Dexmedetomidine Sedation in Dogs: Impact on Electroencephalography, Behavior, Analgesia, and Antagonism with Atipamezole.

This study aimed to assess the impact of dexmedetomidine constant rate infusion (CRI) on key parameters in dogs. Six dogs received a 60 µg/kg/h dexmedetomidine infusion over 10 min, followed by three 15 min decremental CRIs (3, 2, and 1 µg/kg/h). A subsequent reversal phase employed 600 µg/kg/h atipamezole over 5 min. Continuous electroencephalogram (EEG) assessment, and cardiorespiratory and analgesia monitoring (every 3 min) were conducted, including analgesia evaluation through responses to electric stimulation. Dexmedetomidine induced profound sedation, evidenced by lateral recumbency and immobility. Patient State Index (PSI) decreased from awake (90.4 ± 4.3) to Phase 1 (50.9 ± 30.7), maintaining sedation (29.0 ± 18.1 to 33.1 ± 19.1 in Phases 2-4). Bradycardia (37.8 ± 3.5 bpm, lowest at Phase 3) and hypertension (133.7 ± 17.0 mmHg, highest at Phase 1) were observed, with minimal analgesia. Atipamezole promptly reversed sedation, restoring cognitive function (tail wagging behavior), and normalizing cardiovascular parameters. During atipamezole CRI, the EEG exhibited a transition from delta waves to alpha and low beta waves. This transition was observed alongside gradual increases in PSI and electromyographic activities. Additionally, spindle activities disappeared during this process. This study's results suggest potential clinical utility for EEG-guided dexmedetomidine sedation with reversal using atipamezole, warranting further investigation.

Ketamine-Propofol Coadministration for Induction and Infusion Maintenance in Anesthetized Dogs: Effects on Electroencephalography and Antinociception.

The effects of concurrent ketamine and propofol (ketofol) constant rate infusion (CRI) were examined in six dogs. The K:P ratio was 1:2, with an initial CRI of 0.25/0.5 mg/kg/min over ten minutes, followed by a 0.5 mg/kg ketamine bolus for induction. During induction, a comprehensive EEG frequency spectrum from delta to gamma was observed, accompanied by subanesthetic-dose ketofol-induced behavioral excitation, including nystagmus, tongue flicking, salivation and active muscle activity. The dogs were maintained on three 15 min decremental doses of ketofol CRI (0.8/1.6, 0.4/0.8 and 0.2/0.4 mg/kg/min). This phase featured a significant decrease in the Patient State Index, electromyographic activity and a shift to low beta waves (SEF95: 13-18 Hz). Additionally, profound antinociception to electric stimulation and a stable heart rate and blood pressure (MBP 81.5-110 mmHg) were observed, as well as a merging of ketamine and propofol EEG characteristics during maintenance. In the recovery phase, a return to beta and gamma EEG patterns and excitement behavior occurred, accompanied by a significant reduction in antinociception, highlighting features of low doses of ketofol. This study reveals biphasic EEG dynamic changes, associated behaviors and robust antinociception and cardiovascular function, suggesting the utility of ketofol as a total intravenous anesthetic combination in dogs.

Electroencephalographic and Cardiovascular Changes Associated with Propofol Constant Rate of Infusion Anesthesia in Young Healthy Dogs.

This study aimed to evaluate electroencephalography (EEG) and cardiovascular changes associated with propofol constant rate of infusion (CRI) anesthesia in dogs. Six dogs were each given propofol CRI to induce different anesthetic phases including induction (1 mg/kg/min for 10 min), and decremental maintenance doses of 2.4 mg per kg per min, 1.6 mg per kg per min, and 0.8 mg per kg per minute over 45 min. Processed EEG indices including patient state index (PSI), (burst) suppression ratio (SR), and spectral edge frequency (95%) were obtained continuously until the dogs recovered to sternal recumbency. The dogs were intubated and ventilated. Cardiovascular and EEG index values were compared between anesthetic phases. The PSI, SR, mean arterial blood pressure, and subjective anesthetic depth scores were highly correlated throughout anesthetic depth changes. The PSI decreased from 85.0 ± 17.3 at awake to 66.0 ± 29.0 at induction, and then sharply reduced to 19.7 ± 23.6 during maintenance and returned to 61.5 ± 19.2 at extubation. The SR increased from 15.4 ± 30.9% at induction to 70.9 ± 39.8% during maintenance and decreased to 3.4 ± 8.9% at extubation. We concluded that EEG indices can be used to aid in tracking ongoing brain state changes during propofol anesthesia in dogs.

Perioperative Brain Function Monitoring with Electroencephalography in Horses Anesthetized with Multimodal Balanced Anesthetic Protocol Subjected to Surgeries.

This study aimed to investigate the use of electroencephalography (EEG) for detecting brain activity changes perioperatively in anesthetized horses subjected to surgery. Twelve adult horses undergoing various surgeries were evaluated after premedication with xylazine and butorphanol, induction with ketamine, midazolam, and guaifenesin, and maintenance with isoflurane. The frontal EEG electrodes were placed after the horse was intubated and mechanically ventilated. The EEG data were collected continuously from Stage (S)1-transition from induction to isoflurane maintenance, S2-during surgery, S3-early recovery before xylazine sedation (0.2 mg kg IV), and S4-recovery after xylazine sedation. The Patient State Index (PSI), (Burst) Suppression Ratio (SR), and 95% Spectral Edge Frequency (SEF95) were compared across the stages. The PSI was lowest in S2 (20.8 ± 2.6) and increased to 30.0 ± 27.7 (p = 0.005) in S3. The SR increased from S1 (5.5 ± 10.7%) to S3 (32.7 ± 33.8%, p = 0.0001). The spectral power analysis showed that S3 had a significantly higher content of delta wave activity (0.1-4 Hz) in the EEG and lower relative power in the 3 Hz to 15 Hz range when compared to S1 and S2. A similar result was observed in S4, but the lower power was in a narrower range, from 3 Hz to 7 Hz, which indicate profound central nervous system depression potentiated by xylazine, despite the cessation of isoflurane anesthesia. We concluded that the use of EEG provides clinically relevant information about perioperative brain state changes of the isoflurane-anesthetized horse.

Comparison of anesthetic and cardiorespiratory effects of tiletamine-zolazepam-detomidine-butorphanol, tiletamine-zolazepam-xylazine-butorphanol, and ketamine-detomidine-butorphanol in pigs.

OBJECTIVE: To evaluate and compare the anesthetic, analgesic, and cardiorespiratory effects of tiletamine-zolazepam-detomidine-butorphanol (TZDB), tiletamine-zolazepam-xylazine-butorphanol (TZXB), and ketamine-detomidine-butorphanol (KDB) in pigs and to assess anesthetic recovery duration and quality following administration of tolazoline as a reversal agent. ANIMALS: 11 healthy 2.5-month-old castrated male Landrace mixed-breed pigs. PROCEDURES: In a randomized, blinded crossover study design, pigs received the following anesthetic combinations, IM: TZDB (tiletamine-zolazepam [3 mg/kg {1.36 mg/lb}], detomidine [0.18 mg/kg {0.08 mg/lb}], and butorphanol [0.12 mg/kg {0.05 mg/lb}]); TZXB (tiletamine-zolazepam [4 mg/kg {1.8 mg/lb}], xylazine [4 mg/kg], and butorphanol [0.2 mg/kg {0.09 mg/lb}]); and KDB (ketamine [8 mg/kg {3.63 mg/lb}], detomidine [0.18 mg/kg], and butorphanol [0.3 mg/kg {0.14 mg/lb}]). A 7-day washout period was provided between treatments. At 45 minutes of anesthesia, pigs received tolazoline (2 mg/kg [0.9 mg/lb], IM; n = 6) treatment or control (5) treatment with saline (0.9% NaCl) solution. RESULTS: All anesthetic combinations induced anesthesia. Endotracheal intubation was completed within 5 minutes after anesthetic administration in all pigs, except in 2 pigs following administration of KDB. Durations (mean ± SD) of endotracheal intubation and lateral recumbency in pigs that did not receive tolazoline were 55.3 ± 4.8 minutes, 83.8 ± 15.8 minutes, and 28.2 ± 4.5 minutes and 112.4 ± 18.7 minutes, 117.2 ± 16.7 minutes, and 79.7 ± 6.0 minutes, respectively, for the TZDB, TZXB, and KDB anesthetic treatments. Tolazoline significantly shortened the duration of anesthetic recovery for all anesthetic treatments without affecting the recovery quality. CONCLUSIONS AND CLINICAL RELEVANCE: All 3 anesthetic combinations were suitable for providing anesthesia in pigs. Tolazoline administration shortened the duration of anesthetic recovery without affecting the quality of recovery.

Evaluation of Endotracheal Tube Cuff Pressure and the Use of Three Cuff Inflation Syringe Devices in Dogs.

Over-inflation of an endotracheal tube (ETT) cuff may lead to tracheal mucosal irritation, tracheal wall ischemia or necrosis, whereas under-inflation increases the risk of pulmonary aspiration as well as leaking anesthetic gas and polluting the environment. The objectives of this two-phase study were to (1) identify the incidence of improper ETT cuff inflation (both over- and under-inflation) using the minimum occlusive volume (MOV) technique coupled with a regular injectable syringe in the anesthetized dogs, and (2) evaluate the performance of two commercially available inflation syringe devices (Tru-Cuff and AG Cuffill®) with the regular injectable syringe in inflating the ETT cuff to a recommended safe cuff pressure range (20-30 cmH2O). Dogs undergoing general anesthesia at Purdue Veterinary Medicine Teaching Hospital were included. The ETT cuff pressure was assessed with an aneroid manometer after the syringe inflation. The results of the first objective showed that a total of 80 dogs enrolled and that 50 of these 80 dogs required ETT cuff inflation. Among the 50 dogs, only 14% had proper ETT cuff inflation; 76% of the ETT cuffs were over-inflated and 10% were under-inflated. Ninety dogs were enrolled for the second objective study and they were randomly and equally assigned to the three syringe device treatment groups. The results showed that 80% of the ETT cuffs were over-inflated in the regular injectable syringe treatment group, whereas only 6.7% and 3.3% ETT cuffs were over-inflated in the Tru-Cuff and AG Cuffill® syringe treatment groups, respectively. The AG Cuffill® syringe treatment group had a significantly (p < 0.05) higher percentage of properly inflated ETT cuffs (86.7%) compared to the other two groups (regular injectable syringe [3.3%]; Tru-Cuff syringe [50%]. We concluded that there was a high incidence of improper ETT cuff inflation when using MOV technique coupled with a regular injectable syringe. The use of an AG Cuffill® syringe significantly reduced improper ETT cuff inflation.

Effects of transdermal fentanyl solution application and subsequent naloxone hydrochloride administration on minimum alveolar concentration of isoflurane in dogs.

OBJECTIVE To assess the isoflurane-sparing effect of a transdermal formulation of fentanyl solution (TFS) and subsequent naloxone administration in dogs. DESIGN Experiment. ANIMALS 6 healthy mixed-breed dogs. PROCEDURES Minimum alveolar concentration (MAC) of isoflurane was determined in each dog with a tail clamp method (baseline). Two weeks later, dogs were treated with TFS (2.7 mg/kg [1.23 mg/lb]), and the MAC of isoflurane was determined 4 and 24 hours later. After the 4-hour MAC assessment, saline (0.9% NaCl) solution was immediately administered IV and MAC was reassessed. After the 24-hour MAC assessment, naloxone hydrochloride (0.02 mg/kg [0.01 mg/lb], IV) was immediately administered and MAC was reassessed. Heart rate, respiratory rate, arterial blood pressure, end-tidal partial pressure of CO2, and oxygen saturation as measured by pulse oximetry were recorded for each MAC assessment. RESULTS Mean ± SD MAC of isoflurane at 4 and 24 hours after TFS application was 45.4 ± 4.0% and 45.5 ± 4.5% lower than at baseline, respectively. Following naloxone administration, only a minimal reduction in MAC was identified (mean percentage decrease from baseline of 13.1 ± 2.2%, compared with 43.8 ± 5.6% for saline solution). Mean heart rate was significantly higher after naloxone administration (113.2 ± 22.2 beats/min) than after saline solution administration (76.7 ± 20.0 beats/min). No significant differences in other variables were identified among treatments. CONCLUSIONS AND CLINICAL RELEVANCE The isoflurane-sparing effects of TFS in healthy dogs were consistent and sustained between 4 and 24 hours after application, and these effects should be taken into consideration when anesthetizing or reanesthetizing TFS-treated dogs.

Optimized computed tomography protocol for assessment of dentition in alpacas.

OBJECTIVE To determine the optimal protocol for acquisition of CT images of the dentition in alpacas. ANIMALS 3 healthy adult male alpacas. PROCEDURES Each alpaca was anesthetized with an IM injection of a combination of ketamine, xylazine, and butorphanol and positioned in sternal recumbency on the CT couch with its legs folded in a natural cush position and its head positioned within the isocenter of the gantry of a 64-slice CT scanner. Images were acquired by means of 6 protocols (sequential and helical modes at slice thicknesses of 1.25, 2.5, and 5 mm). Five images (2 molar, 2 premolar, and mandibular incisor teeth) were selected from each protocol for evaluation by 3 veterinary radiologists. For each image, tooth root visibility and sharpness and image noise artifact were subjectively evaluated on a 3-point scoring system. RESULTS Slice thickness significantly affected tooth root visibility and tooth root sharpness but did not affect image noise artifact. Acquisition mode significantly affected tooth root visibility and tooth root sharpness as well as image noise artifact. Tooth root visibility and sharpness did not differ significantly between the helical and sequential images when the slice thickness was 1.25 mm. Image noise artifact was greater for helical images than sequential images but did not differ by slice thickness within either acquisition mode. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that for a 64-slice CT scanner, the optimal protocol for the acquisition of CT images of the dentition in alpacas was a sequential scan with a slice thickness of 1.25 mm.

Evaluation of three intravenous injectable anaesthesia protocols in healthy adult male alpacas.

Few studies have investigated the effects of intravenous injectable anaesthesia in alpacas. The objective of this study was to evaluate three intravenous injectable anaesthesia protocols in healthy adult alpacas exposed to noxious stimulation. A prospective randomised crossover study was done using six healthy adult male alpacas. Cardiopulmonary variables including heart rate, respiratory rate, mean arterial pressure, end-tidal pCO2 and haemoglobin oxygen saturation were collected immediately after and every two minutes following induction of each of three anaesthesia protocols in six male castrated alpacas. A hoof tester was used to apply consistent pressure every two minutes after induction and the response was recorded. Time from induction to muscle contraction and leg withdrawal were recorded, as well as time from induction to extubation, sternal recumbency and standing. There was no significant difference in duration of anaesthesia or cardiopulmonary variables among the three anaesthesia protocols. Total duration of anaesthesia was approximately 20 minutes for each protocol. Hypoxaemia and mild hypercarbia were common among all protocols. Induction and recovery scores were excellent.

Assessment of agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scoring the recovery of horses from anesthesia by use of subjective grading scales and development of a system for evaluation of the recovery of horses from anesthesia by use of accelerometry.

OBJECTIVE To evaluate agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scores determined by use of a simple descriptive scale (SDS) or a composite grading scale (CGS) for quality of recovery of horses from anesthesia and to investigate use of 3-axis accelerometry (3AA) for objective evaluation of recovery. ANIMALS 12 healthy adult horses. PROCEDURES Horses were fitted with a 3AA device and then were anesthetized. Eight diplomates evaluated recovery by use of an SDS, and 7 other diplomates evaluated recovery by use of a CGS. Agreement was tested with κ and AC1 statistics for the SDS and an ANOVA for the CGS. A library of mathematical models was used to map 3AA data against CGS scores. RESULTS Agreement among diplomates using the SDS was slight (κ = 0.19; AC1 = 0.22). The CGS scores differed significantly among diplomates. Best fit of 3AA data against CGS scores yielded the following equation: RS = 9.998 × SG0.633 × ∑UG0.174, where RS is a horse's recovery score determined with 3AA, SG is acceleration of the successful attempt to stand, and ∑UG is the sum of accelerations of unsuccessful attempts to stand. CONCLUSIONS AND CLINICAL RELEVANCE Subjective scoring of recovery of horses from anesthesia resulted in poor agreement among diplomates. Subjective scoring may lead to differences in conclusions about recovery quality; thus, there is a need for an objective scoring method. The 3AA system removed subjective bias in evaluations of recovery of horses and warrants further study.

Hemodynamic influence of acepromazine or dexmedetomidine premedication in isoflurane-anesthetized dogs.

OBJECTIVE: To investigate hemodynamic effects of acepromazine and dexmedetomidine premedication in dogs undergoing general anesthesia induced with propofol and maintained with isoflurane in oxygen and assess the influence of these drugs on oxygen-carrying capacity and PCV. DESIGN: Prospective, randomized crossover study. ANIMALS: 6 healthy adult dogs. PROCEDURES: Dogs received acepromazine (0.05 mg/kg [0.023 mg/lb]) or dexmedetomidine (15.0 µg/kg [6.82 µg/lb]) IM. Fifteen minutes later, anesthesia was induced with propofol and maintained at end-tidal isoflurane concentration of 1.28% (1 minimum alveolar concentration) for 30 minutes. Hemodynamic variables were recorded at predetermined times. The experiment was repeated 48 hours later with the alternate premedication. Results were analyzed by repeated-measures ANOVA with a mixed-models procedure. RESULTS: Bradycardia, hypertension, and significant cardiac output (CO) reduction developed after dexmedetomidine premedication but improved during isoflurane anesthesia. Hypotension developed after acepromazine administration and persisted throughout the isoflurane maintenance period, but CO was maintained throughout the anesthetic period when dogs received this treatment. Oxygen delivery and consumption were not different between treatments at most time points, whereas arterial oxygen content was lower with acepromazine premedication owing to lower PCV during isoflurane anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Acepromazine exacerbated hypotension, but CO did not change in dogs anesthetized with propofol and isoflurane. Dexmedetomidine reduced CO but prevented propofol-isoflurane-induced hypotension. In general, oxygen-carrying capacity and PCV were higher in dexmedetomidine-treated than in acepromazine-treated dogs anesthetized with propofol and isoflurane.

Teaching veterinary anesthesia and surgery: the impact of instructor availability on anesthesia, operative, and recovery times in dogs undergoing ovariohysterectomy or castration.

Veterinary students learning to perform elective ovariohysterectomy (OVH) and castration procedures have traditionally been taught by a few instructors supervising many student groups simultaneously. This study, using a historical control group, explored the impacts of having a dedicated instructor with each student group for anesthetic induction and an entire surgical procedure. Our hypothesis was that preparation, surgical, and anesthesia times would be shorter and, consequently, post-operative recovery times would be shorter with a dedicated instructor compared to traditional methods. Anesthesia records of dogs undergoing elective surgery by third-year veterinary students were reviewed over 3 consecutive years. Traditional instruction was used in year 1 (Y1), and a dedicated instructor per student group was used in year 2 (Y2) and year 3 (Y3). Anesthesia time, surgical time, recovery time, and pre- and post-operative rectal temperature were analyzed, and a stepwise regression model was developed for factors influencing recovery time. Of 206 records reviewed (Y1, 33; Y2, 98; Y3, 75), there were 101 OVH procedures and 105 castration procedures. Preparation, surgery, and anesthesia times were longer in animals undergoing surgery in Y1, when the traditional instruction method was used. Recovery time was not influenced by instructor assignment. Using dedicated instructors to teach OVH and castration to third-year veterinary students decreased overall anesthesia time by 36 to 49 minutes for OVH and 29 to 32 minutes for castration. A teaching model of dedicated instructors requires excellent coordination between surgeons and anesthesiologists to ensure that a similar number of animals can undergo procedures in the time allotted for teaching.

Microscopy and genomic analysis of Mycoplasma parvum strain Indiana.

Mycoplasma parvum [Eperythrozoon parvum] is the second hemotrophic mycoplasma (hemoplasma) described in pigs. Unlike M. suis, its closest phylogenetic relative, M. parvum, is considered a non-pathogenic bacterium in this host species. Natural infection of a domestic, 6-month-old splenectomized pig with M. parvum strain Indiana is described herein. Light and scanning electron microscopy of the bacteria were performed in addition to whole genome sequencing, analysis, and comparison to the genome of M. suis strain Illinois. Neither clinical signs nor anemia were observed during the infection. Microscopy analyses revealed coccoid to rod- shaped organisms varying from 0.2 to 0.5 µm; they were observed individually or in short chains by both light and electron microscopy, however less than 30% of the red blood cells were infected at peak bacteremia. The single circular chromosome of M. parvum was only 564 395 bp, smaller than M. genitalium, previously considered the tiniest member of the Mollicutes. Its general genomic features were similar to others in this class and species circumscription was verified by phylogenomic analysis. A gene-by-gene comparison between M. suis and M. parvum revealed all protein coding sequences (CDS) with assigned functions were shared, including metabolic functions, transporters and putative virulence factors. However, the number of CDS in paralogous gene families was remarkably different with about half as many paralogs in M. parvum. The differences in paralogous genes may be implicated in the different pathogenic potential of these two species, however variable gene expression may also play a role. Both are areas of ongoing investigation.

In vitro evaluation of three intravenous fluid line warmers.

OBJECTIVE: To determine in vitro output temperature differences of 3 IV fluid warmers. DESIGN: Prospective, randomized study. SAMPLE: 3 IV fluid warmers. PROCEDURES: Warming capabilities of a distance-dependent blood and fluid warmer marketed for human and veterinary use (product A) and a veterinary-specific distance-dependent fluid warmer (product B) were compared at 0, 4, 8, and 12 cm from the device to the test vein and at flow rates of 20, 60, 100, 140, 180, 220, 260, and 300 mL/h with room temperature (approx 22°C) fluids (phase 1). The superior warming device was compared against a distance-independent IV fluid warmer (product C) with room temperature fluids at the same flow rates (phase 2). The effect of prewarmed fluids (38°C) versus room temperature fluids was evaluated with the superior warming device from phase 2 (phase 3). RESULTS: In phase 1, product B produced significantly warmer fluids than product A for all flow rates and distances. Both distance-dependent devices produced warmer fluid at 0 cm, compared with 4, 8, and 12 cm. In phase 2, product B produced warmer fluid than product C at 60, 100, 140, and 180 mL/h. In phase 3, there was no significant benefit to use of prewarmed fluids versus room temperature fluids. Output temperatures ≥ 36.4°C were achieved for all rates ≥ 60 mL/h. CONCLUSIONS AND CLINICAL RELEVANCE: Product B had superior warming capabilities. Placing the fluid warmer close to the patient is recommended. Use of prewarmed fluids had no benefit. Lower IV fluid flow rates resulted in lower output fluid temperatures.

Influence of ketamine on the cardiopulmonary effects of intramuscular administration of dexmedetomidine-buprenorphine with subsequent reversal with atipamezole in dogs.

OBJECTIVE: To compare the cardiorespiratory effects of IM administration of dexmedetomidine-buprenorphine (DB) and dexmedetomidine-buprenorphine-ketamine (DBK) in dogs with subsequent reversal with atipamezole. DESIGN: Prospective, randomized crossover study. ANIMALS: 5 healthy dogs. PROCEDURES: Dogs were instrumented for cardiac output (CO) measurement and received DB (15 µg of dexmedetomidine/kg [6.8 µg/lb] and 40 µg of buprenorphine/kg [18.2 µg/lb]) or DBK (DB plus 3 mg of ketamine/kg [1.36 mg/lb]) in randomized order while breathing room air. Atipamezole (150 µg/kg [68.2 µg/lb], IM) was administered 1 hour later. Hemodynamic data were collected in the conscious dogs and then at 5, 10, 15, 20, 30, 45, and 60 minutes after drug administration. Lactate concentration was measured in mixed venous blood samples. Oxygen delivery (Do(2)) and oxygen consumption ([Formula: see text]o(2)) were calculated. RESULTS: Heart rate (HR), CO, and Do(2) decreased after DB and DBK administration. The [Formula: see text]o(2) did not change in the DB group but decreased in the DBK group. The HR was higher in the DBK group than in the DB group throughout the study, but the CO, Do(2), and [Formula: see text]o(2) values were similar for the 2 groups. Blood lactate concentrations remained low (< 1 mmol/L) throughout the study. Arterial hypoxemia and hypercapnea occurred in both groups. Mean arterial blood pressure and pulmonary artery wedge pressure were markedly increased in both groups, but to a greater extent in the DBK group. After atipamezole administration, HR, CO, and Do(2) returned to the baseline values. CONCLUSIONS AND CLINICAL RELEVANCE: Adding ketamine to the DB combination allowed dogs to maintain a higher HR and delayed the onset of sinus arrhythmias but failed to provide a significantly higher CO because of a reduction in stroke volume.

Evaluation of anesthetic, analgesic, and cardiorespiratory effects in dogs after intramuscular administration of dexmedetomidine-butorphanol-tiletamine-zolazepam or dexmedetomidine-tramadol-ketamine drug combinations.

OBJECTIVE: To compare anesthetic, analgesic, and cardiorespiratory effects in dogs after IM administration of dexmedetomidine (7.5 µg/kg)-butorphanol (0.15 mg/kg)-tiletamine-zolazepam (3.0 mg/kg; DBTZ) or dexmedetomidine (15.0 µg/kg)-tramadol (3.0 mg/kg)-ketamine (3.0 mg/kg; DTrK) combinations. ANIMALS: 6 healthy adult mixed-breed dogs. PROCEDURES: Each dog received DBTZ and DTrK in a randomized, crossover-design study with a 5-day interval between treatments. Cardiorespiratory variables and duration and quality of sedation-anesthesia (assessed via auditory stimulation and sedation-anesthesia scoring) and analgesia (assessed via algometry and electrical nerve stimulation) were evaluated at predetermined intervals. RESULTS: DBTZ or DTrK induced general anesthesia sufficient for endotracheal intubation ≤ 7 minutes after injection. Anesthetic quality and time from drug administration to standing recovery (131.5 vs 109.5 minutes after injection of DBTZ and DTrK, respectively) were similar between treatments. Duration of analgesia was significantly longer with DBTZ treatment, compared with DTrK treatment. Analgesic effects were significantly greater with DBTZ treatment than with DTrK treatment at several time points. Transient hypertension (mean arterial blood pressure > 135 mm Hg), bradycardia (heart rate < 60 beats/min), and hypoxemia (oxygen saturation < 90% via pulse oximetry) were detected during both treatments. Tidal volume decreased significantly from baseline with both treatments and was significantly lower after DBTZ administration, compared with DTrK, at several time points. CONCLUSIONS AND CLINICAL RELEVANCE: DBTZ or DTrK rapidly induced short-term anesthesia and analgesia in healthy dogs. Further research is needed to assess efficacy of these drug combinations for surgical anesthesia. Supplemental 100% oxygen should be provided when DBTZ or DTrK are used.

Hemodynamic effects in dogs after intramuscular administration of a combination of dexmedetomidine-butorphanol-tiletamine-zolazepam or dexmedetomidine-butorphanol-ketamine.

OBJECTIVE: To evaluate hemodynamic effects in dogs after IM administration of dexmedetomidine (7.5 µg/kg, butorphanol (0.15 mg/kg), and tiletamine-zolazepam (3 mg/kg [DBTZ]) or dexmedetomidine (15 µg/kg), butorphanol (0.3 mg/kg), and ketamine (3 mg/kg [DBK]). ANIMALS: 5 healthy adult mixed-breed dogs. PROCEDURES: Each dog received DBTZ and DBK in a randomized crossover study with a 48-hour interval between treatments. Anesthesia was induced and maintained with sevoflurane in 100% oxygen while instrumentation with Swan-Ganz and arterial catheters was performed. Following instrumentation, hemodynamic measurements were recorded at 3.54% (1.5 times the minimum alveolar concentration) sevoflurane; then sevoflurane administration was discontinued, and dogs were allowed to recover. Six hours after cessation of sevoflurane administration, baseline hemodynamic measurements were recorded, each dog was given an IM injection of DBTZ or DBK, and hemodynamic measurements were obtained at predetermined intervals for 70 minutes. RESULTS: DBTZ and DBK induced hypoventilation (Paco2, approx 60 to 70 mm Hg), respiratory acidosis (pH, approx 7.2), hypertension (mean arterial blood pressure, approx 115 to 174 mm Hg), increases in systemic vascular resistance, and reflex bradycardia. Cardiac output, oxygen delivery, and oxygen consumption following DBTZ or DBK administration were similar to those following sevoflurane administration to achieve a surgical plane of anesthesia. Blood l-lactate concentrations remained within the reference range at all times for all protocols. CONCLUSIONS AND CLINICAL RELEVANCE: In healthy dogs, both DBTZ and DBK maintained oxygen delivery and oxygen consumption to tissues and blood lactate concentrations within the reference range. However, ventilation should be carefully monitored and assisted when necessary to prevent hypoventilation.

Evaluation of dexmedetomidine and ketamine in combination with various opioids as injectable anesthetic combinations for castration in cats.

OBJECTIVE: To compare the efficacy and cardiorespiratory effects of dexmedetomidine-ketamine in combination with butorphanol, hydromorphone, or buprenorphine with or without reversal by atipamezole in cats undergoing castration. DESIGN: Prospective, randomized, split-plot, blinded study. ANIMALS: 30 healthy male cats. PROCEDURES: Cats were assigned to receive dexmedetomidine (25 ?g/kg [11.4 ?g/lb]) and ketamine (3 mg/kg [1.4 mg/lb]) with butorphanol (0.2 mg/kg [0.09 mg/lb]; DKBut; n = 10), hydromorphone (0.05 mg/kg [0.023 mg/lb]; DKH; 10), or buprenorphine (30 ?g/kg [13.6 ?g/lb]; DKBup; 10). Drugs were administered as a single IM injection. Supplemental isoflurane was administered to cats if the level of anesthesia was inadequate for surgery. At the conclusion of surgery, half the cats (5 cats in each treatment group) received atipamezole (250 ?g/kg [113.6 ?g/lb], IM) and the remainder received saline (0.9% NaCl) solution IM. All cats received meloxicam (0.2 mg/kg, SC) immediately prior to the conclusion of surgery. RESULTS: All drug combinations induced lateral recumbency, and intubation was achievable in 13 of 30 (43%) cats at 10 minutes after injection. Supplemental isoflurane was needed for the surgery in 1 of 10 of the DKBut-, 2 of 10 of the DKH-, and 7 of 10 of the DKBup-treated cats. Cats that received atipamezole had a significantly shorter recovery time. CONCLUSIONS AND CLINICAL RELEVANCE: DKBut and DKH combinations were suitable injectable anesthetic protocols for castration in cats commencing at 10 minutes after injection, but cats receiving DKBup may require additional time or anesthetics for adequate anesthesia.

Evaluation of dexmedetomidine and ketamine in combination with opioids as injectable anesthesia for castration in dogs.

OBJECTIVE: To compare efficacy and cardiorespiratory effects of dexmedetomidine and ketamine in combination with butorphanol, hydromorphone, or buprenorphine (with or without reversal by atipamezole) in dogs undergoing castration. DESIGN: Prospective, randomized, split-plot, blinded study. ANIMALS: 30 healthy client-owned sexually intact male dogs. PROCEDURES: Dogs (n = 10 dogs/group) were assigned to receive dexmedetomidine (15 µg/kg [6.82 µg/lb]) and ketamine (3 mg/kg [1.36 mg/lb]) with butorphanol (0.2 mg/kg [0.09 mg/lb]; DKBut), the same dosages of dexmedetomidine and ketamine with hydromorphone (0.05 mg/kg [0.023 mg/lb]; DKH), or the same dosages of dexmedetomidine and ketamine with buprenorphine (40 µg/kg [18.18 µg/lb]; DKBup). All drugs were administered as a single IM injection for induction and maintenance of anesthesia for castration. At conclusion of the surgery, 5 dogs in each treatment group received atipamezole (150 µg/kg [68.18 µg/lb], IM), and the remainder received saline (0.9% NaCl) solution IM. Cardiorespiratory variables and quality of anesthesia were assessed. Supplemental isoflurane was administered to the dogs when anesthesia was considered inadequate during surgery. RESULTS: All drug combinations rapidly induced anesthesia. Dogs were intubated within 10 minutes after injection. Supplemental isoflurane was needed during surgery in 1, 3, and 4 dogs in the DKBup, DKBut, and DKH groups, respectively. Dogs that received atipamezole had a significantly shorter recovery time. Some dogs in each group had bradycardia and hypoxemia with hypertension. CONCLUSIONS AND CLINICAL RELEVANCE: DKBup was the most suitable injectable anesthetic combination used. Recovery was shortened by IM administration of atipamezole. There were minimal adverse effects in all groups.

Efficacy of oral transmucosal and intravenous administration of buprenorphine before surgery for postoperative analgesia in dogs undergoing ovariohysterectomy.

OBJECTIVE: To compare the efficacy of preoperative administration of buprenorphine (via oral transmucosal [OTM] and IV routes) for postoperative analgesia in dogs undergoing ovariohysterectomy. DESIGN: Prospective, randomized, blinded study. ANIMALS: 18 dogs undergoing routine ovariohysterectomy. PROCEDURES: Dogs were allocated to 3 groups (6 dogs/group) and were assigned to receive buprenorphine (20 µg/kg [9.09 µg/lb], IV; a low dose [20 µg/kg] via OTM administration [LOTM]; or a high dose [120 µg/kg [54.54 µg/lb] via OTM administration [HOTM]) immediately before anesthetic induction with propofol and maintenance with isoflurane for ovariohysterectomy. Postoperative pain was assessed by use of a dynamic interactive pain scale. Dogs were provided rescue analgesia when postoperative pain exceeded a predetermined threshold. Blood samples were collected, and liquid chromatography-electrospray ionization-tandem mass spectrometry was used to determine plasma concentrations of buprenorphine and its metabolites. Data were analyzed with an ANOVA. RESULTS: Body weight, surgical duration, propofol dose, isoflurane concentration, and cardiorespiratory variables did not differ significantly among treatment groups. Number of dogs requiring rescue analgesia did not differ significantly for the HOTM (1/6), IV (3/6), and LOTM (5/6) treatments. Similarly, mean ± SEM duration of analgesia did not differ significantly for the HOTM (20.3 ± 3.7 hours), IV (16.0 ± 3.8 hours), and LOTM (7.3 ± 3.3 hours) treatments. Plasma buprenorphine concentration was ≤ 0.60 ng/mL in 7 of 9 dogs requiring rescue analgesia. CONCLUSIONS AND CLINICAL RELEVANCE: Buprenorphine (HOTM) given immediately before anesthetic induction can be an alternative for postoperative pain management in dogs undergoing ovariohysterectomy.