Multicenter study to investigate factors associated with change in rectal temperature during anesthesia in dogs.

OBJECTIVE: To determine factors associated with change in rectal temperature (RT) of dogs undergoing anesthesia. ANIMALS: 507 dogs. PROCEDURES: In a prospective observational study, the RT of dogs undergoing anesthesia at 5 veterinary hospitals was recorded at the time of induction of anesthesia and at the time of recovery from anesthesia (ie, at the time of extubation). Demographic data, body condition score, American Society of Anesthesiologists (ASA) physical status classification, types of procedure performed and medications administered, duration of anesthesia, and use of heat support were also recorded. Multiple regression analysis was performed to determine factors that were significantly associated with a decrease or an increase (or no change) in RT. Odds ratios were calculated for factors significantly associated with a decrease in RT. RESULTS: Among the 507 dogs undergoing anesthesia, RT decreased in 89% (median decrease, -1.2°C [-2.2°F]; range, -0.1°C to -5.7°C [-0.2°F to -10.3°F]), increased in 9% (median increase, 0.65°C [1.2°F]; range, 0.1°C to 2.1°C [3.8°F]), and did not change in 2%. Factors that significantly predicted and increased the odds of a decrease in RT included lower weight, ASA classification > 2, surgery for orthopedic or neurologic disease, MRI procedures, use of an α2-adrenergic or µ-opioid receptor agonist, longer duration of anesthesia, and higher heat loss rate. Lack of µ-opioid receptor agonist use, shorter duration of anesthesia, and lower heat loss rate were significantly associated with an increase in RT. CONCLUSIONS AND CLINICAL RELEVANCE: Multiple factors that were associated with a decrease in RT in dogs undergoing anesthesia were identified. Knowledge of these factors may help identify dogs at greater risk of developing inadvertent perianesthetic hypothermia.

Characterization of Quinoline Yellow Dyes As Transient Aryl Hydrocarbon Receptor Agonists.

The aryl hydrocarbon receptor (AHR) and estrogen receptor alpha (ERα) are two ligand activated transcription factors that are targeted by a wide range of anthropogenic compounds. Crosstalk between both receptors is well established but little understood. We previously developed a dual color luciferase assay (i.e., XEER) which allows time dissolved monitoring of the activation of both receptors in situ. The system was now used in conjunction with HPLC-qTOF to identify several quinophthalone dyes as transient receptor agonists of the AHR. Altogether the approach identified three widely used dyes, that is the plastic colorant latyl yellow 3G (LY), the structurally related textile dye disperse yellow 64 (DY), and the cosmetic dye quinoline yellow (QY). The latter was the most potent agonist followed by LY and DY as confirmed by the XEER assay and CYP1A1 gene induction in MCF7 cells. In addition QY, LY, and DY also inhibited ER signaling in an AHR-dependent manner. This establishes some evidence for quinoline yellow dyes as potential disruptors of AHR/ER signaling, raising potential toxicological concern. Although none of the dyes featured any signs of genotoxicity in vitro, our data point to the need for a systematic approach when screening for substances of potential toxicological and endocrine relevance.

Client perceptions of the value of veterinary anesthesiologist involvement with anesthesia and pain management, benefits of a preanesthetic consultation, and quality of care for dogs undergoing elective orthopedic surgery.

OBJECTIVE: To compare perceptions related to veterinary anesthesiologist involvement with anesthesia and pain management, benefits of a preanesthetic consultation (PAC) with an anesthesiologist, and quality of patient care between clients who did and did not participate in a PAC prior to their dogs' elective orthopedic surgery. SAMPLE: 80 dog owners. PROCEDURES: Owners of dogs undergoing elective stifle joint surgery participated in the study. Participants were randomly assigned to PAC and control groups (n = 40 participants/group). The PAC group participated in a PAC with an anesthesiologist and completed a written survey (12 items with Likert-type response options). The control group completed a similar survey (identical except for 2 statements related to the PAC experience) without participating in a PAC. Results were compared between groups by statistical methods. RESULTS: The proportion of clients in the PAC group who strongly agreed with the statements that a PAC was beneficial, their questions about the pet's anesthesia and pain management plan were answered, they knew who would perform anesthesia and what safeguards were in place, veterinary specialty hospitals should have an anesthesiologist on staff, they were willing to pay more to have an anesthesiologist supervise the anesthesia and pain management, and a PAC with an anesthesiologist should be standard of care in veterinary medicine was greater than that for control group clients. Responses to quality-of-care items did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Participating in a PAC was associated with more positive perceptions of anesthesiologists and knowledge about the anesthesia plan. Further research with a validated survey instrument is needed to confirm these findings.

Are adverse effects of cannabidiol (CBD) products caused by tetrahydrocannabinol (THC) contamination?

Cannabidiol (CBD)-containing products are widely marketed as over the counter products, mostly as food supplements. Adverse effects reported in anecdotal consumer reports or during clinical studies were first assumed to be due to acid-catalysed cyclization of CBD to psychotropic Δ 9tetrahydrocannabinol (Δ 9-THC) in the stomach after oral consumption. However, research of pure CBD solutions stored in simulated gastric juice or subjected to various storage conditions such as heat and light with specific liquid chromatographic/tandem mass spectrometric (LC/MS/MS) and ultra-high pressure liquid chromatographic/quadrupole time-of-flight mass spectrometric (UPLC-QTOF) analyses was unable to confirm THC formation. Another hypothesis for the adverse effects of CBD products may be residual Δ 9-THC concentrations in the products as contamination, because most of them are based on hemp extracts containing the full spectrum of cannabinoids besides CBD. Analyses of 362 hemp-based products of the German market (mostly CBD oils) confirmed this hypothesis: 39 products (11%) contained Δ 9-THC above the lowest observed adverse effect level (2.5 mg/day). Hence, it may be assumed that the adverse effects of some commercial CBD products are based on a low-dose effect of Δ 9-THC, with the safety of CBD itself currently being unclear with significant uncertainties regarding possible liver and reproductive toxicity. The safety, efficacy and purity of commercial CBD products is highly questionable, and all of the products in our sample collection showed various non-conformities to European food law such as unsafe Δ 9-THC levels, hemp extracts or CBD isolates as non-approved novel food ingredients, non-approved health claims, and deficits in mandatory food labelling requirements. In view of the growing market for such lifestyle products, the effectiveness of the instrument of food business operators' own responsibility for product safety and regulatory compliance must obviously be challenged, and a strong regulatory framework for hemp products needs to be devised.

Effects of intravenous terbutaline on heart rate, arterial pressure and blood gases in anesthetized horses breathing air.

OBJECTIVE: To investigate the effects of intravenous (IV) administration of terbutaline on PaO2, PaCO2, pH, heart rate (HR) and arterial pressures in healthy, laterally recumbent horses breathing ambient air under total intravenous anesthesia (TIVA). STUDY DESIGN: Prospective experimental study. ANIMALS: Eight healthy adult horses were enrolled. Six horses, four mares and two geldings weighing 433-624 kg, completed the study. METHODS: Horses were sedated with xylazine (1.0 mg kg-1) IV for placement of arterial and venous catheters. Anesthesia was induced with midazolam (0.1 mg kg-1) and ketamine (2.2 mg kg-1) IV and maintained with an IV infusion of guaifenesin (50 mg mL-1), ketamine (2 mg mL-1) and xylazine (0.5 mg mL-1) at 1.9 ± 0.3 mL kg-1 hour-1. Horses were in left lateral recumbency and breathed air spontaneously. Arterial blood was collected for pH and blood gas analysis during xylazine sedation, 15 minutes after induction of anesthesia, immediately before and 5, 15 and 30 minutes after administration of terbutaline (2 µg kg-1), and when the horse was standing after recovery from anesthesia. HR, systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were recorded at 5 minute intervals during anesthesia. Normal data were analyzed with anova and non-normal data were analyzed with a Friedman test with a p < 0.05 considered significant. RESULTS: The mean PaO2 decreased from baseline to <60 mmHg (8.0 kPa) during anesthesia (p < 0.0001) and did not improve after administration of terbutaline. After terbutaline administration, HR increased (p = 0.002), and SAP, MAP and DAP decreased (p < 0.001) with the greatest changes occurring immediately after terbutaline administration. CONCLUSIONS AND CLINICAL RELEVANCE: Terbutaline (2 µg kg-1) IV did not improve PaO2 and was associated with adverse cardiovascular effects during TIVA in healthy, laterally recumbent horses breathing air.

Anesthesia of the Equine Neonate in Health and Disease.

Anesthetizing the neonatal foal presents significant challenges as a result of physiologic differences from the adult equine. This article gives the reader an overview of these differences and the impact they have on anesthetic drug selection, monitoring, and support of the equine neonate. Special emphasis is directed to the sick neonate and appropriate preparation and maintenance of anesthesia in the face of commonly presented disease conditions.

Epithelioid hemangioendothelioma of the lung presenting with pneumonia and heart rhythm disturbances in a teenage girl.

The epithelioid hemangioendothelioma (EHE) is a rare low-grade tumor of vascular origin that may arise at any site. However, lung and liver represent the 2 main locations. Symptoms of the pulmonary EHE are usually nonspecific and mild. Distant metastases of PEHE are frequent. However, heart metastases have only been reported in connection with primary EHE of the liver. We describe the case of a 15-year-old girl presenting with an abscess forming pneumonia and severe rhythm disturbances associated with an EHE of the lung. The untypical fulminant clinical course, the surgical interventions, and the involvement of the heart as a life threatening complication, eventually on the basis of cardiac metastases of PEHE, are emphasized.

A comparison of epidural buprenorphine plus detomidine with morphine plus detomidine in horses undergoing bilateral stifle arthroscopy.

OBJECTIVE: To compare the analgesic efficacy of buprenorphine plus detomidine with that of morphine plus detomidine when administered epidurally in horses undergoing bilateral stifle arthroscopy. STUDY DESIGN: Prospective, randomized, blinded clinical trial. ANIMALS: Twelve healthy adult horses participating in an orthopedic research study. Group M (n = 6) received morphine (0.2 mg kg(-1)) and detomidine (0.15 mg kg(-1)) epidurally; group B (n = 6) received buprenorphine (0.005 mg kg(-1)) and detomidine (0.15 mg kg(-1)) epidurally. METHODS: Horses received one of two epidural treatments following induction of general anesthesia for bilateral stifle arthroscopy. Heart rate (HR), mean arterial blood pressure (MAP), end-tidal CO(2) (Pe'CO(2)), and end-tidal isoflurane concentrations (E'Iso%) were recorded every 15 minutes following epidural administration. Post-operative assessment was performed at 1, 2, 3, 6, 9, 12, and 24 hours after standing; variables recorded included HR, respiratory rate (f(R)), abdominal borborygmi, defecation, and the presence of undesirable side effects. At the same times post-operatively, each horse was videotaped at a walk and subsequently assigned a lameness score (0-4) by three ACVS diplomates blinded to treatment and who followed previously published guidelines. Nonparametric data were analyzed using Wilcoxon's rank-sum test. Inter- and intra-rater agreement were determined using weighted kappa coefficients. Statistical significance was set at p

A complex congenital anomaly: liver eventration because of intrathoracic rib and vertebral segmentation disorder--a case report.

The complicated processes of chest development and differentiation frequently lead to malformations of the ribs and vertebrae. An intrathoracic rib is a rare anomaly. We report here, for the first time, a complex congenital malformation with liver eventration because of a right intrathoracic rib and vertebral segmentation disorder of the spine in a 7-year-old girl without respiratory impairment. Diagnostic features and therapy for congenital rib anomalies are described.