Performance of the Parasympathetic Tone Activity (PTA) index to predict changes in mean arterial pressure in anaesthetized horses with different health conditions.

The parasympathetic tone activity (PTA) index is based on heart rate variability and has been developed recently in animals to assess their relative parasympathetic tone. This study aimed to evaluate PTA index in anaesthetized horses with different health conditions and the performance of PTA variations (∆PTA) to predict changes in mean arterial pressure (MAP). Thirty-nine client-horses were anaesthetized for elective or colic surgery and divided into "Elective" and "Colic" groups. During anaesthesia, dobutamine was administered as treatment of hypotension (MAP <60 mmHg). In both groups, no significant variation of PTA and MAP were detected immediately before and after cutaneous incision. The PTA index increased 5 min before each hypotension, whereas it decreased 1 min after dobutamine administration. Horses of the Colic group had lower PTA values than those of the Elective group, whereas MAP did not differ between groups. To predict a 10% decrease in MAP, ΔPTA performance was associated with: AUC ROC [95% CI] =0.80 [0.73 to 0.85] (p < 0.0001), with a sensitivity of 62.5% and a specificity of 94.6% for a threshold value of 25%. The PTA index in anaesthetized horses appears to be influenced by the health condition. The shift toward lower PTA values in colic horses may reflect a sympathetic predominance. An increase in PTA of >25% in 1 min showed an acceptable performance to predict MAP decrease of >10% within 5 min. Even though these results require further evaluation, this index may thus help to predict potential autonomic dysfunctions in sick animals.

Ultrasound-guided dorsal approach for the brachial plexus block in common kestrels (Falco tinnunculus): a cadaver study.

OBJECTIVE: To develop an ultrasound-guided dorsal approach to the brachial plexus and to investigate the nerve distribution and staining of a dyed injectate in common kestrel (Falco tinnunculus) cadavers. STUDY DESIGN: Prospective, cadaver study. ANIMALS: A group of three common kestrel cadavers (six wings). METHODS: All cadavers were fresh-frozen at -20 °C and thawed for 10 hours at room temperature before the study. The cadavers were placed in sternal recumbency and their wings were abducted. A 8-13 MHz linear-array transducer was placed over the scapulohumeral joint, at the centre of a triangle formed by the scapula and the humerus. The brachial plexus was identified between the scapulohumeralis muscle and the pectoralis major muscle, as hypoechoic structures lying just cranially to the axillary vessels. After ultrasound-guided brachial plexus identification, a 22 gauge, 50 mm insulated needle was advanced in-plane using ultrasound visualization. A volume of 0.5 mL kg-1 of a 3:1 (2% lidocaine:methylene blue) solution was injected. Following cadaver dissection, the pattern of the spread was assessed, and the extent of nerve staining was measured with a calliper and deemed adequate if more than 0.6 cm of the nerve staining was achieved. RESULTS: The brachial plexus was clearly identified in all wings with the dorsal approach. After dye injection, all the branches of the brachial plexus defined as nerves 1-5 (N1, N2, N3, N4 and N5) were completely stained in five (83%) and partially stained in one (17%) of the six wings. CONCLUSIONS AND CLINICAL RELEVANCE: The ultrasound-guided dorsal approach allows a clear visualization of the brachial plexus structure. The injection of 0.5 mL kg-1of a lidocaine/dye solution produced complete nerve staining in most cases. Further in vivo studies are mandatory to confirm the clinical efficacy of this locoregional anaesthesia technique in common kestrels (Falco tinnunculus).

Evaluation of the sublingual microcirculation with sidestream dark field video microscopy in horses anesthetized for an elective procedure or intestinal surgery.

OBJECTIVE: To compare the sublingual microcirculation between healthy horses anesthetized for elective procedures and horses with colic anesthetized for abdominal surgery and to determine the effect of mean arterial blood pressure (MAP) on the microcirculation. ANIMALS: 9 horses in the elective group and 8 horses in the colic group. PROCEDURES: Sublingual microcirculation was assessed with sidestream dark field video microscopy. Videos were captured at 3 time points during anesthesia. Recorded microvasculature parameters were De Backer score (DBS), total density of perfused vessels (PVD) and small vessels (PVD-S), total proportion of perfused vessels (PPV) and small vessels (PPV-S), vascular flow index (MFI), and heterogeneity index (HI). Blood pressure during hypotensive (MAP < 60 mm Hg) and normotensive (MAP ≥ 60 mm Hg) episodes was also recorded. RESULTS: During normotensive episodes, the elective group had significantly better PPV and PPV-S versus the colic group (median PPV, 76% vs 50%; median PPV-S, 73% vs 51%). In both groups, PPV decreased during anesthesia (elective group, -29%; colic group, -16%) but significantly improved in the elective group 15 minutes before the end of anesthesia (59%). During hypotensive episodes, PVD-S was better preserved in the colic group (11.1 vs 3.8 mm/mm2). No differences were identified for the microcirculatory parameters between normo- and hypotensive episodes in the colic group. CONCLUSIONS AND CLINICAL RELEVANCE: Sublingual microcirculation was better preserved in healthy horses anesthetized for elective procedures than in horses with colic anesthetized for abdominal surgery despite resuscitation maneuvers. Results indicated that the macrocirculation and microcirculation in critically ill horses may be independent.

Comparison of intraocular pressure and pupil diameter after sedation with either acepromazine or dexmedetomidine in healthy dogs.

OBJECTIVE: To compare intraocular pressure (IOP) and pupillary diameter (PD) following intravenous (IV) administration of dexmedetomidine and acepromazine in dogs. STUDY DESIGN: Prospective, randomized experimental trial. ANIMALS: A group of 16 healthy adult dogs aged (mean ± standard deviation) 4.9 ± 3.3 years and weighing 15.7 ± 9.6 kg, without pre-existing ophthalmic disease. METHODS: IV dexmedetomidine hydrochloride (0.002 mg kg-1; DEX) or acepromazine maleate (0.015 mg kg-1; ACE) was administered randomly to 16 dogs (eight per group). The IOP and PD, measured using applanation tonometry and Schirmer's strips mm scale, respectively, and the heart rate (HR), systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures and respiratory rate (fR) were recorded at baseline, at time of injection, and then 5, 10, 15, 20 and 25 minutes after injection. A single ophthalmologist, unaware of treatment, performed all measurements under consistent light conditions. Values were compared with baseline and among treatments using a multivariate mixed-effects model (p ≤ 0.05). RESULTS: The IOP was significantly lower in the DEX group compared with the ACE group at 10 (p < 0.01) and 15 minutes (p < 0.01) after drug injection. PD was significantly smaller compared to baseline for the entire duration of the study (p < 0.01) in both groups. Dogs in the DEX group had significant lower HR (p < 0.01) and fR (p < 0.01), higher SAP (p < 0.01) and DAP (p < 0.01) at all time points, and higher MAP (p < 0.01) during the first 15 minutes following drug injection in comparison with the ACE group. CONCLUSIONS AND CLINICAL RELEVANCE: Our results suggest that premedication with IV dexmedetomidine temporarily decreases IOP when compared with IV acepromazine. Both drugs cause miosis.

The Modification and Performance of a Large Animal Anesthesia Machine (Tafonius®) in Order to Deliver Xenon to a Horse.

INTRODUCTION: Xenon, due to its interesting anesthetic properties, could improve the quality of anesthesia protocols in horses despite its high price. This study aimed to modify and test an anesthesia machine capable of delivering xenon to a horse. MATERIALS AND METHODS: An equine anesthesia machine (Tafonius, Vetronic Services Ltd., UK) was modified by including a T-connector in the valve block to introduce xenon, so that the xenon was pushed into the machine cylinder by the expired gases. A xenon analyzer was connected to the expiratory limb of the patient circuit. The operation of the machine was modeled and experimentally tested for denitrogenation, wash-in, and maintenance phases. The system was considered to consist of two compartments, one being the horse's lungs, the other being the machine cylinder and circuit. A 15-year-old, 514-kg, healthy gelding horse was anesthetized for 70 min using acepromazine, romifidine, morphine, diazepam, and ketamine. Anesthesia was maintained with xenon and oxygen, co-administered with lidocaine. Ventilation was controlled. Cardiorespiratory variables, expired fraction of xenon (FeXe), blood gases were measured and xenon was detected in plasma. Recovery was unassisted and recorded. RESULTS: FeXe remained around 65%, using a xenon total volume of 250 L. Five additional boli of ketamine were required to maintain anesthesia. PaO2 was 45 ± 1 mmHg. The recovery was calm. Xenon was detected in blood during the entire administration time. CONCLUSION: This pilot study describes how to deliver xenon to a horse. Although many technical problems were encountered, their correction could guide future endeavors to study the use of xenon in horses.

Sedative and cardiovascular effects of intranasal or intramuscular dexmedetomidine in healthy dogs.

OBJECTIVE: To compare the clinical effects and sedation scores following either intranasal (IN) or intramuscular (IM) administration of dexmedetomidine in dogs. STUDY DESIGN: Prospective, blinded, randomized, clinical study. ANIMALS: A total of 20 client-owned dogs scheduled for noninvasive diagnostic procedures. METHODS: Dogs were allocated to be administered dexmedetomidine 0.02 mg kg-1 IN (IN group) or IM (IM group). Sedation was scored before and at 5 minute intervals (for 45 minutes) after drug administration using a composite simple descriptive sedation scale giving a score of 0 (not sedated) to 13 (well sedated). Respiratory frequency (fR), heart rate, haemoglobin oxygen saturation (SpO2) and noninvasive arterial blood pressure were recorded every 5 minutes for 45 minutes. Normally distributed data were analyzed using two-way ANOVA and post hoc Sidak's multiple comparison test. Non-normally distributed data were compared using the Scheier Ray Hare test and post hoc Mann-Whitney U test. Statistical significance was set at p<0.05. RESULTS: Weight, age and sex were not different between groups. Dexmedetomidine onset of action after IN administration was not shorter compared to IM administration (6.3±3.3 versus 9.4±4.6 minutes, p=0.120). Sedation score in the IN group was higher [10 (0-11)] compared to the IM group [6 (0-8)] (p<0.001). At time of peak sedation, heart rate decreased 56% from baseline values in the IM group, and 18% in the IN group. No significant differences in SpO2 and fR were found between the two groups at any time point. No undesirable effects were observed. CONCLUSIONS AND CLINICAL RELEVANCE: Intranasal dexmedetomidine 0.02 mg kg-1 produced effective sedation with less bradycardia and more profound sedation compared to IM administration in healthy dogs and may be considered as an alternative route for dexmedetomidine administration in dogs.

Percutaneous transilial pinning for treatment of seventh lumbar vertebral body fracture. A retrospective analysis of 17 cases.

OBJECTIVE: To evaluate outcomes after percutaneous application of transilial pinning in dogs with seventh lumbar vertebral body fracture with concurrent lumbosacral luxation. METHODS: We reviewed the medical records of dogs with seventh lumbar vertebral body fracture stabilized with percutaneous transilial pinning that were treated at our hospital between January 2000 and March 2014. Radiographic measurements were used for comparing craniocaudal and ventrodorsal displacement pre- and postoperatively. RESULTS: Seventeen dogs met the inclusion criteria. The neurological status of the majority of treated dogs improved quickly, with immediate pain reduction after surgery. Implants were well tolerated throughout the application period and were removed at a mean time of 54.4 ± 9.2 days. One dog experienced a major complication (implant failure) and required surgical revision a week after the initial procedure. Minor complications included pin-tract inflammation, signs of back pain lasting five weeks and acute lameness after implant removal. Postoperative radiographic measurements showed shortening of the vertebral body and residual dorsoventral dislocation. Otherwise, functional recovery was good (5 of 17 dogs) to excellent (10 of 17 dogs) in the majority of the patients. CLINICAL RELEVANCE: The use of two percutaneous transilial pins can be considered as treatment for the management of seventh lumbar fracture-luxation in dogs. Our modified stabilization technique is relatively easy to perform; less invasive on the soft tissues; and uses implants that are versatile, modifiable, and easily removable.

Transnasal administration of a combination of dexmedetomidine, midazolam and butorphanol produces deep sedation in New Zealand White rabbits.

OBJECTIVE: To study the sedative and cardiorespiratory effects of transnasal (TN) administration of a combination of dexmedetomidine (DEX), midazolam (MID) and butorphanol (BUT) administered through a nasal catheter to rabbits undergoing diagnostic procedures. STUDY DESIGN: Descriptive cross-sectional experimental study. ANIMALS: Eight healthy New Zealand White rabbit does (12 ± 1 months old, 3.5 ± 0.3 kg). METHODS: DEX (0.1 mg kg(-1)), MID (2 mg kg(-1)) and BUT (0.4 mg kg(-1)) were mixed (DMB) in a syringe and applied to the rabbits' nasopharyngeal mucosa after the accurate catheterization of one nostril. The onset, duration and quality of effects including analgesia were scored using a numeric rating scale of sedation for rabbits. Continuous monitoring of vital parameters was performed via clinical and multiparametric recording. Physiological variables were explored using repeated measures anova for parametric data or Friedman's test for non-parametric data. Tukey's or Dunn's post hoc multiple comparisons test was used depending on normality. The statistical significance was set at p < 0.05. RESULTS: Loss of the righting reflex, deep sedation and profound analgesia ensued simultaneously at 1.4 ± 1.1 minutes after DMB administration. These effects lasted 45 minutes before subsiding into moderate sedation, which lasted for an additional 25 minutes. Residual central nervous system impairment persisted up to 100 minutes. Blood pressure dropped progressively over time by 50%, whereas respiratory frequency decreased by 70%, consistent with moderate hypoxemia and hypercarbia. CONCLUSION AND CLINICAL RELEVANCE: The TN route is a reliable and effective means for administration of DEX, MID and BUT to rabbits. The overall profound sedative effects and analgesic proprieties of the DMB combination can be selectively reversed depending on the needs of the procedure. Oxygen supplementation and careful monitoring are mandatory even in healthy subjects. The DMB protocol should be cautiously used in rabbits with cardiovascular or respiratory deficiencies.

Dacryocystography in a cat with orbital pneumatosis.

A 2-year-old neutered male European short-haired cat was presented for a persistent discharge from the scar of previous left eye enucleation, performed 6 months prior by the referring veterinarian. A surgical exploration of the orbit was performed and retained nictitating membrane glandular and conjunctival tissues were removed. Eleven days later, the cat developed an orbital pneumatosis caused by retrograde movement of air through a patent nasolacrimal system and diagnosed by survey radiographic examination of the skull. Nasolacrimal system patency was assessed by dacryocystography performed by injection of iodinated contrast medium under pressure into the orbital cavity. Computed tomography dacryocystography confirmed the radiographic findings. The condition resolved following dacryocystography, possibly as an inflammatory response to the contrast medium. To our knowledge, this is the first case of orbital pneumatosis reported in a cat.