Seroprevalence of Aspergillus IgG and disease prevalence of chronic pulmonary aspergillosis in a country with intermediate burden of tuberculosis: a prospective observational study.

OBJECTIVES: Chronic pulmonary aspergillosis (CPA) is an emerging global disease with tuberculosis (TB) being the most important risk factor. Epidemiologic data on the seroprevalence of Aspergillus IgG and prevalence of CPA in different areas, especially in country with intermediate burden of TB, are lacking. METHODS: We prospectively recruited healthy volunteers, TB close contacts, active TB patients and participants with old pulmonary TB in Taiwan during 2012-2019. We measured serum Aspergillus fumigatus and niger-specific IgG levels and assessed if the participants were having CPA. RESULTS: A total of 1242 participants (including 200 healthy volunteers, 326 TB close contacts, 524 active TB patients and 192 old TB cases) were recruited. Using 27 mgA/L (milligrams of antigen-specific antibodies per liter) as cut-off level, the seropositive rate of A. fumigatus-specific IgG was 33.0% (66/200), 37.7% (123/326), 26.5% (139/524) and 43.2% (83/192) among the four groups, respectively. In multivariate logistic regression, pulmonary cavitation (OR 1.73; 95% CI 1.07-2.80), female sex (OR 1.49; 95% CI 1.14-1.95), old TB (OR 1.59; 1.05-2.42) were independent risk factors for Aspergillus IgG positivity. One (0.2%) active TB patient and four (2.1%) old TB patients developed CPA. Correlation between A. fumigatus and A. niger-specific IgG was high (Spearman correlation coefficient: 0.942). DISCUSSION: Geographic variation in Aspergillus IgG seroprevalence and CPA prevalence exists. A universal cut-off value for Aspergillus IgG may not exist. In areas and populations in which background Aspergillus IgG level is unknown, Aspergillus IgG may be better used as a test of exclusion for CPA using prespecified cut-off level.

Factors associated with subsequent nontuberculous mycobacterial lung disease in patients with a single sputum isolate on initial examination.

Very few studies have focused on the outcome and management of patients with a single sputum isolate of nontuberculous mycobacterium (NTM) on initial examination. Patients with a single isolate of Mycobacterium avium complex (MAC), M. chelonae-abscessus, M. kansasii, or M. fortuitum from at least three sputum samples collected within 1 month were retrospectively identified. Those with follow-up sputum samples within 1 year were included in the analysis. Among the 202 patients included, M. fortuitum (n = 71, 35.1%) and MAC (n = 70, 34.7%) were the most common NTM species isolated, followed by M. chelonae-abscessus (n = 40, 19.8%) and M. kansasii (n = 21, 10.4%). The mean clinical follow-up period was 26.2 months. Forty-four patients (21.8%) had subsequent positive cultures of the same NTM species, while eight (4.0%) had bronchiectasis and developed NTM lung disease (NTM-LD). Neither patients without bronchiectasis nor those with M. fortuitum subsequently developed NTM lung disease. Among bronchiectatic patients with NTM other than M. fortuitum, age ≤65 years (p 0.006, OR 32.13), malignancy (p 0.048, OR 14.35), and initial radiographic score >2 (p 0.027, OR 20.06) were associated with subsequent NTM-LD. In all of the NTM patients, bronchiectasis (p <0.001, OR 5.46) and age ≤65 years (p 0.002, OR 3.29) were significantly associated with subsequent positive NTM culture. In patients with a single isolation of NTM from respiratory specimens, the presence of bronchiectasis and younger age indicates higher risk of subsequent culture-positivity and NTM-LD. Single isolation of M. fortuitum is of little clinical significance. Other patients with NTM, younger age, and more severe radiographic pulmonary lesion also warrant further attention.

Clinical characteristics and outcomes of patients with pleural infections due to Stenotrophomonas maltophilia at a medical center in Taiwan, 2004-2012.

Stenotrophomonas maltophilia can cause various clinical diseases; however, pleural infections due to S. maltophilia are rare. We evaluated the clinical characteristics and outcomes of patients with pleural infections (complicated parapneumonic effusion or empyema) due to S. maltophilia who were treated at a medical center in Taiwan from 2004 to 2012. During the study period, 40 patients were treated for pleural infections due to S. maltophilia. The incidence of S. maltophilia pleural infections ranged from 2.66 per 1,000,000 patient-days in 2009 to 12.44 per 1,000,000 patient-days in 2011. Most of the patients with S. maltophilia pleural infections were immunocompromised male adults and all of the infections were acquired in healthcare settings. The majority of patients had polymicrobial pleural infections (n = 31, 77.5 %) and the most common pathogen was Pseudomonas aeruginosa (n = 12). The causes of pleural infections due to S. maltophilia were pneumonia due to S. maltophilia in two patients (5 %), post-surgical/tube thoracostomy in 26 (65 %) patients, and fistula (bronchopleural, esophagopleural and biliopleural) in 12 (30 %) patients. The 14-day and 30-day mortality rates were 32.5 % and 42.5 %, respectively. Pleural infections due to S. maltophilia are most commonly the result of surgical procedures, thoracostomy, and underlying fistulas. These infections are associated with a high mortality rate, especially among immunocompromised patients.

Pharmacokinetics of lidocaine following the application of 5% lidocaine patches to cats.

Lidocaine patches have been used to provide local analgesia in dogs and cats. We conducted this study to assess the systemic and local absorption of lidocaine from topical patches in cats. Eight 2-year-old cats received either intravenous lidocaine at 2 mg/kg or one 700 mg lidocaine patch placed on the lateral thorax for 72 h, in a cross-over randomized repeated measures design. Plasma was collected at specific times and the skin was biopsied at the time of patch removal for the quantitative analysis of lidocaine and its major metabolite, monoethylglycinexylidide (MEGX), by gas chromatography with mass spectrometry. Percent absorption time plots for systemic lidocaine appearance were constructed using the Loo-Riegelman method. Approximately, constant rate absorption was observed from 12-72 h after patch application at a mean +/- SD rate of 109 +/- 49 microg/kg/h, resulting in steady-state lidocaine plasma concentrations of 0.083 +/- 0.032 microg/mL and MEGX concentrations of 0.012 +/- 0.009 microg/mL. Overall bioavailability of transdermal lidocaine was 6.3 +/- 2.7%, and only 56 +/- 29% of the total lidocaine dose delivered by the patch reached systemic circulation. Skin lidocaine concentrations were much higher than plasma concentrations, at 211 +/- 113 microg/g in the thoracic skin beneath the patch and 2.2 +/- 0.6 microg/g in the contralateral thoracic skin without the patch. As both lidocaine and MEGX were recovered from contralateral skin, it is likely that lidocaine accumulated in the skin from low systemic concentrations of circulating lidocaine over the 72-h period of patch application. Plasma lidocaine concentrations remained well below systemically toxic concentrations, and no obvious clinical side effects were observed in any of the cats. The low systemic absorption rate coupled with high local lidocaine concentrations on the skin support the safe use of lidocaine patches in cats.

Anesthetic effects of ketamine or isoflurane induction prior to isoflurane anesthesia in medetomidine-premedicated dogs.

Dogs were given medetomidine (10 microg/kg body weight, intramuscularly) followed in 10 minutes by either ketamine (4 mg/kg body weight, intravenously) or isoflurane mask induction and maintained on isoflurane for 30 minutes. Medetomidine induced lateral recumbency in all dogs. Endotracheal intubation was faster and smoother when dogs were given ketamine than when induced with isoflurane. Analgesia was excellent in all groups. Respiratory depression was more profound when dogs were given ketamine. Recovery quality was smooth and similar among all groups. Medetomidine-premedicated dogs could be induced with either ketamine or isoflurane and maintained on 1.3% isoflurane to achieve good analgesia with smooth recovery from anesthesia.

Effects of preemptive atropine administration on incidence of medetomidine-induced bradycardia in dogs.

OBJECTIVE: To determine the cardiorespiratory effects of preemptive atropine administration in dogs sedated with medetomidine. DESIGN: Randomized crossover trial. ANIMALS: 12 healthy adult dogs. PROCEDURES: Dogs underwent 6 treatments. Each treatment consisted of administration of atropine (0.04 mg/kg [0.018 mg/lb] of body weight, IM) or saline solution (0.9% NaCl, 1 ml, IM) and administration of medetomidine (10, 20, or 40 microg/kg [4.5, 9.1, or 18.2 microg/lb], IM) 10 minutes later. Treatments were administered in random order, with a minimum of 1 week between treatments. Cardiorespiratory effects before and after atropine and medetomidine administration were assessed. Duration of lateral recumbency and quality of sedation and recovery were assessed. RESULTS: Bradycardia (heart rate < 60 beats/min) was seen in all dogs when saline solution was administered followed by medetomidine, and the dose of medetomidine was not associated with severity or frequency of bradycardia or second-degree heart block. However, a medetomidine dose-dependent increase in mean and diastolic blood pressures was observed, regardless of whether dogs received saline solution or atropine. Preemptive atropine administration effectively prevented bradycardia and second-degree heart block but induced pulsus alternans and hypertension. The protective effects of atropine against bradycardia lasted 50 minutes. Blood gas values were within reference limits during all treatments and were not significantly different from baseline values. Higher doses of medetomidine resulted in a longer duration of lateral recumbency. CONCLUSIONS AND CLINICAL RELEVANCE: Preemptive administration of atropine in dogs sedated with medetomidine effectively prevents bradycardia for 50 minutes but induces hypertension and pulsus alternans.

Effects of butorphanol and carprofen on the minimal alveolar concentration of isoflurane in dogs.

OBJECTIVE: To evaluate the effects of butorphanol and carprofen, alone and in combination, on the minimal alveolar concentration (MAC) of isoflurane in dogs. DESIGN: Randomized complete-block crossover study. ANIMALS: 6 healthy adult dogs. PROCEDURE: Minimal alveolar concentration of isoflurane was determined following administration of carprofen alone, butorphanol alone, carprofen and butorphanol, and neither drug (control). Anesthesia was induced with isoflurane in oxygen, and MAC was determined by use of a tail clamp method. Three hours prior to induction of anesthesia, dogs were fed a small amount of canned food without any drugs (control) or with carprofen (2.2 mg/kg of body weight [1 mg/lb]). Following initial determination of MAC, butorphanol (0.4 mg/kg [0.18 mg/lb], i.v.) was administered, and MAC was determined again. Heart rate, respiratory rate, indirect arterial blood pressure, endtidal partial pressure of CO2, and saturation of hemoglobin with oxygen were recorded at the time MAC was determined. RESULTS: Mean +/- SD MAC of isoflurane following administration of butorphanol alone (1.03 +/- 0.22%) or carprofen and butorphanol (0.90 +/- 0.21%) were significantly less than the control MAC (1.28 +/- 0.14%), but MAC after administration of carprofen alone (1.20 +/- 0.13%) was not significantly different from the control value. The effects of carprofen and butorphanol on the MAC of isoflurane were additive. There were not any significant differences among treatments in regard to cardiorespiratory data. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that administration of butorphanol alone or in combination with carprofen significantly reduces the MAC of isoflurane in dogs; however, the effects of butorphanol and carprofen are additive, not synergistic.

Renal effects of carprofen administered to healthy dogs anesthetized with propofol and isoflurane.

OBJECTIVE: To evaluate renal effects of carprofen in healthy dogs following general anesthesia. DESIGN: Randomized clinical trial. ANIMALS: 10 English hound dogs (6 females and 4 males). PROCEDURE: Dogs were randomly assigned to control (n = 5) or carprofen (5) groups. Anesthesia was induced with propofol (6 to 8 mg/kg [2.7 to 3.6 mg/lb] of body weight, i.v.) and maintained with isoflurane (end-tidal concentration, 2.0%). Each dog underwent two 60-minute anesthetic episodes with 1 week between episodes, and mean arterial blood pressure was maintained between 60 and 90 mm Hg during each episode. Dogs in the carprofen group received carprofen (2.2 mg/kg [1 mg/lb], p.o.) at 9:00 AM and 6:00 PM the day before and at 7:00 AM the day of the second anesthetic episode. Glomerular filtration rates (GFR) were determined during each anesthetic episode by use of renal scintigraphy. Serum creatinine and BUN concentrations and the urine gamma-glutamyltransferase-to-creatinine concentration (urine GGT:creatinine) ratio were determined daily for 2 days before and 5 days after general anesthesia. RESULTS: Significant differences were not detected in BUN and serum creatinine concentrations, urine GGT:creatinine ratio, and GFR either between or within treatment groups over time. CONCLUSIONS AND CLINICAL RELEVANCE: Carprofen did not significantly alter renal function in healthy dogs anesthetized with propofol and isoflurane. These results suggest that carprofen may be safe to use for preemptive perioperative analgesia, provided that normal cardiorespiratory function is maintained.

Cardiorespiratory responses and plasma cortisol concentrations in dogs treated with medetomidine before undergoing ovariohysterectomy.

OBJECTIVE: To evaluate effects of medetomidine on anesthetic dose requirements, cardiorespiratory variables, plasma cortisol concentrations, and behavioral pain scores in dogs undergoing ovariohysterectomy. DESIGN: Randomized, prospective study. ANIMALS: 12 healthy Walker-type hound dogs. PROCEDURE: Dogs received medetomidine (40 micrograms/kg [18.2 micrograms/lb] of body weight, i.m.; n = 6) or saline (0.9% NaCl) solution (1 ml, i.m.; 6) prior to anesthesia induction with thiopental; thiopental dose needed for endotracheal intubation was compared between groups. Ovariohysterectomy was performed during halothane anesthesia. Blood samples were obtained at various times before drug administration until 300 minutes after extubation. Various physiologic measurements and end-tidal halothane concentrations were recorded. RESULTS: In medetomidine-treated dogs, heart rate was significantly lower than in controls, and blood pressure did not change significantly from baseline. Plasma cortisol concentrations did not increase significantly until 60 minutes after extubation in medetomidine-treated dogs, whereas values in control dogs were increased from time of surgery until the end of the recording period. Control dogs had higher pain scores than treated dogs from extubation until the end of the recording period. CONCLUSION AND CLINICAL RELEVANCE: Administration of medetomidine reduced dose requirements for thiopental and halothane and provided postoperative analgesia up to 90 minutes after extubation. Dogs undergoing ovariohysterectomy by use of thiopental induction and halothane anesthesia benefit from analgesia induced by medetomidine administered prior to anesthesia induction. Additional analgesia is appropriate 60 minutes after extubation.

Sedative and cardiorespiratory effects of medetomidine, medetomidine-butorphanol, and medetomidine-ketamine in dogs.

OBJECTIVE: To determine sedative and cardiorespiratory effects of i.m. administration of medetomidine alone and in combination with butorphanol or ketamine in dogs. DESIGN: Randomized, crossover study. ANIMALS: 6 healthy adult dogs. PROCEDURES: Dogs were given medetomidine alone (30 micrograms/kg [13.6 micrograms/lb] of body weight, i.m.), a combination of medetomidine (30 micrograms/kg, i.m.) and butorphanol (0.2 mg/kg [0.09 mg/lb], i.m.), or a combination of medetomidine (30 micrograms/kg, i.m.) and ketamine (3 mg/kg [1.36 mg/lb], i.m.). Treatments were administered in random order with a minimum of 1 week between treatments. Glycopyrrolate was given at the same time. Atipamezole (150 micrograms/kg [68 micrograms/lb], i.m.) was given 40 minutes after administration of medetomidine. RESULTS: All but 1 dog (given medetomidine alone) assumed lateral recumbency within 6 minutes after drug administration. Endotracheal intubation was significantly more difficult when dogs were given medetomidine alone than when given medetomidine and butorphanol. At all evaluation times, percentages of dogs with positive responses to tail clamping or to needle pricks in the cervical region, shoulder region, abdominal region, or hindquarters were not significantly different among drug treatments. The Paco2 was significantly higher and the arterial pH and Pao2 were significantly lower when dogs were given medetomidine and butorphanol or medetomidine and ketamine than when they were given medetomidine alone. Recovery quality following atipamezole administration was unsatisfactory in 1 dog when given medetomidine and ketamine. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a combination of medetomidine with butorphanol or ketamine resulted in more reliable and uniform sedation in dogs than did medetomidine alone.

Anesthetic and cardiorespiratory effects of a 1:1 mixture of propofol and thiopental sodium in dogs.

OBJECTIVE: To compare anesthetic and cardiorespiratory effects of a 1:1 (vol:vol) mixture of propofol and thiopental sodium with either drug used alone in dogs. DESIGN: Randomized crossover study. ANIMALS: 10 healthy Walker Hounds. PROCEDURE: Dogs received propofol (6 mg/kg [2.7 mg/lb] of body weight), thiopental (15 mg/kg [6.8 mg/lb]), or a mixture of propofol (6 mg/kg) and thiopental (15 mg/kg) at 1-week intervals. Drugs were slowly administered i.v. over 90 seconds or until dogs lost consciousness. Increments of 10% of the initial dose were administered until intubation was possible. Amount of drug required for intubation, quality of induction and recovery, times from induction to intubation and to walking with minimal ataxia, and duration of intubation and lateral recumbency were recorded. Heart and respiratory rates, mean, systolic, and diastolic blood pressure, hemoglobin saturation of oxygen (SpO2), and end-tidal CO2 concentration (ETCO2) were determined before and after intubation. RESULTS: Amounts of propofol and thiopental required to permit intubation were less, but not significantly so, when administered in combination than when administered alone. Duration of lateral recumbency and time from induction to walking were greater and recovery quality was worse in the thiopental group, compared with the other groups. Dogs in all groups remained normotensive. Respiratory rate, heart rate, ETCO2, and SpO2 did not differ among groups. CONCLUSIONS AND CLINICAL RELEVANCE: A 1:1 mixture of propofol and thiopental induced anesthesia of similar quality to propofol or thiopental alone. Recovery quality and recovery times were similar to those of propofol and superior to those of thiopental.

Anesthetic and cardiorespiratory effects of tiletamine-zolazepam-medetomidine in cheetahs.

OBJECTIVE: To evaluate anesthetic and cardiorespiratory effects of an intramuscular injection of a tiletamine-zolazepam-medetomidine combination in cheetahs. DESIGN: Prospective study. ANIMALS: 17 adult captive cheetahs. PROCEDURE: The anesthetic combination was administered intramuscularly via a dart. Induction quality, duration of lateral recumbency, duration of recovery, and quality of anesthetic reversal with atipamezole were assessed. Cardiorespiratory variables (arterial blood gas partial pressures, arterial blood pressure, heart and respiratory rates, end-tidal CO2, oxygen saturation, and rectal temperature) were measured during anesthesia. RESULTS: Sedation and lateral recumbency developed within 1.9 +/- 1.0 (mean +/- SD) and 4.3 +/- 2.0 minutes of drug administration, respectively. Clinically acceptable cardiorespiratory and blood gas values were recorded for at least 87 minutes after drug administration in all but 1 cheetah. Hypoxemia and arrhythmias developed in 1 cheetah breathing room air but resolved after treatment with oxygen. Hypertension developed in all cheetahs. Significant differences in heart and respiratory rates, mean arterial blood pressure, arterial pH, partial pressure of oxygen, and hemoglobin saturation were found between cheetahs that did and did not receive oxygen supplementation. After administration of atipamezole, sternal recumbency and mobility returned within 6.9 +/- 5.8 and 47.5 +/- 102.2 minutes, respectively. Postreversal sedation, which lasted approximately 4 hours, developed in 4 cheetahs. CLINICAL IMPLICATIONS: Tiletamine-zolazepam-medetomidine delivered via a dart provided an alternative method for induction and maintenance of anesthesia in cheetahs. Atipamezole at the dose used was effective for reversal of this combination in the initial phase of anesthesia.

Comparison of anesthetic and cardiorespiratory effects of diazepam-butorphanol-ketamine, acepromazine-butorphanol-ketamine, and xylazine-butorphanol-ketamine in ferrets.

Ten ferrets were used in a crossover study to determine the sedative effects of intramuscularly administered diazepam (3 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight); acepromazine (0.1 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight); and xylazine (2 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight). All of the ferrets became laterally recumbent following the administration of each drug combination. The xylazine-butorphanol-ketamine combination induced significantly longer (p less than 0.05) durations of tail-clamp analgesia (mean+/-standard deviation [SD], 81.0+/-19.1 min versus 20.5+/-25.4 min and 30.0+/-26.9 min), dorsal recumbency (mean+/-SD, 94.6+/-13.6 min versus 75. 6+/-34.7 min and 55.2+24.8 min), and muscle relaxation suitable for endotracheal intubation (mean+/-SD, 67.1+/-23.0 min versus 7.0+/-22.1 min and 9.5+/-15.4 min) than the diazepam-butorphanol-ketamine and acepromazine-butorphanol-ketamine combinations, respectively. The recovery time from dorsal recumbency to standing was not significantly different among the three treatment groups. The heart rate was significantly lower in the xylazine-butorphanol-ketamine group; however, systolic blood pressure was not significantly different among the treatment groups. Ventilatory function was more depressed in the diazepam-butorphanol-ketamine and xylazine-butorphanol-ketamine groups than in the acepromazine-butorphanol-ketamine group. A period (approximately 45 minutes) of hypoxia was observed in the xylazine-butorphanol-ketamine-treated ferret. Of the three combinations evaluated in ferrets, xylazine-butorphanol-ketamine was concluded to be the most effective anesthetic combination. However, hypoxemia and ventricular arrhythmias were observed in the xylazine-butorphanol-ketamine-treated ferrets, so the effectiveness of the xylazine-butorphanol-ketamine combination should be weighed against its cardiorespiratory side effects.

Effects of a microdose of medetomidine on diazepam-ketamine induced anesthesia in dogs.

OBJECTIVE: To evaluate cardiorespiratory and anesthetic effects of a microdose of medetomidine hydrochloride on diazepam-ketamine (DK) hydrochloride induced anesthesia in dogs. DESIGN: Randomized crossover study. ANIMALS: 6 two-year-old healthy female dogs. PROCEDURE: A study was designed to compare quality of anesthetic induction, recovery, analgesia, muscle relaxation, duration of immobilization, and ease of endotracheal intubation between diazepam-ketamine-medetomidine (DKM) and diazepam-ketamine induced anesthesia in 6 dogs. Diazepam (0.25 mg/kg [0.114 mg/lb] of body weight, i.v.) and ketamine (5 mg/kg [2.27 mg/lb], i.v.) with or without a microdose of medetomidine (5 micrograms/kg, i.v.) were administered to dogs. A baseline ECG was obtained, and baseline measurements of arterial blood gas tensions, arterial pressures, heart and respiratory rates, and minute volume were taken before drug administration. All measurements were repeated again 5, 10, 20, and 30 minutes after drug administration. Endotracheal intubation was attempted 1 minute after drug administration and then again 5, 10, 20, and 30 minutes after drug administration. Analgesia was evaluated by tail clamp and needle prick testing. RESULTS: Medetomidine improved quality of anesthetic induction, ease of endotracheal intubation, and extended duration of analgesia and lateral recumbency in anesthetized dogs. The addition of medetomidine to DK increased blood pressure and decreased heart and respiratory rates and minute volume. Hypoxemia was observed in 1 dog after DKM induced anesthesia. CLINICAL IMPLICATIONS: Administration of a microdose of medetomidine provides a useful adjunct to DK induced anesthesia in dogs. Oxygen insufflation is recommended for a minimum of the first 5 minutes of DKM induced anesthesia.

Evaluation of sedative and cardiorespiratory effects of diazepam-butorphanol, acepromazine-butorphanol, and xylazine-butorphanol in ferrets.

Ten ferrets were used in a crossover study to determine the sedative effects of intramuscularly (IM) administered diazepam (3 mg/kg body weight)-butorphanol (0.2 mg/kg body weight), acepromazine (0.1 mg/kg body weight)-butorphanol (0.2 mg/kg body weight), or xylazine (2.0 mg/kg body weight)-butorphanol (0.2 mg/kg body weight). All ferrets became laterally recumbent following the administration of each drug combination. The xylazine-butorphanol combination caused a significantly longer (p less than 0.05) duration of analgesia than the diazepam-butorphanol and acepromazine-butorphanol combinations. None of the ferrets could be intubated with any of the drug combinations. The time from induction to recovery was significantly shorter in the acepromazine-butorphanol-treated ferrets. A significantly lower heart rate was observed in the xylazine-butorphanol-treated ferrets; however, an acceptable systolic blood pressure was maintained. Ventilatory function was more depressed in the diazepam-butorphanol- and xylazine-butorphanol-treated ferrets than in the acepromazine-butorphanol-treated ferrets. Xylazine-butorphanol was found to be the best combination for use in ferrets.

Comparison of sedative and cardiorespiratory effects of diazepam, acepromazine, and xylazine in ferrets.

The sedative and cardiorespiratory effects of an intramuscular injection of diazepam (3 mg/kg body weight), acepromazine (0.1 mg/kg body weight), or xylazine (2 mg/kg body weight) in ferrets (n = 10, crossover design) was evaluated. Time from injection to assuming lateral recumbency was not significantly different between the three drugs. Duration of recumbency expressed as mean+/-standard deviation was significantly longer with xylazine (68.3+/-20.8 min) than with diazepam (43.2+/-8.2 min) or acepromazine (49.8+/-11.2 min). Sedation was graded to be the best in the xylazine-treated ferrets and worst in the diazepam-treated ferrets. Analgesia was judged only to be present following xylazine injection. Systolic blood pressure, oxyhemoglobin saturation, and end-expired carbon dioxide (CO2) were similar with all three drugs. It was concluded that, at the doses administered, xylazine provided better chemical restraint in the healthy ferret than either acepromazine or diazepam.

Comparison of anesthetic and cardiorespiratory effects of tiletamine-zolazepam-xylazine and tiletamine-zolazepam-xylazine-butorphanol in ferrets.

Nine ferrests were used in a crossover study to determine the anesthetic effects of intramuscular (i.m.) administration of a low dose of tiletamine-zolazepam (1.5 mg/kg body weight)-xylazine (1.5 mg/kg body weight); a high dose of tiletamine-zolazepam (3 mg/kg body weight)-xylazine (3 mg/kg body weight); and tiletamine-zolazepam (1.5 mg/kg body weight)-xylazine (1.5 mg/kg body weight)-butorphanol (0.2 mg/kg body weight). All ferrets became laterally recumbent within two minutes following the administration of each drug combination. The tiletamine-zolazepam-xylazine-butorphanol combination induced significantly longer (p less than 0.05) durations of tail clamp analgesia (mean +/- standard deviation [SD], 90.0 +/- 17.1 min versus 17.8 +/- 15.8 min and 41.9 +/- 26.3 min) and endotracheal intubation (mean +/- SD, 84.8 +/- 21.7 min versus 5.2 +/- 10.3 min and 26.3 +/- 29.8 min) than the low-dose tiletamine-zolazepam-xylazine and high-dose tiletamine-zolazepam-xylazine combinations, respectively. Heart rates and the times from dorsal recumbency to standing were not significantly different among the three treatment groups. However, systolic blood pressure was significantly lower in the tiletamine-zolazepam-xylazine-butorphanol group. Ventilatory function was more depressed in the tiletamine-zolazepam-xylazine-butorphanol group than in the low-dose tiletamine-zolazepam-xylazine and high-dose tiletamine-zolazepam-xylazine groups. A short period of hypoxia was observed in the tiletamine-zolazepam-xylazine-butorphanol-treated ferrets. Tiletamine-zolazepam-xylazine-butorphanol was found to be the best of the three combinations evaluated in these ferrets. The addition of butorphanol to the low-dose tiletamine-zolazepam-xylazine combination greatly enhanced the duration of analgesia, endotracheal intubation, and dorsal recumbency. However, since hypoxemia occurred during the tiletamine-zolazepam-xylazine-butorphanol anesthesia, oxygen (O2) insufflation is recommended. Doubling the dose of the low-dose tiletamine-zolazepam-xylazine increased the duration of analgesia and endotracheal intubation without prolonging the recovery when compared to the low-dose tiletamine-zolazepam-xylazine group.