Intravenous anaesthesia using detomidine, ketamine and guaiphenesin for laparotomy in pregnant pony mares

Objective To characterize intravenous anaesthesia with detomidine, ketamine and guaiphenesin in pregnant ponies. Animals Twelve pony mares, at 260–320 days gestation undergoing abdominal surgery to implant fetal and maternal vascular catheters. Materials and methods Pre‐anaesthetic medication with intravenous (IV) acepromazine (30 µg kg^?1), butorphanol (20 µg kg^?1) and detomidine (10 µg kg^?1) preceded induction of anaesthesia with detomidine (10 µg kg^?1) and ketamine (2 mg kg^?1) IV Maternal arterial blood pressure was measured directly throughout anaesthesia and arterial blood samples were taken at 20‐minute intervals for measurement of blood gases and plasma concentrations of cortisol, glucose and lactate. Anaesthesia was maintained with an IV infusion of detomidine (0.04 mg mL^?1), ketamine (4 mg mL^?1) and guaiphenesin (100 mg mL^?1) (DKG) for 140 minutes. Oxygen was supplied by intermittent positive pressure ventilation (IPPV) adjusted to maintain PaCO₂ between 5.0 and 6.0 kPa (38 and 45 mm Hg), while PaO₂ was kept close to 20.0 kPa (150 mm Hg) by adding nitrous oxide. Simultaneous fetal and maternal blood samples were withdrawn at 90 minutes. Recovery quality was assessed. Results DKG was infused at 0.67 ± 0.17 mL kg^?1 hour^?1 for 1 hour then reduced, reaching 0.28 ± 0.14 mL kg^?1 hour^?1 at 140 minutes. Arterial blood gas values and pH remained within intended limits. During anaesthesia there was no change in heart rate, but arterial blood pressure decreased by 10%. Plasma glucose and lactate increased (10‐fold and 2‐fold, respectively) and cortisol decreased by 50% during anaesthesia. Fetal umbilical venous pH, PO₂ and PCO₂ were 7.34 ± 0.06, 5.8 ± 0.9 kPa (44 ± 7 mm Hg) and 6.7 ± 0.8 kPa (50 ± 6 mm Hg); and fetal arterial pH, PO₂ and PCO₂ were 7.29 ± 0.06, 4.0 ± 0.7 kPa (30 ± 5 mm Hg) and 7.8 ± 1.7 kPa (59 ± 13 mm Hg), respectively. Surgical conditions were good but four ponies required a single additional dose of ketamine. Ponies took 60 ± 28 minutes to stand and recovery was good. Conclusions and clinical relevance Anaesthesia produced with DKG was smooth while cardiovascular function in mare and fetus was well preserved. This indicates that DKG infusion is suitable for maintenance of anaesthesia in pregnant equidae.     

Propofol anaesthesia for surgery in late gestation pony mares

Objective To characterize propofol anaesthesia in pregnant ponies. Animals Fourteen pony mares, at 256 ± 49 days gestation, undergoing abdominal surgery to implant fetal and maternal vascular catheters. Materials and methods Pre‐anaesthetic medication with intravenous (IV) acepromazine (20 µg kg^?1), butorphanol (20 µg kg^?1) and detomidine (10 µg kg^?1) was given 30 minutes before induction of anaesthesia with detomidine (10 µg kg^?1) and ketamine (2 mg kg^?1) IV Maternal arterial blood pressure was recorded (facial artery) throughout anaesthesia. Arterial blood gas values and plasma concentrations of glucose, lactate, cortisol and propofol were measured at 20‐minute intervals. Anaesthesia was maintained with propofol infused initially at 200 µg kg^?1 minute^?1, and at 130–180 µg kg^?1 minute^?1 after 60 minutes, ventilation was controlled with oxygen and nitrous oxide to maintain PaCO₂ between 5.0 and 6.0 kPa (37.6 and 45.1 mm Hg) and PaO₂ between 13.3 and 20.0 kPa (100 and 150.4 mm Hg). During anaesthesia flunixin (1 mg kg^?1), procaine penicillin (6 IU) and butorphanol 80 µg kg^?1 were given. Lactated Ringer's solution was infused at 10 mL kg^?1 hour^?1. Simultaneous fetal and maternal blood samples were withdrawn at 85–95 minutes. Recovery from anaesthesia was assisted. Results Arterial blood gas values remained within intended limits. Plasma propofol levels stabilized after 20 minutes (range 3.5–9.1 µg kg^?1); disposition estimates were clearance 6.13 ± 1.51 L minute^?1 (mean ± SD) and volume of distribution 117.1 ± 38.9 L (mean ± SD). Plasma cortisol increased from 193 ± 43 nmol L^?1 before anaesthesia to 421 ± 96 nmol L^?1 60 minutes after anaesthesia. Surgical conditions were excellent. Fetal umbilical venous pH, PO₂ and PCO₂ were 7.35 ± 0.04, 6.5 ± 0.5 kPa (49 ± 4 mm Hg) and 6.9 ± 0.5 kPa (52 ± 4 mm Hg); fetal arterial pH, PO₂ and PCO₂ were 7.29 ± 0.06, 3.3 ± 0.8 kPa (25 ± 6 mm Hg) and 8.7 ± 0.9 kPa (65 ± 7 mm Hg), respectively. Recovery to standing occurred at 46 ± 17 minutes, and was generally smooth. Ponies regained normal behaviour patterns immediately. Conclusions and clinical relevance Propofol anaesthesia was smooth with satisfactory cardiovascular function in both mare and fetus; we believe this to be a suitable anaesthetic technique for pregnant ponies.     

Antinociceptive effect of intrathecally applied alpha2 agonists (xylazine and detomidine) in sheep and the response to atipamezole

This study evaluated the antinociceptive and physiologic effects of xylazine (X) and detomidine (D) administered intrathecally (IT) at the lumbosacral space, before and after the injection of atipamezole (A) IV. The study was approved by the National Animal Protection Authorities. Five adult healthy female sheep were anaesthetized with propofol on four occasions to inject the following treatments IT: groups 1 and 2, 0.05 mg kg^?1 X (2 mg mL^?1 saline) IT; groups 3 and 4, 0.01 mg kg^?1 D (0.5 mg mL^?1 saline) IT ( Waterman et al. 1988 ). Nociceptive threshold (TH) was tested by applying pulsed and stepwise enhanced direct current ( Ludbrook et al. 1995 ) at one hind leg pastern and noting the current at the moment of foot lift. Maximum current applied was 40 mA. Baseline TH was measured twice before anaesthesia and every 10 minutes when the sheep regained consciousness. Atipamezole was given IV immediately after reaching maximum analgesic action of X and D as defined by two equal or decreasing TH values and measurements were continued for 90 minutes. The dose of A for groups 1 and 3 was 0.005 mg kg^?1 (0.25 mg mL^?1 saline) IV, and for groups 2 and 4 was 0.0025 mg kg^?1 A (0.25 mg mL^?1 saline) IV. Heart rate (HR), mean direct arterial pressure (MAP), PaO₂ and PaCO₂ were measured. The differences between measurements recorded before and after treatment were analysed using a paired t‐test for the drug effects and a nonparametric Wilcoxon's rank sum test for the comparison between groups. A p‐value < 0.05 was considered significant. All sheep were able to stand before A IV. Threshold baseline value was 4.5 ± 1.7 (mean ± SD) mA for all animals. Xylazine caused a significantly higher TH rise (35.2 ± 1.8 mA), faster onset (21.1 ± 16.0 minutes) and longer duration of the TH enhancement (104.1 ± 8.6 minutes) than D (TH: 16.3 ± 7.8 mA, onset: 49.5 ± 28.4 minutes, duration: 59.3 ± 27.3 minutes). A significant increase in PaCO₂ was observed in the X and D treated animals, 0.39 ± 0.21 kPa (2.9 ± 1.6 mm Hg) and 0.39 ± 0.29 kPa (2.9 ± 2.2 mm Hg), respectively. Heart rate was significantly decreased by ?21 ± 17 beats minute^?1 for X animals and ?13 ± 13 beats minute^?1 for D. Mean arterial pressure (?9 ± 13 mm Hg for X and ?1 ± 11 mm Hg for D animals) and PaO₂ 0.65 ± 1.32 kPa (4.9 ± 9.9 mm Hg) for X and 1.45 ± 4.19 kPa (10.9 ± 31.4 mm Hg) for D animals) did not change significantly. The nociceptive threshold was not affected by A in any group. Threshold values of all X treated animals before A was 39.3 ± 1.4 mA and after was 37.2 ± 6.3 (group 1) and 40 ± 0 (group 2). Threshold values of all D treated animals before A was 21.0 ± 8.3 and after was 19.4 ± 7.3 (group 3) and 24.8 ± 8.0 (group 4). At the dosages administered intrathecally in this study, X and to a lower degree D induce antinociception without major physiologic changes. Atipamezole up to 0.005 mg kg^?1 IV does not affect the resulting antinociception as assessed by electrical stimulation.     

Aerosolized salbutamol (albuterol) improves PaO2 in hypoxaemic anaesthetized horses – a prospective clinical trial in 81 horses

Objective To compare the arterial pH and blood gas values, heart rate and mean arterial blood pressure, in hypoxaemic anaesthetized horses, before and after treatment, with a salbutamol (albuterol) aerosol. Animal population Eighty‐one client‐owned horses weighing between 114 and 925 kg. Fifty‐seven underwent emergency abdominal surgery and 24 were anaesthetized for elective procedures. Materials and methods Pre‐anaesthetic medication included xylazine, detomidine, butorphanol and morphine, alone or in various combinations. Induction of anaesthesia was achieved with guaifenesin and ketamine, diazepam and ketamine, or guaifenesin and thiopental. The trachea of all animals was intubated and anaesthesia maintained with either halothane (33 horses) or isoflurane (48 horses) in oxygen. Heart rate and rhythm were monitored continuously. Arterial blood pressure was monitored directly, and arterial blood collected for pH and blood gas analyses. When arterial PaO₂ fell below 9.3 kPa (70 mm Hg) and failed to respond to corrective measures including positive pressure ventilation and treatment of hypotension (mean arterial blood pressures <70 mm Hg), a salbutamol aerosol (2 µg kg^?1) was delivered via the endotracheal tube. Twenty minutes later, a second arterial blood sample was analysed. Results There were no significant differences in mean arterial blood pressure, heart rate, arterial pH, base excess and bicarbonate before and after treatment. Arterial O₂ tension increased significantly from a mean ± SD of 8.3 ± 1.7 kPa (62.4 ± 13.1 mm Hg) before administration to 15.9 ± 9.8 kPa (119.4 ± 57.7 mm Hg) after treatment. There was a small but significant decrease in PaCO₂ from 7.4 ± 1.5 kPa (55.2 ± 11.2 mm Hg) to 7.0 ± 1.3 kPa (52.9 ± 9.8 mm Hg) between sample times. No changes in heart rhythm were observed. A high percentage (approximately 70%) of animals sweated following treatment. Conclusions Salbutamol administered at a dose of 2 µg kg^?1 via the endotracheal tube of anaesthetized horses with PaO₂ values less than 9.3 kPa (70 mm Hg) resulted in an almost two‐fold increase in PaO₂ values within 20 minutes of treatment. No changes in heart rate or mean arterial blood pressure were associated with the use of salbutamol in this study. The improvement in PaO₂ may be a result of bronchodilatation and improved ventilation, increased perfusion secondary to an increase in cardiac output, or a combination of these two factors. Cardiac output and ventilation–perfusion distribution were not measured in this study; therefore, the reason for the increase in PaO₂ values cannot be conclusively determined. Clinical relevance Administration of a salbutamol aerosol is a simple but effective technique that can be used to improve PaO₂ values in hypoxaemic horses during inhalant anaesthesia with no apparent detrimental side effects.     

Some cardiopulmonary effects of capnoperitoneum in anesthetized guinea pigs (Cavia porcellus): spontaneous ventilation versus intubation and mechanical ventilation

ObjectiveTo compare cardiopulmonary variables and blood gas analytes in guinea pigs (Cavia porcellus) during anesthesia with and without abdominal carbon dioxide (CO₂) insufflation at intra-abdominal pressures (IAPs) 4 and 6 mmHg, with and without endotracheal intubation.Study designProspective experimental trial.AnimalsA total of six intact female Hartley guinea pigs.MethodsA crossover study with sequence randomization for IAP and intubation status was used. The animals were sedated with intramuscular midazolam (1.5 mg kg^–1) and buprenorphine (0.2 mg kg^–1) and anesthetized with isoflurane, and an abdominal catheter was inserted for CO₂ insufflation. Animals with endotracheal intubation were mechanically ventilated and animals maintained using a facemask breathed spontaneously. After 15 minutes of insufflation, the following variables were obtained at each IAP: pulse rate, respiratory rate, rectal temperature, oxygen saturation, end-tidal CO₂ (intubated only), peak inspiratory pressure (intubated only), noninvasive blood pressure and blood gas and electrolyte values, with a rest period of 5 minutes between consecutive IAPs. After 4 weeks, the procedure was repeated with the guinea pigs assigned the opposite intubation status.ResultsIntubated guinea pigs had significantly higher pH and lower partial pressure of CO₂ in cranial vena cava blood (PvCO₂) than nonintubated guinea pigs. An IAP of 6 mmHg resulted in a significantly higher PvCO₂ (65.9 ± 19.0 mmHg; 8.8 ± 2.5 kPa) than at 0 (53.2 ± 17.2 mmHg; 7.1 ± 2.3 kPa) and 4 mmHg (52.6 ± 10.8 mmHg; 7.01 ± 1.4 kPa), mean ± standard deviation, with intubated and nonintubated animals combined.Conclusions and clinical relevanceAlthough the oral anatomy of guinea pigs makes endotracheal intubation difficult, capnoperitoneum during anesthesia induces marked hypercapnia in the absence of mechanical ventilation. An IAP of 4 mmHg should be further evaluated for laparoscopic procedures in guinea pigs because hypercapnia may be less severe than with 6 mmHg.     

Cardiovascular effects of sevoflurane in Holstein calves

Objective The purpose of this study was to determine the cardiovascular effects of sevoflurane in calves. Study design Prospective experimental study. Animals Six, healthy, 8–12‐week‐old Holstein calves weighing 80 ± 4.5 (mean ± SEM) kg were studied. Methods Anesthesia was induced by face‐mask administration of 7% sevoflurane in O₂. Calves tracheae were intubated, placed in right lateral recumbency, and maintained with 3.7% end‐tidal concentration sevoflurane for 30 minutes to allow catheterization of the auricular artery and placement of a Swan‐Ganz thermodilution catheter into the pulmonary artery. After instrumentation, administration of sevoflurane was temporarily discontinued until mean arterial pressure was > 100 mm Hg. Baseline values were recorded and the vaporizer output increased to administer 3.7% end‐tidal sevoflurane concentration. Ventilation was controlled to maintain normocapnia. The following were recorded at 5, 10, 15, 30 and 45 minutes after collection of baseline data and expressed as the mean value (± SEM): direct systolic, diastolic, and mean arterial blood pressures; cardiac output; mean pulmonary arterial pressure; pulmonary arterial occlusion pressure, heart rate; and pulmonary arterial temperature. Cardiac index and systemic and pulmonary vascular resistance values were calculated using standard formulae. Arterial blood gases were analyzed at baseline, and at 15 and 45 minutes. Differences from baseline values were determined using one‐way analysis of variance for repeated measures with post‐hoc differences between mean values identified using Dunnet's test (p < 0.05). Results Mean time from beginning sevoflurane administration to intubation of the trachea was 224 ± 9 seconds. The mean end‐tidal sevoflurane concentration at baseline was 0.7 (± 0.11)%. Sevoflurane anesthesia was associated with decreased arterial blood pressure at all sampling times. Mean arterial blood pressure decreased from a baseline value of 112 ± 7 mm Hg to a minimum value of 88 ± 4 mm Hg at 5 minutes. Compared with baseline, arterial pH was decreased at 15 minutes. Pulmonary arterial blood temperature was decreased at 15, 30 and 45 minutes. Arterial CO₂ tension increased from a baseline value of 43 ± 3 to 54 ± 4 mm Hg (5.7 ± 0.4 to 7.2 ± 0.3 kPa) at 15 minutes. Mean pulmonary arterial pressure was increased at 30 and 45 minutes. Pulmonary arterial occlusion pressure increased from a baseline value of 18 ± 2 to 23 ± 2 mm Hg at 45 minutes. There were no significant changes in other measured variables. All calves recovered from anesthesia uneventfully. Conclusion We conclude that sevoflurane for induction and maintenance of anesthesia was effective and reliable in these calves and that neither hypotension nor decreased cardiac output was a clinical concern. Clinical relevance Use of sevoflurane for mask induction and maintenance of anesthesia in young calves is a suitable alternative to injectable and other inhalant anesthetics.     

The effect of low dose rocuronium bromide on eyeball position, muscle relaxation, and ventilation in dogs

A central eyeball position is often required during sedation or anaesthesia to facilitate examination of the eye. However, use of neuromuscular blockade to produce a central eye position may result in depressed ventilation. This study evaluated the eyeball position, muscle relaxation and changes in ventilation during general anaesthesia after the IV administration of 0.1 mg kg^?1 rocuronium. With client consent, 12 dogs of different breeds, body mass 27.2 ± 11.8 kg, aged 5.6 ± 2.8 years (mean ± SD) were anaesthetized for ocular examination. Pre‐anaesthetic medication was 0.01 mg kg^?1 medetomidine and 0.2 mg kg^?1 butorphanol IV. Anaesthesia was induced with propofol to effect and maintained with 10 mg kg^?1 hour^?1 propofol by infusion. The dogs were placed in left lateral recumbency, their trachea intubated and connected to a circle breathing system (Fi O₂ = 1.0). All dogs breathed spontaneously. The superficial peroneal nerve of the right hind leg was stimulated every 15 seconds with a train‐of‐four (TOF) stimulation pattern and neuromuscular function was assessed with an acceleromyograph (TOF‐Guard). Adequacy of ventilation was measured with the Ventrak 1550. After 10 minutes of anaesthesia to allow stabilisation of baseline values, 0.1 mg kg^?1 rocuronium was administered IV. Minute volume (Vm ), tidal volume (Vt ), respiratory rate (RR), Pe ′CO₂ and maximal depression of T1 and TOF ratio were measured. Data were analysed using a paired t‐test. The changes in the eyeball position were recorded. A total of 100 ± 33 seconds after the injection of rocuronium, T1 was maximally depressed to 62 ± 21% and the TOF ratio to 42 ± 18% of baseline values. Both variables returned to baseline after 366 ± 132 seconds (T1) and 478 ± 111 seconds (TOF). There was no significant reduction in Vm (2.32 ± 1.1 L minute^?1), Vt (124.1 ± 69.3 mL) and RR (10 ± 3.8 breaths minute^?1) and no increase in Pe ′CO₂ (6.5 ± 2.1 kPa (48.8 ± 16.1 mm Hg)) throughout the procedure. The eyeball rotated to a central position 35 ± 7 seconds after rocuronium IV and remained there for a minimum of 20 ± 7 minutes in all dogs. We conclude that rocuronium at a dose of 0.1 mg kg^?1 can be administered to dogs IV with minimal changes in ventilatory variables. The eyeball is fixed in a central position for at least 20 minutes, which greatly facilitates clinical examination.     

Circulatory, respiratory and behavioral responses in isoflurane anesthetized llamas

Objectives To evaluate the circulatory, respiratory and behavioral effects of isoflurane (ISO) anesthesia in llamas during mechanical ventilation and spontaneous breathing. Design Prospective randomised study. Animals Six adult, neutered male llamas (10 ± 1 years [mean ± SD], 179 ± 32 kg). Materials and methods Animals in which the minimum alveolar concentration (MAC) had been previously determined were anesthetized with ISO in oxygen. Inspired and end‐tidal (ET) ISO were sampled continuously. Arterial blood pH, respiratory and circulatory variables, and clinical signs of anesthesia were recorded at three doses (1.0, 1.5 and 2.0 times the individual animal's MAC; mean MAC value 1.13%) of ISO during spontaneous and controlled ventilation. A series of Latin squares was used to determine order of dose. Controlled ventilation (CV) (target PaCO₂ 38 ± 5 mm Hg [5.0 ± 0.6 kPa]) preceded spontaneous ventilation (SV) at each dose. Animals breathed spontaneously for approximately 10 minutes prior to data collection. Body temperature was maintained at 37 ± 0.6 °C. Circulatory and respiratory data were analysed with a mixed model, least squares analysis of variance, for repeated measures taken at equally spaced intervals. p < 0.05. Results Dose and mode of ventilation had significant influences on measured variables. For example, heart rate increased as dose increased; 67 ± 14 beats minute^?1 at 1.0 MAC‐CV versus 77 ± 6 beats minute^?1 at 2 MAC‐CV. Conversely, mean arterial pressure decreased with increasing dose; 82 ± 13 mm Hg at MAC‐CV versus 52 ± 15 mm Hg at 2 MAC‐CV. Arterial CO₂ increased with increasing dose during SV; 45 ± 5 mm Hg [6 ± 0.6 kPa] at MAC versus 53 ± 4 mmHg [7 ± 0.5 kPa] at 2 MAC. Reflex activity (e.g. palpebral reflex) and muscle tone (e.g. jaw tone) decreased while eyelid aperture increased with increasing anesthetic dose. Conclusions and Clinical Relevance The influence of ISO dose and mode of ventilation on circulatory and respiratory variables in llamas is qualitatively similar to that reported in other species. Changes in reflex activity and muscle tone may be used to guide appropriate anesthetic delivery in ISO‐induced llamas.     

Efficacy of a portable oxygen concentrator with pulsed delivery for treatment of hypoxemia during equine field anesthesia

ObjectiveHypoxemia is common during equine field anesthesia. Our hypothesis was that oxygen therapy from a portable oxygen concentrator would increase PaO₂ during field anesthesia compared with the breathing of ambient air.Study designProspective clinical study.AnimalsFifteen yearling (250 – 400 kg) horses during field castration.MethodsHorses were maintained in dorsal recumbency during anesthesia with an intravenous infusion of 2000 mg ketamine and 500 mg xylazine in 1 L of 5% guaifenesin. Arterial samples for blood gas analysis were collected immediately post-induction (PI), and at 15 and 30 minutes PI. The control group (n = 6) breathed ambient air. The treatment group (n = 9) were administered pulsed-flow oxygen (192 mL per bolus) by nasal insufflation during inspiration for 15 minutes PI, then breathed ambient air. The study was performed at 1300 m above sea level. One-way and two-way repeated-measures anova with post-hoc Bonferroni tests were used for within and between-group comparisons, respectively. Significance was set at p ≤ 0.05.ResultsMean ± SD PaO₂ in controls at 0, 15 and 30 minutes PI were 46 ± 7 mmHg (6.1 ± 0.9 kPa), 42 ± 9 mmHg (5.6 ± 1.1 kPa), and 48 ± 7 mmHg (6.4 ± 0.1 kPa), respectively (p = 0.4). In treatment animals, oxygen administration significantly increased PaO₂ at 15 minutes PI to 60 ± 13 mmHg (8.0 ± 1.7 kPa), compared with baseline values of 46 ± 8 mmHg (6.1 ± 1 kPa) (p = 0.007), and 30 minute PI values of 48 ± 7 mmHg (6.5 ± 0.9 kPa) (p = 0.003).ConclusionsThese data show that a pulsed-flow delivery of oxygen can increase PaO₂ in dorsally recumbent horses during field anesthesia with ketamine-xylazine-guaifenesin.Clinical relevanceThe portable oxygen concentrator may help combat hypoxemia during field anesthesia in horses.     

Use of proxy measurements of insulin sensitivity and insulin secretory response to distinguish between normal and previously laminitic ponies

Reasons for performing study: Insulin resistance may be a risk factor for pasture‐associated laminitis. Diagnosis of insulin resistance could help identify individuals at increased risk of laminitis. Objective: To calculate proxy measurements of insulin sensitivity (reciprocal of the square root of insulin: RISQI and quantitative insulin sensitivity check index: QUICKI) and insulin secretory response (modified insulin‐to‐glucose ratio: MIRG) based on basal glucose and insulin concentrations in normal (NP) and previously laminitic (PLP) ponies. Methods: Proxies were calculated in 7 NP and 5 PLP from 20 separate measurements of insulin and glucose taken in spring, summer and winter when ponies were adapted to eating either pasture or hay. Proxies were RISQI: Insulin^‐0.5, QUICKI: 1/(log[fasting Insulin]+ log[fasting Glucose]) and MIRG: (800?0.3×[Insulin‐50]²)/[Glucose‐30]. A modified insulin‐to‐glucose ratio for ponies (MIGRP) was investigated using: (3000?0.012 ×[Insulin‐500]²)/[Glucose‐30]. Statistical analysis used linear mixed models. Results: Diet did not significantly affect measurements, so values were pooled for further analysis. RISQI (mean ± s.d.) was lower in PLP (0.26 ± 0.15 [mu/l]^‐0.5) than NP (0.29 ± 0.12 [mu/l]^‐0.5; P = 0.05). QUICKI was lower in PLP (0.31 ± 0.05) than NP (0.33 ± 0.04; P = 0.047). There was no difference in MIRG between NP and PLP. MIGRP (median [interquartile range]) was greater in PLP (4.0 [7.9][mu_ins]²/10·l·mg_gluc) than NP (2.6 [3.2][mu_ins]²/10·l·mg_gluc; P = 0.022). In spring, NP had higher RISQI and QUICKI and lower MIGRP than PLP (P<0.001). In PLP, RISQI and QUICKI were higher in summer than spring (P<0.02) and MIGRP was lower in summer than other seasons (P<0.01). In NP, RISQI, QUICKI and MIGRP were each different between seasons (P<0.017). MIRG did not vary with season. Conclusions: RISQI, QUICKI and MIGRP, but not MIRG, differentiated between NP and PLP. None of the proxies accurately identified individual PLP. Seasonal changes in insulin sensitivity and insulin secretory response were apparent. Potential relevance: Current proxy measurements cannot determine an individual's laminitis susceptibility. MIGRP may be useful in hyperinsulinaemic animals.     

Anti‐nociceptive and sedative effects of romifidine,tramadol and their combination administered intravenously slowly in ponies

ObjectiveTo evaluate the anti-nociceptive and sedative effects of slow intravenous (IV) injection of tramadol, romifidine, or a combination of both drugs in ponies.Study designWithin-subject blinded.AnimalsTwenty ponies (seven male, 13 female, weighing mean ± SD 268.0 ± 128 kg).MethodsOn separate occasions, each pony received one of the following three treatments IV; romifidine 50 μg kg⁻ (R) tramadol 3 mg kg⁻¹ given over 15 minutes (T) or tramadol 3 mg kg⁻¹followed by romifidine 50 μg kg⁻¹ (RT). Physiologic parameters and caecal borborygmi (CB) were measured and sedation and response to electrical stimulation of the coronary band assessed before and up to 120 minutes following drugs administration. Results were analyzed using the Friedman’s test and 2 way anova as relevant.ResultsWhen compared to baseline, heart (HR, beats minute⁻¹) and respiratory rates (f_R, breaths minute⁻¹) increased with treatment T (highest mean ± SD, HR 43 ± 1; f_R 33 ± 2) and decreased with R (lowest HR 29 ± 1 and f_R 10 ± 4) and RT (lowest HR 32 ± 1 and f_R 9 ± 3). There were no changes in other measured physiological variables. The height of head from the ground was lower following treatments R and TR than T. There was slight ataxia with all three treatments. No excitatory behavioural effects were observed. The response to electrical stimulation was reduced for a prolonged period relative to baseline following all three treatments, the effect being significantly greatest with treatment RT.ConclusionTramadol combined with romifidine at the stated doses proved an effective sedative and anti-nociceptive combination in ponies, with no unacceptable behavioural or physiologic side effects.Clinical relevanceSlow controlled administration of tramadol should reduce the occurrence of adverse behavioural side effects.     

Comparison of two injectable anesthetic regimes in feral cats at a large-volume spay clinic

Same‐day mass sterilization of feral cats requires rapid onset, short‐duration anesthesia. The purpose of this study was to compare our current anesthetic protocol, Telazol–ketamine–xylazine (TKX) with medetomidine–ketamine–buprenorphine (MKB). Feral female cats received either IM TKX (n = 68; 0.25 mL cat^?1; tiletamine 12.5 mg, zolazepam 12.5 mg, K 20 mg, and X 5 mg per 0.25 mL) or MKB (n = 17; M 40 µg kg^?1, K 15 mg kg^?1, and B 10 µg kg^?1). Intervals measured included time from injection to recumbency, time to surgery, duration of surgery, and time from reversal of anesthesia (TKX: yohimbine 0.50 mg cat^?1 IV; MKB: atipamezole 0.50 mg cat^?1 IM) to sternal recumbency. Following instrumentation (Vet/Ox 4403 and Vet/BP Plus 6500), physiological measurements were recorded at 5‐minute intervals, and included rectal temperature, heart rate (HR), respiratory rate (RR), SpO₂ (lingual or rectal probes), and indirect mean arterial blood pressure (MAP) (oscillometric method). Nonparametric means were compared using Mann–Whitney U‐tests. Parametric means were compared using a two‐factorial anova with Bonferroni's t‐tests. The alpha‐priori significance level was p < 0.05. Values were mean ± SD. Body weight (TKX: 2.9 ± 0.5 kg, MKB: 2.7 ± 0.7 kg), time to recumbency (TKX: 4 ± 1 minutes, MKB: 3 ± 1 minutes), time to surgery (TKX: 28 ± 7 minutes, MKB: 28 ± 5 minutes), and duration of surgery (TKX: 11 ± 7 minutes, MKB: 8 ± 5 minutes) did not differ between groups. In contrast, MKB cats required less time from reversal to sternal recumbency (TKX: 68 ± 41 minutes, MKB: 7 ± 2 minutes) and were recumbent for shorter duration (TKX: 114 ± 39 minutes, MKB: 53 ± 6 minutes). Temperature decreased during the study in both groups, but overall temperature was higher in MKB cats (38.0 ± 0.95 °C) than in TKX cats (37.5 ± 0.95 °C). RR, HR, and SpO₂ did not change during the study in either group. However, overall HR and RR were higher in TKX cats (RR: 18 ± 8 breaths minute^?1, HR: 153 ± 30 beats minute^?1) compared to MKB cats (RR: 15 ± 7 breaths minute^?1, HR: 128 ± 19 beats minute^?1). In contrast, overall SpO₂ was lower in the TKX group (90 ± 6%) compared to the MKB group (94 ± 4%). MAP was also lower in the TKX group (112 ± 29 mm Hg) compared to that in the MKB group (122 ± 20 mm Hg). However, MAP increased in the TKX group during surgery compared to pre‐surgical values, but did not change in the MKB group. The results of this study suggested that MKB might be more suitable as an anesthetic for the purpose of mass sterilization of feral female cats.     

Changes in the equine EEG during surgery: The effect of an intravenous infusion of thiopentone

Spontaneous EEG changes during castration have been identified in horses anaesthetized with halothane ( Murrell et al. 1999 ). This study, using the same model, investigated the effect of thiopentone on the response of the equine EEG to surgical stimulation. Six yearling ponies, mean weight 210 ± 36 kg, were studied. Following pre‐anaesthetic medication with acetylpromazine, general anaesthesia was induced with guaiphenesin and thiopentone. Anaesthesia was maintained with halothane, F É _hal 1.2%, vaporized in oxygen and an infusion of thiopentone IV. The infusion was started 30 minutes after the induction of anaesthesia to achieve a target plasma concentration of 10 µg ml^?1. Ventilation was controlled to maintain normocapnia (PaCO₂ was measured by arterial blood gas analysis) and the EEG was recorded continuously. Baseline measurements were recorded over 5 minutes at least 10 minutes after the infusion began but before the start of surgery. Castration was defined as section of the spermatic cord. Six blood samples were taken during the baseline and castration time periods for analysis of serum thiopentone concentration by high performance liquid chromatography. The derived EEG variables median (F50) and spectral edge (F95) frequencies and total power (Atot) were examined. For each horse, the EEG data were averaged to produce a single value for F50, F95 and Atot every 30 seconds. These values, recorded during the five minutes baseline and two castration time periods were compared using repeated measures anova . Data are presented as mean ± SD The mean serum concentration of thiopentone during the infusion (23 ± 10.5 µg ml^?1) varied widely between individual animals. The F50 was significantly higher (p = 0.0001) during castration compared to the baseline period [104.4 ± 8.8% (testicle 1); 105.8 ± 13.4% (testicle 2)]. Atot decreased significantly (p < 0.0001) during castration [98.8 ± 4.4% (testicle 1); 93.7 ± 6.5% (testicle 2)]. The measured serum thiopentone concentrations were larger than the target concentration, which made the results more difficult to interpret. The ponies appeared to be divided into two groups. In four animals F50, F95 and Atot changed very little during castration compared to the baseline time period. Three of these animals had the largest serum thiopentone concentrations. In the two other animals F50 increased and Atot decreased, the changes were particularly marked in one animal. These animals had lower serum thiopentone concentrations than the first group. Compared to the previous study ( Murrell et al. 1999 ), in the two ponies which responded with EEG changes during castration, the decrease in Atot was smaller in magnitude, the increase in F50 was similar. Changes in Atot may indicate changes in the adequacy of anaesthesia ( Hall & Clarke 1991 ). An infusion of thiopentone IV did not obtund an increase in F50 but minimized changes in adequacy of anaesthesia during castration. These results support an anti‐analgesic action of thiopentone on the equine central nervous system ( Hall & Clarke 1991 ). Acknowledgements: JM is a Horserace Betting Levy Board Scholar.     

Use of a laryngeal mask airway in rabbits during isoflurane anesthesia

The purpose of this study was to find out if an LMA (#1 LMA‐Classic) would provide a better airway than a face mask in spontaneously breathing anesthetized rabbits, and to test if it could be used for mechanically controlled ventilation. Sixteen rabbits (4.1 ± 0.8 kg, mean ± SD) were assigned randomly to three treatment groups; face mask with spontaneous ventilation (FM‐SV; n = 5), LMA with spontaneous ventilation (LMA‐SV; n = 5), and LMA with controlled ventilation (LMA‐CV; n = 6). Rabbits were anesthetized in dorsal recumbency using a circle circuit at constant ET isoflurane (2.3%, Datex airway gas monitor) and constant rectal temperature (38.85 °C) for 2 hours. PaCO₂, PaO₂, minute volume, tidal volume (Wright's respirometer), and Pe CO₂ were measured at 15 minute intervals. Two individuals in the FM‐SV group had PaCO₂ >100 mm Hg (>13.3 kPa). One rabbit in the FM‐SV had PaO₂ <80 mm Hg (<10.7 kPa). All FM‐SV rabbits showed signs of airway obstruction and two were withdrawn from the study at 45 and 90 minutes, respectively, because of cyanosis. Tidal volume could not be measured in the FM‐SV group. No signs of airway obstructions were observed in either of the LMA groups. Four rabbits in the LMA‐CV group developed gastric tympany, and one of these refluxed after 110 minutes. The significance of differences between the two spontaneously breathing groups and between the two LMA groups were measured using Wilcoxon's rank sum test (with significance assumed at p < 0.05). There were no statistical differences between FM‐SV and LMA‐SV in any variable tested. PaCO₂ and Pe ′CO₂ were less in the LMA‐CV group than in the LMA‐SV group, while PaO₂, tidal volume, and minute volume were all more. We conclude that biologically, the LMA provides a better airway than the face mask during spontaneous breathing and that it can be used for IPPV, but that gastric tympany is likely to occur during IPPV.     

The association of lung function and plasma volume expansion in neonatal alpaca crias following plasma transfusion for failure of passive transfer

Objective– Failure of passive transfer in neonatal alpacas is often corrected by IV administration of commercial camelid plasma. The goal of this study was to characterize changes in pulmonary function, gas exchange, and cardiovascular parameters associated with IV plasma transfusion. Design– Prospective clinical study. Setting– A university‐based referral hospital. Animals– Eleven clinically healthy alpaca crias (age: 1–18 days) with failure of passive transfer (IgG<8 g/L [800 mg/dL]). Interventions– Thirty milliliters per kilogram of commercial camelid plasma was administered IV over 90 minutes. Before and after the transfusion, the following cardiopulmonary measurements were obtained: arterial blood gas analysis, pulmonary functional residual capacity (FRC), PCV, total plasma protein and echocardiographic M‐mode measures. Additionally, central venous pressure and indirect arterial blood pressure were monitored throughout the plasma transfusion. Measurements and Main Results– The IV plasma transfusion resulted in significantly reduced PCV (−5.4±5.1%), increased total plasma protein (+4±4 g/L [0.4±0.4 g/dL]), elevated central venous pressure and changes in left and right ventricular M‐mode indices, consistent with plasma volume expansion. Transfusion was further associated with a significant increase in arterial oxygen pressure (PaO₂) (+11.2±15 mm Hg) and decrease in FRC (−5.6±8.3 mL/kg). Conclusions– IV administration of 30 mL/kg camelid plasma to neonatal crias resulted in measurable plasma volume expansion and a concurrent reduction in FRC. Administration of this quantity of plasma appeared to be safe in healthy neonatal crias. However, changes in lung volume associated with plasma administration may create risks for crias with underlying cardiopulmonary or systemic disease.     

Comparison of cardiopulmonary effects of etorphine and thiafentanil administered as sole agents for immobilization of impala (Aepyceros melampus)

ObjectiveTo compare the cardiopulmonary effects of the opioids etorphine and thiafentanil for immobilization of impala.Study designTwo-way crossover, randomized study.AnimalsA group of eight adult female impala.MethodsImpala were given two treatments: 0.09 mg kg^–1 etorphine or 0.09 mg kg^–1 thiafentanil via remote dart injection. Time to recumbency, quality of immobilization and recovery were assessed. Respiratory rate, heart rate (HR), mean arterial blood pressure (MAP) and arterial blood gases were measured. A linear mixed model was used to analyse the effects of treatments, treatments over time and interactions of treatment and time (p < 0.05).ResultsTime to recumbency was significantly faster with thiafentanil (2.0 ± 0.8 minutes) than with etorphine (3.9 ± 1.6 minutes; p = 0.007). Both treatments produced bradypnoea, which was more severe at 5 minutes with thiafentanil (7 ± 4 breaths minute^–1) than with etorphine (13 ± 12 breaths minute^–1; p = 0.004). HR increased with both treatments but significantly decreased over time when etorphine (132 ± 17 to 82 ± 11 beats minute^–1) was compared with thiafentanil (113 ± 22 to 107 ± 36 beats minute^–1; p < 0.001). Both treatments caused hypertension which was more profound with thiafentanil (mean overall MAP = 140 ± 14 mmHg; p < 0.001). Hypoxaemia occurred with both treatments but was greater with thiafentanil [PaO₂ 37 ± 13 mmHg (4.9 kPa)] than with etorphine [45 ± 16 mmHg (6.0 kPa)] 5 minutes after recumbency (p < 0.001). After 30 minutes, PaO₂ increased to 59 ± 10 mmHg (7.9 kPa) with both treatments (p < 0.001).Conclusions and clinical relevanceThe shorter time to recumbency with thiafentanil may allow easier and faster retrieval in the field. However, thiafentanil caused greater hypertension, and ventilatory effects during the first 10 minutes, after administration.     

Pulsed delivery of nitric oxide counteracts hypoxaemia in the anaesthetized horse

Objective To study the effect of the pulsed delivery of nitric oxide (NO) on pulmonary gas exchange in the anaesthetized horses. Design Prospective, controlled randomized. Animals Five healthy Standardbred trotters, three geldings and two mares. Methods The horses were anaesthetized with thiopentone and isoflurane and positioned in dorsal recumbency. Nitric oxide was added as a pulse to the inspired gas during the first half of each inspiration. In three horses the effect of NO on the ventilation–perfusion distribution was also investigated using the multiple inert gas elimination technique. Data were analysed with repeated measures ANOVA. Results During spontaneous breathing, arterial oxygen tension (PaO₂) increased with NO inhalation, from 14 ± 2 to 29 ± 3 kPa (105 ± 15 to 218 ± 23 mm Hg) (p < 0.001). Arterial oxygen tension also increased, from 17 ± 3 to 31 ± 5 kPa (128 ± 23 to 233 ± 38 mm Hg) (p < 0.05) during intermittent positive pressure ventilation. The increase in PaO₂ was mainly due to a reduced right to left vascular shunt, but ventilation and perfusion matching also improved. The beneficial effect of NO inhalation was lost within 5 minutes of its discontinuation. Conclusion Delivery of NO as a pulse during inspiration is an effective method for counteracting impaired gas exchange caused by anaesthesia in horses. Pulsation has to be continuous because of the transience of NO's therapeutic effect. Clinical relevance Horses with impaired pulmonary gas exchange during anaesthesia can be treated with pulsed NO inhalation.     

Influence of fentanyl on intra-abdominal pressure during laparoscopy in dogs

ObjectiveTo evaluate the influence of fentanyl on intra-abdominal pressures in spontaneously breathing dogs during capnoperitoneum.Study designProspective clinical study.AnimalsEleven healthy client-owned and five healthy experimental dogs undergoing laparoscopy.MethodsDogs were premedicated with acepromazine (0.03 mg kg^?1 IV) and carprofen (4 mg kg^?1 IV). Anaesthesia was induced with propofol and maintained with isoflurane in oxygen. The abdomen was insufflated with CO₂ (11–16 cm H₂O). Intra-abdominal pressures were measured with a transducer. Respiratory variables were measured with a spirometry sensor and side-stream capnography. Following preparation, fentanyl (1 μg kg^?1) was injected over 30 seconds IV. Data were recorded 5 minutes before, during and 5 minutes after treatment. The following time points were selected for statistical analysis (anova, p < 0.05): ?160, ?140, ?120, ?100, ?80, ?60, ?40, ?20, 0, 30, 50, 70, 90, 110, 130 and 150 seconds after the start of fentanyl injection.ResultsIntra-abdominal pressure increased during inspiration in 15 dogs but decreased in one dog. Fentanyl treatment did not alter these patterns. Peak inspiratory and end-expiratory intra-abdominal pressures continuously decreased over time during the whole experiment and fentanyl exaggerated the decrease in inspiratory pressures but did not affect the rate of decrease in expiratory pressures. Differences between intra-abdominal pressures were stable before, but decreased after fentanyl administration from 4.1 ± 1.4 to 3.3 ± 1.2 cm H₂O (at 0 and 150 seconds time points). End-tidal CO₂ partial pressures increased from 6.0 ± 0.8 to 6.6 ± 0.9 kPa, respiratory rate decreased from 10.8 ± 2.6 to 7.8 ± 2.2 breaths per minute and tidal volume decreased from 13.7 ± 4.4 to 12.4 ± 2.9 mL kg^?1 after fentanyl but these variables did not change before fentanyl treatment. Airway pressures did not change.Conclusions and clinical relevanceFentanyl did not increase intra-abdominal pressures in dogs.     

Detomidine-Butorphanol-Propofol for Carotid Artery Translocation and Castration or Ovariectomy in Goats

Objective—To determine the safety and efficacy of propofol, after detomidine-butorphanol premedication, for induction and anesthetic maintenance for carotid artery translocation and castration or ovariectomy in goats. Study Design—Case series. Animals—Nine 4-month-old Spanish goats (17.1 ± 2.6 kg) were used to evaluate propofol anesthesia for carotid artery translocation and castration or ovariectomy. Methods—Goats were premedicated with detomidine (10 μg/kg intramuscularly [IM]) and butorphanol (0.1 mg/kg IM) and induced with an initial bolus of propofol (3 to 4 mg/kg intravenously [IV]). If necessary for intubation, additional propofol was given in 5-mg (IV) increments. Propofol infusion (0.3 mg/kg/min IV) was used to maintain anesthesia, and oxygen was insufflated (5 L/min). The infusion rate was adjusted to maintain an acceptable anesthetic plane as determined by movement, muscle relaxation, ocular signs, response to surgery, and cardiopulmonary responses. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, heart rate (HR), ECG, respiratory rate (RR), Spo₂, and rectal temperature (T) were recorded every 5 minutes postinduction; arterial blood gas samples were collected every 15 minutes. Normally distributed data are represented as mean ± SD; other data are medians (range). Results—Propofol (4.3 ± 0.9 mg/kg IV) produced smooth, rapid (15.2 ± 6 sec) sternal recumbency. Propofol infusion (0.52 ± 0.11 mg/kg/min IV) maintained anesthesia. Mean anesthesia time was 83 ± 15 minutes. Muscle relaxation was good; eye signs indicated surgical anesthesia; two goats moved before surgery began; one goat moved twice during laparotomy. Means are reported over the course of the data collection period. Means during the anesthesia for pH_a (arterial PH), P_aco₂, P_ao₂, HCO₃, and BE (base excess) ranged from 7.233 ± 0.067 to 7.319 ± 0.026, 54.1 ± 4.6 to 65.3 ± 12.0 mm Hg, 133.1 ± 45.4 to 183.8 ± 75.1 mm Hg, 26.9 ± 2.6 to 28.2 ± 2.1 mEq/L, and -0.8 ± 2.9 to 1.4 ± 2.2 mEq/L. Means over time for MAP were 53 ± 12 to 85 ± 21 mm Hg. Mean HR varied over time from 81 ± 6 to 91 ± 11 beats/minute; mean RR, from 9 ± 8 to 15 ± 5 breaths/minute; S_po₂, from 97 ± 3% to 98 ± 3%; mean T, from 36.0 ± 0.6±C to 39.1 ± 0.7±C. Over time, S_po₂ and S_ao₂ did not change significantly; HR, RR, T, and P_aco₂ decreased significantly; SAP, DAP, MAP, pH_a, P_ao₂, and BE increased significantly. HCO₃ concentrations increased significantly, peaking at 45 minutes. Recoveries were smooth and rapid; the time from the end of propofol infusion to extubation was 7.3 ± 3 minutes, to sternal was 9.2 ± 5 minutes, and to standing was 17.7 ± 4 minutes. Median number of attempts to stand was two (range of one to four). Postoperative pain was mild to moderate. Conclusions—Detomidine-butorphanol-propofol provided good anesthesia for carotid artery translocation and neutering in goats. Clinical Relevance—Detomidine-butorphanol-propofol anesthesia with oxygen insufflation may be safely used for surgical intervention in healthy goats.     

Ketoprofen reduces the minimum alveolar concentration (MAC) in dogs anaesthetized with isoflurane and fentanyl

Non‐steroidal anti‐inflammatory drugs may potentiate the opioid induced reduction in volatile anaesthetic requirements ( Gomez de Segura et al. 1998 ). This study determined the reduction in the MAC of isoflurane (ISO) produced by ketoprofen (KETO) in dogs anaesthetized with fentanyl (FENT) and ISO. Six healthy female crossbred dogs, weighing 13.5 ± 1.3 (mean ± SD) kg and aged 3.0 ± 0.9 years were studied. Approval of the study was obtained from the institutional ethics committee. Anaesthesia was induced in all dogs via a facemask with 5% ISO in 5 L minute^?1 oxygen. The dogs' trachea were intubated and lungs were ventilated to maintain normocapnia (Pe ′CO₂ 4.7–6 kPa, 35–45 mm Hg). A heating pad was used to maintain body temperature. The animals were anaesthetized four times at one week intervals with the following anaesthetic and analgesic protocols randomly administered. Study 1, MAC (ISO); Isoflurane MAC. Study 2, MAC (ISO + FENT); dogs anaesthetized with ISO received a loading dose of 30 µg kg^?1 FENT IV over 20 minutes followed by a maintenance infusion of 0.2 µg kg^?1 minute^?1 FENT. Study 3, MAC (ISO + FENT + KETO1); as study 2 plus 1 mg kg^?1 KETO. Study 4, MAC (ISO + FENT + KETO2); as study 2 plus 2 mg kg^?1 KETO. The MAC was determined in duplicate by applying a standard electrical stimulus (50 V, 50 H₂ over 60 seconds via two needles placed SC over the tarsus). The stimulus was applied 15 minutes after every step change in anesthetic concentration. The Wilcoxon test was applied to data to determine significant differences among MAC measurements. Fentanyl significantly decreased MAC (ISO) from 1.27% ± 0.02% to 0.73% ± 0.08%, a reduction of 42% (p < 0.05). Ketoprofen 1 mg kg^?1 further decreased the MAC value (although not statistically significantly) with a reduction of 47% from MAC (ISO) (0.67% ± 0.13%) and 8% from MAC (ISO + FENT). When KETO 2 mg kg^?1 was given, the reduction in MAC was 50% compared to MAC (ISO) (0.63% ± 0.08%; p < 0.05) and 14% compared to MAC (ISO + FENT) p < 0.05. Administration of KETO further reduces MAC (ISO) compared to levels observed with FENT alone. The observed reduction may have clinical advantages.