical assessment scoring and planimetry were performed between one-30 d postoperatively. Computed tomography-angiography (CTA) was performed on days zero, 10, and 30, and histological examinations were performed on days zero and 14 and at 6 and 12 mon postoperatively. RESULTS: Statistically significant differences in the clinical assessment scores were observed between groups A and B on days 14 (p = 0.046) and 21 (p = 0.016). On the other hand, the time for complete healing was similar in the two groups. CTA revealed significant differences in the muscle width (day 0 compared to days 10 and 30 [p = 0.001, p = 0.026, respectively], and days 10 to 30 [p = 0.022]), ST muscle density, and the caliber of the distal caudal femoral artery and vein (day 0 compared to day 10 [p < 0.001], and days 10 to 30 [p < 0.001]). Histologically significant differences in inflammation, degeneration, edema, neovascularization, and fibrosis were observed on day 14 compared to zero and 6 mon, but no differences were found between the time interval of 6 and 12 mon. CONCLUSIONS: An ST flap can be used effectively to manage hindlimb full-thickness skin defects.

Comparison of Two Surgical Techniques Based on the Semitendinosus Myocutaneous Flap in Cats.

The objective of this experimental study was to compare the semitendinosus (ST) to the split-semitendinosus (SST) myocutaneous flap in covering distal limb skin defects in cats. Twenty-eight purpose-bred laboratory DSH cats were used and allocated into two groups (ST-group (A); n = 14, SST-group (B); n = 14). ST flaps, based on the distal muscle pedicle, and SST flaps, after longitudinal division of the muscle based on both muscle pedicles, were tested over skin defects created on the medial distal tibia. Clinical assessment, planimetry, CT-angiography (CTA) and histological examination were compared between groups. Days to complete flap healing between ST and SST-flaps (30.36 ± 9.1, 32.29 ± 5.44, respectively) and final total flap areas (68.36% ± 27.18, 51.83% ± 22.48, respectively) revealed no significant differences. On CTAs, the caliber of the distal caudal femoral vein on day 10 was statistically significant higher (p < 0.001) for group A and a significantly higher caliber of the distal caudal femoral artery on day 30 for group B (p = 0.021). Histology revealed statistically higher degeneration at 6 months (p = 0.047) for group A, and statistically higher fibrosis at 12 months (p = 0.019) for group B. Both ST and SST flaps had similar healing times and provided coverage of skin tibial defects in cats.

Evaluation of the Effectiveness of Medical-Grade Honey and Hypericum Perforatum Ointment on Second-Intention Healing of Full-Thickness Skin Wounds in Cats.

This study aimed to determine the effects of two topical treatments on second-intention wound healing in cats. Eight 2 × 2 cm full-thickness wounds were created, four on each side of the dorsal midline of eight laboratory cats, to receive either medical-grade honey ointment (MGH) and its control (HC), or Hypericum-based ointment (HP) and its control (HPC). MGH or HP ointment was applied to four wounds on the same side, while the remaining four were used as controls, chosen at random. Planimetry, laser Doppler flowmetry, daily physical examinations, and histologic examinations on days 0, 7, 14, and 25 were used to assess the healing of wounds. Tissue perfusion was better in the MGH-treated (2.14 ± 0.18 mm/s) and HP-treated wounds (2.02 ± 0.13 mm/s) than in the untreated controls HC (1.59 ± 0.11 mm/s) and HPC (1.60 ± 0.05 mm/s), respectively (p = 0.001). Histopathology revealed that the median edema score was lower in the MGH-treated (2; range 1-4) compared to the HC-treated wounds (3; range 2-4) on day 7 (p < 0.05). The median angiogenesis score was higher on day 7 in the MGH-treated (2; range 1-3) compared to the HP-treated wounds (2; range 1-2) (p = 0.046). The fibroblast concentration was increased in the MGH-treated wounds (3.5; range 3-4) compared to the HP-treated wounds (3; range 2-4) on day 25 (p = 0.046). MGH and HP increased tissue perfusion compared to the untreated controls. The MGH-treated wounds had histologic parameters superior to the HP-treated wounds regarding angiogenesis and fibroblast concentration in cutaneous wound healing in cats. Topical application of MGH and HP did not accelerate the healing process of feline cutaneous wounds.

Transdiaphragmatic Gastrotomy for the Extraction of Distal Esophageal Foreign Bodies in 13 Dogs (1997-2016).

The records of 13 dogs with distal esophageal foreign body obstruction not amenable to endoscopic management that had transdiaphragmatic gastrotomy (TG) for the foreign body extraction were reviewed. West Highland white terriers were over-represented. Mean age of the dogs at presentation was 38.6 mo, and mean duration of clinical signs associated with esophageal foreign bodies was 5.8 days. A TG was performed via an eighth or ninth left intercostal thoracotomy, and clinical results were successful in 12 dogs. In 1 dog, gastrotomy failed to retrieve a foreign body and esophagotomy was performed. Foreign bodies that were removed included 3 fishhooks and 10 animal bones. Postoperatively, all dogs developed esophagitis, 1 dog showed esophageal stricture, and 1 dog died of pyothorax associated with esophageal perforation 1 day postsurgery. Overall, 12 dogs survived and were free of clinical signs after a median follow-up time of 17 mo. TG is an effective surgical technique for the retrieval of distal esophageal foreign bodies.

The Effect of a Hydrocolloid Dressing on Second Intention Wound Healing in Cats.

The objective of the present study was to evaluate the effect of a hydrocolloid dressing on second intention wound healing in cats. Two full-thickness skin wounds, measuring 2 × 2 cm, were created on both sides of the dorsal midline of 10 cats; bilaterally, one randomly selected wound was bandaged with a hydrocolloid dressing and the second one (control) with a semiocclusive pad. Subjective clinical evaluation of granulation tissue formation, of the quantity and nature of wound exudate, and planimetry were performed on the right-side wounds, and histological examination on the left. No significant differences in subjective clinical evaluation or in planimetry were observed between the hydrocolloid-treated wounds and controls. Most wounds had serous or absence of exudate (41.25% and 25%, respectively), whereas purulent exudate was observed in 7.5% of wounds. Edema was significantly increased in the hydrocolloid-treated wounds compared with controls on day 7 but no significant differences in the other histological variables were observed.

Effects of two occlusive, hydrocolloid dressings on healing of full-thickness skin wounds in cats.

OBJECTIVES: To determine the effects of two occlusive, hydrocolloid dressings on second intention wound healing in cats. METHODS: Three 2×2 cm full-thickness skin wounds were created on each side of the trunk of 10 cats. Two bilateral wounds were bandaged using different hydrocolloid dressings, namely Hydrocoll and DuoDerm while a semi-occlusive pad (Melolin) was applied to the third bilateral wound (control group). Wound planimetry, subjective evaluation of wound healing, and qualitative bacterial cultures were performed on the right-sided wounds, whereas left-sided wounds were subjected to histological examination. RESULTS: Subjective evaluation revealed accelerated (p <0.01) granulation tissue formation in hydrocolloid-treated wounds. The amount of wound exudate was initially greater (p <0.01) in these wounds. Seventeen out of 120 evaluated wounds (14.2%) produced purulent exudate, 11 of which showed Staphylococcus aureus growth. Fewer control wounds (3/17) emitted purulent exudate, but all of them yielded moderate bacterial growth as compared to hydrocolloid-treated wounds (8/17) which had a low incidence of bacterial growth. The only significant difference in histological variables was increased cellular infiltration noted on day 7 in Hydrocoll-treated wounds compared to controls. No significant differences in planimetry variables were found between groups. CLINICAL SIGNIFICANCE: Despite the initially increased amount of wound exudate and the low growth of Staphylococcus aureus, hydrocolloid dressings accelerate granulation tissue formation and can hence be suggested for second intention wound healing in cats.

Comparison of three skin-stretching devices for closing skin defects on the limbs of dogs.

Our objective was to evaluate the effectiveness of skin-stretching devices for closing defects on the extremities of dogs. Antebrachial skin defects were created on the limbs of 24 dogs randomly divided into three groups. Skin stretchers included staples and sutures passing through them (group A), sutures and hypodermic needles (group B), and Pavletic device (group C). Wounds on the left were further undermined in all groups. Tension and blood perfusion were assessed. After removing the stretchers on day 3, the defects were sutured and wound healing was clinically scored. Histological variables evaluated were cellular infiltration, edema, collagen orientation, and thickness of epidermis. Significant differences in tension were found among groups (p 0.0005) and between measurement times for undermined (p = 0.001) or non-undermined (p < 0.0005) wounds. In contrast, blood perfusion values did not differ significantly. Clinical scores for group B seemed to be better than those for groups A and C, but differences were not significant. Primary wound closure using the Pavletic device was not feasible. No significant differences in histological variables were found between groups. Skin stretching with staples or hypodermic needles resulted in successful wound management with minor side effects on skin histology and circulation.

Evaluation of the effectiveness of an ointment based on Alkannins/Shikonins on second intention wound healing in the dog.

The enantiomeric naphthoquinones alkannins and shikonins (A/S) have been established as potent wound healing agents. The purpose of this study was to evaluate the effectiveness of an A/S based ointment for humans on second intention wound healing in the dog, as compared to wound flushing with Lactated Ringer's solution (LRS). Ten mixed breed dogs, aged 2 to 5 y, were used. One 2.5 × 2.5 cm full-thickness skin defect was created on the lateral aspect of each arm for subjective evaluation, laser-Doppler flowmetry (LDF), and planimetry. Additionally, 3 matching 2 × 2 cm wounds were created on opposite sides of the dorsal midline for histologic evaluation. Wounds were treated once daily with the A/S based ointment on the right side and by flushing with LRS on the left until healed (about 20 d). During the healing process, tissue perfusion (mean LDF value) was found to be significantly higher on the side treated with the A/S based ointment compared with the LRS-treated side. Histologically, angiogenesis (on days 4 and 11), collagen production score (on days 4, 11, and 20), and epithelial thickness score (on day 11) were significantly higher in the wounds treated with the A/S based ointment. Wound size, as evaluated by planimetry, decreased significantly from day 0 to day 20 on both sides, but no significant differences were found between the A/S based ointment and LRS-treated wounds.

Comparison of absorbable and nonabsorbable sutures for intradermal skin closure in cats.

Paired skin incisions were made in 6 cats and closed intradermally with the copolymer of glycolide, ɛ-caprolacton, and trimethylene-carbonate, or polypropylene suture. The macroscopic and histologic appearance of the incisions was compared. Polypropylene suture compared favorably to glycolide, ɛ-caprolacton, and trimethylene-carbonate suture for closure of skin incisions in cats.

Naturally occurring isohexenylnaphthazarins and wound healing: experimental study in dogs.

BACKGROUND: The healing efficacy of isohexenylnaphthazarins (IHN) has been well proved on chronic or contaminated wounds. OBJECTIVE: To evaluate the wound healing activity of an experimental ointment containing IHN on acute and noncontaminated wounds in dogs. METHODS: In each of six beagle dogs, four full-thickness skin defects were created bilaterally: one 2 x 2 cm defect on the lateral aspect of each arm for subjective evaluation, laser Doppler flowmetry (LDF), and planimetry and three 1.5 x 1.5 cm defects on opposite sides of the dorsal midline for histologic evaluation. Wounds on the left were treated with an ointment based on IHN and on the right with another based on petroleum jelly (Vaseline) and beeswax. RESULTS: Wound size decreased significantly in both sides. The significantly increased percentage of epithelialization was higher (p = .0274) in the petroleum jelly-treated wounds on day 20. Tissue perfusion (LDF) increased significantly bilaterally in the center of the wound but only in the IHN-treated side cranial to the wound. Histologically, angiogenesis was significantly higher (p = .0431) on day 5 in the IHN-treated wounds compared with the petroleum jelly-treated wounds. Collagen production increased significantly bilaterally. CONCLUSION: The IHN-based ointment promoted some of the proliferative processes, but it did not enhance the overall wound healing of acute, surgically created wounds in dogs.

Use of a temporary incontinent end-on colostomy in a cat for the management of rectocutaneous fistulas associated with atresia ani.

A 2 1/2-month-old cat was evaluated for the presence of multiple draining tracts ventral to the tail of 8 days duration. Clinical and radiographic examination revealed that the cat had rectocutaneous fistulas and type II atresia ani. The cat underwent a temporary end-on colostomy for faecal diversion. Sixty days after surgery and after the fistulas resolved the animal underwent a second surgery for colostomy closure and anal reconstruction. Two years after surgery the cat was reported to be in good health with no faecal incontinence.

Incisional block with bupivacaine for analgesia after celiotomy in dogs.

A blind, placebo-controlled clinical trial was performed to evaluate the postoperative analgesic effect of preoperative infiltration of the incision site with bupivacaine in dogs undergoing celiotomy. Sixty dogs were randomly allocated into four groups: preoperative bupivacaine, postoperative bupivacaine, preoperative saline, and postoperative saline. All dogs were premedicated with acepromazine and meperidine; then they were anesthetized with thiopentone and isoflurane. Each group received either bupivacaine or normal saline before midline incision or just before skin closure. After surgery, pain scores were assigned using a numerical rating scale. Preoperative bupivacaine was associated with significantly lower pain scores and a significantly lower need for opioid administration. The authors conclude that a preoperative incisional block with bupivacaine seems to be a useful adjunct for controlling pain after celiotomy in dogs.