Successful cardiopulmonary resuscitation following cardiac arrest in a hypoglycemic cat.

This case highlights the successful recovery to discharge of a hypothermic cat in cardiac arrest, with minimal lasting clinical signs. Immediately after resuscitation, the cat was blind and non-ambulatory paraparetic. Within 4 days, the cat became fully ambulatory, but vision loss remains. We believe that the cat's hypothermia likely contributed to this successful outcome. Other factors which may have played a role in the cat's recovery were the administration of mannitol and anti-seizure medications. Key clinical message: We share learning points regarding re-warming rates for hypothermic patients and the use of Doxapram for stimulation of the central respiratory center.

Ressuscitation cardio-pulmonaire réussie suivant un arrêt cardiaque chez un chat hypoglycémique. Le présent cas souligne le succès de la guérison jusqu'au congé d'un chat hypothermique en arrêt cardiaque, avec des signes cliniques permanents minimes. Immédiatement après la ressuscitation, le chat était aveugle et paraparétique non-ambulant. À l'intérieur d'un délai de 4 jours le chat est devenu complètement ambulatoire, mais la perte de vision persistait. Nous sommes d'avis que l'hypothermie du chat aurait contribué à cette conclusion positive. D'autres facteurs qui pourraient avoir joué un rôle dans la guérison du chat étaient l'administration de mannitol et de médicaments anti-convulsions.Message clinique clé :Nous partageons des notions d'apprentissage concernant les vitesses de réchauffement pour les patients hypothermiques et l'utilisation de Doxapram pour la stimulation du centre central de la respiration.(Traduit par Dr Serge Messier).

Adverse reactions to fentanyl transdermal patches in calves: a preliminary clinical and pharmacokinetic study.

OBJECTIVE: To describe adverse reactions and measure plasma fentanyl concentrations in calves following administration of a fentanyl transdermal patch (FTP). STUDY DESIGN: Prospective, experimental clinical study. ANIMALS: Six female Holstein calves and one male Angus calf. Four calves were healthy experimental animals and three calves were clinical patients. METHODS: Plasma fentanyl concentrations were measured in blood collected from a jugular vein. FTP 2 µg kg-1 hour-1 and 1 µg kg-1 hour-1 was applied to four and three calves, respectively. Heart rate, respiratory rate, temperature and ataxia were recorded at the same times as blood collection (0, 2, 4, 6, 12, 24, 36, 48, 60, 72, 84 and 96 hours). Substance P concentrations were determined via radioimmunoassay for two calves. RESULTS: After the FTP (2 µg kg-1 hour-1) application, two calves developed tachycardia, hyperthermia, excitement and ataxia within 6 hours; no adverse effect was observed in the other two calves. The three calves administered FTP (1 µg kg-1 hour-1) exhibited tachycardia and excitement, and the FTP were removed at 4 hours. Naloxone was administered to two calves before the adverse clinical signs ceased, while adverse events in the other three calves resolved within 2 hours of FTP removal. Variables returned to previous baseline values by 2-4 hours after FTP removal. Maximum plasma fentanyl concentrations were variable among calves (0.726-6.923 ng mL-1). Substance P concentrations measured in two calves were not consistently depressed during FTP application. Fentanyl concentrations at 4 and 6 hours were significantly associated with the appearance of adverse effects. CONCLUSIONS AND CLINICAL RELEVANCE: FTP (1-2 µg kg-1 hour-1) administered to calves may result in adverse behavioral and cardiovascular effects. Patch removal and treatment with an opioid antagonist may resolve these adverse effects. Additional research is needed to determine optimal FTP dosing for cattle.

Postoperative comparison of four perioperative analgesia protocols in dogs undergoing stifle joint surgery.

OBJECTIVE: To compare 4 analgesic protocols in dogs undergoing stifle joint surgery. DESIGN: Randomized, blinded, prospective clinical trial. Animals-48 client-owned dogs that underwent stifle joint surgery. PROCEDURES: Dogs undergoing tibial plateau leveling osteotomy were randomly assigned to receive a constant rate infusion of a combination of morphine, lidocaine, and ketamine; a lumbosacral epidural with morphine and ropivacaine; both treatments (ie, constant rate infusion and lumbosacral epidural); or only IM premedication with morphine. Indices of cardiorespiratory function and isoflurane requirement were recorded at 5-minute intervals during anesthesia. A validated sedation scoring system and the modified Glasgow composite measure pain score were used to assess comfort and sedation after surgery and anesthesia once the swallowing reflex returned and a body temperature of ≥ 36.7°C (98.1°F) was attained. Pain and sedation scores were acquired at 60-minute intervals for 4 hours, then at 4-hour intervals for 24 hours. Dogs with a postoperative pain score > 5 of 24 were given morphine as rescue analgesia. RESULTS: No differences in heart rate, respiratory rate, systolic arterial blood pressure, end-tidal Pco2, end-tidal isoflurane concentration, and vaporizer setting were detected among groups. No differences in pain score, sedation score, rescue analgesia requirement, or time to first rescue analgesia after surgery were detected. CONCLUSIONS AND CLINICAL RELEVANCE: Pain scores were similar among groups, and all 4 groups had similar rescue analgesia requirements and similar times to first administration of rescue analgesia. All 4 analgesic protocols provided acceptable analgesia for 24 hours after stifle joint surgery.