Effect of a novel cannulation device for vascular access on AVF maturation in a goat carotid-jugular fistula model.

OBJECTIVE: The Ark is a 3-D printed titanium device designed to be implanted around the draining vein of an arteriovenous fistula (AVF) to facilitate vascular access. The purpose of this study was to assess AVF maturation after Ark implantation in a large animal model. METHODOLOGY: End-to-side AVFs were created between the carotid artery and jugular vein in nine pygmy goats that included three control (AVF only) and six experimental (AVF and Ark device) animals. For experimental animals, an Ark device was implanted approximately 10 cm downstream of the anastomosis at the time of AVF creation. Postoperative ultrasounds and cannulations of the jugular vein fistula were performed over 12 months. At the conclusion of the study, the AVF was ligated and Ark devices along with a segment of the arterialized vein and surrounding tissues were explanted for gross and histological assessment. RESULTS: The control and experimental Ark groups exhibited increased dilation and flow as well as diminished depth underscoring the parallel developments in vascular attributes and AVF maturation between the two groups. Gross pathology, histology, and micro-CT imaging revealed intact endothelium, mature tissue integration throughout the porous Ark device, and no underlying stenosis. No adverse events such as foreign body reaction, skin or vessel erosion were identified. CONCLUSION: The study showed maturation without stenosis of the fistula in all animals. This study confirmed that the Ark device functions as a scaffold around the access vein, allows fistula maturation, and can be consistently cannulated without infiltrations over a 12-month period in a large animal model.

Ruminant model for hemodialysis cannulation.

BACKGROUND: Preventative strategies that minimize hemodialysis access complications remain limited. OBJECTIVE: This study aimed to address this gap by developing a Caprine cannulation model to investigate the impact of repeated cannulations on vascular access patency rates. RESEARCH DESIGN AND MEASURES: In this pilot study, a meta-analysis was conducted using experimental control data from four trials to explore the impact of Caprine breed (independent variable) on the dependent variables that affect hemodialysis cannulation, including AVF growth, AVF depth, and flow rate. SUBJECTS: Arteriovenous Fistulas (AVFs) were created using the carotid artery and jugular vein in the necks of seven goats from the French alpine, dwarf, and pygmy breeds. All seven AVFs exhibited vessel remodeling patterns similar to that observed in humans and remained patent, enabling hemodialysis access over the 6 month study. RESULTS: Over the course of 18 weeks, a total of 291 cannulations were completed using standard 15 g dialysis needles without complications demonstrating the feasibility of using the Caprine species as a cannulation model. The ease of access coupled with the animals' cooperative behavior further contributes to the suitability of the Caprine species for hemodialysis investigations. Notably, no infections or clinically significant incidents were observed throughout the study. CONCLUSIONS: The stability of AVF patency and flow underscores the viability and potential of the Caprine species animal model as a valuable research platform for exploring interventions aimed at improving vascular access survival in hemodialysis patients.

Sedation with dexmedetomidine decreases skin perfusion in cats.

OBJECTIVE: To evaluate skin perfusion in cats receiving dexmedetomidine compared to a placebo. ANIMALS: 9 healthy adult research cats. METHODS: A randomized, blinded, placebo-controlled study design was used. Two sites, the dorsal metatarsus (site: limb) and lateral flank (site: flank), were evaluated with laser speckle contrast imaging (LSCI) at baseline and following administration of dexmedetomidine (1, 3, or 5 mcg/kg, IV) or a placebo (0.9% saline, IV). Mean speckle contrast (MSC), a surrogate for perfusion, was obtained from LSCI and compared between treatments. Heart rate, sedation score, and body temperature were recorded. Skin perfusion to the flank and limb, reported as MSC, was assessed via LSCI at baseline and at 5, 10, and 15 minutes posttreatment. RESULTS: There was a significant decrease in heart rate (P < .001) in cats receiving 1, 3, and 5 mcg/kg dexmedetomidine compared to placebo. There was a significant increase in median sedation score at all time points postsedation compared to baseline (P < .018). Changes in MSC for the metatarsus were not significantly different between treatments at any time point (P = .12). For the flank, MSC was significantly higher for cats treated with dexmedetomidine compared to baseline (P ≤ .01). Skin perfusion to the flank decreased as early as 5 minutes posttreatment with dexmedetomidine and persisted for at least 15 minutes, regardless of dexmedetomidine dose. CLINICAL RELEVANCE: Dexmedetomidine decreased skin perfusion in cats, even at low doses. Veterinarians may elect for an alternative sedative medication when decreased skin perfusion is a concern.

Intranasal butorphanol and midazolam administered prior to intramuscular alfaxalone provides safe and effective sedation in Quaker parrots (Myiopsitta monachus).

OBJECTIVE: To evaluate 2 doses of alfaxalone on cardiopulmonary parameters, temperature, sedation, endotracheal intubation, the incidence of muscle tremors, and radiographic positioning in Quaker parrots previously administered intranasal midazolam and butorphanol. ANIMALS: 10 healthy adult Quaker parrots (male = 5; female = 5). PROCEDURES: A randomized, masked, crossover study was conducted where birds received midazolam (2 mg/kg) and butorphanol (2 mg/kg) intranasally 15 minutes prior to a low- or high-dose of intramuscular alfaxalone: 2 mg/kg (LDA) or 5 mg/kg (HDA), respectively. Heart (HR) and respiratory rate (RR), cloacal temperature, sedation quality, and ability to position for radiographs were recorded over time. The incidence of muscle tremors and the ability to intubate were recorded. Data were compared to baseline values and between treatments where appropriate. Significance was set at P < .05. RESULTS: There were no significant differences in HR, RR, cloacal temperature, and sedation scores between treatments at any time point. Duration of time from midazolam-butorphanol administration to complete recovery from treatment administration was significantly shorter for LDA when compared to HDA (90 [60 to 195] vs 127.5 [90 to 10] minutes, respectively). Compared to baseline, sedation scores were significantly higher from T = 15 to 60 for LDA and from T = 15 to 75 for HDA. The incidence of muscle tremors was greater in HDA (9/10) than in LDA (7/10). All birds were successfully intubated and positioned for radiographs. CLINICAL RELEVANCE: The combination of intranasal midazolam-butorphanol and intramuscular alfaxalone at the doses examined was a safe and effective method for sedating Quaker parrots. LDA produced adequate sedation with a shorter time to recovery and with fewer muscle fasciculations when compared to HDA.

Gastrointestinal transit time is faster in Beagle dogs compared to cats.

OBJECTIVE: To characterize gastrointestinal transit times (GITTs) and pH in dogs, and to compare to data recently described for cats. ANIMALS: 7 healthy, colony-housed Beagles. PROCEDURES: The GITTs and pH were measured using a continuous pH monitoring system. For the first period (prefeeding), food was withheld for 20 hours followed by pH capsule administration. Five hours after capsule administration, dogs were offered 75% of their historical daily caloric intake for 1 hour. For the second period (postfeeding), food was withheld for 24 hours. Dogs were allowed 1 hour to eat, followed by capsule administration. Both periods were repeated 3 times. The GITTs and pH were compared to published feline data. RESULTS: The mean ± SD transit times in dogs for the pre- and postfeeding periods, respectively, were esophageal, 3 ± 5 minutes and 13 ± 37 minutes; gastric, 31 ± 60 minutes and 829 ± 249 minutes; and intestinal, 795 ± 444 minutes and 830 ± 368 minutes. The mean ± SD gastrointestinal pH in dogs for the pre- and postfeeding periods, respectively, were esophageal, 6.6 ± 0.6 and 5.7 ± 1.0; gastric, 3.0 ± 1.4 and 1.8 ± 0.3; intestinal, 7.9 ± 0.3 and 7.7 ± 0.6; first-hour small intestinal, 7.6 ± 0.5 and 7.1 ± 0.4; and last-hour large intestinal, 7.9 ± 0.6 and 7.7 ± 1.0. The first-hour small intestinal pH and total transit times varied between dogs and cats depending on feed period (P = .002 and P = .04, respectively). Post hoc analysis revealed significantly shorter total transit times in dogs prefeeding (P = .005; mean ± SD for cats, 2,441 ± 1,359 minutes; for dogs, 828 ± 439 minutes) and postfeeding (P = .03; mean ± SD for cats, 3,009 ± 1,220 minutes; for dogs, 1,671 ± 513 minutes). Total transit time for dogs was also shorter pre- versus postfeeding (P = .003). CLINICAL RELEVANCE: GITT is faster in Beagles compared to cats, but gastrointestinal pH are similar when fed the same diet.

The pharmacokinetics and pharmacodynamics of midazolam after intravenous administration to donkeys (Equus africanus asinus).

The pharmacokinetics and pharmacodynamics of midazolam were studied in eight 1-to-3-year-old healthy gelded donkeys. Blood samples were obtained. Heart rate, respiratory rate, rectal temperature, sedation/excitement, ataxia, and response to tactile and auditory stimuli were recorded at baseline until 48 hours after intravenous (IV) midazolam (0.1 mg/kg) administration. Plasma midazolam and 1-hydroxymidazolam were measured using reversed-phase high-performance liquid chromatography. Pharmacokinetic variables were calculated using non-compartmental analysis. Physiologic data were analyzed using a mixed-effects model followed by Dunnett's test and behavioral data were analyzed using a Friedman test then a Dunn's test; P < 0.05 was considered significant. Midazolam was detectable for up to 60 minutes post-treatment in 7 donkeys. The median total body clearance, volume of distribution at steady state, elimination half-life, and area under concentration-time profile were 1210 mL/kg/h, 359 mL/kg, 0.27 hours, and 82.7 h × ng/mL, respectively. 1-hydroxymidazolam was detected (29 to 105 ng/mL) between 5 to 15 minutes post-treatment in 4 donkeys. Compared to baseline, rectal temperature and ataxia increased from 90 to 720 minutes (P ≤ 0.038) and 3 to 15 minutes (P ≤ 0.024) post-treatment, respectively. No other parameters showed statistically significant differences. Healthy donkeys cleared midazolam rapidly from plasma after IV administration. Transient ataxia and recumbency without sedation were observed.

La pharmacocinétique et la pharmacodynamique du midazolam ont été étudiées chez huit ânes hongres en bonne santé âgés de 1 à 3 ans. Des échantillons de sang ont été obtenus. La fréquence cardiaque, la fréquence respiratoire, la température rectale, la sédation/excitation, l'ataxie et la réponse aux stimuli tactiles et auditifs ont été enregistrées au départ jusqu'à 48 heures après l'administration intraveineuse (IV) de midazolam (0,1 mg/kg). Le midazolam plasmatique et le 1-hydroxymidazolam ont été mesurés par chromatographie liquide haute performance en phase inversée. Les variables pharmacocinétiques ont été calculées à l'aide d'une analyse non compartimentale. Les données physiologiques ont été analysées à l'aide d'un modèle à effets mixtes suivi du test de Dunnett et les données comportementales ont été analysées à l'aide d'un test de Friedman puis d'un test de Dunn; P < 0,05 était considéré comme significatif. Le midazolam était détectable jusqu'à 60 minutes après le traitement chez sept ânes. La clairance corporelle totale médiane, le volume de distribution à l'état d'équilibre, la demi-vie d'élimination et l'aire sous le profil concentration-temps étaient respectivement de 1210 mL/kg par heure, 359 mL/kg, 0,27 heure et 82,7 heures × ng/mL. Le 1-hydroxymidazolam a été détecté (29 à 105 ng/mL) entre 5 et 15 minutes après le traitement chez quatre ânes. Par rapport au départ, la température rectale et l'ataxie ont augmenté de 90 à 720 minutes (P ≤ 0,038) et de 3 à 15 minutes (P ≤ 0,024) après le traitement, respectivement. Aucun autre paramètre n'a montré de différences statistiquement significatives. Des ânes en bonne santé ont rapidement éliminé le midazolam du plasma après administration IV. Une ataxie transitoire et un décubitus sans sédation ont été observés.(Traduit par Docteur Serge Messier).

The effect of a smoke-evacuation unit on ultrafine particle concentrations in the operating room during approach to the proximal tibia for tibial plateau-leveling osteotomy surgery in dogs.

OBJECTIVE: To evaluate the effectiveness of a smoke-evacuation unit on reducing ultrafine particle concentration in the operating room (OR) during the approach to the proximal tibia for tibial plateau-leveling osteotomy (TPLO). STUDY DESIGN: Prospective, randomized, controlled clinical trial. SAMPLE POPULATION: Twenty-nine client-owned dogs undergoing unilateral TPLO at a single institution were assigned to either smoke-evacuator groups (SE; n = 15) or non-smoke-evacuator groups (NSE; n = 14). METHODS: Dogs were randomly assigned to the SE group or the NSE group. An airborne particle measuring device measured and recorded baseline and intraoperative particles per cm3 (ppc) during the approach to the proximal tibia during which electrosurgery was used to provide hemostasis, dissect subcutis, transect and elevate fascia. The mean ppc, maximum ppc, and baseline ppc were compared between groups. Mean ppc was also compared to the baseline ppc within each group. RESULTS: During surgery, mean ppc (1352) and maximum ppc (62 450) for the NSE group were higher in than mean ppc (763) and maximum ppc (10 100) for the SE group (P < .0001, P < .0001, respectively). Mean ppc was higher in both SE (mean ppc = 763; P < .0001) and NSE (mean ppc = 1352; P = .0001) than their respective baseline ppc (213 and 240). CONCLUSION: The use of a smoke evacuator decreased particle concentrations 56.4% during the approach to the proximal tibia. Performing the approach to the proximal tibia resulted in higher particle concentrations than the baseline, regardless of smoke-evacuator use. CLINICAL SIGNIFICANCE: Surgeons should be aware of smoke produced by electrosurgery, potential health consequences, and methods of smoke mitigation (smoke evacuation).

Evaluation of gastrointestinal transit times and pH in healthy cats using a continuous pH monitoring system.

OBJECTIVES: The aim of this study was to characterize gastrointestinal (GI) transit times and pH in healthy cats. METHODS: GI transit times and pH were measured in six healthy, colony-housed, purpose-bred spayed female cats using a continuous, non-invasive pH monitoring system in a sequential order design. For the first period ('pre-feeding'), food was withheld for 20 h, followed by oral administration of a pH capsule. Five hours post-capsule administration, cats were meal-fed by offering them their daily allowance of food for 1 h. For the second period ('post-feeding'), food was withheld for 24 h and cats were fed for 1 h, after which a pH capsule was orally administered. Studies in both periods were repeated three times. GI transit times and pH were compared between the two periods. RESULTS: The median transit times for the pre- and post-feeding periods, respectively, were: gastric - 94 mins (range 1-4101) and 1068 mins (range 484-5521); intestinal - 1350 mins (range 929-2961) and 1534 mins (range 442-2538); and GI - 1732 mins (range 1105-5451) and 2795 mins (range 926-6563). The median GI pH values for the first and second periods, respectively, were: esophageal - 7.0 (range 3.5-7.8) and 4.5 (range 2.9-6.4); gastric - 2.7 (range 1.7-6.2) and 2.0 (range 1.1-3.3); intestinal - 8.2 (range 7.6-8.7) and 7.8 (range 6.7-8.5); first-hour small intestinal - 8.2 (range 7.4-8.7) and 8.3 (range 7.9-8.6); and last-hour large intestinal - 8.5 (range 7.0-8.9) and 7.8 (range 6.3-8.7). Gastric (P <0.0020) and intestinal pH (P <0.0059) were significantly increased in the pre-feeding period compared with the post-feeding period. CONCLUSIONS AND RELEVANCE: Gastric and intestinal pH differed significantly when the capsule was administered 5 h prior to feeding compared with 1 h after feeding. Transit times for both periods showed high degrees of intra- and inter-individual variability.

Reference intervals for hematological and biochemical analytes in a single herd of clinically healthy gelding donkeys in Saint Kitts.

There is a large population of donkeys in Saint Kitts; however, hematological and biochemical reference intervals (RIs) are lacking. This study addressed this deficiency by following the American Society for Veterinary Clinical Pathology RI guidelines. Sixty-six healthy, gelding standard donkeys with a median and interquartile range age of 5 years (3.5 - 8 years) and a mean ± standard deviation body weighed of 156 ± 16.7 kg were used to produce a five-part differential complete blood count using an impedance-based analyzer. Clinical chemistry analytes were quantified using a photometric-based analyzer utilizing two reagent rotors that determined 14 and 11 analytes, respectively. An electrochemical-based analyzer quantified chloride, sodium and potassium. Reference intervals were computed using Reference Value Advisor. Results of analytes determined using different rotors/analyzers were assessed using Passing-Bablok regression and Bland-Altman plot analyses. Reference intervals for 43 hematological and biochemical analytes were generated. Reference intervals for hematocrit, red blood cells, white blood cells, total protein, glucose, blood urea nitrogen, and creatinine were 23.67% - 38.08%, 4.08 - 6.42 1012/L, 4.7 - 12.34 109/L, 5.84 - 6.93 g/dL, 64.7 - 130.9 mg/dL, 11.1 - 13.4 mg/dL, and 0.67 - 1.36 mg/dL, respectively. There was good agreement between detection system for albumin, aspartate aminotransferase, gamma glutamyl transferase, total protein, globulin, and potassium, but not for blood urea nitrogen, calcium, creatinine kinase, and sodium. This study is the first to establish hematological and biochemical RIs in donkeys in Saint Kitts. These values will be useful for clinical decision-making.

Subclinical Hypoventilation in Dogs Undergoing Ventral Slot Decompressive Surgery for Cervical Myelopathy Due to Intervertebral Disc Herniation.

The objective of this prospective cohort study was to document the occurrence of post-operative hypoventilation in dogs undergoing decompressive ventral slot or hemilaminectomy for the treatment of intervertebral disc herniation (IVDH). Twenty dogs undergoing ventral slot surgery and 20 dogs undergoing hemilaminectomy surgery for the treatment of IVDH that presented to XX between 2017 and 2020 were enrolled. Dogs were anesthetized using a standard protocol. Blood gas samples were taken at up to 11 time points beginning during anesthetic recovery and continuing for a maximum of 72 h post-operatively. Dogs with cervical lesions that were non-ambulatory before surgery had more evidence of subclinical hypoventilation in the immediate peri-extubation period than dogs with less severe injuries or those undergoing hemilaminectomy surgery. We found no difference in the ventilation status in dogs undergoing cervical or thoracolumbar decompressive surgery for IVDH from 8 to 72 h post-operatively. Other markers of acid-base status indicated that subclinical hypoventilation within the peri-extubation period was transient and self-limiting. There was a moderate positive correlation between sedation scores and estimated PaCO2. These data suggest that dogs with severe cervical spinal cord injuries may be at risk for subclinical hypoventilation in the immediate peri-extubation period. Increased sedation may be correlated with decreased ventilatory status in dogs recovering from decompressive vertebral column surgery.

The Effects of Prophylactic Dexmedetomidine Administration on General Anesthesia Recovery Quality in Healthy Dogs Anesthetized With Sevoflurane and a Fentanyl Constant Rate Infusion Undergoing Elective Orthopedic Procedures.

To determine the effects of a dexmedetomidine slow bolus, administered prior to extubation, on recovery from sevoflurane-anesthesia and a fentanyl continuous rate infusion (CRI) in dogs undergoing orthopedic surgical procedures. Sixty-two client-owned, healthy dogs weighing 27.4 ± 11 kg undergoing elective orthopedic procedures were premedicated with: 0.1 mg/kg hydromorphone intramuscular, 0.05 mg/kg hydromorphone intravenously (IV) or 5 mcg/kg fentanyl IV. Following premedication, dogs were induced with propofol, administered locoregional anesthesia and maintained with sevoflurane and a fentanyl CRI (5-10 mcg/kg/hr). Dogs were randomly assigned to one of two treatment groups: 0.5 mcg/kg dexmedetomidine (DEX) or 0.5 ml/kg saline (SAL). Following surgery, patients were discontinued from the fentanyl CRI and administered DEX or SAL IV over 10 min. Following treatment, dogs were discontinued from sevoflurane and allowed to recover without interference. Recoveries were video recorded for 5 min following extubation and assessed by two blinded anesthesiologists using a visual analog scale (VAS; 0-10 cm) and a numerical rating scale (NRS; 1-10). Mean arterial pressure (MAP), heart rate (HR), pulse oximetry (SpO2), temperature, respiratory rate (RR), and end-tidal sevoflurane (EtSevo) and carbon dioxide (EtCO2) concentrations were recorded at specific time-points from induction to 5 min post-bolus administration and analyzed using linear mixed models. Fentanyl, propofol, and hydromorphone dose and the time to extubation were compared using an unpaired t-test. Differences in recovery scores between groups were evaluated with a Mann-Whitney test. Data reported as mean ± SD or median [interquartile range] when appropriate. A p < 0.05 was significant. There were no significant differences between groups in fentanyl, propofol, and hydromorphone dose, duration of anesthesia, intraoperative MAP, HR, RR, SpO2, temperature, EtCO2, EtSevo or anesthetic protocol. MAP was higher in DEX compared to SAL at 10 (104 ± 27 and 83 ± 23, respectively) and 15 (108 ± 28 and 86 ± 22, respectively) min after treatment. DEX had significantly lower VAS [0.88 (1.13)] and NRS [2.0 (1.5)] scores when compared to SAL [VAS = 1.56 (2.59); NRS = 2.5 (3.5)]. Time to extubation (min) was longer for DEX (19.7 ± 11) when compared to SAL (13.4 ± 10). Prophylactic dexmedetomidine improves recovery quality during the extubation period, but prolongs its duration, in sevoflurane-anesthetized healthy dogs administered fentanyl.

The analgesic and sedative effects of GV20 pharmacopuncture with low-dose hydromorphone in healthy dogs undergoing ovariohysterectomy.

This study evaluates the analgesic efficacy of low-dose hydromorphone administered via pharmacopuncture at Governing Vessel 20 (GV20) for postoperative pain management following canine ovariohysterectomy. Fifty clinically healthy female dogs undergoing ovariohysterectomy were allocated to receive hydromorphone [0.1 mg/kg body weight (BW)] intramuscularly (IM, n = 25) or hydromorphone (0.01 mg/kg BW) pharmacopuncture at GV20 (GV, n = 25) following extubation. This was a prospective, blinded, randomized clinical trial. Pain and sedation scores were evaluated using the Glasgow Composite Measure Pain Scale Short Form (CMPS-SF) at 1, 2, 3, 4, and 12 hours following study treatment. Time of treatment failure (CMPS-SF ≥ 6/24) was recorded and analyzed using Kaplan-Meier survival analysis. Patient demographics and duration of surgery and anesthesia were analyzed using the appropriate unpaired Student's t-test. The Glasgow CMPS-SF and sedation score were analyzed using a repeated measures 2-way analysis of variance (ANOVA) followed by Bonferroni post-test where appropriate. Significance was set a P < 0.05. There were no significant differences in patient demographics, anesthesia and surgery duration, and study treatment failure. The Glasgow CMPS-SF scores were significantly higher for IM compared with GV [2 (0 to 8) versus 1 (0 to 6), respectively; P = 0.044] at 4 hours. Sedation scores were significantly higher for IM compared with GV at 2 [2 (1 to 3) and 1 (1 to 3), respectively; P = 0.0004] and 4 [1 (1 to 3) and 1 (1 to 2), respectively; P = 0.03] hours. Pharmacopuncture with low-dose hydromorphone provided adequate postoperative analgesia in dogs undergoing ovariohysterectomy with reduced sedative effects. Pharmacopuncture is a good alternative in dogs when reduced dosing of opioids is recommended.

Les effets analgésiques et sédatifs de la pharmacopuncture du GV20 avec de l'hydromorphone à faible dose chez des chiens sains subissant une ovariohystérectomie. Cette étude visait à évaluer l'efficacité analgésique de l'hydromorphone à faible dose administrée par pharmacopuncture au Vaisseau Gouverneur 20 (GV20) pour la gestion de la douleur postopératoire après une ovariohystérectomie canine. Cinquante chiennes cliniquement saines subissant une ovariohystérectomie ont été assignées à une pharmacopuncture d'hydromorphone [0,1 mg/kg de poids corporel (PC)] par voie intramusculaire (IM, n = 25) ou d'hydromorphone (0,01 mg/kg de poids corporel) à GV20 (GV, n = 25) après extubation. Il s'agissait d'un essai clinique prospectif, en aveugle et randomisé. Les scores de douleur et de sédation ont été évalués à l'aide de la Glasgow Composite Measure Pain Scale Short Form (CMPS-SF) à 1, 2, 3, 4 et 12 heures après le traitement de l'étude. Le temps d'échec du traitement (CMPS-SF ≥ 6/24) a été enregistré et analysé à l'aide de l'analyse de survie de Kaplan-Meier. Les données démographiques des patients et la durée de la chirurgie et de l'anesthésie ont été analysées à l'aide du test t de Student non apparié approprié. Le Glasgow CMPS-SF et le score de sédation ont été analysés à l'aide d'une analyse de variance à deux voies (ANOVA) à mesures répétées suivie d'un post-test de Bonferroni, le cas échéant. La signification a été fixée à un P < 0,05. Il n'y avait pas de différences significatives dans les caractéristiques démographiques des patients, la durée de l'anesthésie et de la chirurgie et l'échec du traitement de l'étude. Les scores Glasgow CMPS-SF étaient significativement plus élevés pour IM par rapport à GV [2 (0 à 8) versus 1 (0 à 6), respectivement; P = 0,044] à 4 heures. Les scores de sédation étaient significativement plus élevés pour IM par rapport à la GV à 2 [2 (1 à 3) et 1 (1 à 3), respectivement; P = 0,0004] et 4 [1 (1 à 3) et 1 (1 à 2), respectivement; P = 0,03] heures. La pharmacopuncture avec de l'hydromorphone à faible dose a fourni une analgésie postopératoire adéquate chez les chiens subissant une ovariohystérectomie avec des effets sédatifs réduits. La pharmacopuncture est une bonne alternative chez le chien lorsqu'un dosage réduit des opioïdes est recommandé.(Traduit par Dr Serge Messier).

The effects of xylazine or detomidine when used as a pre-anesthetic sedative on recovery quality and duration in horses undergoing elective equine castration.

The purpose of this prospective, blinded, randomized clinical trial was to compare the effects of low dose detomidine to xylazine on recovery quality and duration in a castration procedure. Horses were administered either detomidine [0.015 mg/kg body weight (BW)] or xylazine (1.1 mg/kg BW) intravenously (IV) before IV induction with ketamine (2.2 mg/kg BW) and diazepam (0.05 mg/kg BW). Two anesthesiologists who were unaware of treatment allocation scored the recoveries using a simple descriptive scale (with a low number representing the most desirable recovery) and recoveries were timed. Horses in the detomidine group (n = 16) had a median recovery score of 16 (range: 11 to 26), whereas horses in the xylazine group (n = 12) had a median recovery score of 12 (range: 10 to 16) (P = 0.001). There was no difference in surgery time (P = 0.52), time from the end of surgery to standing (P = 0.45), or time from induction to standing (P = 0.48) between the groups.

Les effets de la xylazine ou de la détomidine lors d'utilisation comme sédatif pré-anesthésique sur la qualité et la durée de la récupération chez les chevaux soumis à une castration équine élective. Le but de cet essai clinique prospectif, en aveugle et randomisé était de comparer les effets de la détomidine à faible dose à la xylazine sur la qualité et la durée de la récupération dans une procédure de castration. Les chevaux ont reçu soit de la détomidine [0,015 mg/kg de poids corporel (PC)] soit de la xylazine (1,1 mg/kg de PC) par voie intraveineuse (IV) avant l'induction IV avec de la kétamine (2,2 mg/kg de PC) et du diazépam (0,05 mg/kg de PC). Deux anesthésistes qui ignoraient l'attribution du traitement ont noté les récupérations à l'aide d'une échelle descriptive simple (avec un petit nombre représentant la récupération la plus souhaitable) et les récupérations ont été chronométrées. Les chevaux du groupe détomidine (n = 16) avaient un score de récupération médian de 16 (éventail de valeurs : 11 à 26), tandis que les chevaux du groupe xylazine (n = 12) avaient un score de récupération médian de 12 (éventail de valeurs : 10 à 16) (P = 0,001). Il n'y avait aucune différence dans le temps de chirurgie (P = 0,52), le temps entre la fin de la chirurgie et la position debout (P = 0,45) ou le temps entre l'induction et la position debout (P = 0,48) entre les groupes.(Traduit par Dr Serge Messier).

Analgesic effects of a retrobulbar block with 0.75% ropivacaine in dogs undergoing enucleation.

OBJECTIVE: To assess the analgesic effects of a retrobulbar block with ropivacaine in dogs undergoing enucleation. STUDY DESIGN: Prospective, randomized, masked placebo-controlled trial. ANIMALS: A total of 23 client-owned dogs. METHODS: Dogs were randomized to be administered a preoperative inferior-temporal palpebral retrobulbar injection of either ropivacaine 0.75% (1 mL 10 kg-1; group RG) or equivalent volume of 0.9% saline (control; group CG). Intraoperative variables recorded to detect a response to noxious stimuli included heart rate (HR) and mean arterial pressure (MAP). Three observers assessed and recorded pain using a numerical rating pain scale and visual analog scale (VAS) before anesthesia (baseline) and postoperatively at 0, 0.5, 1, 2, 3, 4, 5, 6 and 24 hours after extubation. Rescue analgesia was administered if intraoperative HR or MAP increased by ≥ 20% from the previously recorded surgical time point, average postoperative pain scores totaled ≥ 9/20, scored ≥ 3/4 in any one category with VAS ≥ 35/100, or if VAS was ≥ 35/100 with a palpation score > 0/4. RESULTS: Intraoperatively, there was no significant difference in HR or MAP between groups. Rescue analgesia was administered intraoperatively to four and one dogs and postoperatively to five and seven dogs in groups CG and RG, respectively, with no significant difference between groups. VAS scores were significantly lower in ropivacaine dogs at extubation (p = 0.02), but not at other postoperative time points. Adverse events were not observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE: Preoperative retrobulbar 0.75% ropivacaine injection (1 mL 10 kg-1) provided analgesia in dogs following enucleation at extubation; however, intraoperative and postoperative pain control did not differ from a placebo injection with saline. Lack of differences between groups may have been influenced by sample size limitations.

The thermal antinociceptive effects of a high-concentration formulation of buprenorphine alone or followed by hydromorphone in conscious cats.

OBJECTIVE: To evaluate the thermal antinociceptive effects of a high-concentration formulation of buprenorphine alone or followed by hydromorphone in conscious cats. STUDY DESIGN: Randomized, blinded, placebo-controlled crossover study design. ANIMALS: A total of six purpose-bred, adult female ovariohysterectomized Domestic Short Hair cats. METHODS: Cats were allocated into three treatments each consisting of two injections, subcutaneous then intravenous (IV) administration, 2 hours apart: treatment SS, two injections of 0.9% saline; treatment BS, buprenorphine (0.24 mg kg-1, 1.8 mg mL-1) and saline; and treatment BH, buprenorphine (0.24 mg kg-1) and hydromorphone (0.1 mg kg-1). Skin temperature (ST) and thermal threshold (TT) were recorded before (baseline) and for 24 hours following first injection. TT data were analyzed using mixed linear models and a Benjamini-Hochberg sequential adjustment procedure (p < 0.05). RESULTS: There were no significant differences among treatments for baseline ST and TT values, treatment SS over time and between treatments BS and BH. Compared with baseline, TT was significantly increased at all time points in treatments BH and BS except at 2 hours in treatment BS. TT was significantly higher than SS at 3-18 hours and 4-12 hours for treatments BS and BH, respectively. Maximal increases in TT were 47.5 °C at 2 hours, 53.9 °C at 3 hours and 52.4 °C at 6 hours in treatments SS, BS and BH, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of IV hydromorphone following high-concentration buprenorphine provided no additional antinociception and decreased the duration of effect when compared with high-concentration buprenorphine alone. Alternative analgesics should be considered if additional analgesia is required after administration of high-concentration buprenorphine.

The Effects of Content Delivery Methods on Ultrasound Knobology and Image Quality Recognition Training in First-Year Veterinary Students.

As new technologies are incorporated into the practice of veterinary medicine, it is imperative we utilize the most effective and impactful content delivery methods. Ultrasound technology has become more affordable and compact for veterinary hospitals, leading to easier incorporation into practice. This study compares three methods of delivering ultrasound knobology content to first-year veterinary students at Texas A&M University College of Veterinary Medicine and Biomedical Sciences. In a prospective study, first-year veterinary students were randomly selected to receive one of three content delivery methods: self-directed active learning (SDL), in-person instructor demonstration, or online module instruction. Knowledge acquisition was assessed using a 10-question quiz for short-term understanding followed by a 10-question quiz after a 6-week period to assess long-term knowledge retention. Student demographics were analyzed using the Chi-square test. Quiz scores were analyzed between groups using Kruskal-Wallis tests followed by Dunn's post-tests for multiple comparisons. Values of p ≤ .05 were considered significant. On the short-term and retention quiz questions, students participating in SDL scored significantly higher (10 [5-10]) than those receiving in-person instructor demonstration (9 [3-10] p = .01 and 8 [2-10] p = .0004, respectively) or the online module instruction training (Group C) (6 [1-10] p < 0.0001 and 8 [4-10] p < .001, respectively). Based on quiz scores, veterinary students exhibited better ultrasound knobology and image quality recognition proficiency immediately and at 6-weeks following SDL when compared with other content delivery methods. Self-directed learning methods are recommended when teaching ultrasonography to veterinary students.

Feline procedural sedation and analgesia: When, why and how.

PRACTICAL RELEVANCE: Procedural sedation and analgesia (PSA) describes the process of depressing a patient's conscious state to perform unpleasant, minimally invasive procedures, and is part of the daily routine in feline medicine. Maintaining cardiopulmonary stability is critical while peforming PSA. CLINICAL CHALLENGES: Decision-making with respect to drug choice and dosage regimen, taking into consideration the cat's health status, behavior, any concomitant diseases and the need for analgesia, represents an everyday challenge in feline practice. While PSA is commonly perceived to be an uneventful procedure, complications may arise, especially when cats that were meant to be sedated are actually anesthetized. AIMS: This clinical article reviews key aspects of PSA in cats while exploring the literature and discussing complications and risk factors. Recommendations are given for patient assessment and preparation, clinical monitoring and fasting protocols, and there is discussion of how PSA protocols may change blood results and diagnostic tests. An overview of, and rationale for, building a PSA protocol, and the advantages and disadvantages of different classes of sedatives and anesthetics, is presented in a clinical context. Finally, injectable drug protocols are reported, supported by an evidence-based approach and clinical experience.

Clinical utility of a targeted smartphone application to aid veterinary students in calculating constant rate infusions and perioperative fluid drip rates.

BACKGROUND: To compare the utility of a targeted smartphone application (TSPA) with a non-programmable calculator (NPC) when calculating fluid drip rates (FDR) and constant rate infusions (CRIs). METHODS: In a prospective randomised clinical study, 48 fourth-year veterinary students entered one of four parallel groups involving two mock scenarios: fentanyl calculation using an NPC followed by lidocaine calculation using a TSPA, fentanyl (TSPA) followed by lidocaine (NPC), lidocaine (NPC) followed by fentanyl (TSPA) or lidocaine (TSPA) followed by fentanyl (NPC). Students calculated volume of drug added to maintenance fluids and drops/second that correctly administered the drug dose and FDR. Time to completion was assessed using an analysis of variance. A Fisher's exact test assessed the effect of study period, scenario and device in the proportion of correct/incorrect answers. RESULTS: Participants took longer to complete the scenarios in period 1 and 2 with the NPC (380.7±195.6 seconds and 488±154.8 seconds, respectively) than the TSPA (247.5±88.8 seconds and 224±94.2 seconds, respectively) (P<0.0031 and P<0.0001). Participants were more likely to complete the scenarios incorrectly with the NPC (n=32) when compared with the TSPA (n=7) (P<0.0001). CONCLUSIONS: TSPAs are more efficient and accurate when calculating CRIs and FDR compared with conventional methods. Medical mathematics must be emphasised during the veterinary curriculum.

Norwich terriers possess a greater vertebral heart scale than the canine reference value.

Previous studies have demonstrated evidence that normal reference ranges for radiographic vertebral heart scale values can vary among dog breeds. The purpose of this retrospective, observational study was to determine whether the normal vertebral heart scale values published by Buchanan and Bücheler for lateral radiographs are applicable to the Norwich terrier. Secondary objectives were to determine if clinical signs of respiratory disease, age, sex, weight, body condition score, recumbency, or thoracic depth-to-width ratio had any influence on vertebral heart scale measurements in this breed. The electronic medical record systems of two universities were reviewed and Norwich terriers were included in the study if they had orthogonal thoracic radiographs performed and no historical or radiographic evidence of cardiopulmonary disease. A vertebral heart scale was calculated for each patient. Sixty-one client-owned, Norwich terrier dogs with no clinical signs of cardiovascular disease were evaluated. The vertebral heart scale for Norwich terriers without evidence of cardiac disease (10.6 ± 0.6) was found to be significantly greater than the canine reference value of 9.7 ± 0.5 initially established by Buchanan and Bücheler. No significant correlation was found between clinical signs of respiratory disease, sex, age, thoracic depth-to-width ratio or lateral recumbency, and vertebral heart scale. Norwich terriers with a body condition score ≥6 had a significantly higher vertebral heart scale than those with a body condition score ≤5. Breed-specific ranges and body condition scores need to be considered when interpreting vertebral heart scale values for Norwich terriers.

Evaluation of the bacterial ocular surface microbiome in clinically normal cats before and after treatment with topical erythromycin.

The ocular surface microbiome of veterinary species has not been thoroughly characterized using next generation sequencing. Furthermore, alterations in the feline ocular surface microbiome over time or following topical antibiotic treatment are unknown. Aims of this study were to further characterize the ocular surface microbiome of healthy cats and to identify whether there are microbial community changes over time and following topical antibiotic use. Twenty-four eyes from twelve adult, research-bred, female spayed domestic shorthaired cats were evaluated. Erythromycin ophthalmic ointment (0.5%) was applied to the ocular surface of one randomly assigned eye per cat three times daily for 7 days, while the fellow eye served as an untreated control. The ocular surface was sampled by swabbing the inferior conjunctival fornix of both eyes prior to initiating treatment (day 0), after 1 week of treatment (day 7), and 4 weeks after concluding treatment (day 35). Genomic DNA was extracted from the swabs and sequenced using primers that target the V4 region of bacterial 16S rRNA genes. At baseline, the most common bacterial phyla identified were Proteobacteria (42.4%), Firmicutes (30.0%), Actinobacteria (15.6%), and Bacteroidetes (8.1%). The most abundant bacterial families sequenced were Corynebacteriaceae (7.8%), Helicobacteraceae (7.5%), Moraxellaceae (6.1%), and Comamonadaceae (5.6%). Alpha and beta diversity measurements were largely unchanged in both treatment and control eyes over time. However, univariate and linear discriminant analyses revealed significant and similar changes in the abundance of some bacterial taxa over time in both treatment and control eyes. Overall, the feline ocular surface microbiome remained stable over time and following topical antibiotic therapy.