Reference values for activated coagulation time in cats

OBJECTIVE: To establish reference values for activated coagulation time (ACT) in cats by use of jugular venipuncture and direct collection of blood into ACT vacuum tubes. ANIMALS: 100 clinically normal cats that were to have elective surgery performed at a private practice. PROCEDURE: Collection of 3 blood samples for ACT measurement was attempted for each cat at the time of elective surgery: sample 1, obtained before sedation; sample 2, tube 1 of 2 consecutive samples obtained from a single venipuncture of the contralateral jugular vein after sedation with acepromazine and ketamine hydrochloride; and sample 3, tube 2 collected immediately following collection of sample 2 without removing the needle from the vein. Venipuncture quality was rated subjectively on a 3-point scale. RESULTS: Median ACT were 95 seconds for each sample group. The middle 95% of values ranged inclusively from 55 to 185 seconds (sample 1), 65 to 135 seconds (sample 2), 45 to 145 seconds (sample 3), and 55 to 165 seconds overall (samples 1, 2, and 3). Significant differences in ACT values were not detected between sample groups. Significant relationships between ACT and venipuncture quality or sex of cat were not detected. CONCLUSIONS AND CLINICAL RELEVANCE: With the ACT protocols used, clinically normal cats had ACT of < 165 seconds. The ACT in cats does not appear to be significantly affected by sex, sedation with acepromazine and ketamine, or by moderately traumatic venipunctures. These results refute widespread statements that ACT should be < 65 seconds in healthy cats. Cats with ACT repeatedly > 165 seconds should be further evaluated for hemostatic disorders.     

Challenges of Cardiopulmonary Bypass—A Review of the Veterinary Literature

Cardiopulmonary bypass (CPB) has been used in veterinary medicine in experimental surgery and to address congenital and acquired diseases. We review the veterinary literature and expose common challenges of CPB in dogs and cats. Specifically, we describe the most specific elements of this technique in veterinary patients. The variety in animal size has made it difficult to standardize cannulation techniques, oxygenators, and priming volumes and solutions. The fact that one of the most common cardiovascular disorders, mitral valve disease, occurs predominantly in small dogs has limited the use of bypass in these patients because of the need for small, low prime oxygenators and pumps that have been unavailable until recently. Coagulation, hemostasis, and blood product availability have also represented important factors in the way CPB has developed over the years. The cost and the challenges in operating the bypass machine have represented substantial limitations in its broader use.     

Effects of propofol on the electrocardiogram and systolic blood pressure of healthy cats pre-medicated with acepromazine

OBJECTIVE: To obtain and analyze the electrocardiogram and systolic blood pressure of cats before, during, and after a continuous infusion of propofol. STUDY DESIGN: Prospective, uncontrolled experimental trial. ANIMALS: Twenty healthy adult crossbred male and female cats aged between 3 and 5 years, weighing 2.8-5.0 kg (mean 3.9 kg). METHODS: Cats were pre-medicated with acepromazine 0.1 mg kg(-1) subcutaneously and anesthesia was induced with intravenous (IV) propofol 6 mg kg(-1) and maintained with a continuous infusion of propofol at 0.5 mg kg(-1) minute(-1) for 60 minutes. Electrocardiographic parameters and systolic blood pressure obtained by Doppler ultrasound were recorded before pre-medication (T0), 30 (T30), and 60 (T60) minutes after beginning the continuous infusion, and 30 minutes after its cessation (T90). Repeated measures anova was used to perform statistical analysis. RESULTS: A significant decrease in heart rate was observed at all time points when compared with T0 values. The PR interval increased significantly at T60 and T90. Systolic blood pressures during anesthesia were significantly lower than at T0 and T90. CONCLUSION AND CLINICAL RELEVANCE: The changes seen were not clinically important in normal cats but given the reduction in heart rate and systolic blood pressure, careful consideration should be given before using this technique in patients in which hypotension or a reduction in heart rate would be poorly tolerated.     

Resection of Subvalvular Aortic Stenosis Surgical and Perioperative Management in Seven Dogs

Open heart surgery was performed during cardiopulmonary bypass (CPB) to surgically correct subvalvular aortic stenosis in seven dogs. After initiation of total CPB, cardiac arrest was induced by antegrade and retrograde administration of blood cardioplegia. The subvalvular fibrous stenosis was resected through a transverse aortotomy. Intraoperatively and postop-eratively, dobutamine, nitroprusside, lidocaine, blood(-products), and crystalloid solutions were used to manage hypotension and optimize cardiac index.
Aortic cross-clamp time varied from 73 to 166 minutes, and duration of CPB varied from 130 to 210 minutes, latrogenic incision into the mitral valve in two dogs was the most significant introperative complication. Postoperative complications included: hypoproteinemia (n = 7), premature ventricular depolarization (n = 6), increased systemic vascular resistance index (n = 5), increased O₂ extraction (n = 3), pulmonary edema (n = 2), and decreased cardiac index (n = 1). All seven dogs were discharged alive and in stable condition. Six dogs are alive and in stable condition after a mean follow up of 15.8 months.
This is the first detailed report of CPB in a series of clinical veterinary patients. Using the techniques described in this paper, open heart surgery of considerable duration can be performed successfully in dogs with significant myocardial hypertrophy and endomyocardial fibrosis secondary to subvalvular aortic stenosis.     

Activated coagulation test in normal and heparinized ponies and horses.

Activated coagulation test (ACT) was performed in 37 adult ponies and 31 adult horses. The mean ACT time of all ponies and horses was 2 minutes 38 seconds, with a standard deviation (SD) of 29 seconds. The ACT was compared with the Lee-White clotting test in heparinized ponies. The correlation of ACT with the Lee-White test was 0.95. Anticoagulation heparinized ponies during prolonged cardiopulmonary bypass was successfully monitored with the ACT. The ACT is simple and reproducible, has a definite end point, and would seem to be an ideal screening test for hemorrhagic diathesis in equine animals.     

Cardiorespiratory effects of hemic versus nonhemic prime during and immediately following mitral valve replacement in dogs.

In order to limit the hemodilution effect during cardiopulmonary bypass (CPB) in low weight animal patients, blood is often used as a component of the prime solution. This study was undertaken to evaluate the effects of the addition of blood to the prime solution on the hemodynamic and respiratory parameters during and following mitral valve replacement in dogs. Ten dogs were randomly assigned to receive either a hemic (HP), 75% blood component, or a nonhemic prime (NP) solution. The hemodilution was 5 +/- 4% and 25 +/- 10% for the HP and NP groups, respectively. Cardiopulmonary measurements were taken 20 minutes before initiating CPB, during CPB, and 20 min after termination. The hematocrit level, the hemoglobin concentration, and the arterial oxygen content were significantly lower in the NP group during and following CPB. However, the systemic oxygen transport index was not significantly different between the NP group (355 +/- 87 mL/min/m2) and the HP group (546 +/- 155 mL/min/m2) following CPB. Our study indicates that, in normal dogs undergoing hemodilution from a nonhemic prime solution, the cardiovascular function is able to maintain the systemic oxygen transport in the period immediately following mitral valve replacement.     

Effects of increasing infusion rates of dopamine, dobutamine, epinephrine, and phenylephrine in healthy anesthetized cats

OBJECTIVE: To determine the cardiopulmonary effects of increasing doses of dopamine, dobutamine, epinephrine, and phenylephrine and measure plasma concentrations of norepinephrine, epinephrine, and dopamine in cats anesthetized with isoflurane. ANIMALS: 6 healthy adult cats. PROCEDURES: Each cat was anesthetized with isoflurane (1.5 X minimum alveolar concentration) on 4 occasions. Cardiopulmonary measurements were obtained after a 30-minute stabilization period; 20 minutes after the start of each infusion dose; and 30, 60, and 90 minutes after the infusion was discontinued. Cats received 5 progressively increasing infusions of epinephrine or phenylephrine (0.125, 0.25, 0.5, 1, and 2 microg/kg/min) or dobutamine or dopamine (2.5, 5, 10, 15, and 20 microg/kg/min). The order of treatment was randomly allocated. Results-All 4 treatments increased oxygen delivery. Heart rate (HR) increased during administration of all drugs except phenylephrine, and mean arterial pressure increased during administration of all drugs except dobutamine. A progressive metabolic acidosis was detected, but whole-blood lactate concentration only increased during administration of epinephrine and dobutamine. Systemic vascular resistance index increased during administration of phenylephrine, decreased during administration of dobutamine, and remained unchanged during administration of dopamine and epinephrine. A positive inotropic effect was detected with all treatments. CONCLUSIONS AND CLINICAL RELEVANCE: During anesthesia in cats, administration of dopamine, dobutamine, and epinephrine may be useful for increasing cardiac output, with dopamine having the most useful effects. Administration of phenylephrine increased cardiac and systemic vascular resistance indexes with minimal effect on HR and may be useful for increasing mean arterial pressure without increasing HR.     

Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cats

OBJECTIVE: To compare cardiovascular effects of equipotent infusion doses of propofol alone and in combination with ketamine administered with and without noxious stimulation in cats. ANIMALS: 6 cats. PROCEDURE: Cats were anesthetized with propofol (loading dose, 6.6 mg/kg; constant rate infusion [CRI], 0.22 mg/kg/min) and instrumented for blood collection and measurement of blood pressures and cardiac output. Cats were maintained at this CRI for a further 60 minutes, and blood samples and measurements were taken. A noxious stimulus was applied for 5 minutes, and blood samples and measurements were obtained. Propofol concentration was decreased to 0.14 mg/kg/min, and ketamine (loading dose, 2 mg/kg; CRI, 23 microg/kg/min) was administered. After a further 60 minutes, blood samples and measurements were taken. A second 5-minute noxious stimulus was applied, and blood samples and measurements were obtained. RESULTS: Mean arterial pressure, central venous pressure, pulmonary arterial occlusion pressure, stroke index, cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, oxygen delivery index, oxygen consumption index, oxygen utilization ratio, partial pressure of oxygen in mixed venous blood, pH of arterial blood, PaCO2, arterial bicarbonate concentration, and base deficit values collected during propofol were not changed by the addition of ketamine and reduction of propofol. Compared with propofol, ketamine and reduction of propofol significantly increased mean pulmonary arterial pressure and venous admixture and significantly decreased PaO2. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of propofol by CRI for maintenance of anesthesia induced stable hemodynamics and could prove to be clinically useful in cats.     

Platelet function in clinically healthy cats and cats with hypertrophic cardiomyopathy: analysis using the Platelet Function Analyzer‐100

Background: There is currently no simple analytical tool for the evaluation of hypercoagulability in cats. The Platelet Function Analyzer‐100^® (PFA‐100; Dade Behring Inc., Deerfield, IL, USA) is a bench‐top machine that evaluates platelet function by measuring closure time (CT) in citrated whole blood under high shear conditions. We hypothesized that cats with hypertrophic cardiomyopathy (HCM) have up‐regulated platelet function, which shortens their CT and increases their risk for thromboembolic events. Objectives: The goals of this study were to: (1) establish a feline reference interval for CT using the PFA‐100, (2) measure CT in blood from cats with HCM, and (3) determine if there is a measurable difference between the CT of healthy cats compared with cats with HCM. Methods: Citrated blood samples from 42 clinically healthy cats and 30 cats with HCM were analyzed according to manufacturer's specifications. CT was measured in triplicate and the mean value was used for analysis. Transformed data were compared between clinically healthy cats and cats with HCM using a Student's t‐test, and among cats with mild, moderate, or severe HCM using ANOVA. Results: The median CT of clinically healthy cats was 64 seconds (range 43–176 seconds). The median CT of cats with HCM was 74 seconds (range 48–197 seconds). There was no significant difference in CT between cats with HCM and clinically healthy cats. There also were no significant differences in cats with mild, moderate, or severe HCM. Conclusions: A feline reference interval for PFA‐100 CT will be useful in future studies of platelet function in cats. Cats with HCM do not have shorter CTs when compared with clinically healthy cats.     

The Pharmacokineties of Alfentanil in Healthy Cats

Alfentanil (50 μg/kg) was administered intravenously, over 1 minute, to 6 healthy cats. Blood samples were collected from a preplaced arterial catheter at 0.625, 1.25, 2.5, 5, 10, 15, 20, 30, 45, 60, 90, 120, 180, 240, 360, and 480 minutes after the end of the alfentanil injection. A radio-immunoassay technique was used to measure alfentanil concentrations in plasma obtained from these samples. Arterial blood pressure was measured at 0.625, 1.25, 2.5, 5, 10, 15, 20, and 30 minutes and pH and blood gas measurements were carried out at 5, 10 and 30 minutes after the alfentanil. Analgesia, tested by placing a clamp on the base of the tail for 5 seconds, was assessed at each blood sampling time until analgesia was absent. The cats were observed for behavioural changes at each sample time. Alfentanil caused a transient increase in blood pressure and respiratory and metabolic acidosis. Following alfentanil all cats became excited and showed pupillary dilation. Analgesia was present for 21.7 ± 14 minutes. The plasma concentration-time data for 5 cats were best described by a 3 compartment open model with the curve fitting the equation: C_to= 162.6e^-0.2062t+ 60.le^-0.041t+ 13.2e^-0.0062t The harmonic means for the half lives of the rapid distribution, the slow distribution and the elimination phases were 4.12, 18.8, 119.2 minutes respectively.     

Sedative and physiologic effects of orally administered alpha 2-adrenoceptor agonists and ketamine in cats

OBJECTIVE: To compare efficacy of 3 regimens of orally administered sedatives and determine physiologic effects of 1 of these regimens in healthy cats. DESIGN: Prospective randomized study. ANIMALS: 34 cats. PROCEDURE: Cats were assigned to 1 of 3 groups that were treated by oral administration of detomidine and ketamine, xylazine and ketamine, or medetomidine and ketamine. Cats were monitored for degree of sedation at 5-minute intervals for 60 minutes. Physiologic effects in cats treated with detomidine and ketamine were measured at 5-minute intervals for 30 minutes and compared with effects in cats treated i.m. with detomidine and ketamine or xylazine and ketamine. RESULTS: All cats treated orally with detomidine and ketamine became laterally recumbent; sedation was more variable in the other 2 groups treated orally. Vomiting and excessive salivation were the only adverse effects. Bradycardia (heart rate < 145 beats/min) was detected at each evaluation time in cats treated orally with detomidine and ketamine and in all cats treated i.m. Minimal differences among groups were detected for heart and respiratory rates, rectal temperature, and hemoglobin oxygen saturation. CONCLUSIONS AND CLINICAL RELEVANCE: Oral administration of detomidine and ketamine is an effective method of sedating healthy cats and induces minimal physiologic effects that are similar to those resulting from i.m. administration of sedatives.     

Stress hyperglycemia in sick cats: a retrospective study over 4 years

Between January 1997 and December 2000 blood glucose concentrations were measured in 2278 sick cats at the time of their initial presentation at the hospital. In 827 cats (36%) hyperglycemia (blood glucose >8 mmol/l) was documented, 1388 cats (61%) had normal blood glucose levels, 63 cats (3%) were hypoglycemic. In 674 of 827 cats (81.5%) no further investigations were performed and the veterinarian judged the hyperglycemia to be stress related. In 153 of the 827 cats (18.5%) blood glucose measurements were repeated and/or serum fructosamine concentrations evaluated. In 106 cats (69%) stress hyperglycemia and in 47 (31%) diabetes mellitus was then diagnosed. Blood glucose concentrations in cats with stress hyperglycemia were between 8.1 and 60.4 mmol/l (Median 10.3), in cats with diabetes mellitus between 8.5 and 70.0 (Median 27.7). Blood glucose concentrations in cats with diabetes mellitus were significantly higher than in cats with stress hyperglycemia. Cats with stress hyperglycemia suffered from a variety of different diseases, the most frequently encountered were surgical problems, neoplasia, heart diseases, upper and lower urinary tract diseases. Blood glucose concentrations in cats with heart diseases and in cats with neoplasia was higher than in cats with other disorders, however, the difference was not significant. Cats with diabetes mellitus were significantly more frequent male castrated than cats with stress hyperglycemia. Cats with stress hyperglycemia were significantly older than cats with normoglycemia.     

Efficacy of lidocaine hydrochloride for laryngeal desensitization: a clinical comparison of techniques in the cat

Assessment of laryngeal relaxation and ease of intubation in cats was made after preanesthetic medication with acepromazine/meperidine/atropine (IM) and induction of anesthesia 20 minutes later by thiopental administration (IV). Healthy cats (n = 32) scheduled for elective surgery were randomly assigned to 1 of 4 treatment groups to be provided with laryngeal desensitization: group 1, 2% lidocaine HCl (2 mg/kg of body weight) given IV 30 seconds before thiopental induction; group 2, 2% lidocaine HCl (2 mg/kg) topically applied to the larynx; group 3, 10% lidocaine HCl (10 mg) as a topical aerosol; and group 4, no treatment before intubation. A significant (P less than 0.05; ANOVA) difference between groups in the reaction to intubation attempts was apparent. Cats receiving 2% lidocaine IV or no treatment for desensitization had a greater response to intubation than did those receiving 2% or 10% lidocaine topically. The number of attempts required to intubate cats was significantly (P less than 0.05) greater in cats with no treatment than in cats treated topically with 2% or 10% lidocaine. Response to IV administration of 2% lidocaine HCl was not significantly different from the response to other treatments, indicating little advantage over no laryngeal desensitization. It was concluded that topical application of 2% lidocaine (2 mg/kg) or 10% lidocaine aerosol 1 1/2 minutes before intubation provides effective laryngeal desensitization in the cat.     

Remission of Diabetes Mellitus in Cats with Diabetic Ketoacidosis

Background: Diabetic ketoacidosis (DKA) has long been considered a key clinical feature of type‐1 diabetes mellitus (DM) in humans although. An increasing number of cases of ketoacidosis have been reported in people with type‐2 DM. Hypothesis/Objectives: Cats initially diagnosed with DKA can achieve remission from diabetes. Cats with DKA and diabetic remission are more likely to have been administered glucocorticoids before diagnosis. Animals: Twelve cats with DKA and 7 cats with uncomplicated DM. Methods: Retrospective case review. Medical records of cats presenting with DKA or DM were evaluated. Diabetic remission was defined as being clinically unremarkable for at least 1 month after insulin withdrawal. The cats were assigned to 1 of 3 groups: (1) cats with DKA and diabetic remission; (2) cats with DKA without diabetic remission; and (3) cats with DM and diabetic remission. Results: Seven cats with DKA had remission from diabetes. These cats had significantly higher concentrations of leukocytes and segmented neutrophils, and significantly lower concentrations of eosinophils in blood and had pancreatic disease more often than did cats with uncomplicated DM and diabetic remission. With regard to pretreatment, 3/7 cats in group 1, 1/5 cats in group 2, and 1/7 cats in group 3 had been treated with glucocorticoids. Conclusions and Clinical Importance: Remission of DM in cats presenting with DKA is possible. Cats with DKA and remission have more components of a stress leucogram, pancreatic disease, and seemed to be treated more often with glucocorticoids than cats with uncomplicated DM and diabetic remission.     

The influence of crystalloid type on acid–base and electrolyte status of cats with urethral obstruction

Objective: To compare the effect of a balanced isotonic crystalloid solution with that of 0.9% sodium chloride on the acid–base and electrolyte status of cats with urethral obstruction.
Design: Randomized prospective clinical trial.
Setting: Academic veterinary emergency room.
Animals: Sixty-eight cats with naturally occurring urethral obstruction.
Interventions: Cats were randomized to receive either a balanced isotonic crystalloid solution (Normosol-R, n =39) or 0.9% sodium chloride ( n =29) for fluid therapy. Baseline venous blood gas and blood electrolyte values were obtained at the time of admission and at intervals during the course of therapy.
Measurements and main results: Baseline values were similar between groups. Cats receiving Normosol-R had a significantly higher blood pH at 12 hours, a significantly greater increase in blood pH from baseline at 6 and 12 hours, as well as a significantly higher blood bicarbonate concentration at 12 hours and a significantly greater increase in blood bicarbonate from baseline at 6 and 12 hours. Conversely, the increase in blood chloride from baseline was significantly higher at 2, 6, and 12 hours in cats receiving 0.9% sodium chloride. There were no significant differences in the rate of decline of blood potassium from baseline between groups. Subgroup analysis of hyperkalemic cats (K⁺>6.0 mmol/L) and acidemic cats (pH<7.3) yielded similar findings.
Conclusions: While both crystalloid solutions appear safe and effective for fluid therapy in cats with urethral obstruction, the use of a balanced electrolyte solution may allow more rapid correction of blood acid–base status within the first 12 hours of fluid therapy. The use of a potassium-containing balanced electrolyte solution does not appear to affect the rate of normalization of blood potassium in treated cats with urethral obstruction.     

Activated coagulation times of whole blood in normal dogs and dogs with coagulopathies

The activated coagulation time (ACT) of whole blood was determined at 37C and at room temperature for 42 normal dogs and eight dogs with naturally–occurring or experimentally–induced coagulation defects.
Normal ACT values ranged from 64 to 95 seconds at 37C, and 83 to 129 seconds at room temperature. In abnormal dogs, ACT was increased on 14 of 17 occasions that a prolonged activated partial thromboplastin time (APTT) was recorded: the ACT failed to detect an abnormality on three occasions the APTT was slightly increased. ACT determination at 37C correlated better with APTT than did ACT testing at room temperature.
The ACT test is simple, inexpensive and convenient. It is a useful screening test for intrinsic coagulation defects in the dog. It is suggested that the test be performed at 37C: at this temperature an ACT of 95 seconds or more in a dog warrants further investigation.     

Use of combined conventional and real-time PCR to determine the epidemiology of feline haemoplasma infections in northern Italy

Although knowledge of feline haemotropic mycoplasmas (haemoplasmas) has dramatically improved in recent years, some issues still remain to be elucidated. The aim of the current study was to evaluate the prevalence of feline haemoplasma infections in blood samples collected from cats in northern Italy. A convenience-sample of 307 cats (40 anaemic; 258 non-anaemic; nine with unknown haematocrit [HCT]) was investigated using polymerase chain reaction assays. Furthermore, the date of blood collection, signalment and clinicopathological data were retrospectively evaluated to assess predictors and risk factors for infection. Haemoplasma infections were highly prevalent in the sample investigated with an overall prevalence of 18.9% (95% confidence interval: 14.5-23.3%). The prevalence for the three feline haemoplasmas was 17.3% for 'Candidatus Mycoplasma haemominutum' (CMhm), 5.9% for Mycoplasma haemofelis (Mhf) and 1.3% for 'Candidatus Mycoplasma turicensis' (CMt). Feline immunodeficiency virus-positive status represented a risk factor for infection with an odds ratio of 4.19 (P=0.02). Moreover, a higher prevalence was observed in summer (odds ratio 1.78; P=0.04) which may be consistent with arthropod-borne disease transmission. Cats infected with Mhf showed significantly lower HCT (P=0.03), haemoglobin values (P=0.02) and red blood cell counts (P=0.04), lower mean corpuscular haemoglobin concentration (P<0.01) and higher white blood cell counts (P<0.01) when compared with non-infected cats.     

The effect of the duration of propofol administration on recovery from anesthesia in cats

OBJECTIVE: To determine the effect of induction, a 30-minute, and a 150-minute infusion of propofol on the rate of recovery in cats. STUDY DESIGN: Randomized, cross-over, prospective experimental study. ANIMALS: Six healthy adult spayed female cats (mean 4.3, range 2-7 years old) weighing 3.9 +/- 0.5 kg. METHODS: Cats received each of three treatments: anesthetic induction with propofol (T1), induction followed by a 30-minute infusion (T30) and induction followed by a 150-minute infusion (T150). Propofol infusions were increased or decreased to maintain a sluggish pedal withdrawal reflex. Animals were monitored throughout the anesthetic period and during the recovery. Venous blood samples were collected from a central venous catheter before anesthesia and at 30 minutes for the 30-minute infusion and at 30, 60, 90, 120 and 150 minutes for the 150-minute infusion. The ability of the cat to lift its head, crawl, stand and walk without ataxia was recorded at 5, 10, 20, 40, 60, 80, 120, 160, 180, 210 and 240 minutes after the completion of propofol administration. Data from physiological values were analyzed using either a Student's t-test (30-minute infusion) or an anova (150-minute infusion). A nonparametric Friedman test (and post-hoc Tukey's Studentized range test) was used to determine whether there were differences in the time taken to recover. Results were considered significant if p < 0.05. RESULTS: Time taken to walk without ataxia was significantly greater in T150 (148 +/- 40 minutes) compared with T1 (80 +/- 15 minutes) and T30 (74 +/- 26 minutes). (No other recovery times were significantly different). Anesthesia with propofol was accompanied by a moderate but significant respiratory depression and a decrease in PCV and total protein. CONCLUSIONS AND CLINICAL RELEVANCE: Prolonged anesthesia with propofol in healthy cats may be associated with a delayed recovery.     

Use of a combination of propofol and fentanyl, alfentanil, or sufentanil for total intravenous anesthesia in cats

OBJECTIVE: To determine the cardiorespiratory effects of an i.v. infusion of propofol alone or in association with fentanyl, alfentanil, or sufentanil in cats and, for each combination, the minimal infusion rate of propofol that would inhibit a response to noxious stimuli. DESIGN: Randomized crossover study. ANIMALS: 6 cats. PROCEDURE: Cats were anesthetized 4 times in random order. After i.v. administration of fentanyl, alfentanil, sufentanil, or saline (0.9% NaCl) solution, anesthesia was induced with propofol (7 mg/kg 13.2 mg/lb], i.v.) and maintained for 90 minutes with a continuous infusion of propofol in conjunction with fentanyl (0.1 microg/kg/min [0.045 microg/lb/min]), alfentanil (0.5 microg/kg/min [0.23 microg/lb/min]), sufentanil (0.01 microg/kg/min [0.004 microg/lb/min]), or saline solution (0.08 mL/kg/min [0.036 mL/lb/min]). RESULTS: Minimal infusion rate of propofol required to prevent a response to a noxious stimulus was higher when cats received saline solution. After 70 minutes, minimal infusion rate of propofol was significantly higher with fentanyl than with sufentanil. Decreases in heart rate, systolic blood pressure, rectal temperature, and respiratory rate were detected with all treatments. Oxygen saturation did not change significantly, but end-tidal partial pressure of carbon dioxide increased with all treatments. There were no significant differences in recovery times or sedation and recovery scores among treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that infusion of propofol in combination with fentanyl, alfentanil, or sufentanil results in satisfactory anesthesia in cats.