Comportamento da glicemia em dois diferentes períodos de jejum alimentar pré-anestésico em cães / Blood glucose behavior in two different periods of preanesthetic food fasting in dogs

O jejum pré-anestésico de cães é de suma importância, pois com ele podem ser evitados problemas antes, durante e após o procedimento cirúrgico. Como o animal encontra-se em uma posição jacente, o jejum inadequado pode ocasionar refluxo, que pode levar a uma broncoaspiração e esofagite, causando complicações pós-cirúrgicas, como: apatia, pneumonia, regurgitação, êmese, disfagia e emagrecimento. Um dos carboidratos fundamentais no jejum é a glicose, que tem como função básica o fornecimento de energia. Para que o procedimento aconteça de forma equilibrada, a mensuração da concentração de glicose é indispensável, pois a identificação de um animal hiperglicêmico ou hipoglicêmico possibilita o diagnóstico precoce de inúmeras morbidades, além de atuar diretamente na terapêutica. O ideal é que o cão esteja com os níveis glicêmicos adequados (60 a 120 mg/dL), dessa forma, evita-se a ocorrência de adversidades.(AU)

Pre-anesthetic fasting of dogs is of paramount importance, because with it it is possible the avoidance of some problems before, during and after the surgery procedure. Since the animal is in a recumbent position, inadequate fasting can cause reflux, which can lead to bronchoaspiration and esophagitis, causing post-surgical complications, such as: apathy, pneumonia, regurgitation, emesis, dysphagia and slimming. One of the fundamental carbohydrates in fasting is glucose, because its basic function is to provide energy. For the procedure to happen in a balanced way, the measurement of glucose concentration is essential, since identifying a hyperglycemic or hypoglycemic animal helps the early diagnosis of numerous morbidities, in addition to acting directly in the therapy. The ideal is that the dog has adequate glycemic levels (60 to 120 mg/dL), thus avoiding possible adversities.(AU)

Fratura de úmero em uma curicaca (Theristicus caudatus) - manejo anestésico e cirúrgico / Humerus fracture in a buff-necked ibis (Theristicus caudatus) - anesthesia and surgical procedures

Background: The medical science of birds, with the exception of aviculture, has a very short history compared to other subdisciplines of veterinary medicine. With this in mind, the current work aims to report the case of a buff-necked ibis with an open fracture of the left humerus, presenting the surgical treatment and anesthetic protocol used, in order to contribute to the avian medical literature. Case: An adult buff-necked ibis (Theristicus caudatus) was referred to the University Veterinary Hospital with an open fracture of the left humeral shaft, 7 days after rescue. During the physical examination, a skin lesion was identified in the fracture area, with signs of low vascularization, devitalization, necrotic tissues, and purulent secretions being noted. On radiographic examination, the fracture was classified as comminuted, with exposure of the left humeral shaft. After evaluating the limb, it was decided to amputate the wing, and 24 h later, the patient was referred to the operating room after fasting for 4 h. As pre-anesthetic medication, ketamine (20 mg/kg) and midazolam (1 mg/kg) were administered, both intramuscularly. Orotracheal intubation was performed, after which the tracheal tube was connected to a Baraka-type gas-free system and the supply of isoflurane was started through a universal vaporizer, diluted in 100% oxygen. For transoperative analgesia, brachial plexus block was performed using 2% lidocaine (2 mg/kg). During the surgical procedure, an incision was made in the skin and subcutaneous tissue in the middle third of the left humerus, and detachment of the greater deltoid muscle was performed with a periosteal elevator, followed by excision of the tensor propatagialis. In the ventrodorsal region, circular ligation of the brachial vein, ulnar vein and artery, and median-ulnar nerve was carried out, and disarticulation of the scapulacoracoid-humeral region. Subsequently, abolition of dead space and a myorrhaphy were performed, followed by demorrhaphy. In the immediate post-operative period, morphine (5 mg/kg), meloxicam (0.1 mg/kg), and enrofloxacin (10 mg/kg) were administered intramuscularly. The patient was discharged from the hospital 6 h after the end of the surgical procedure. Discussion: Interest in the conservation of wild birds is one of the causes of the increased demand for anesthetic and surgical procedures in these species. However, it is a challenge for professionals in the field. The use of analgesics is recommended for reasons of well-being, but also because of the possibility of reducing the concentration of inhalational anesthetics in surgical procedures. Ketamine associated with midazolam promotes sufficient sedation and muscle relaxation in the patient, enabling safe preoperative management, in addition to reducing the amount of inhaled anesthetics used during the transoperative period. Isofluorane promotes safe general anesthesia for birds and has an advantage over injectable drugs, as it provides better dynamic control of anesthetic depth in these species. The brachial plexus block performed is a simple procedure that promotes quality anesthesia and analgesia in the perioperative period. The choice for amputation was due to the absence of musculature for closure, severe skin, muscle, and bone devitalization, and the infectious process in the region, factors that would prevent osteosynthesis. Although amputation through the bone is preferable, the disarticulation technique was used due to the absence of a healthy proximal humeral fragment. The patient's death can be explained by the poor nutritional status the bird was in, as it presented an open fracture with severe contamination, a concomitant injury that occurred during the possible trauma, and the excessive time between the day of the trauma and the day of medical attendance. However, the surgical and anesthetic procedures were adequate and satisfactory for the patient. The importance of identifying and treating diseases secondary to contaminated fractures in these species is emphasized.

Systolic blood pressure in anesthetized bitches measured with photoplethysmography

Background: Photoplethysmography is widely used in human medicine, with few studies on its use in veterinary medicine. Its sensor detects fluctuations in blood volume at the site, providing direct readings of cardiac pulse and peripheral oxygen saturation, as well as estimating cardiac output, respiratory rate and blood pressure. This study aimed to evaluate the use of photoplethysmography and compare it to vascular Doppler ultrasound as an indirect method of measuring systolic blood pressure in bitches undergoing elective ovariohysterectomy, using the invasive assessment of systolic blood pressure as a reference. Materials, Methods and Results: After clinical and laboratory evaluation, 34 healthy bitches were selected to undergo elective ovariohysterectomy. After food and water fasting, patients received pethidine hydrochloride intramuscularly as pre-anesthetic medication, followed by anesthetic induction with fentanyl citrate and propofol intravenously. General anesthesia was maintained by inhalation with isoflurane diluted in 100% oxygen. Intraoperative analgesia consisted of continuous infusion of fentanyl citrate intravenously. The animals were randomly divided into 2 groups, the thoracic limb group (TLG) and the pelvic limb group (PLG). In each patient, non-invasive blood pressure measurement was obtained simultaneously with Doppler (DOP) and photoplethysmography (PPG). The sensors of both devices were placed on the end of the same limb. The PPG sensor was positioned in the interdigital region. In patients belonging to the TLG, the Doppler sensor was placed in the ventral region of the thoracic limb, under the ulnar artery. In PLG patients, the Doppler sensor was placed in the dorsal region of the pelvic limb, over the dorsal artery of the foot. The sphygmomanometer was positioned close to the sensors. For systolic blood pressure (SBP) measurement, the cuff was inflated until the Doppler sound signal and the plethysmographic wave were lost. The cuff was then deflated until the Doppler pulse sound resumed and the photoplethysmography showed at least 2 continuous waves on a regular basis. The corresponding pressure value observed on the manometer consisted of the SBP. The same 2 evaluators performed all SBP measurements: 1 responsible for the DOP method and the other for the PPG method; both were blind to the other's findings, thus minimizing potential bias in the results. All animals underwent cannulation of the auricular artery for invasive measurement of systolic blood pressure, using a multiparameter monitor. All blood pressure measurements were performed at 5-min intervals, as well as obtaining additional parameters (heart and respiratory rate, esophageal temperature, partial tissue oxygen saturation, carbon dioxide concentration) and electrocardiographic monitoring. All parameters were documented for further statistical analysis. A strong correlation (r² = 0.95) was obtained between the DOP and PPG methods regardless of the limb on which the sensors were placed. There was a low correlation between the invasive method of measuring systolic blood pressure and the other methods. There was better agreement between the DOP and PPG methods (r2 = -0.0061; P = 0.85) when systolic blood pressure was measured in the TLG. Discussion: In the PLG, the values obtained with the DOP and PPG methods were significantly higher than those obtained with the invasive method, while the values obtained in the TLG differed slightly. It was found that the best measurement site by non-invasive methods was the thoracic limb. It was concluded that the non-invasive methods showed a low correlation with the invasive method; however, both methods had similar characteristics and photoplethysmography can be used to replace the vascular Doppler method.

Effect of pre-anesthetic fasting on gastric emptying and plasma glucose in healthy dogs of different age groups / Efeito do jejum pré-anestésico sobre o esvaziamento gástrico e a glicemia plasmática em cães hígidos de diferentes faixas etárias

Gastric emptying and plasma glucose were evaluated in young and adult dogs, fed with dry and wet food, submitted to different periods of pre-anesthetic fasting (6, 8, and 12 hours). Forty healthy dogs were selected, which were segmented into four groups according to the age group and type of diet. It was evaluated the gastric emptying by ultrasound and serum glycemia. Only 17.5% presented complete gastric emptying, and no significant differences were found between the 6 and 8-hour fasting evaluations, or between the age groups and the diets, considering significance level p<0.05. Mean plasma glucose values from the groups indicated normal glycemia at all times of evaluation. A significant difference was found between the means of glycemia in young and adult dogs, with the 8-hour fasting with wet diet (p=0.03) and with 12 hours with dry diet (p=0.04). Healthy young and adult dogs, in physiological equilibrium, maintain average values of plasma glucose despite prolonged periods of pre-anesthetic fasting, which may be necessary, since 8-hour fasting for solid food is not enough to provide complete gastric emptying.(AU)

Avaliou-se o esvaziamento gástrico e a glicemia plasmática em cães jovens e adultos, alimentados com ração seca e úmida, submetidos a diferentes períodos de jejum pré-anestésico (6, 8 e 12 horas). Foram selecionados 40 cães hígidos, os quais foram segmentados em 4 grupos de acordo com a faixa etária e o tipo de dieta administrada. Foi avaliado o esvaziamento gástrico por ultrassonografia e a glicemia sérica. Apenas 17,5% apresentaram completo esvaziamento gástrico, não sendo encontradas diferenças significativas entre as avaliações com 6 e 8 horas de jejum, ou entre as faixas etárias e dietas, considerando nível de significância p<0,05. Os valores médios da glicose plasmática dos grupos indicaram normoglicemia em todos os momentos de avaliação. Foi encontrada diferença significativa entre as médias da glicemia dos cães jovens e adultos, no período de 8 horas de jejum com dieta úmida (p=0,03) e com 12 horas nos animais com dieta seca (p=0,04). Conclui-se que cães hígidos jovens e adultos, em equilíbrio fisiológico, mantêm valores normais de glicemia plasmática apesar de períodos prolongados de jejum pré-anestésico, os quais podem ser necessários, tendo em vista que 8 horas de jejum alimentar de sólidos não é suficiente para proporcionar completo esvaziamento gástrico.(AU)

Effect of pre-anesthetic fasting on gastric emptying and plasma glucose in healthy dogs of different age groups / Efeito do jejum pré-anestésico sobre o esvaziamento gástrico e a glicemia plasmática em cães hígidos de diferentes faixas etárias

Gastric emptying and plasma glucose were evaluated in young and adult dogs, fed with dry and wet food, submitted to different periods of pre-anesthetic fasting (6, 8, and 12 hours). Forty healthy dogs were selected, which were segmented into four groups according to the age group and type of diet. It was evaluated the gastric emptying by ultrasound and serum glycemia. Only 17.5% presented complete gastric emptying, and no significant differences were found between the 6 and 8-hour fasting evaluations, or between the age groups and the diets, considering significance level p<0.05. Mean plasma glucose values from the groups indicated normal glycemia at all times of evaluation. A significant difference was found between the means of glycemia in young and adult dogs, with the 8-hour fasting with wet diet (p=0.03) and with 12 hours with dry diet (p=0.04). Healthy young and adult dogs, in physiological equilibrium, maintain average values of plasma glucose despite prolonged periods of pre-anesthetic fasting, which may be necessary, since 8-hour fasting for solid food is not enough to provide complete gastric emptying.(AU)

Avaliou-se o esvaziamento gástrico e a glicemia plasmática em cães jovens e adultos, alimentados com ração seca e úmida, submetidos a diferentes períodos de jejum pré-anestésico (6, 8 e 12 horas). Foram selecionados 40 cães hígidos, os quais foram segmentados em 4 grupos de acordo com a faixa etária e o tipo de dieta administrada. Foi avaliado o esvaziamento gástrico por ultrassonografia e a glicemia sérica. Apenas 17,5% apresentaram completo esvaziamento gástrico, não sendo encontradas diferenças significativas entre as avaliações com 6 e 8 horas de jejum, ou entre as faixas etárias e dietas, considerando nível de significância p<0,05. Os valores médios da glicose plasmática dos grupos indicaram normoglicemia em todos os momentos de avaliação. Foi encontrada diferença significativa entre as médias da glicemia dos cães jovens e adultos, no período de 8 horas de jejum com dieta úmida (p=0,03) e com 12 horas nos animais com dieta seca (p=0,04). Conclui-se que cães hígidos jovens e adultos, em equilíbrio fisiológico, mantêm valores normais de glicemia plasmática apesar de períodos prolongados de jejum pré-anestésico, os quais podem ser necessários, tendo em vista que 8 horas de jejum alimentar de sólidos não é suficiente para proporcionar completo esvaziamento gástrico.(AU)