Development and verification of saphenous, tibial and common peroneal nerve block techniques for analgesia below the thigh in the nonchondrodystrophoid dog

OBJECTIVE: To document simple and reliable local, infiltrating nerve blocks for the saphenous, tibial and common peroneal nerves in the dog. STUDY DESIGN: Laboratory technique development; in vivo blind, controlled, prospective study. ANIMALS: Twenty canine cadavers and 18 clinically normal, client-owned dogs. METHODS: A peripheral nerve blockade technique of the tibial, common peroneal, and saphenous nerves was perfected through anatomic dissection. Injections were planned in the caudal thigh for the tibial and common peroneal nerves, and in the medial thigh for the saphenous nerve. Cadaver limbs were injected with methylene blue dye and subsequently dissected to confirm successful dye placement. Clinically normal dogs undergoing general anesthesia for unrelated, elective procedures were randomly assigned to treatment (bupivacaine; n = 8) or control (saline; n = 8) nerve blocks of the nerves under study. Upon recovery from general anesthesia, skin sensation in selected dermatomes was evaluated for 24 hours. RESULTS: Cadaver tibial, common peroneal, and saphenous perineural infiltrations were successful in nonchondrodystrophoid dogs (100, 100, and 97%, respectively.) Intraneural injection was rare (1%; 1/105; tibial nerve) in cadaver dogs. In the treatment group of normal dogs, duration of loss of cutaneous sensation in some dermatomes (saphenous, superficial and deep peroneal nerve) was significantly different than control dogs; the range of desensitization occurred for 1-20 hours. No clinical morbidity was detected. CONCLUSIONS: This technique for local blockade of the tibial, common peroneal, and saphenous nerves just proximal to the stifle is easy to perform, requires minimal supplies and results in significant desensitization of the associated dermatomes in clinically normal, nonchondrodystrophoid dogs. CLINICAL RELEVANCE: This technique may be an effective tool for post-operative analgesia to the femoro-tibial joint and distal pelvic limb. Other applications, using sustained-release drugs or methods, may include anesthesia/analgesia in high-risk patients or as a treatment for chronic pelvic limb pain or self-mutilation.     

Motor nerve conduction velocity and latency in the dog

Supramaximal percutaneous nerve stimulation was used in motor nerve conduction velocity studies conducted in ten middle-aged, clinically normal dogs. Dogs were separated into two groups; dogs in one group weighted less than or equal to 7.5 kg and dogs in the other group weighted greater than or equal to 15.9 kg. Mean values and SEM were recorded for radial (72.1 +/- 1.9 m/s), median 65.6 +/- 2.1 m/s), ulnar (58.9 +/- 1.0 m/s), tibial (68.2 +/- 1.4 m/s), and peroneal (79.8 +/- 1.8 m/s) nerves. Values for latency, amplitude, and duration for proximal and distal evoked potentials were recorded. Analysis of mean nerve conduction velocity values for all nerves between the two groups indicated no statistical difference (P greater than 0.05). However, the two groups were statistically different (P less than 0.05) when values for distal latency and measurements of nerve length were compared. These data suggest that if latency is substituted for velocity measurements, various populations of dogs must be considered to clarify interpretation.     

Sensory and motor neuropathy in a Border Collie

A 5-month-old female Border Collie was evaluated because of progressive hind limb ataxia. The predominant clinical findings suggested a sensory neuropathy. Sensory nerve conduction velocity was absent in the tibial, common peroneal, and radial nerves and was decreased in the ulnar nerve; motor nerve conduction velocity was decreased in the tibial, common peroneal, and ulnar nerves. Histologic examination of nerve biopsy specimens revealed considerable nerve fiber depletion; some tissue sections had myelin ovoids, foamy macrophages, and axonal degeneration in remaining fibers. Marked depletion of most myelinated fibers within the peroneal nerve (a mixed sensory and motor nerve) supported the electrodiagnostic findings indicative of sensorimotor neuropathy. Progressive deterioration in motor function occurred over the following 19 months until the dog was euthanatized. A hereditary link was not established, but a littermate was similarly affected. The hereditary characteristic of this disease requires further investigation.     

Electrodiagnostic evaluation in feline hypertrophic muscular dystrophy

Standard needle electromyography (EMG) of 56 muscles and nerve conduction velocities (NCV) of the ulnar and common peroneal nerves were investigated in each of six cats affected with hypertrophic feline muscular dystrophy, 10 related heterozygote carriers and 10 normal cats. The EMG findings were considered normal in carrier and control cats, and consisted of 33% normal readings, 22% myotonic discharges, 18% fibrillation potentials, 11% prolonged insertional potentials, 10% complex repetitive discharges and 6% positive sharp waves in affected cats. Muscles of the proximal limbs were most frequently affected. No differences in NCV were found between the three cat groups. It was concluded that dystrophin-deficient dystrophic cats have widespread and frequent EMG changes, predominantly myotonic discharges and fibrillation potentials, which are most pronounced in the proximal appendicular muscles.     

Comparative Plasma Pharmacokinetics and Tolerance of Florfenicol following Intramuscular and Intravenous Administration to Camels,Sheep and Goats

Florfenicol, a monofluorinated analogue of thiamphenicol, has a broad antibacterial spectrum. The pharmacokinetics of florfenicol was studied following a single intravenous (i.v.) or intramuscular (i.m.) injection at a dose of 20 mg/kg body weight in healthy male camels, sheep and goats. The concentration of florfenicol in plasma was determined using a microbiological assay. Pharmacokinetic analysis was performed using a two-compartment open model. Following i.m. administration, the maximum plasma concentration of florfenicol (C _max) reached in camels, sheep and goats was 0.84±0.08, 1.04±0.10 and 1.21±0.10 g/ml, respectively, the the time required to reach C _max (t _max) in the same three respective species was 1.51±0.14, 1.44±0.10 and 1.21±0.10 h. The terminal half-life (t _1/2) and the fraction of the drug absorbed (F%) in camels, sheep and goats were 151.3±16.33, 137.0±12.16 and 127.4±11.0 min, and 69.20%±7.8%, 65.82%±6.7% and 60.88%±5.9%, respectively. The MRT in the same three respective species was 4.01±0.45, 3.42±0.39 and 2.98±0.32 h. Following i.v. administration, the terminal half-life (t _1/2) and total body clearance (Cl_B) in camels, sheep and goats were 89.5±9.2, 78.8±8.3 and 71.1±8.9 min and 0.33±0.04, 0.30±0.03 and 0.27±0.03 L/h per kg, respectively. The area under the curve (AUC_0–) and the mean residence time (MRT) in the same three respective species were 60.61±6.98, 62.45±6.56 and 74.07±7.85 g/ml per h, and 2.71±0.31, 2.34±0.25 and 2.11±0.23 h. These data suggest that sheep and goats absorb and clear florfenicol to a broadly similar extent, but the rate and extent of absorption of the drug tends to be higher in camels. Drug treatment caused no clinically overt adverse effects. Plasma enzyme activities and metabolites indicative of hepatic and renal functions measured 1, 2, 4 and 7 days following the drug treatment were within the normal range, indicating that the drug is safe at the dose used.     

ULTRASONOGRAPHY OF PERIPHERAL NERVES DURING WALLERIAN DEGENERATION AND REGENERATION FOLLOWING TRANSECTION

Ultrasonography was performed on sciatic, tibial and/or peroneal nerves and interosseous muscles in 7 dogs using a ultrasound machine with a 7.5 MHz linear array transducer. A tibial nerve was transected near the distal aspect of the bellies of the gastroenemius muscle. Serial neurologic examinations, electromyography, and ultrasonography were performed before and after surgery. Dogs were euthanized at variable intervals and histopathology performed on nerve samples. In sagittal images, normal nerves had hyperechoic walls with multiple internal linear echoes. In transverse images, the nerves were round or oval hyperechoic structures with internal punctate echoes. After transection, the proximal stump was consistently seen whereas the distal stump and nerve were harder to identify. Neuromas were present in all 5 dogs followed beyond 2 days and appeared as hypoechoic bulbous swellings most apparent at 3 weeks after surgery. Only 1 dog developed a neuroma large enough to be considered of potential clinical significance. Four dogs were followed beyond 2 months. Regeneration was evidenced by a steady growth of nerve with an irregular outline (2 dogs) or by a knobby connection between the proximal and distal stumps (1 dog). Regeneration was not detected in 1 dog.     

Neurophysiologic maps of cutaneous innervation of the hind limb of sheep

The area of skin supplied by afferent fibers in a peripheral nerve is called the cutaneous area (CA) of that nerve. The CA of hind limb nerves that were responsive to movement of wool/hairs were mapped neurophysiologically in 25 barbiturate-anesthetized sheep. The CA of the dorsal cutaneous branches of the caudal lumbar spinal nerves and of the sacral spinal nerves extended over the lateral aspect of the thigh. The CA of the lateral cutaneous femoral nerve was restricted to the stifle region, that of the saphenous nerve did not reach the digits, that of the deep peroneal nerve lay between the 3rd and 4th digits, and that of the lateral plantar nerve was confined to the lateral aspect of the 4th digit. The CA of the superficial peroneal nerve enveloped the dorsal, medial, and lateral aspects of the distal portions of the hind limb. In some sheep, the boundaries of the CA of the superficial peroneal nerve were juxtaposed caudally in such way that the medial plantar nerve did not have an autonomous zone. Differences in sizes of the CA resulted in corresponding differences in the overlap between adjacent CA and concomitant differences in the sizes of autonomous zones.     

Sensory nerve conduction velocities in forelimb of ponies

Normal nerve conduction velocity values in 10 ponies were determined for sensory nerve fibers in the median and ulnar nerves. A percutaneous signal-averaging technique was developed and used. Medial and lateral palmar digital nerves on the abaxial surface of the proximal sesamoid bones were used as the sites for percutaneous stimulation, whereas recording sites included the medial and lateral palmar nerves just distal to the carpus and the median and ulnar nerves in the middle of the radius. Sensory nerve conduction velocities can be evaluated simply and clinically in the limbs of horses, using percutaneous signal-averaging techniques.     

Sensory nerve conduction velocities in the cutaneous afferents of the ulnar and peroneal nerves of the dog: Tissue temperature-dependent reference ranges

Sensory nerve conduction velocities in the cutaneous afferents of the ulnar and peroneal nerves of the neurologically normal adult dog were determined by stimulation at stimulus intensities of 15, 20 and 25 V through subcutaneously placed electrodes and by the averaged evoked response technique. Stimulus intensities of 15 V for the ulnar nerve and 20 V for the peroneal nerve were adequate to measure the sensory nerve conduction velocities of these nerves. A linear relationship was seen between sensory nerve conduction velocity (y in m/s) and tissue temperature (x in °C) and the regression equations were expressed as follows: y=1.6x+12.3 at a stimulus intensity of 15 V for the ulnar nerve and y=2.0x–10.6 at 20 V for the peroneal nerve, respectively. The 95% confidence limits of the regressions of the sensory nerve conduction velocities against tissue temperature, obtained at a stimulus intensity of 15 V for the ulnar nerve or at a stimulus intensity of 20 V for the peroneal nerve, were proposed for a tissue temperature-dependent reference range to enable the clinician to evaluate graphically the sensory nerve conduction velocity in a diseased dog.     

A new method for recording and analysing evoked motor potentials from dogs

Normal values for motor conduction in the tibial, ulnar and fibular nerves of dogs have been determined using a new method for recording and analysing evoked motor potentials. The use of an alligator clip as a roving surface electrode for recording, and a personal computer to analyse the evoked potentials has facilitated faster and more reproducible motor conduction studies. Compound muscle action potential (CMAP) and motor nerve conduction velocity data are in good agreement with previous studies. Normal values for CMAP area, residual latency and proximal to distal ratios for CMAP area and amplitude are presented for the first time.     

Morphometric Parameters of Peripheral Nerves in Calves Correlated with Conduction Velocity

Background

Peripheral nerve injuries are the most frequent neurologic disorder in cattle. So far, no physiologic values have been established for the motor nerve conduction velocity (mNCV) in this precocial species.

Objectives

The electrophysiologic and morphometric reference values of peripheral nerves in calves were determined. It was hypothesized that these parameters would correlate to the high degree of maturity in the first days of life in this species compared to other species.

Animals

Twenty‐six healthy calves were used in this study.

Methods

The mNCV of the radial and the sciatic/common peroneal nerve was measured in all 26 calves. Nerve biopsies from a group of 6 calves were taken to correlate the obtained electrophysiologic data with morphological parameters.

Results

The mean mNCV of the radial nerve was 48.3 ± 10.6 m/s, whereas the mean mNCV of the sciatic/peroneal nerve was with 83.8 ± 5.9 m/s significantly faster (P < .0001). The average fiber diameter was 8.40 ± 2.80 μm (range, 1.98–17.90 μm) and the average g‐ratio was 0.61 ± 0.04 SD.

Conclusion and Clinical Importance

The established reference values for mNCV in calves correlate well with the evaluated morphometric parameters. Attributable to their comparably fast mNCV and high fiber diameters, juvenile calves appear to be much more mature individuals than other mammals. Electrophysiologic characterization of peripheral nerve injury now is feasible in this species.     

Electrodiagnostic evaluation of peripheral nerve function in rheas and barred owls

OBJECTIVE: To establish reference values for electrodiagnostic evaluation of peripheral nerve function in birds. ANIMALS: 6 rheas and 6 barred owls. PROCEDURE: Birds were anesthetized with propofol or isoflurane in oxygen. Using a computer-based electromyograph system and needle electrodes for stimulation and recording, electromyography (EMG) was performed on the pectoral, biceps brachialis, and gastrocnemius muscles, and evoked EMG was performed on the tibial and ulnar nerves. Motor nerve conduction velocity (MNCV) was calculated. Repetitive stimulation was performed on these 2 nerves. Late F waves were recorded for each nerve, when possible. RESULTS: Activity was evident during insertion of the electrodes, but muscles tested were electrically quiescent after spontaneous EMG. Motor nerve conduction velocity was faster in the tibial nerve than ulnar nerve but did not differ significantly between species. Mean +/- SEM MNCV was 132.3+/-7.8 m/s for the tibial nerve and 59.7+/-7.8 m/s for the ulnar nerve. A significant difference was not observed in responses at the fourth or ninth stimulation during repetitive stimulation. Subsequent to the initial stimulation, amplitudes were +/-22.7% of the initial motor potential amplitude. Recorded F waves were inconsistent, which may have been associated with technique. CONCLUSIONS AND CLINICAL RELEVANCE: Reference range (mean +/-2 SEM) for MNCV was 34.1 to 75.3 m/s for the ulnar nerve and 116.7 to 147.9 m/s for the tibial nerve in barred owls and rheas. After repetitive stimulation, motor potential amplitudes may be +/-22.7% of the initial amplitude response.     

The characteristic pattern of aspartate aminotransferase and alanine aminotransferase in the bitch with the cystic hyperplasia-pyometra complex: Effect of medical or surgical treatment

In 75 clinically normal unspayed female control dogs between two and eleven years old the average plasma level of aspartate aminotransferase (AST) was 21.6±5.7 (±SD) IU/l, of alanine aminotransferase (ALT) 40.4±13.0 IU/l and of the AST/ALT ratio 0.6±0.2. These values showed only minor changes over years.In 96 bitches with the cystic hyperplasia-pyometra complex there was a very significant increase of the AST, decrease of the ALT and increase of the AST/ALT ratio. The changes were more pronounced in 62 clinically ill bitches with typical endometritis post oestrum, in 18 dogs with gram negative organisms in the uterus and in 53 bitches with white blood cell (WBC) levels higher than 40×10⁹/l. Renal failure had no influence on the specific changed values. The changed values returned either temporarily to normal after prostaglandin (PGF₂)-treatment or definitely after ovario-hysterectomy.     

Assessment of dorsal nerve root and spinal cord dorsal horn function in clinically normal dogs by determination of cord dorsum potentials

OBJECTIVE: To establish normal predictive values for cord dorsum potential (CDP) onset latency after thoracic and pelvic limb sensory or mixed nerve stimulation in adult dogs. ANIMALS: 26 clinically normal adult dogs. PROCEDURE: Sensory nerve action potentials (SNAP) were recorded proximally from tibial and lateral superficial radial nerves after distal stimulation. The CDP were recorded from the L4-L5 interarcuate ligament for the tibial nerve and from the C7-T1 interarcuate ligament for the radial nerve. Linear regression analyses were performed for CDP onset latency, and mean +/- SD was calculated for CDP onset to peak latency differences and sensory nerve conduction velocities (SNCV). RESULTS: For the tibial nerve, expected CDP onset latency (CDPOL) = -1.194 + 0.014 X pelvic limb length (mm; R2 = 0.912); CDPOL = -2.156 + 0.011 X pelvic limb/spinal length (mm; R2 = 0.911); and CDPOL = 0.941 + 2.197 X tibial nerve SNAP latency (milliseconds; R2 = 0.903). For the radial nerve, CDPOL = -0.9 + 0.014 x thoracic limb length (mm; R2 = 0.873); and CDPOL = 1.454 + 1.874 X radial nerve SNAP latency (milliseconds; R2 = 0.903). Mean +/- SD for CDP onset to peak latency difference for tibial and radial nerves was 3.1+/-0.3 and 3.0+/-0.4 milliseconds, respectively. CONCLUSIONS: Strong linear associations exist between CDPOL and a number of easily measured peripheral independent variables in dogs. There is also a narrow range of normal values for CDP onset to peak latency differences that is independent of limb length. CLINICAL RELEVANCE: CDP evaluation can be used to accurately assess functional severity and distribution of abnormalities in proximal sensory nerves, dorsal nerve roots, and spinal cord dorsal horns in dogs with suspected neuropathy, radiculopathy, or myelopathy involving the brachial or lumbosacral intumescences.     

ULTRASONOGRAPHY OF PERIPHERAL NERVES IN THE NORMAL ADULT HORSE

A study of the ultrasonographic appearance and size of the sciatic, tibial, peroneal, suprascapular, radial, median, and ulnar nerves and a comparison with the anatomic size and location of these nerves in the normal adult horse is reported. Cadavers and live horses were studied. Landmarks for localization and techniques for nerve identification are described. The depth and diameter of each nerve at various locations and the success rate in imaging each nerve are reported. Statistically significant correlations were found between anatomically and ultrasonographically measured nerve depths and diameters. The success rate in identifying nerves was 70% in the live horses and 49% in cadavers, with the deep peroneal nerve being the easiest to identify. Some applications of this technique in horses are discussed.     

Mycobacterial neuritis in a cat

A 2-year-old spayed female domestic shorthair cat was referred for evaluation of rapidly progressive lameness of the right hind limb, which was paralyzed. Histologic examination of biopsy specimens revealed pyogranulomatous inflammation affecting the sciatic, common peroneal, and tibial nerves, and slender, beaded, acid-fast bacilli within macrophages, nerve fibers, and degenerate axons. A diagnosis of mycobacterial neuritis was made and the cat was treated with clofazimine and enrofloxacin for extended periods. Treatment was partially effective; the goal of returning normal function to the limb was not achieved, but disease progression was halted and the cat remained a viable pet.     

Electrophysiologic studies of the cutaneous innervation of the pelvic limb of male dogs

The area of skin supplied by the afferent fibers in one cutaneous nerve is called the cutaneous area (CA) for that nerve. The CA of peripheral branches of lumbar and sacral spinal nerves responsive to the stimulation of hair follicle mechanoreceptors were mapped in 27 dogs. The amount of overlap among the CA was similar to that found for other CA of the body. The CA of peripheral branches of the sciatic nerve were restricted to the lateral, cranial, and caudal aspects of the pelvic limb distal to the stifle. The CA of the saphenous nerve was located on the medial side of the limb, except for a small area located on the lateral side of the crus. The distal part of the CA of the saphenous nerve was completely overlapped in the hind paw by branches of the superficial peroneal nerve laterally and the medial plantar branch of the tibial nerve medially. The CA for the deep peroneal nerve was located on the dorsal surface of the webbing between digits 2 and 3 and the adjacent skin of these digits. The CA of the plantar branches of the tibial nerve were small in comparison with the diameter of the nerve, suggesting that these branches contained nerve fibers supplying other, deeper structures in the hindpaw and that damage to these nerves would interfere with cutaneous sensation in only a small region on the plantar surface of the hindpaw. Knowledge of the CA of the various branches of the sciatic nerve allows more accurate localization of injury to the sciatic nerve or its branches by using areas of anesthesia.     

Electrophysiologic characteristics of tibial and sciatic nerves in the hen

The peripheral nerve of the hen has become an increasingly important animal model in studies of peripheral neuropathy, especially that induced by organophosphorus agent exposure. However, few electrophysiologic studies have been performed, and few data on normal peripheral nerve function exist. The purpose in the present study was to measure the characteristics of the compound action potential of peripheral nerves of the healthy hen. The results showed that conduction velocities of the tibial and the sciatic nerves were 41 m/s and 60 m/s, respectively. The relative refractory period was slightly shorter in the sciatic nerve. The tibial nerve exhibited a lower threshold for stimulation and a significantly shorter chronaxie (19 microseconds) than did the sciatic nerve (25 microseconds). Variability between animals was relatively small. These data should provide useful reference points on studies in which peripheral neuropathy is induced or suspected.     

Morphologic and morphometric studies of the vagus and recurrent laryngeal nerves in clinically normal adult dogs

Morphologic and morphometric studies were performed on the vagus nerve and its major branch, the recurrent laryngeal nerve (RLN): (1) to determine normal histologic data in myelinated fibers of clinically normal young adult dogs, (2) to establish reference values for mean fiber diameter in the vagus nerve and in the proximal and distal portions of the RLN, and (3) to delineate relative frequency distribution curves for each nerve. Few degenerative changes were observed in single teased-nerve fiber preparations. There was no statistical difference between left and right sides of the vagus nerve or between the proximal and distal portions of the RLN (right and left sides). In contrast to the unimodal distribution of fibers in the vagus nerve and the proximal portion of the RLN, the distribution of fibers in the distal portion of the RLN was bimodal. Mean (+/- SD) fiber diameters of the vagus nerve and in the proximal portion of the RLN (3.02 +/- 1.44 microns and 3.63 +/- 1.49 microns, respectively) were not significantly different, despite a shift to large-diameter fibers in the latter. However, mean fiber diameters of distal and proximal portions of the RLN (5.56 +/- 1.88 microns and 3.63 +/- 1.49 microns, respectively) were significantly (P less than 0.001) different. Approximately 86% of fibers in the vagus nerve and 76% of fibers in the proximal portion of the RLN, had a diameter less than 5 microns, and about 70% of fibers in the distal portion of the RLN had a diameter greater than 5 microns.(ABSTRACT TRUNCATED AT 250 WORDS)