Postoperative pain and short-term complications after two elective sterilization techniques: ovariohysterectomy or ovariectomy in cats.

BACKGROUND: Surgical sterilization of cats is one of the most commonly performed procedures in veterinary practice and it can be accomplished by two different techniques: ovariohysterectomy (OVH) or ovariectomy (OVE). Although there is an apparent preference for OVH in United States and Canada, OVE seems to be the standard of care in many European countries due to its advantages, such as a smaller surgical incision and potentially less complications associated with surgical manipulation of the uterus. The aim of this randomized, blind, prospective study was to compare postoperative pain and short-term complications in cats undergoing ovariohysterectomy or ovariectomy. METHODS: Twenty female cats were randomly assigned into two groups (OVH, n = 10 and OVE, n = 10). Pain was assessed prior to surgery (baseline) and 1, 2, 4, 8 12 and 24 h after the procedure using pain and sedation scales, physiologic parameters and blood glucose levels. Short-term complications were evaluated in the early postoperative period and reassessed at day 7 and day 10. RESULTS: Changes in cardiovascular parameters were not clinically relevant, however cats in OVH group had higher heart rates at T1 h compared with baseline (p = 0.0184). Blood glucose levels in OVH group were also higher at T1 h compared with baseline (p = 0.0135) and with OVE group (p = 0.0218). Surgical time was higher in OVH group (p = 0.0115). Even though no significant differences in pain scores were observed between groups or time points, cats in OVH group had greater need for rescue analgesia compared with OVE (2/10 and 0/10, respectively). Complications were not observed in any cat during surgery, at days 7 and 10 postoperatively or at discharge. CONCLUSIONS: Both surgical techniques promoted similar intensity of postoperative pain in cats and there were no short-term complications throughout the study's evaluation period. Therefore, both techniques may be indicated for surgical sterilization of cats, according to the surgeon's preference and expertise. Cats that underwent ovariectomy did not require rescue analgesia and surgical time was shorter in that group.

Pulse pressure variation as a guide for volume expansion in dogs undergoing orthopedic surgery.

OBJECTIVE: To investigate whether pulse pressure variation (PPV) can predict fluid responsiveness in healthy dogs during clinical surgery. STUDY DESIGN: Prospective clinical study. ANIMALS: Thirty-three isoflurane-anesthetized dogs with arterial hypotension during orthopedic surgery. METHODS: Fluid challenge with lactated Ringer's solution (15 mL kg-1 in 15 minutes) was administered in mechanically ventilated dogs (tidal volume 10 mL kg-1) with hypotension [mean arterial pressure (MAP) < 65 mmHg]. The volume expansion was considered effective if cardiac output (CO; transesophageal Doppler) increased by ≥ 15%. Cardiopulmonary data were analyzed using two-way ANOVA, receiver operating characteristics (ROC) curves and Spearman coefficient; p < 0.05 was considered significant. RESULTS: Effective volume expansion, mean ± standard deviation 42 ± 4% increase in CO (p < 0.0001) was observed in 76% of the dogs, resulting in a decrease in PPV (p < 0.0001) and increase in MAP (p < 0.0001), central venous pressure (CVP; p = 0.02) and ejection fraction (p < 0.0001) compared with before the fluid challenge. None of these changes occurred when volume expansion resulted in a nonsignificant CO increase of 4 ± 5%. No significant differences were observed in blood gas analysis between responsive and nonresponsive dogs. The increase in CO was correlated with the decrease in PPV (r = -0.65; p < 0.0001) but absolute values of CO and PPV were not correlated. The PPV performance (ROC curve area: 0.89 ± 0.06, p = 0.0011) was better than that of CVP (ROC curve area: 0.54 ± 0.12) and MAP (ROC curve area: 0.59 ± 0.13) to predict fluid responsiveness. The best cut-off for PPV to distinguish responders and nonresponders was 15% (50% sensitivity and 96% specificity). CONCLUSIONS AND CLINICAL RELEVANCE: In mechanically ventilated, healthy, isoflurane-anesthetized dogs, PPV predicted fluid responsiveness to volume expansion, and MAP and CVP did not show such applicability.

Radial shock wave therapy in dogs with hip osteoarthritis.

OBJECTIVE: The study aims were to evaluate the effects of radial shock wave therapy (RSWT) in dogs with hip osteoarthritis (OA) using clinical assessment and kinetic analysis. METHODS: Thirty dogs diagnosed with bilateral hip OA and 30 healthy dogs were used. In OA dogs, one limb was randomly selected for treatment with RSWT while the contralateral limb served as an untreated control. Dogs were evaluated while walking on a pressure walkway. Peak vertical force (PVF) and vertical impulse (VI) were documented; symmetry index (SI) was also calculated. Blinded clinical evaluation was performed using a visual analogue scale (VAS). Owner perception data regarding levels of physical activity were also collected. The RSWT protocol (2000 pulses, 10 Hz, 2-3.4 bars) consisted of three weekly treatment sessions (days 1, 8 and 16). Follow-up data were collected 30, 60 and 90 days after the first session. Data were compared between time points, groups and limbs pairs. RESULTS: At the end of the experimental period, mean PVF and VI values had increased (25.9 to 27.6%BW and 2.1 to 12.7%BW × s respectively) in treated limbs, with no significant differences in control limbs; SI values suggest improvement. Mean PVF and VI remained lower in the treated compared to the healthy group following treatment. The VAS scores suggested improvement in pain and lameness in treated dogs. Owner perception data suggested improved levels of physical activity following treatment. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Outcomes of this study suggested beneficial effects of RSWT in dogs with hip osteoarthritis.

Anesthetic complications in diabetic dogs subjected to phacoemulsification / Complicações anestésicas em cães diabéticos submetidos a facoemulsificação

The aim of this paper was to compare the incidence of anesthetic complications in diabetic and nondiabetic dogs subjected to phacoemulsification. In total, 30 male and female dogs of different breeds were used. The dogs were distributed into two groups: diabetic (DG) (n=15) and control (CG) (n=15). The animals were premedicated with acepromazine (0.03mg/kg) and meperidine (4mg/kg), intramuscularly. After 20 minutes, anesthesia was induced with propofol (2 to 5mg/kg) and maintained with isoflurane. The animals were monitored and the heart rate, respiratory rate, peripheral oxyhemoglobin saturation, end tidal carbon dioxide tension, inspired and expired isoflurane fraction, and invasive arterial pressure were recorded at 10 minute intervals during the surgical procedure. Arterial hemogasometry was performed after anesthetic induction (T0) and at the end of the surgical procedure. Diabetic patients (DG 10±2 years) were older than non-diabetic group (CG 6±2 years). The expired isoflurane fraction after induction was 30% higher in the control group (CG 1.3±0.3%, DG 1.0±0.2%) (p<0.01). The most common anesthetic complication was hypotension. In total, 80% of the diabetic animals (n=12) exhibited mean arterial pressure (MAP) lower than 60mmHg (54±9.6mmHg) after anesthetic induction, and 83% of the hypotensive dogs (n=10) required vasoactive drugs to treat hypotension. Regarding hemodynamic changes, diabetic patients subjected to general anesthesia were more likely to exhibit hypotension which may be due to the response of older animals to the drugs used; however, this change deserves further investigation.(AU)

O objetivo do presente estudo foi comparar a incidência de complicações anestésicas em cães diabéticos e não diabéticos submetidos a cirurgia de facoemulsificação. Foram utilizados 30 cães, machos ou fêmeas de diversas raças. Os cães foram distribuídos em dois grupos: diabético (GD) (n=15) e controle (GC) (n=15). Os animais foram pré-tratados com acepromazina (0,03mg/kg) e meperidina (4mg/kg), pela via intramuscular. Após 20 minutos, a indução foi realizada com propofol (2 a 5mg/kg) e a manutenção da anestesia com isofluorano. Os animais foram monitorados e as variáveis de frequência cardíaca, frequência respiratória, saturação oxihemoglobina periférica, concentração dióxido de carbono no final da expiração, fração inspirada e expirada de isofluorano e pressão arterial invasiva, foram registradas em intervalos de 10 minutos durante o procedimento cirúrgico. A hemogasometria arterial foi realizada após a indução (T0) e ao final do procedimento cirúrgico (T40). A idade dos animais do grupo diabético (10±2 anos) foi superior em relação aos animais do grupo controle (6±2 anos) (p<0,0001). A concentração expirada de isofluorano após a indução foi 30% superior nos animais do grupo controle (GC 1,3±0,3%, GD 1,0±0,2%) (p<0,01). A complicação anestésica mais comum foi a hipotensão arterial, 80% dos animais diabéticos (n=12) apresentaram pressão arterial média inferior a 60mmHg (54±9.6 mmHg) após indução anestésica; 83% dos cães hipotensos (n=10) necessitaram de fármacos vasoativos para tratamento da hipotensão. Com relação às alterações hemodinâmicas, os pacientes diabéticos submetidos à anestesia geral foram mais propensos à hipotensão arterial que pode ser decorrente da resposta dos animais mais velhos aos fármacos empregados; entretanto essa alteração merece maior investigação.(AU)

Early parenteral nutrition in enterectomized dogs / Nutrição parenteral precoce em cães submetidos à enterectomia

The aim of this study was to explore the role of early central parenteral nutrition support with and without lipid emulsion in enterectomized dogs undergoing small bowel partial resection. Enterectomized dogs often cannot be fed properly via an oral or enteral route immediately post-surgery. After enterectomy, the animals received parenteral nutrition or crystalloid solution until they were able to voluntarily take in an oral diet. All dogs were recruited at the University of Sao Paulo veterinary teaching hospital. Eighteen dogs with intussusception, a foreign intestinal body, linear foreign intestinal body, or intussusception associated with a foreign intestinal body underwent enterectomy surgery and were randomly assigned to receive one of three treatments: crystalloid solution (CS group), parenteral nutrition with a mix of glucose and amino acids (GA group) or parenteral nutrition with a mix of glucose, amino acids and lipids (GAL group). A serum chemistry panel and complete blood count were collected prior to surgery and at the end of the study. Albumin increased in the GA and GAL group (p=0.042 and p=0.038 respectively) after hospitalization, but no significant differences were identified among the groups. Body weight decreased by 4.9% (p=0.042) in the CS group, but there were no significant changes in the GAL and GA groups. There was a significant decrease in the recovery scores in the GA and GAL groups during hospitalization (p=0.039 in both groups). Early parenteral nutrition was beneficial for patient recovery in post-surgical small bowel partial resection, indicating better quality, and no major complications or side effects were observed during the hospitalization period in the studied dogs.(AU)

O objetivo desse estudo era estudar os efeitos da nutrição parenteral central precoce com e sem emulsão lipídica em cães submetidos à ressecção parcial do intestino delgado. Os cães enterectomizados frequentemente não conseguem ser adequadamente alimentados por via oral ou enteral no pós-cirúrgico imediato. Após a enterectomia, os animais receberam nutrição parenteral ou solução cristaloide até o momento em que fossem capazes de alimentar-se voluntariamente por via oral. Todos os animais foram selecionados no hospital veterinário da Universidade de São Paulo. Dezoito cães diagnosticados com intussuscepção, corpo estranho intestinal, corpo estranho linear ou intussuscepção associada com corpo estranho intestinal foram submetidos à enterectomia e aleatoriamente alocados para receber um dos três tratamentos: solução cristaloide (grupo CS), nutrição parenteral com mistura de glicose e aminoácidos (grupo GA) ou nutrição parental com mistura de glicose e lipídios (grupo GAL). Hemograma e bioquímica sérica foram coletados antes da cirurgia e no final do estudo. Houve aumento de albumina no grupo GA e GAL (p=0,042 e p=0,038 respectivamente) após a hospitalização, mas não houve diferença significativa entre grupos. O peso corpóreo diminuiu cerca de 4,9% (p=0,042) no grupo CS mas não houve alterações significativas no grupo GAL e GA. Houve uma diminuição significativa no escore de recuperação no grupo GA e GAL durante a hospitalização (p=0,039 em ambos os grupos). A nutrição parenteral precoce mostrou-se benéfica para a recuperação no pós-operatório dos cães submetidos à ressecção parcial do intestino delgado, sinalizando uma melhora na qualidade da recuperação e ausência de grandes complicações ou efeitos colaterais durante o período de hospitalização dos animais estudados.(AU)