Short-term efficacy of epidural pain management in dogs undergoing cystoscopy.

BACKGROUND: The effects of epidural anesthesia in dogs undergoing cystoscopy are unknown. OBJECTIVE: To investigate the effect of epidural analgesia on postcystoscopy pain in dogs. ANIMALS: Twenty-six dogs undergoing routine cystoscopy for lower urinary tract disease. METHODS: Prospective, randomized, blinded observational study. Dogs were assigned either to a treatment group that received epidural anesthesia (preservative free morphine sulfate, 0.09 mg/kg; 1% ropivacaine, 0.2 mg/kg; total volume delivered, 1 mL/4.5 kg of body weight to a maximum of 10 mL; n = 9) or to a nonepidural control group (n = 13). Vital signs were monitored for 24 hours, and sedation and pain scores, behavioral assessments, and presence or absence of complications was evaluated for 5 days postprocedure. RESULTS: All dogs tolerated the epidural without complications. Four dogs were removed from the study because of status unblinding, lack of patient cooperation, or incomplete follow-up. No significant differences were noted in postprocedural pain scores in dogs that received epidural analgesia. Significant differences in postprocedural pain scores were noted in the nonepidural control group. No significant differences were noted in vital signs, behavioral assessments, or the proportion of dogs with a 50% increase in pain scores between the epidural and nonepidural groups. CONCLUSIONS AND CLINICAL IMPORTANCE: Epidural anesthesia was well-tolerated. Dogs not receiving the epidural had poor postprocedural pain control. A consistent benefit for the epidural vs nonepidural group could not be identified. Additional studies are required to better assess the impact and efficacy of epidural anesthesia for cystoscopic procedures.

Factors associated with survival in dogs with chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) is associated with morbidity and mortality in dogs. Plasma fibroblast growth factor-23 (FGF-23) concentration is an independent predictor of CKD progression and survival in cats and people with CKD. OBJECTIVES: To investigate the relationship among FGF-23, parathyroid hormone (PTH), vitamin D metabolites, and other clinical variables with survival time in dogs with CKD. ANIMALS: Twenty-seven azotemic CKD dogs. METHODS: Dogs were recruited prospectively into the study and followed until death or study conclusion. Dogs were International Renal Interest Society (IRIS) staged into stage 2 (n = 9), stage 3 (n = 12), and stage 4 (n = 6) CKD. Survival times were calculated from the date of study inclusion. Univariable Cox regression was used to assess variables associated with survival including body condition score (BCS), muscle condition score, hematocrit, creatinine, CKD stage, serum phosphorus, urine protein:creatinine ratio (UPC), calcium phosphorus product (CaPP), PTH, 25-hydroxyvitamin D, 1,25--dihydroxyvitamin D, and FGF-23 concentrations. RESULTS: Significant hazard ratios (hazard ratio; 95% confidence interval; P value) were as follows: BCS < 4/9 (1.579; 1.003-2.282; P = .05), muscle atrophy (2.334; 1.352-4.030; P = .01), increased creatinine (1.383; 1.16-1.64; .01), hyperphosphatemia (3.20; 1.357-7.548; P = .005), increased UPC (3.191; 1.310-7.773; P = .01), increased CaPP (4.092; 1.771-9.454; P = .003), and increased FGF-23 (2.609; 1.090-6.240; P = .05). Survival times for each IRIS CKD stage were significantly different (P = .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Multiple variables, including FGF-23, were associated with duration of survival in CKD dogs. FGF-23 could be a prognostic marker in dogs with CKD.