Intraoperative cholangiography and bile duct flushing in 47 dogs receiving laparoscopic cholecystectomy for benign gallbladder disease: A retrospective analysis.

OBJECTIVE: To describe a laparoscopic approach for performing intraoperative cholangiography (IOC) and bile duct flushing (BDF) during laparoscopic cholecystectomy (LC) in dogs. To investigate the clinical outcomes of dogs undergoing these procedures for the treatment of benign gallbladder disease, ie gallbladder mucocele (GM) or cholecystitis. STUDY DESIGN: Retrospective study. ANIMALS: Forty-seven client-owned dogs. METHODS: Medical records of client-owned dogs with benign gallbladder diseases that underwent IOC and BDF during LC between September 2016 and December 2019 were reviewed. Of these dogs, only dogs with GM or cholecystitis were included in the study. The fundus dissection first method was used for LC. Intraoperative cholangiography and BDF procedures were performed laparoscopically using a catheter inserted into the cystic duct following dissection within the subserosal layer of the gallbladder. Videos recorded during each procedure were reviewed, and data on procedure duration, completion, outcome, and technical approach were recorded. RESULTS: Forty-seven dogs were included in the study. The median procedure time for BDF and IOC was 4 min (range, 2-48 min), and no intraoperative or postoperative complications occurred. CONCLUSION: During LC, BDF and IOC were performed safely and successfully. Intraoperative cholangiography identified obstructions and strictures in the common bile duct that were not detected using BDF alone. CLINICAL SIGNIFICANCE: Our findings suggest that BDF and IOC are both safe and time effective and should be considered for routine use by surgeons during LC.

Meta-analysis of the effects of lidocaine on postoperative reflux in the horse.

OBJECTIVE: To determine the efficacy of lidocaine at reducing incidence of postoperative reflux (POR) in horses by using quantitative statistical analysis. STUDY DESIGN: Systematic meta-analytical review. SAMPLE POPULATION: Studies on horses undergoing gastrointestinal surgery for small intestinal lesions, identified by systematic search between 2001 and 2017. METHODS: A search with PubMed/MEDLINE, Web of Science, and Google Scholar was performed, followed by secondary searches of veterinary trade journals and bibliographies of relevant articles. The primary outcome measure for this study was the effect of lidocaine therapy on the odds of POR. Subgroup analysis assessed included the timing of lidocaine therapy, incidence of mortality, and incidence of repeat celiotomy. A meta-analysis was performed with a random effects model, with the effect size calculated as an odds ratio (OR) with 95% confidence intervals (CI). Statistical significance was set at P < .05. RESULTS: Among 1933 peer reviewed publications that met the initial search criteria, 12 relevant studies were available for analysis. Lidocaine was associated with an increased incidence of diagnosis of POR (OR 6.3, 95% CI [1.4, 27.0], P = .01). Horses treated with lidocaine were more likely to survive to discharge (OR 6.8, 95% CI [3.9, 11.7], P < .01). CONCLUSION: Lidocaine was associated with an increased survival rate in horses undergoing exploratory celiotomy for small intestinal disease according to this meta-analysis of the recent literature. CLINICAL SIGNIFICANCE: This body of published evidence provides support to administer lidocaine in horses to improve survival rather than preventing POR.

Intraoperative acridine orange photodynamic therapy and cribriform electron-beam irradiation for canine intranasal carcinomas: 14 cases.

Canine intranasal carcinomas are almost always malignant. Surgery alone often results in rapid tumor regrowth. Radiotherapy is the treatment of choice for dogs with intranasal tumors. Here, we retrospectively assessed treatment of intranasal carcinoma by marginal tumor resection followed by intraoperative acridine orange (AO) photodynamic therapy (PDT) and cribriform plate electron-beam intraoperative radiotherapy (IORT). Fourteen canine cases were assessed, 12 of which had stage I tumors, one with stage III, and one with stage IV. Recurrence was detected in 8, with a median recurrence from the time of treatment of 6 months (range: 3 to 16 months). The median progression-free survival time and overall survival time after treatment were 13 and 22 months, respectively. Adverse events were mild. Marginal tumor resection followed by intraoperative AO-PDT and cribriform plate electron-beam IORT may increase the tumor control time in dogs with marginally resectable intranasal malignant tumors beyond that incurred by surgery alone.

Thérapie photodynamique peropératoire à l'acridine orange et irradiation par faisceau électrique pour carcinome intranasal canin : 14 cas. Un carcinome intranasal canin est presque toujours malin. Une simple opération chirurgicale résulte souvent dans la rapide réapparition de la tumeur. Dans cet article, nous discutons d'un traitement d'un carcinome intranasal par résection marginale de la tumeur effectué simultanément à une thérapie photodynamique (TPD) peropératoire à l'acridine orange (AO) et une radiothérapie peropératoire (RPO) par faisceau électrique des lames criblées. L'étude a porté sur quatorze cas chez le chien dont 12 tumeurs étaient classées au stade I, une au stade III et une au stade IV. Huit des cas étaient des cas de récidive selon une moyenne de 6 mois depuis la période du traitement (plage de 3 à 16 mois). Le temps de survie moyen à l'état stabilisé et le temps de survie général après traitement étaient respectivement de 13 et 22 mois. Les incidents thérapeutiques sont moindres (cinq cas d'emphysème sous-cutané et quatre cas de rhinite). La résection marginale de la tumeur conduite simultanément avec une TPD-AO peropératoire et une RPO par faisceau électrique des lames criblées semble permettre une plus longue phase de maîtrise des tumeurs chez le chien porteur d'une tumeur intranasale maligne à résection marginales possible par rapport aux résultats obtenus par simple intervention chirurgicale.(Traduit par les auteurs).

Effect of an intraoperative infusion of amino acids on body temperature, serum biochemistry, serum insulin and recovery variables in healthy dogs undergoing ovariohysterectomy.

Change in body temperature (BT), serum biochemistry and recovery variables were compared after infusion of amino acids (AA) or lactated Ringer's solution (LRS) in dogs undergoing ovariohysterectomy. Dogs received eight parts 10 per cent AA and two parts LRS (AA, n=10) or only LRS (CG, n=10) at 10 ml/kg/hour during 90 minutes of anaesthesia. BT was measured during anaesthesia and 60 minutes of recovery. Extubation time and shivering were noted. Serum samples were obtained before anaesthesia (T0), end of anaesthesia (T90) and 18 hours after (T18h). Friedman, Mann-Whitney, Kruskal-Wallis or Fisher's exact tests were used for analysis. A decrease in BT of -2.16 (-1.59 to -3.24)°C for group AA and -2.79 (-1.98 to -4.52)°C for group CG was different (P=0.02). Time to extubation was 5 (3-9) minutes for group AA and 9 (5-15) minutes for group CG and was different (P=0.01). Only 30 per cent of dogs in group AA and 100 per cent of dogs in group CG shivered during recovery (P=0.003). Glucose, insulin and blood urea nitrogen at T90 were higher than T0 and T18h for group AA. Dogs receiving intraoperative infusion of AA had a higher BT, extubated sooner and shivered less than control dogs at recovery from anaesthesia.

Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs.

BACKGROUND: Migrating plant material is often suspected clinically to be the underlying cause of iliopsoas myositis in the dog, but cannot always be found pre- or intraoperatively. In most cases, recurrence of clinical signs is related to failure to remove the plant material. Preoperative ultrasonography can be useful to visualize migrating plant material and to determine anatomical landmarks that can assist in planning a surgical approach. The purpose of the present study was to report the role of intraoperative (intra-abdominal) ultrasonography for visualizing and removing the plant material from iliopsoas abscesses using a ventral midline laparotomy approach. RESULTS: A retrospective case series of 22 dogs with iliopsoas muscle abnormalities and suspected plant material was reported. Preoperative visualization and subsequent retrieval of the plant material was performed during a single hospitalization. In all 22 dogs, the plant material (including complete grass awns, grass awn fragments and a bramble twig) was successfully removed via ventral midline laparotomy in which intraoperative ultrasonography was used to direct the grasping forceps tips to the foreign body and guide its removal. In 11 of these 22 dogs, the plant material was not completely removed during prior surgery performed by the referring veterinarians without pre- or intraoperative ultrasonography. Clinical signs resolved in all dogs and all dogs resumed normal activity after successful surgical removal of the plant material. CONCLUSION: Intraoperative ultrasonography is a safe and readily available tool that improves success of surgical removal of plant material within the iliopsoas abscesses via ventral midline laparotomy. Moreover, ultrasonographic findings of unusual plant material can be useful in planning and guiding surgical removal, by providing information about the size and shape of the foreign body.

Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats.

OBJECTIVES: To assess the effect of intra-operative radiology on the quality of lag screw insertion for the management of sacroiliac joint luxations in cats. METHODS: In this retrospective single-centre study, the surgical, anaesthetic and imaging records of 40 screws (32 cats) placed with lag effect for management of sacroiliac luxation were reviewed. Postoperative radiographs were assessed for sacroiliac joint reduction, screw position, and sacral width purchased by each screw. Cases were divided into two groups according to the use of (IOR) or the absence of intra-operative radiology (NIOR). RESULTS: A total of 23 lag screws were placed with the aid of intra-operative radiology and 17 without. Three of the 23 screws placed in the IOR group exited the sacrum as opposed to eight of 17 screws in the NIOR group (p = 0.03). Mean sacral width purchased by the screws in the IOR group (70.8%) was also significantly higher (p = 0.002) than in the NIOR group (54.6%). Mean general anaesthetic times for unilateral and bilateral screw placement for the IOR group and NIOR group were not significantly different. CLINICAL SIGNIFICANCE: The use of intra-operative radiology can significantly improve the quality of lag screw insertion for the stabilization of sacroiliac luxations in cats, which should lead to a reduced incidence of postoperative screw loosening.

Treatment of intrathoracic grass awn migration with video-assisted thoracic surgery in two dogs.

CASE DESCRIPTION A 17-month-old sexually intact male Vizsla and a 2-year-old spayed female mixed-breed dog were examined because of suspected intrathoracic grass awn migration. CLINICAL FINDINGS Thoracic CT revealed focal areas of pulmonary infiltration in the right caudal lung lobe in one dog and in the left caudal lung lobe in the other. In 1 patient, bronchoscopy revealed 2 grass awns in the bronchi. Results of thoracic radiography and bronchoscopy were unremarkable in the second patient; however, a grass awn was recovered from the tonsillar crypt during oropharyngeal examination. TREATMENT AND OUTCOME In both dogs, grass awns were successfully retrieved from the pleural cavity by means of video-assisted thoracic surgery during 1-lung ventilation. In one patient, a grass awn was recovered bronchoscopically from the left caudal lung lobe bronchus and another was visualized distally in an accessory lung lobe bronchus but could not be retrieved. This dog underwent accessory lung lobectomy. The second dog underwent left caudal lung lobectomy. Both patients recovered uneventfully from surgery, were discharged from the hospital, and had no apparent recurrence of clinical signs at telephone follow-up 31 months and 18 months after surgery. CLINICAL RELEVANCE With careful case selection, successful management of intrathoracic grass awn migration in dogs can be achieved by means of video-assisted thoracic surgery. Comprehensive preoperative evaluation including both computed tomography and bronchoscopy is suggested. Further investigation is necessary to evaluate whether treatment of this condition with video-assisted thoracic surgery is as effective as with traditional open thoracotomy.

Ultrasonographic findings and outcomes of dogs with suspected migrating intrathoracic grass awns: 43 cases (2010-2013).

OBJECTIVE: To describe ultrasonographic findings and outcomes for dogs with suspected migrating intrathoracic grass awns. DESIGN: Retrospective case series. ANIMALS: 43 client-owned dogs. PROCEDURES: Records for dogs with suspected migrating intrathoracic grass awns examined between 2010 and 2013 were reviewed. Ultrasonographic images and additional information such as signalment and pleural fluid analysis, radiographic, bronchoscopic, and CT findings were collected. Surgical treatments and outcomes were also reviewed. RESULTS: Transthoracic or transesophageal ultrasonography revealed grass awns in the pleural space (n = 13) or pulmonary parenchyma (10) of 23 dogs. Surgical removal of grass awns was successful on the first attempt in 21 of these 23 dogs (including 11/23 that had intraoperative ultrasonography performed to aid localization and removal of the awn). In the remaining 2 dogs, a second surgery was required. Twenty dogs with evidence of migrating intrathoracic grass awns had no foreign body identified on initial ultrasonographic evaluation and were treated medically; 16 developed draining fistulas, and awns identified ultrasonographically at follow-up visits were subsequently removed from the sublumbar region (n = 10) or thoracic wall (6). The remaining 4 dogs had no grass awn visualized. Clinical signs resolved in all dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Transthoracic, transesophageal, and intraoperative ultrasonography were useful for localization and removal of migrating intrathoracic grass awns. Ultrasonography may be considered a valuable and readily available diagnostic tool for monitoring dogs with suspected migrating intrathoracic grass awns.

Effect of intraoperative constant rate infusion of lidocaine on short-term survival of dogs with septic peritonitis: 75 cases (2007-2011).

OBJECTIVE: To investigate whether intraoperative administration of a lidocaine infusion to dogs with septic peritonitis was associated with short-term (48 hours) survival after surgery. DESIGN: Retrospective case series. ANIMALS: 75 dogs with septic peritonitis. PROCEDURES: Medical records of dogs with septic peritonitis that underwent laparotomy between January 2007 and December 2011 at the Royal Veterinary College were reviewed. Select variables during the preoperative, intraoperative, and postoperative periods and short-term survival after surgery were compared between dogs that received an opioid only (group O; n = 33) and dogs that received lidocaine (50 µg/kg/min [22.7 µg/kg/min], IV; group L; 42) in addition to an opioid during surgery. RESULTS: The proportion of dogs that survived for 48 hours after surgery was significantly greater for group L (35/42) than for group O (20/33). Intraoperative infusion of lidocaine increased the odds of short-term survival (OR, 8.77; 95% CI, 1.94 to 39.57). No significant differences were observed between the 2 treatment groups for variables assessed during the preoperative and postoperative periods. During the intraoperative period, more dogs in group L received an IV bolus of a synthetic colloid than did dogs in group O, but the number of IV boluses administered was not associated with short-term survival. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that IV infusion of lidocaine might improve the short-term survival of dogs with septic peritonitis. Prospective clinical trials are necessary to determine the efficacy of lidocaine as a supportive treatment for dogs with septic peritonitis.

Evaluating Femoral-Sciatic Nerve Blocks, Epidural Analgesia, and No Use of Regional Analgesia in Dogs Undergoing Tibia-Plateau-Leveling-Osteotomy.

This is a retrospective study evaluating femoral-sciatic nerve blocks (FSBs), epidural analgesia, and non-regional analgesia (NRA) in dogs undergoing tibia-plateau-leveling-osteotomy surgery. Thirty-five records met the criteria for each of the FSB and epidural analgesia groups. Seventeen anesthesia records met the criteria for the NRA or control group. The parameters reported were: isoflurane vaporizer setting, rescue analgesia/anesthesia drugs received, heart rate, systolic blood pressure, and recovery quality (0-4, with 0 being poor and 4 being good). Rescue analgesia-anesthesia during surgery was performed with either fentanyl, ketamine, or propofol. A larger percentage of dogs in the NRA group required rescue analgesia during surgery. The FSB group had a higher recovery quality with median (95% confidence interval of four (±0.3) when compared to two (±0.8) in NRA (p < 0.01). No difference between groups was observed on any other parameter reported. As part of a multimodal analgesia approach for tibia-plateau-leveling-osteotomy surgery, the use of femoral and sciatic nerves blocks with bupivacaine appears to be an alternative technique to help with analgesia and anesthesia during surgery.

The effect of two different intra-operative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses.

OBJECTIVE: To compare the effect of two different intraoperative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Eighteen healthy client-owned adult horses (ASA I-II) admitted for elective surgery. Horses were of a median body mass of 595 (238-706) kg and a mean age of 9 ± 5 years. METHODS: A standardized anaesthetic protocol was used. Horses were positioned in dorsal recumbency and randomly allocated to one of two groups. Controlled mechanical ventilation (CMV) was adjusted to maintain the end-tidal carbon dioxide tension (Pe'CO2 ) at 40 ± 5 mmHg (5.3 ± 0.7 kPa) (group 40) or 60 ± 5 mmHg (8.0 ± 0.7 kPa) (group 60). Arterial blood gas analysis was performed at the start of the anaesthetic period (T0), at one point during the anaesthetic (T1), immediately prior to disconnection from the breathing system (T2) and at the first spontaneous breath in the recovery box (T3). The time from disconnection from the breathing system to return to spontaneous ventilation (RSV) was recorded. Data were analysed using a two sample t-test or the Mann-Whitney U-test and significance assigned when p < 0.05. RESULTS: Horses in group 60 resumed spontaneous breathing significantly earlier than those in group 40, [52 (14-151) and 210 (103-542) seconds, respectively] (p < 0.001). Arterial oxygen tension (PaO2 ), pH, base excess (BE) and plasma bicarbonate (HCO3-) were not different between the groups at RSV, however, PaO2 was significantly lower in group 60 during (T1) and at the end of anaesthesia (T2). CONCLUSIONS AND CLINICAL RELEVANCE: Aiming to maintain intra-operative Pe'CO2 at 60 ± 5 mmHg (8.0 ± 0.7 kPa) in mechanically ventilated horses resulted in more rapid RSV compared with when Pe'CO2 was maintained at 40 ± 5 mmHg (5.3 ± 0.7 kPa).

Intraoperative acridine orange photodynamic therapy and cribriform electron-beam irradiation for canine intranasal tumors: A pilot study.

Untreated canine intranasal tumors carry a poor prognosis. We retrospectively evaluated the efficacy of marginal tumor resection in combination with intraoperative acridine orange (AO) photodynamic therapy (PDT) and 1 fraction of 5 Gy megavoltage irradiation for canine intranasal malignant tumors. When cribriform plate invasion or turbinate destruction around the cribriform plate was present, an additional fraction of 20 Gy was delivered with an electron beam during surgery. The study included 6 dogs, 2 of which were classified as stage I, 1 as stage II, and 3 as stage IV. The median local disease-free survival time and overall survival after the treatment were 8.5 and 13 months, respectively. Recurrence was noted in 2 of the 6 dogs after 4 and 7 months. Adverse events were mild (subcutaneous emphysema in 1 case, and rhinitis in 3 cases). Combination AO therapy may increase the tumor control time of dogs with marginally resectable intranasal malignant tumors.

Pour des tumeurs intra-nasales malignes, une thérapie photodynamique administrant de l'acridine orange pendant l'opération et une irradiation par mégavoltage aux plaques cribriforms: l'etude préliminaire. Le pronostic des tumeurs intra-nasales canines non traitées est défavorable. Cette étude avait pour objectif d'évaluer rétrospectivement l'efficacité de la résection marginale d'une tumeur associée à une thérapie photodynamique (TPD) administrant de l'acridine orange (AO) pendant l'opération et à 1 fraction de 5 Gy d'irradiation par mégavoltage dans le traitement des tumeurs intra-nasales malignes. En cas d'invasion des plaques cribriformes et/ou de présence de cornets autour des lésions cribriformes, une fraction supplémentaire de 20 Gy a été administrée pendant l'opération par faisceaux d'électrons. Six chiens ont été inclus dans l'étude. Deux chiens présentaient des tumeurs de stade I, un de stade II et trois de stade IV. La durée moyenne de survie sans récidive locale et de survie globale après le traitement étaient respectivement de 8,5 et 13 mois. Une nouvelle tumeur est apparue chez deux des six chiens, respectivement 4 et 7 mois après le traitement. Les effets indésirables étaient bénins (un cas d'emphysème sous-cutané et trois cas de rhinite. L'association de la thérapie par AO améliorerait la durée de contrôle de la tumeur chez les chiens présentant des tumeurs intra-nasales malignes marginalement résécables.(Traduit par les auteurs).

Effects of 10% hydroxyethyl starch (HES 200/0.5) solution in intraoperative fluid therapy management of horses undergoing elective surgical procedures.

The aim of the present study was to investigate the effect of pentastarch on colloid osmotic pressure (COP) and cardiopulmonary function during and up to 24 h after anaesthesia in horses. Twenty-five systemically healthy horses were anaesthetised using isoflurane-medetomidine balanced anaesthesia. Twelve were assigned to treatment with hydroxyethyl starch (HES) (H group) and 13 to no HES (NH group). In the H group, 6 mL/kg of pentastarch 10% HES (200/0.5) was infused over 1 h starting 30 min after induction of anaesthesia. Horses of the NH group received an equal amount of lactated Ringer's solution (LRS). COP and blood biochemical, cardiopulmonary and anaesthesia-related variables were measured at different time points before and after treatment. Pentastarch was effective in correcting the decrease in COP observed with LRS administration. No differences between treatments were detected for blood glucose, lactate, total proteins and electrolytes. Packed cell volume was lower with the H group immediately after finishing HES-administration and for an additional 30 min. In all horses, all blood biochemical variables other than lactate returned to normal after 12 h. No clinically relevant differences between treatments were detected for cardiopulmonary variables, although 23.1% of the NH-horses needed rescue-HES to maintain cardiovascular function, while none of the H-horses needed additional colloids. Overall, 6 mL/kg HES (200/0.5) was found to be effective in maintaining COP during anaesthesia in systemically healthy horses. Intermediate and long-term effects were below the limit of detection. The potentially beneficial effects on cardiovascular function need further investigation, especially in critically ill horses.

General anesthesia in horses on fluid and electrolyte therapy.

The purpose of this article is to update the community of veterinarians performing general anesthesia in horses on fluid therapy. The rationale behind intraoperative fluid therapy, fluid dynamics, and various fluid options (crystalloids, hypertonic saline, colloids) is discussed. Additionally, electrolytes (calcium, potassium, and sodium) are included in the discussion in relation to general anesthesia and intraoperative fluid management.

Anesthesia for the horse with colic.

This article discusses anesthesia for horses with colic from acute gastrointestinal disease. Emphasis is placed on new developments in pre-, intra-, and immediate postoperative management over the last decade, including early goal-directed therapy (EGDT) in the resuscitation of septic patients, the controversy over the optimal fluid type to administer, and the management of complications, such as cardiovascular depression, hypoventilation and hypoxemia, and decreased colloid oncotic pressure (COP). An update on analgesia is also provided; older drugs such as ketamine and lidocaine are increasingly being recognized both for their analgesic properties and other potentially beneficial effects in endotoxemic horses.

Intraoperative antinociception and postoperative analgesia following epidural anesthesia versus femoral and sciatic nerve blockade in dogs undergoing stifle joint surgery.

OBJECTIVE: To compare analgesic efficacy of preoperative epidural anesthesia with efficacy of femoral and sciatic nerve blockade in dogs undergoing hind limb orthopedic surgery. DESIGN: Prospective randomized blinded clinical study. ANIMALS: 22 dogs requiring stifle joint surgery. PROCEDURES: Dogs were premedicated with acepromazine and morphine, and anesthesia was induced with diazepam and propofol and maintained with sevoflurane in oxygen. Prior to surgery, a combination of 1.0% lidocaine solution with 0.25% bupivacaine solution was administered either into the lumbosacral epidural space (11 dogs) or perineurally along the femoral and sciatic nerves (11). Intraoperative nociception was assumed if heart rate or systolic blood pressure increased by > 10% from baseline, in which case fentanyl (2 µg/kg [0.9 µg/lb], IV) was administered as rescue analgesia. Following recovery from anesthesia, signs of postoperative pain were assessed every 30 minutes for 360 minutes from the time of local anesthetic administration via the modified Glasgow pain scale. Patients with scores > 5 (scale, 0 to 20) received hydromorphone (0.1 mg/kg [0.05 mg/lb], IV) as rescue analgesia and were then withdrawn from further pain scoring. RESULTS: Treatment groups did not differ significantly in the number fentanyl boluses administered for intraoperative rescue analgesia. Time to administration of first postoperative rescue analgesia was comparable between groups. Furthermore, there was no significant difference between groups in baseline pain scores, nor were there significant differences at any other point during the postoperative period. CONCLUSIONS AND CLINICAL RELEVANCE: Femoral and sciatic nerve blocks provided intraoperative antinociception and postoperative analgesia similar to epidural anesthesia in dogs undergoing stifle joint surgery.

Evaluation of peri-operative epidural analgesia with ropivacaine, ropivacaine and sufentanil, and ropivacaine, sufentanil and epinephrine in isoflurane anesthetized dogs undergoing tibial plateau levelling osteotomy.

The purpose of this study was to compare four epidural protocols for peri-operative analgesia in dogs undergoing tibial plateau levelling osteotomy. Forty client-owned dogs were randomly assigned to one of four treatments - groups R0.5 and R1 received 0.5mg/kg and 1mg/kg ropivacaine, respectively. Group SR0.5 received 1 µg/kg sufentanil plus 0.5mg/kg ropivacaine, and group SER0.5 received 1 µg/kg sufentanil, 0.5mg/kg ropivacaine plus 6 µg/kg epinephrine. Dilution, when required, was performed with saline, so that the injected volume was always 0.2 mL/kg. Intra-operatively, nociception assessment was based on the evaluation of changes in heart rate, respiratory rate and mean arterial pressure. Post-operative pain assessment was performed using the Glasgow visual analogue pain scale, and an ad hoc multifactorial pain score. Motor block was evaluated using a modified Bromage score. Intra-operatively, none of the animals was hypotensive. All groups except SER0.5 required rescue intra-operative fentanyl (40%, 30% and 40% of the animals in groups R0.5, R1 and SR0.5, respectively). Group SER0.5 showed lower post-operative pain scores, and group R1 significantly greater motor block, compared to the other treatment groups. None of the dogs had urinary retention. Epidural sufentanil-epinephrine-ropivacaine provided superior peri-operative analgesia compared to the other treatments, without producing clinically relevant side effects.

Intraoperative parathyroid hormone concentration to confirm removal of hypersecretory parathyroid tissue and time to postoperative normocalcaemia in nine dogs with primary hyperparathyroidism.

OBJECTIVE: To determine (1) whether the intraoperative parathyroid hormone concentration ([PTH]) during parathyroidectomy (PTX) can be used to indicate cure in dogs with primary hyperparathyroidism and (2) the time taken for postoperative serum calcium concentration to normalise. DESIGN: Retrospective study (2005-10) from a private referral hospital in Sydney, New South Wales, Australia. PROCEDURE: Nine client-owned dogs underwent surgical PTX for naturally occurring primary hyperparathyroidism. [PTH] was measured from serum samples taken immediately post-induction (pre-PTX]) and at least 20 min after adenoma removal (post-PTX) for all dogs, and during parathyroid gland manipulation (intra-PTX) for six dogs. The concentration of ionised calcium (iCa) was measured at various time points postoperatively until it normalised, then stabilised or decreased below reference ranges. Statistical analysis compared the mean pre-, intra- and post-PTX [PTH] and the average rate of decline of iCa concentration postoperatively. RESULTS: All dogs demonstrated a significant decrease from mean pre-PTX [PTH] (168.51 pg/mL) to mean post-PTX [PTH] (29.20 pg/mL). There was a significant increase in mean intra-PTX [PTH] (279.78 pg/mL). The average rate of decline of iCa concentration postoperatively to within the reference range (1.12-1.40 mmol/L) occurred after 24 h. CONCLUSION: Intraoperative measurements of [PTH] can be used clinically to determine cure of primary hyperparathyroidism. Parathyroid hormone increases significantly during parathyroid gland manipulation. Plasma iCa concentration returns to within the reference range on average 24 h after successful PTX. Not all dogs require vitamin D or calcium supplementation pre- or postoperatively.

Risk factors and clinical relevance of positive intraoperative bacterial cultures in dogs with total hip replacement.

OBJECTIVE: To report incidence and relevance of positive intraoperative total hip replacement (THR) bacterial cultures taken at the time of surgical closure in dogs having unilateral THR. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 100) with cemented (CFX), cementless (BFX), or hybrid THR. METHODS: Medical records (January 2007-March 2010) of dogs that had THR were reviewed. Signalment, type and side of THR, concurrent surgery, operative and anesthetic times, intraoperative coxofemoral closing (CC) bacterial culture results, organism cultured, duration of postoperative antibiotic administration, physical examination findings at 3 weeks, 3 months, and at 6 months to 1 year after surgery, radiographic findings at 3 months and between 6 months and 1 year after surgery, and incidence of complications were retrieved. RESULTS: There was a significant difference in duration of surgery between CC culture negative and CC culture positive groups (103.27 minutes versus 122.50 minutes, respectively, P < .038) and in total anesthetic time between CC culture negative and culture positive groups (165.20 minutes versus 189.50 minutes, respectively, P < .038). There was no significant difference between CC culture negative and culture positive groups for median age (30 months versus 39 months, respectively, P < .75), median weight (36.91 kg versus 35.68 kg, respectively, P < .61), median clinical signs (4 months versus 3.5 months, respectively, P < .65), sex (males 44.32% versus females 25.00%, respectively, P < .20), laterality (left 55.68% versus right 50.00%, respectively, P < .71), concurrent surgery (extracapsular lateral imbrication/medial patella luxation/lateral patella luxation [ECLI/MPL/LPL] 22.73% versus none 25.00%, respectively, P < 1.00), and THR type (hybrid 17.05% versus 25.00% respectively; CFX 60.23% versus 75.0%; BFX 22.73% versus 0.0%; Fisher's exact test P < .17). CONCLUSIONS: Surgical and anesthetic duration were significantly associated with positive CC culture results. Positive CC culture results were not associated with adverse results at 3 months and at 6-month to 1-year follow-up evaluation.

Comparison of three intraoperative patient warming systems.

The purpose of this randomized clinical trial was to compare the efficacy of three patient warming devices (i.e., circulating water blanket, forced-air, and warming panels) used either alone or in combination on patients undergoing surgeries lasting >60 min. In total, 238 dogs were included and divided into either the celiotomy or nonceliotomy group. Dogs in each group were further divided into one of three subgroups. Dogs in subgroup 1 (n=39) were placed on a circulating water blanket with a forced-air warming blanket placed over the trunk. Subgroup 2 dogs (n=40) were placed on a forced-air warming blanket only. Subgroup 3 dogs (n=40) were placed on warming panels. Significant temperature drops occurred from time of induction (38.1°C±0.64°C) to the start of surgical procedures (36.7°C±0.95°C). Although body temperature was maintained once the warming units were started in all groups, there were significant differences in temperatures for the type of surgical procedures (i.e., celiotomies versus nonceliotomies) performed over time except for subgroup 3. The warming panels and forced-air devices were equally effective in preserving body temperature in anesthetized patients.