Effect of insulation with bubble wrap and an absorbent pad on heat loss in anaesthetised cats.

Aims: To evaluate the efficacy of insulating the limbs and thorax of cats with a combination of bubble wrap and an absorbent, plastic-lined pad in reducing heat loss during ovariohysterectomy. Methods: A preliminary study was performed to compare heat loss of 1 L bags of Hartmann's solution heated to 38°C which were either wrapped in two layers of bubble wrap and an absorbent pad (n = 6) or were unwrapped (n = 6). Bags were allowed to cool in a temperature-controlled room and the temperature of the bags was measured every 10 minutes for 60 minutes. The clinical study, included 16 intact female cats undergoing ovariohysterectomy. The cats were premedicated with I/M morphine and either medetomidine or dexmedetomidine, and anaesthesia was induced with I/V propofol and maintained with isoflurane in 100% oxygen. Cats were randomly assigned to either the treatment group (n = 8) whose limbs and thorax wrapped with two layers of bubble wrap and an absorbent pad immediately after induction, or the control group (n = 8) which were unwrapped. Body temperature (measured with an oesophageal temperature probe), heart rate, respiratory rate, mean arterial pressure and partial pressure of end-tidal CO2 were recorded immediately after induction (T start), before surgery started (T surgery), and at the end of isoflurane administration (T end). The times from T end to extubation, from T end to when the cat could maintain sternal recumbency and from T end to when the cat was able to stand, were also recorded. Results: In the preliminary study of heat loss by fluid bags, the mean temperature at 60 minutes was higher in wrapped bags (35.4 (SD 0.2)°C) compared to unwrapped bags (33.0 (SD 0.3)°C; p < 0.01). For cats undergoing ovariohysterectomy, mean body temperature of wrapped cats was higher than that of unwrapped cats both at T surgery (36.0 (SE 0.3) vs. 34.5 (SE 0.3)°C; p = 0.001) and at T end (37.2 (SE 0.5) vs. 36.0 (SE 0.5)°C; p = 0.01). Wrapped cats regained the ability to stand more rapidly that unwrapped cats (26.4 (SE 5.8) vs. 47.0 (SE 5.8) minutes p = 0.01). Conclusions: Wrapping the limbs and thorax of cats undergoing ovariohysterectomy in a combination of bubble wrap and absorbent pads reduced heat loss, which in turn improved recovery time from general anaesthesia. Clinical relevance: This inexpensive and practical method may reduce perioperative hypothermia, in cats undergoing abdominal surgery.

A survey of dog and cat anaesthesia in a sample of veterinary practices in New Zealand.

AIMS: To survey current anaesthesia practices for dogs and cats in small and mixed animal practices in New Zealand in order to improve anaesthesia education. METHODS: A questionnaire was sent to 440 small and mixed animal practices, including questions regarding the type of practice, preanaesthetic examination, anaesthetic drugs and management, anaesthetic machines, monitoring and topics of interest for continuing professional development. RESULTS: Responses were obtained from 113/440 (26%) practices, with 78 (69%) respondents from small and 35 (31%) from mixed animal practices. A preanaesthetic physical examination was carried out by >95% of respondents and premedication was usually given to dogs (112/113; 99%) and cats (95/113; 85%). Acepromazine was the preferred sedative for dogs and cats, with morphine or buprenorphine. Propofol and alfaxalone were the preferred induction agents, and isoflurane was preferred for maintenance in both dogs and cats. A venous catheter was usually placed for anaesthesia in dogs (59/113; 52%), but less so in cats (39/113; 35%). Perioperative fluid was administered at 10 mL/kg/hour by 62/110 (56%) respondents. Intubation was usually used for anaesthesia in dogs (111/112; 99%), and cats (87/112; 78%). Almost 40% of respondents usually administered supplementary oxygen if patients were not intubated. Local analgesia was used by 69/111 (88%) respondents sometimes or always if applicable. Morphine or buprenorphine, and meloxicam were common choices for post-operative analgesia after neuter surgery in dogs and cats. A semiclosed (non-rebreathing) system was used in animals weighing <10 kg, and a Mapleson E or F non-rebreathing circuit was used by 66/109 (61%) practices. Only 15/111 (14%) practices had a ventilator in their practice. A dedicated anaesthetist was usually used by 104/113 (92%) practices, and apnoea alarms, pulse oximeters, thermometers and oesophageal stethoscopes were the main monitoring devices available in practices. Loco-regional block, pain management, and anaesthetic drugs were the main topics of interest for continuing education. CONCLUSIONS AND CLINICAL RELEVANCE: Responses by the veterinarians taking part in this survey indicated that they had a reasonably good standard of anaesthetic practice. A physical examination was carried out preanaesthesia, and premedication including analgesia was routinely administered to most patients. A dedicated anaesthetist usually monitored patients and most respondents reported they had access to basic anaesthetic monitoring equipment. Areas where changes could lead to improved anaesthetic practice were increased use of I/V catheterisation, endotracheal intubation, and supplementary oxygen, and reduced I/V fluid rates.

Binding space and time through action.

Space and time are intimately coupled dimensions in the human brain. Several lines of evidence suggest that space and time are processed by a shared analogue magnitude system. It has been proposed that actions are instrumental in establishing this shared magnitude system. Here we provide evidence in support of this hypothesis, by showing that the interaction between space and time is enhanced when magnitude information is acquired through action. Participants observed increases or decreases in the height of a visual bar (spatial magnitude) while judging whether a simultaneously presented sequence of acoustic tones had accelerated or decelerated (temporal magnitude). In one condition (Action), participants directly controlled the changes in bar height with a hand grip device, whereas in the other (No Action), changes in bar height were externally controlled but matched the spatial/temporal profile of the Action condition. The sign of changes in bar height biased the perceived rate of the tone sequences, where increases in bar height produced apparent increases in tone rate. This effect was amplified when the visual bar was actively controlled in the Action condition, and the strength of the interaction was scaled by the magnitude of the action. Subsequent experiments ruled out that this was simply explained by attentional factors, and additionally showed that a monotonic mapping is also required between grip force and bar height in order to bias the perception of the tones. These data provide support for an instrumental role of action in interfacing spatial and temporal quantities in the brain.

Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee.

These guidelines provide an up-date of previous IFCN report on "Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application" (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 "Report", was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain-behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.

A comparison of anaesthetic recoveries in cats following induction with either alfaxalone or ketamine and diazepam.

AIM: To determine if cats anaesthetised with alfaxalone have different recoveries to cats anaesthetised with a combination of ketamine and diazepam. METHODS: Anaesthesia for ovariohysterectomy was induced in cats with either alfaxalone (n=23) or a combination of ketamine and diazepam (n=22). All cats were premedicated with combinations of acepromazine and morphine. Recoveries were scored using a categorical grading scheme applied to 18 parameters over 60 minutes following extubation. The parameters scored covered movement, sensitivity to touch, sound and light, body position, sneezing and vocalisation. One person scored all recoveries and they were blinded to the induction drug used. Scores were compared between drugs at different times using the Kruskal-Wallis rank sum test. RESULTS: Recovery scores were not normally distributed. Analysis of the data using the Kruskal-Wallis rank sum test revealed that cats induced with alfaxalone showed an increase in recovery scores at 5 minutes for pawing at the head (p=0.001). No parameters differed significantly at 10 and 20 minutes. For cats anaesthetised with ketamine and diazepam there was an increase at 30 minutes in pacing, jerky sudden movements, unsettledness and increased sensitivity to touch at the surgical site and on the head (p≤0.01). At 60 minutes cats anaesthetised with ketamine and diazepam still showed an increase in unsettledness compared to those cats anaesthetised with alfaxalone (p=0.005). CONCLUSIONS: The results suggest that recoveries of cats following alfaxalone induction are significantly different to recoveries after induction with ketamine and diazepam. Overall, cats induced with ketamine and diazepam had more active and unsettled recoveries than alfaxalone over the 60-minute period observed. CLINICAL RELEVANCE: Cats recovering from alfaxalone anaesthesia have more settled recoveries than cats recovering from ketamine and diazepam anaesthesia. If a quiet settled recovery is desired following a surgical procedure, alfaxalone is likely to be a better choice than ketamine and diazepam.

A comparison of two different ketamine and diazepam combinations with an alphaxalone and medetomidine combination for induction of anaesthesia in sheep.

AIMS: To investigate the perceived adverse effects of a particular batch of ketamine during induction of anaesthesia in sheep and to assess if any adverse effects would make intubation more difficult for the veterinary students. METHODS: Thirty adult sheep (mean bodyweight 74.5 (SD 9.4) kg) were randomly assigned to one of six groups of five sheep. Sheep in Groups A and B received I/V 0.5 mg/kg diazepam and 10 mg/kg ketamine (Ketamine Injection; Parnell Laboratories NZ Ltd, of the suspect batch); those in Groups C and D received I/V 0.5 mg/kg diazepam and 10 mg/kg ketamine (Ketalar; Hospira NZ Ltd.), and those in Groups E and F received I/V 2 µg/kg medetomidine and 2 mg/kg alphaxalone. In Groups A, C and E, intubation was by an experienced anaesthetist, and in Groups B, D and F intubation was by a veterinary student. Time from injection to successful intubation, the ease of intubation, saturation of haemoglobin with oxygen (SpO2) and partial pressure of oxygen in arterial blood (PaO2) were measured before the sheep were connected to an anaesthetic machine and allowed to breath oxygen. Times to extubation, holding its head up and standing, maximum and minimum heart rates, respiratory rates, maximal end tidal CO2, and the quality of recovery were then recorded. RESULTS: There were no measurable differences in outcomes between sheep in Groups A and B compared with C and D. Time to intubation was slightly shorter for the experienced anaesthetist than the student, but the difference was not significant. The sheep in Groups E and F took less time to recover than those in Groups A-D (p<0.05), but there were no significant differences between the groups in either the ease of induction or quality of recovery. Most sheep in Groups E and F showed minor excitatory effects, mainly at induction, which did not interfere with induction. Respiratory rates were lower in Groups E and F than Groups A-D (p<0.01), but SpO2 was higher in Groups E and F than A and B (p<0.05). CONCLUSIONS: The clinical impression that the batch of Parnell ketamine produced unexpected effects was shown to be incorrect. All the combinations produced anaesthesia that allowed intubation by the veterinary student. CLINICAL RELEVANCE: All the drug combinations produced satisfactory anaesthesia in sheep, but the alphaxaloneand medetomidine combination resulted in faster recovery.

Long-term outcomes after partial tarsal arthrodesis in working farm dogs in New Zealand.

AIM: To report the long-term outcome (return to work and owner satisfaction) for working farm dogs in New Zealand after partial tarsal arthrodesis for proximal intertarsal and/or tarsometatarsal tarsal joint injury. METHODS: Working farm dogs that underwent partial tarsal arthrodesis were identified by diagnosis and breed code via a search of the medical records of Massey University Veterinary Teaching Hospital (MUVTH) and Veterinary Specialist Orthopaedic Services (VetSOS). Fourteen dogs fulfilled the selection criteria and were all actively in work on farms at the time of injury. Data from case files were analysed, and the ability of the dog to work after surgery and owners' satisfaction were assessed using a questionnaire sent to owners at a median follow-up interval of 57 months. RESULTS: Following partial tarsal arthrodesis, 7/14 (50%) dogs could perform normal work duties required while 4/14 (29%) dogs could perform most of the duties they had undertaken before injury, though some allowance had to be made for reduced performance. Thirteen owners were satisfied or very satisfied with the outcome of surgery and 12/14 thought the financial investment required for the surgery was worthwhile. Of the three dogs that did not return to work, infection requiring implant removal (one dog) and less than optimal post-operative limb alignment (two dogs) were assessed to contribute to the poor outcome. Two other dogs that required implant removal due to infection did successfully return to work. CONCLUSIONS: In this limited cases series, partial tarsal arthrodesis in working dogs had a good prognosis for return to work. Any conclusion regarding the benefit of a particular surgical technique requires a prospective evaluation with a larger number of animals. It is important to minimise the risk of infection and optimally align the tarsus to avoid a poor outcome. CLINICAL RELEVANCE: New Zealand veterinarians can now provide more accurate prognostic information to owners whose working dogs suffer tarsal trauma requiring partial arthrodesis.

Preliminary investigation of somatosensory evoked potentials in equine headshaking.

The aim of this study was to develop a technique for recording electrical activity of the equine cerebral cortex following application of a noxious electrical stimulus to the maxillary branch of the trigeminal nerve in order to investigate trigeminal nerve neurophysiology in control and headshaking horses. Triphasic somatosensory evoked potentials (SEPs) were recorded using subcutaneous needle electrodes in four control and four headshaking horses under general anaesthesia. Dural electroencephalography electrodes were used to record SEPs in one further control and one further headshaking horse. Headshaking horses appeared to have decreased middle latency and inter-peak intervals following stimulation of the trigeminal nerve compared with control horses, supporting abnormal trigeminal nerve physiology in equine headshaking.

Dissociating the contributions of human frontal eye fields and posterior parietal cortex to visual search.

Imaging, lesion, and transcranial magnetic stimulation (TMS) studies have implicated a number of regions of the brain in searching for a target defined by a combination of attributes. The necessity of both frontal eye fields (FEF) and posterior parietal cortex (PPC) in task performance has been shown by the application of TMS over these regions. The effects of stimulation over these two areas have, thus far, proved to be remarkably similar and the only dissociation reported being in the timing of their involvement. We tested the hypotheses that 1) FEF contributes to performance in terms of visual target detection (possibly by modulation of activity in extrastriate areas with respect to the target), and 2) PPC is involved in translation of visual information for action. We used a task where the presence (and location) of the target was indicated by an eye movement. Task disruption was seen with FEF TMS (with reduced accuracy on the task) but not with PPC stimulation. When a search task requiring a manual response was presented, disruption with PPC TMS was seen. These results show dissociation of FEF and PPC contributions to visual search performance and that PPC involvement seems to be dependent on the response required by the task, whereas this is not the case for FEF. This supports the idea of FEF involvement in visual processes in a manner that might not depend on the required response, whereas PPC seems to be involved when a manual motor response to a stimulus is required.

Segregation of visual selection and saccades in human frontal eye fields.

The premotor theory of attention suggests that target processing and generation of a saccade to the target are interdependent. Temporally precise transcranial magnetic stimulation (TMS) was delivered over the human frontal eye fields, the area most frequently associated with the premotor theory in association with eye movements, while subjects performed a visually instructed pro-/antisaccade task. Visual analysis and saccade preparation were clearly separated in time, as indicated by 2 distinct time points of TMS delivery that resulted in elevated saccade latencies. These results show that visual analysis and saccade preparation, although frequently enacted together, are dissociable processes.

Diffusion tensor MRI-based estimation of the influence of brain tissue anisotropy on the effects of transcranial magnetic stimulation.

We evaluate and discuss the relevance of fiber anisotropy in estimating the effect of transcranial magnetic stimulation (TMS) on the human brain. Finite element simulations were carried out on a three-dimensional model of the head that included anisotropic conductivity information derived from diffusion tensor imaging (DTI). The results show that anisotropy has minor effects both on the position of the main locus of activation and on its intensity. It has considerably more effect on the spatial distribution of the induced electric field, yielding differences of the order of 10% of the maximum induced field. Moreover the area affected by magnetic stimulation is slightly larger when we include fiber anisotropy in the calculations than in an isotropic model. We also show that the induced field observed in the anisotropic model does not always align with the local fiber orientation but rather follows specific patterns of parallelity. These findings will help to improve the estimation of the areas involved in magnetic stimulation.

The neural correlates of phonological short-term memory: a repetitive transcranial magnetic stimulation study.

Neuropsychological reports and activation studies by means of positron emission tomography and functional magnetic resonance imaging have suggested that the neural correlates of phonological short-term memory are located in the left hemisphere, with Brodmann's area (BA) 40 being responsible for short-term storage, and BA 44 for articulatory rehearsal. However, a careful review of the literature on the role of left BA 40 shows that the data are equivocal. We tested these hypotheses by means of repetitive transcranial magnetic stimulation (rTMS). Participants performed four tasks: two phonological judgements, thought to require only articulatory rehearsal without the contribution of short-term storage; a digit span, which involves both, short-term storage and articulatory rehearsal; and a pattern span, this last being the control task. The sites of stimulation were left BA 40, left BA 44 and the electrode location v(tx), plus a baseline without TMS. Reaction times increased and accuracy decreased in the case of the phonological judgements and digit span after stimulation of both left sites, suggesting that BA 40, in addition to BA 44, is involved in phonological judgements. Possible explanations are discussed, namely, the possibility that (i) the neural correlates of rehearsal are not limited to BA 44 and (ii) phonological judgements involve processes other than rehearsal. We also consider the effects of using different tasks and responses to resolve some of the discrepancies in the literature.

Suspected fatal venous air embolism during anaesthesia in a Pomeranian dog with pulmonary calcification.

CASE HISTORY: Death occurred in a 1.25 kg, 9-month-old female Pomeranian dog undergoing anaesthesia for surgical repair of partially healed fractures of the radius and ulna. CLINICAL FINDINGS: Following sedation, anaesthesia was induced using thiopentone and maintained with halothane in oxygen. An acute decrease in the dog's end-tidal carbon dioxide (EtCO2) measurements was noted approximately 50 min after induction, immediately following delivery of a 5-ml bolus of lactated Ringer's solution (LRS) administered to flush a small (0.06 ml) volume of fentanyl via a pre-placed intravenous (I/V) catheter. Venous air embolism (VAE) was suspected and the dog died despite interventive therapy. On post-mortem examination, several air bubbles were noted when the right ventricle was opened under water. Histologically, the kidneys appeared abnormal with immature glomeruli, and the lungs appeared diffusely mineralised. The origin of the air was probably small bubbles and microbubbles that may have been present in the extension set and 20 ml syringe used for the administration of fentanyl and I/V fluids to the dog. DIAGNOSIS: Renal dysplasia and diffuse pulmonary calcification, with VAE as the probable cause of death. CLINICAL RELEVANCE: In this case of VAE-associated anaesthetic death, it is further speculated that underlying pulmonary disease, in the form of pulmonary calcification, may have contributed to an increased sensitivity to the adverse effects of VAE.

Congenital portosystemic shunts in dogs and cats.

Congenital portosystemic shunts (PPS) are abnormal vascular communications that allow blood from the intestine to bypass the liver, and are classified as intrahepatic or extrahepatic. Clinical signs are generally related to the nervous, gastrointestinal or urinary systems, and are often vague. In addition, changes present on routine blood analysis are often mild and non-specific. For this reason, alternative tests are required for a diagnosis. Diagnostic tests include serum bile-acid concentrations, ammonia tolerance test, portography, ultrasonography and/or scintigraphy. Medical therapy involves reducing absorption of encephalopathic toxins from the gastrointestinal tract and may prolong survival. Surgical therapy is aimed at attenuation of the shunting vessel and provides improved survival rates. The traditional approach has been complete or partial ligation of the shunt. More recent approaches have involved slow, progressive attenuation with ameroid constrictors or cellophane banding. Overall, prognosis following surgical therapy is good in dogs and fair in cats.

Brain activations during visual search: contributions of search efficiency versus feature binding.

We investigated the involvement of the parietal cortex in binding features during visual search using functional magnetic resonance imaging. We tested 10 subjects in four visual search tasks across which we independently manipulated (1) the requirement to integrate different types of features in a stimulus (feature or conjunction search) and (2) the degree of search efficiency (efficient or inefficient). We identified brain areas that were common to all conditions of visual search and areas that were sensitive to the factors of efficiency and feature binding. Visual search engaged an extensive network of parietal, frontal, and occipital areas. The factor of efficiency exerted a strong influence on parietal activations along the intraparietal sulcus and in the superior parietal lobule. These regions showed a main effect of efficiency and showed a simple effect when inefficient conditions were compared directly with efficient pop-out conditions in the absence of feature binding. Furthermore, a correlation analysis supported a tight correspondence between posterior parietal activation and the slope of reaction-time search functions. Conversely, feature binding during efficient pop-out search was not sufficient to modulate the parietal cortex. The results confirm the important role of the parietal cortex in visual search, but suggest that feature binding is not a requirement to engage its contribution.

Gastric dilatation-volvulus in dogs.

Gastric dilatation-volvulus (GDV) is a disease in which there is gross distension of the stomach with fluid or gas and gastric malpositioning. It causes pathology of multiple organ systems and is rapidly fatal. It is common in large- and giant-breed dogs. The disease appears to have a familial predisposition. Thoracic depth/width ratio also appears to predispose dogs to GDV. Implicated dietary factors include dietary particle size, frequency of feeding, speed of eating, aerophagia and an elevated feed bowl. A fearful temperament and stressful events may also predispose dogs to GDV. Abdominal distension, non-productive retching, restlessness, signs of shock, tachypnoea and dyspnoea are possible clinical signs. Initial treatment includes treatment of shock and gastric decompression. Surgical treatment should be performed promptly. There are no studies comparing the use of different anaesthetic agents in the anaesthetic management of GDV. Pre-medication with an opioid/benzodiazepine combination has been recommended. Induction agents that cause minimal cardiovascular changes such as opioids, neuroactive steroidal agents and etomidate are recommended. Anaesthesia should be maintained with an inhalational agent. Surgical therapy involves decompression, correction of gastric malpositioning, debridement of necrotic tissue, and gastropexy. Options for gastropexy include incisional, tube, circumcostal, belt-loop, incorporating, and laparoscopic gastropexy. Expected mortality with surgical therapy is 15-24%. Prognostic factors include mental status on presentation, presence of gastric necrosis, presence of cardiac arrhythmia and plasma lactate levels. Prophylactic gastropexy should be considered in dogs identified as being at high risk.

Mapping of the human visual cortex using image-guided transcranial magnetic stimulation.

We describe a protocol using transcranial magnetic stimulation (TMS) to systematically map the visual sensations induced by focal and non-invasive stimulation of the human occipital cortex. TMS is applied with a figure of eight coil to 28 positions arranged in a 2x2-cm grid over the occipital area. A digitizing tablet connected to a PC computer running customized software, and audio and video recording are used for detailed and accurate data collection and analysis of evoked phosphenes. A frameless image-guided neuronavigational device is used to describe the position of the actual sites of the stimulation coils relative to the cortical surface. Our results show that TMS is able to elicit phosphenes in almost all sighted subjects and in a proportion of blind subjects. Evoked phosphenes are topographically organized. Despite minor inter-individual variations, the mapping results are reproducible and show good congruence among different subjects. This procedure has potential to improve our understanding of physiologic organization and plastic changes in the human visual system and to establish the degree of remaining functional visual cortex in blind subjects. Such a non-invasive method is critical for selection of suitable subjects for a cortical visual prosthesis.

Sedation and chemical restraint of deer.

This review examines the properties of chemical immobilising agents of use or potential use in deer for velvet antler removal. The alpha-2-adrenergic agonist, xylazine, is the most commonly used agent for chemical restraint of stags for this purpose in New Zealand. This compound is often combined with an opioid or ketamine to enhance its effectiveness. Concerns about the carcinogenic potential of a xylazine metabolite have led to a call by the deer industry to limit the use of this drug and stimulated enquiry into alternatives. The potent pure opioid agonists, fentanyl, carfentanil and etorphine, are less effective than xylazine when used alone, and their use presents greater risk to operators and animals and is subject to more stringent legal restrictions. Newer alpha-2-adrenergic agonists, detomidine and medetomidine, are more potent than xylazine and unlikely to result in carcinogenic metabolites. Availability of specific alpha-2-adrenergic antagonists further enhances the usefulness of these drugs. The dissociative agent, ketamine, has proven useful for immobilisation of various domestic and wildlife species and captive species of deer but undesirable side effects and the low concentration, relative to the effective dose, of currently available formulations limit its usefulness. Combination of a dissociative agent with an alpha-2-adrenergic agent reduces the required dose of both and enhances their efficacy. A commercially available combination of the dissociative anaesthetic agent, tiletamine, and the benzodiazepine, zolazepam, is more potent than ketamine and induction times are faster. This combination can be manipulated to varying concentrations by dissolution with alpha-2-adrenergic agents. A long-acting neuroleptic agent, zuclopenthixol, has recently been investigated for calming deer and may be an alternative to classical sedative-immobilising agents. Most chemical immobilisation agents used alone or in combination produce respiratory depression and supplemental oxygen has been recommended. All would likely result in some form of chemical residues in velvet antler.

Chemical analgesia for velvet antler removal in deer.

There is a legal requirement to provide analgesia for velvet antler removal in New Zealand. Currently, this is achieved using local anaesthetic blockade, with or without systemically administered sedative/analgesic agents, or by compression in 1-year-old stags. Lignocaine hydrochloride 2% is most commonly used and is most effective when administered as a high-dose ring block. Combinations of various amino-amide local anaesthetic agents can achieve rapid onset and prolonged duration of analgesia, though concerns about drug residues and carcinogenic potential of a lignocaine metabolite have led to consideration of the amino-ester family of local anaesthetics as alternatives. Systemically administered analgesics, including opioids, alpha-2-adrenergic agents and ketamine provide dose-dependent sedation and analgesia. However, none are sufficient, alone or in combination, to produce surgical analgesia at currently recommended dose rates and when reversal agents are given, analgesic effects are usually reversed as well as sedation. Thus, local anaesthetic blockade is still indicated, though the potential for drug or drug-metabolite residues in velvet antler remains a concern. The need for and effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for post-operative analgesia requires investigation. Amitriptyline, locally administered opioid agonists, tramadol and other systemically administered agents may warrant future investigation for surgical and post-operative analgesia for velvet antler removal.