Direct measurement of intracranial pressure in adult horses

OBJECTIVE: To develop a method for surgical placement of a commercial microsensor intracranial pressure (ICP) transducer and to characterize normal ICP and cerebral perfusion pressures (CPP) in conscious adult horses. ANIMALS: 6 healthy castrated male adult horses (1 Holsteiner, 1 Quarter Horse, and 4 Thoroughbreds). PROCEDURE: Anesthesia was induced and maintained by use of isoflurane as the sole agent. Catheters were inserted percutaneously into the jugular vein and carotid artery. A microsensor ICP transducer was inserted in the subarachnoid space by means of right parietal craniotomy. The burr hole was then sealed with bone wax, the surgical incision was sutured, and the transducer was secured in place. Measurements were collected 1 hour after horses were able to stand during recovery from anesthesia. RESULTS: Mean +/- SD values for ICP and CPP were 2 +/- 4 and 102 +/- 26 mm Hg, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: This report describes a relatively facile technique for obtaining direct and accurate ICP measurements for adult horses. The ICP values obtained in this study are within reference ranges established for other species and provide a point of reference for the diagnosis of abnormal ICP in adult horses.     

Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse

Objective – To develop an indirect method for measurement of intraabdominal pressures in the standing horse using measurement of gastric pressures as a less invasive technique, and to compare this method with direct intraabdominal pressures obtained from the peritoneal cavity. Design – Prospective, experimental study. Setting – University‐based equine research facility. Animals – Ten healthy adult horses, 7 geldings and 3 mares. Interventions – Gastric pressures were measured using a nasogastric tube with a U‐tube manometry technique, while intraperitoneal pressures were measured with a peritoneal cannula. Measurements of intraabdominal pressure were obtained by both methods, simultaneously, and were evaluated using 5 increasing volumes of fluid infused into the stomach (0, 400, 1,000, 2,000, and 3,000 mL). Bias and agreement between the 2 methods were determined using Bland‐Altman analysis and Lin's concordance correlation coefficients. Measurements and Main Results – Mean gastric pressure was 14.44±4.69 cm H₂O and ranged from 0 to 25.8 cm H₂O. Intraperitoneal pressure measurements were generally subatmospheric, and ranged from ?6.6 to 3.1 cm H₂O (mean±SD, ?1.59±2.09 cm H₂O). Measurements of intraperitoneal pressures were repeatable; however, intra‐ and interindividual variance was significantly larger for measurements of gastric pressures. The mean and relative bias for comparison between the 2 techniques was 15.9±5.3 cm H₂O and 244.3±199.2%, respectively. The Lin's concordance correlation coefficient between gastric and intraperitoneal pressures was ?0.003 but this was not statistically significant (P=0.75). Conclusions – There was no statistical concordance between measurements of intraabdominal pressure using gastric and intraperitoneal pressure measurement, indicating that gastric pressures cannot be substituted for intraperitoneal pressure measurement. Direct measurement of intraperitoneal pressures may be a more consistent method for comparison of intraabdominal pressures between horses, due to less variability within and between individuals.     

Cardiovascular effects of insufflation of the abdomen with carbon dioxide in standing horses sedated with detomidine

OBJECTIVE: To determine the cardiovascular effects of 60 minutes of abdominal insufflation with CO2 to an intra-abdominal pressure of 15 mm Hg in standing horses receiving a constant rate infusion of detomidine. ANIMALS: 5 horses. PROCEDURE: Horses were randomly allocated into treatment or control groups. A washout period of a minimum of 7 days separated the 2 experimental periods of the crossover study. Catheters were placed into the right atrium, pulmonary artery, jugular vein, and right transverse facial artery after lidocaine infiltration. All horses were sedated with detomidine (8.54 microg/kg/h, i.v.). Horses in the treatment group received abdominal insufflation with CO2 via a laparoscopic cannula to a final and constant intra-abdominal pressure of 15 mm Hg for 60 minutes. Systemic arterial pressure, right atrial pressure, heart rate, cardiac output, core body temperature, and the pH and gas tensions of arterial and mixed venous blood were obtained. Cardiac index and systemic vascular resistance were calculated. Data were collected in 3 stages: preinsufflation (-10 and -5 minutes), insufflation (0, 15, 30, 45, and 60 minutes), and postinsufflation (70 and 80 minutes). The quality of sedation and level of analgesia were determined. RESULTS: The PaO2 of horses in the treatment group was significantly higher after 60 minutes of pneumoperitoneum than in the control group. Core body temperature decreased significantly from baseline in both groups. CONCLUSIONS AND CLINICAL RELEVANCE: A 60-minute period of abdominal insufflation to an intra-abdominal pressure of 15 mm Hg did not induce significant cardiovascular abnormalities in healthy horses.     

Effects of exercise on gastric volume and pH in the proximal portion of the stomach of horses

OBJECTIVE: To assess effects of exercise on a treadmill with changes in gastric volume and pH in the proximal portion of the stomach of horses. ANIMALS: 3 healthy adult horses. PROCEDURE: A polyester bag of approximately 1,600 mL was placed into the proximal portion of the stomach of each horse via a nasogastric tube. Changes in bag volume, determined by an electronic barostat, were recorded before, during, and after a training session on a treadmill with and without prior withholding of food. In separate experiments, pH in the proximal portion of the stomach was continuously recorded during exercise for fed and food-withheld conditions. Finally, changes in intra-abdominal and intragastric pressure were simultaneously recorded during a training session. RESULTS: Bag volume rapidly decreased to nearly zero during trotting and galloping. Conversely, a return to walking resulted in a sharp increase in volume and a return to pre-exercise values. Intragastric and intra-abdominal pressures increased almost in parallel with walking, trotting, galloping, and galloping on a slope. Gastric pH decreased rapidly to < 4 at the beginning of walking, continued to decrease during trotting and galloping, and remained low until a return to walking. CONCLUSIONS AND CLINICAL RELEVANCE: Increased intra-abdominal pressure during intense exercise in horses causes gastric compression, pushing acidic contents into the proximal, squamous-lined region of the stomach. Increased duration of acid exposure directly related to daily duration of exercise may be the reason that squamous lesions tend to develop or worsen when horses are in intensive training programs.     

Evaluation of a new oscillometric blood pressure monitor in isoflurane-anesthetized dogs

Objective This study was conducted to evaluate the performance of a new veterinary oscillometric noninvasive blood pressure (NIBP) monitor in anesthetized dogs. Study design Assessment was made to determine how closely indirect measurements were associated with direct measurements, and if there were statistically significant differences between the measurements by site. Animals Six mongrel dogs weighing 27.8 ± 2.9 kg. Methods Dogs were anesthetized with thiopental and maintained with isoflurane, which was delivered with controlled ventilation. Direct pressure measurements were obtained via a percutaneously placed arterial catheter. A range of systolic arterial pressures (SAP) were achieved by changing the isoflurane concentrations. Sites of cuff placement for indirect measurements were identified as metacarpus, metatarsus, and anterior tibial. Results At pressures below 80 mm Hg, indirect systolic measurements averaged 4 ± 3 mm Hg, higher than the direct values. At normal and high levels, indirect systolic measurements underestimated direct values by 18 ± 6 and 23 ± 6 mm Hg, respectively. Diastolic and mean pressure measurements followed the same trend, with indirect values being lower than the direct arterial pressures. Systolic, diastolic and mean arterial pressure measurements differed by cuff‐placement site. Conclusions When analyzed by site and level, indirect systolic and mean arterial blood pressures during hypotension were essentially the same as direct pressures. However, at pressures within the normal or high range, indirect measurements underestimated the direct pressures. Clinical relevance Noninvasive blood pressure measurements with a new oscillometric monitor provided an excellent means of detecting arterial hypotension in anesthetized dogs. The metatarsal site for cuff placement was slightly better than the metacarpal or anterior tibial site, considering that the regression line was closest to complete equality between the indirect and direct measurements for SAP.     

Comparison of direct and indirect methods of intra‐abdominal pressure measurement in normal horses

Objectives – To develop a direct method for measuring intra‐abdominal pressures in the standing horse, identify a reference interval for direct intra‐abdominal pressures, compare these pressures to indirect intra‐abdominal pressures measured from the bladder, and determine the optimal bladder infusion volume for indirect pressure measurement. Design – Prospective, experimental study. Setting – A university‐based equine research facility. Animals – Ten healthy adult horses, 5 males and 5 females. Interventions – Direct intra‐abdominal pressures were measured through an intraperitoneal cannula and zeroed at the height midway between the height of the tuber ishii and point of the shoulder. Indirect measurements of intra‐abdominal pressure were performed by measuring intravesicular pressures through a transurethral catheter zeroed at the tuber ishii. Measurements and Main Results – Direct pressure measurements obtained in the standing horse were subatmospheric (mean, ?1.80 cm H₂O; SD, 1.61 cm H₂O; 95% CI, ?2.80 to ?0.80) and were shown to decrease as the horse's weight increased (Pearson's r=?0.67, P=0.04), with no effect of head position (P=0.15). Mean baseline indirect pressure measurements (mean, ?8.63 cm H₂O; SD, 4.37 cm H₂O; 95% CI, ?13.05 to ?4.21) were significantly different from the pressures measured directly from the abdomen (P<0.001). Indirect pressure measurements were noted to increase with increasing volumes infused into the bladder, and were statistically different at a volume of 100 mL (P=0.004). There was low to moderate correlation between direct and indirect pressure measurements of intra‐abdominal pressure over a range of fluid volumes infused into the bladder (Pearson's correlation range ?0.38 to 0.58). Conclusion – Pressures measured directly in the standing horse were subatmospheric, and increased as the horse's weight increased. Indirect pressures measured were altered by increasing volumes infused in the bladder. There was no significant correlation between the 2 methods of intra‐abdominal pressure measurement.     

Evalution of an Epidural Intracranial Pressure Monitoring System in Cats

The accuracy of an inexpensive, easily implantable, epidural intracranial pressure (ICP) monitoring system was assessed in six normal cats by comparing measurements from this system to those obtained with a fiberoptic intraparenchymal monitoring system. The epidural monitoring system consisted of a three-way stopcock and saline-filled extension tubing, connected to a standard blood pressure transducer. Each cat was placed under halothane anesthesia and mechanically ventilated. Both an epidural and a fiberoptic intraparenchymal monitoring device were placed in the left cranium of each cat; correct placement was verified by computed tomography. Mean ICP values were simultaneously recorded from both monitoring devices. After obtaining baseline ICP measurements, the ICP was manipulated via ventilation, jugular compression, and pharmacologic agents. Arterial blood pressure levels, arterial blood gas values, end-tidal carbon dioxide levels, and end-tidal halothane levels were recorded throughout the study. Cerebral perfusion pressure was calculated for each level of ICP. Repeated measures analysis of variance method was used to compare mean ICP values between the two monitoring systems. No significant differences in ICP values obtained from the two systems were found (p>0.05) at any level of ICP. The results of this study show that the epidural monitoring system is a reliable alternative to the fiberoptic intraparenchymal ICP monitoring system in normal cats. The accuracy of the epidural monitoring system in pathologic states needs to be investigated.     

Alternative Intrabladder Manometry Technique for the Indirect Measurement of Intra-abdominal Pressure in Horses

Although indirect methods for estimating intra-abdominal pressure (IAP) have been extensively studied in humans, mainly for identification of IAP increments in critical care unit patients (life-threatening condition), little work has been performed in veterinary medicine, especially in horses. The standard method of acquisition of intrabladder pressure (IBP) in human subjects (fluid-filled system with no balloon distention) has been previously evaluated in horses with an unfavorable outcome. Therefore, we reexamined the previously performed method of IBP investigation in horses by using an air-filled intrabladder manometry system in female horses. Intrabladder pressure was estimated by air-filled balloon manometry in seven healthy adult mares. The results were compared with two sets of directly acquired IAP values obtained by right paralumbar puncture using an 8-G needle in seven horses. Direct IAP values were obtained at times unrelated to IBP measurement acquisitions, and three of the seven horses used (for direct IAP measurement) were different animals from the mares used for assessment of IBP. Both sets of IAP measurements yielded subatmospheric values (IAP₁ = −10.5 ± 2.2 mm Hg; IAP₂ = −11.6 ± 2.0 mm Hg). Slightly subatmospheric IBP values were also recorded in some mares, but the mean (±SD) IBP was 1.4 ± 2.0 mm Hg. There was no correlation between IBP and IAP. These results suggest that this indirect (IBP) method for estimating IAP is not applicable for female horses.     

Cardiopulmonary function in horses during anesthetic recovery in a hydropool.

OBJECTIVE: To determine the cardiovascular and respiratory effects of water immersion in horses recovering from general anesthesia. ANIMALS: 6 healthy adult horses. PROCEDURE: Horses were anesthetized 3 times with halothane and recovered from anesthesia while positioned in lateral or sternal recumbency in a padded recovery stall or while immersed in a hydropool. Cardiovascular and pulmonary functions were monitored before and during anesthesia and during recovery until horses were standing. Measurements and calculated variables included carotid and pulmonary arterial blood pressures (ABP and PAP respectively), cardiac output, heart and respiratory rates, arterial and mixed venous blood gases, minute ventilation, end expiratory transpulmonary pressure (P(endXes)), maximal change in transpulmonary pressure (deltaP(tp)max), total pulmonary resistance (RL), dynamic compliance (Cdyn), and work of breathing (W). RESULTS: Immersion in water during recovery from general anesthesia resulted in values of ABP, PAP P(endXes), deltaP(tp)max, R(L), and W that were significantly greater and values of Cdyn that were significantly less, compared with values obtained during recovery in a padded stall. Mode of recovery had no significant effect on any other measured or calculated variable. CONCLUSIONS AND CLINICAL RELEVANCE: Differences in pulmonary and cardiovascular function between horses during recovery from anesthesia while immersed in water and in a padded recovery stall were attributed to the increased effort needed to overcome the extrathoracic hydrostatic effects of immersion. The combined effect of increased extrathoracic pressure and PAP may contribute to an increased incidence of pulmonary edema in horses during anesthetic recovery in a hydropool.     

Evaluation of an Oscillometric Blood Pressure Monitor on Anesthetized Cats and the Effect of Cuff Placement and Fur on Accuracy

Objectives — (1) To determine the usefulness of one specific oscillometric monitor for making indirect measurements of arterial pressure in cats. (2) To determine the difference between two specific cuff placement sites. (3) To determine if clipping the hair beneath the cuff has an affect on the accuracy of oscillometric blood pressure determination.
Study Design — Prospective study comparing the accuracy of the Datascope Passport (Data-scope Corp, Paramus, NJ) with concurrent invasive measurements.
Animals — Six anesthetized domestic felines weighing 4.5 to 5 kg.
Methods — The direct arterial pressure was measured using a cannula placed in the right common carotid artery. Oscillometric cuffs of appropriate size were placed on both thoracic limbs distal to the elbow and both pelvic limbs distal to the stifle. The hair in the areas of cuff placement on the right limbs was clipped circumferentially. Measurements of systolic, diastolic, and mean arterial pressure (MAP) were taken for each site during normotension, hypotension, and hypertension. Comparisons between indirect and direct measurements were made using a parametric analysis of method comparison.
Results — No significant differences were noted when die clipped limbs were compared with the corresponding limbs which were left undipped ( P >.378) or when the thoracic limb measurements were compared widi those of the pelvic limb ( P >.088). There were significant differences ( P <.002) between the two pressure measurement methods for the systolic, diastolic, and mean arterial pressures over all three pressure ranges.
Conclusions — The Datascope Passport did not accurately estimate the invasively measured arterial pressure.
Clinical Relevance — Use of noninvasive blood pressure monitoring equipment is increasing in use in veterinary medicine, and the accuracy of one specific monitor is reported.     

Cardiovascular effects recorded in horses during anaesthesia after treatment with trichlorfon

Five horses were anaesthetised twice with thiopentone sodium, guaifenesin and halothane. The second anaesthesia was 16 days after the first and two days following oral administration of trichlorfon. Heart rate, carotid arterial, pulmonary arterial and right atrial pressures, cardiac output and blood temperature were measured every 15 minutes for 120 minutes. Heart rate, carotid arterial pressure and cardiac output were similar on both occasions. Pulmonary arterial and right atrial pressures were highest during anaesthesia after treatment with trichlorfon when compared with values obtained before treatment. Pulmonary vascular resistance was significantly decreased at four measurement times during anaesthesia after treatment with trichlorfon. All cardiovascular measurements were within ranges accepted as normal for halothane anaesthesia in horses. In a second experiment, four ponies were anaesthetised with xylazine and ketamine on two occasions one week apart. Two ponies received trichlorfon two days before the second anaesthesia. Heart rate, arterial pressure and respiratory rate recorded during anaesthesia were not different in ponies after organophosphate treatment. The time to standing after the second anaesthesia was significantly increased in all ponies.     

Automatic noninvasive sphygmomanometry in horses

Systolic, diastolic, and mean arterial blood pressures and heart rate were determined in 73 horses, using an indirect automatic oscillometric technique. Blood pressure and heart rate data obtained by sphygmomanometry were compared with similar data obtained from cannulation of the horses' facial or dorsal metatarsal arteries. Good correlation between direct (actual) and indirect (oscillometric) blood pressures and heart rate measurements were obtained when the heart rate was low, using high sensitivity setting. Cardiac arrhythmias or hypotension prevented oscillometric measurements from being obtained in 9 (12%) horses.     

Intra-abdominal hypertension in two adult horses

Objective – To describe the clinical and pathological findings in 2 adult horses with documented increases in intra-abdominal pressure (IAP), and to describe the direct puncture technique used to measure this pressure.
Series Summary – Two adult horses developed increases in IAP secondary to large-volume abdominal effusion. A 9-year-old Quarter Horse cross gelding was presented for evaluation of urinary and neurologic signs. Abdominal ultrasonographic examination showed a hepatic abscess along with abdominal effusion. A 4-year-old Quarter Horse gelding was presented for evaluation of castration complications. A castration site infection extended into surrounding tissues, resulting in peritonitis, abdominal effusion, and severe cellulitis of the limbs. IAP measured in both horses was increased relative to reported equine reference values. Changes in hemodynamic parameters in both horses, notably increased central venous pressure, were consistent with those seen in other species in which intra-abdominal hypertension (IAH) and its sequellae have been documented.
New or Unique Information Provided – Extensive research and clinical literature guides management of humans with IAH and abdominal compartment syndrome. Knowledge of these conditions in companion animal and large domestic species is less well developed. Recent research has established reference values for standing, sedated and recumbent, anesthetized horses. Detailed reports of equine clinical cases of IAH have not been reported in the literature. This report provides information on the clinical, hemodynamic, and pathologic characteristics of 2 horses with measured increases in IAP, and describes the direct puncture technique used to perform these measurements.     

Effect of intratesticular injection of lidocaine on cardiovascular responses to castration in isoflurane-anesthetized stallions

OBJECTIVE: To evaluate the effect of intratesticular administration of lidocaine on cardiovascular responses and cremaster muscle tension during castration of isoflurane-anesthetized stallions. ANIMALS: 28 healthy stallions (mean +/- SD age, 4.2 +/- 2.8 years) with no testicular abnormalities that were scheduled for castration. PROCEDURE: Each horse was given acepromazine (20 microg/kg, IM), romifidine (50 microg/kg, IV), and butorphanol (20 microg/kg, IV). Anesthesia was induced with ketamine (2.5 mg/kg, IV) and midazolam (50 microg/kg, IV) and maintained with isoflurane (1.7% end-tidal concentration). After 10 minutes at a stable anesthetic plane, a needle was placed in each testicle and either no fluid or 15 mL of 2% lidocaine was injected; 10 minutes after needle placement, surgery was commenced. Pulse rate and arterial blood pressures were measured invasively at intervals from 5 minutes prior to castration (baseline) until 5 minutes after the left spermatic cord was clamped. The surgeon subjectively scored the degree of cremaster muscle tension. In 2 horses, lidocaine labeled with radioactive carbon (C(14)) was used and testicular autoradiograms were obtained. RESULTS: Compared with baseline values, castration significantly increased blood pressure measurements; intratesticular injection of lidocaine decreased this blood pressure response and cremaster muscle tension. In 2 horses, autoradiography revealed diffuse distribution of lidocaine into the spermatic cord but poor distribution into the cremaster muscle. CONCLUSIONS AND CLINICAL RELEVANCE: In isoflurane-anesthetized stallions, intratesticular injection of lidocaine prior to castration appeared to decrease intraoperative blood pressure responses and cremaster muscle tension and may be a beneficial supplement to isoflurane anesthesia.     

Effect of weight loading on the coronary band interstitial fluid pressure in horses

Interstitial fluid pressures, as a possible function of limb load, were measured at 2 sites within the digital coronary dermis of both cranial digits in 10 standing horses. Fluid pressure changes and digital load measurements were simultaneously detected and recorded by use of, respectively, modified wick-in-needle and force plate transducers coupled to a microcomputer. Mean pressures, recorded at limb loads between 50 and 80 kg, were 2.29 +/- 3.17 mm of Hg at the toe and 2.49 +/- 5.91 mm of Hg at the heel. Mean pressures, recorded between 150 and 180 kg, were 5.01 +/- 5.23 mm of Hg at the toe and 1.28 +/- 7.69 mm of Hg at the heel. These data indicate that, in the static limb, no statistically significant change in interstitial fluid pressure occurs at loads up to 180 kg.     

Evaluation of a rebound tonometer for measuring intraocular pressure in dogs and horses

OBJECTIVE: To compare intraocular pressure (IOP) measurements obtained with a rebound tonometer in dogs and horses with values obtained by means of applanation tonometry and direct manometry. DESIGN: Prospective study. ANIMALS: 100 dogs and 35 horses with clinically normal eyes, 10 enucleated eyes from 5 dogs, and 6 enucleated eyes from 3 horses. PROCEDURES: In the enucleated eyes, IOP measured by means of direct manometry was sequentially increased from 5 to 80 mm Hg, and IOP was measured with the rebound tonometer. In the dogs and horses, results of rebound tonometry were compared with results of applanation tonometry. RESULTS: For the enucleated dog and horse eyes, there was a strong (r2 = 0.99) linear relationship between pressures obtained by means of direct manometry and those obtained by means of rebound tonometry. Mean +/- SD IOPs obtained with the rebound tonometer were 10.8 +/- 3.1 mm Hg (range, 5 to 17 mm Hg) and 22.1 +/- 5.9 mm Hg (range, 10 to 34 mm Hg) for the dogs and horses, respectively. Mean IOPs obtained with the applanation tonometer were 12.9 +/- 2.7 mm Hg (range, 8 to 18 mm Hg) and 21.0 +/- 5.9 mm Hg (range, 9 to 33 mm Hg), respectively. Values obtained with the rebound tonometer were, on average, 2 mm Hg lower in the dogs and 1 mm Hg higher in the horses, compared with values obtained with the applanation tonometer. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the rebound tonometer provides accurate estimates of IOP in clinically normal eyes in dogs and horses.     

Placement of a long term tracheal cannula in a Thoroughbred racehorse with bilateral laryngeal dysfunction

A Thoroughbred horse with bilateral laryngeal dysfunction was treated by placement of a long term tracheal cannula in order to restore full athletic function. The horse initially presented with right-sided arytenoid dysfunction that was considered to be due to a congenital malformation of the laryngeal cartilage. This was corrected by a right-sided laryngoplasty and ventriculectomy. The horse re-presented 1 year later with idiopathic left laryngeal hemiplegia. The decision was made to place a long-term tracheal cannula due to the low success rate and high complication rate associated with other surgeries used to correct bilateral arytenoid dysfunction. A three-piece tracheotomy cannula and stopper were positioned under general anaesthesia. The horse rapidly adjusted to the tracheal cannula and no post-surgical complications were encountered. The horse resumed training 4 weeks postoperatively. Due to the rules governing racing in Australia the horse was exported to New Zealand where he continued his racing career. It was concluded that tracheotomy is a straightforward technique associated with minimal complications and can provide an excellent prognosis for return of full airway function in racing horses. It is recognised that many issues need to be considered prior to more general acceptance of this technique, including assessment of animal welfare issues and public perception. In appropriate cases consideration should be given to using long term placement of a tracheotomy cannula as a treatment option to restore maximal airflow in horses with upper airway obstruction.     

Direct blood pressure monitoring

Veterinary care has continued to advance by implementing more of the equipment and techniques that are commonly used in human medicine. This includes the placement of arterial catheters and pulmonary artery catheters and continuous monitoring of arterial pressure, central venous pressure, and pulmonary artery pressure. This article describes the technique for placement of appropriate catheters, the equipment that is needed, and the waveforms that are obtained when measuring direct arterial pressures, central venous pressures, and pulmonary arterial pressures.     

Effect of protective padding on forelimb intracompartmental muscle pressures in anesthetized horses

Wick catheters were used to measure intracompartmental muscle pressures (ICMP) within the long heads of the triceps brachii and extensor carpi radialis muscles of 8 horses maintained under halothane anesthesia while their breathing was controlled by intermittent positive-pressure ventilation. Blood gas, cardiac output, and blood pressure determinations were monitored to maintain a stable plane of anesthesia. The horses were positioned in left lateral recumbency and were placed sequentially on each of 4 contact surfaces for 1 hour. The 4 surfaces used for each horse were concrete, foam rubber, air dunnage bag, and a water mattress. Hematologic and biochemical determinations were made before and 24 hours after anesthesia. All horses recovered from the anesthesia. One horse had forelimb lameness for 36 hours after anesthesia, which was clinically diagnosed as a myoneuropathy. The ICMP values were markedly elevated in the muscle bellies of the lower limb of all horses. Supporting the horse on a water mattress caused the least dramatic pressure elevation and foam caused the most. The triceps muscle and, to a lesser extent, the extensor carpi radialis muscle of the lower limb are at risk of ischemia in anesthetized horses because the ICMP may exceed the critical closing pressure of 30 mm of Hg required for capillary blood flow.     

Laminar microvascular flow, measured by means of laser Doppler flowmetry, during the prodromal stages of black walnut-induced laminitis in horses

OBJECTIVE: To measure changes in laminar microvascular blood flow (LMBF) over time in healthy horses and horses in the prodromal stage of black walnut-induced laminitis and to determine the effects of glyceryl trinitrate application on LMBF in horses with acute laminitis. ANIMALS: 10 healthy adult horses. PROCEDURE: Laser Doppler flowmetry was used to measure LMBF Baseline measurements were obtained, horses were given deionized water via a nasogastric tube, and measurements were obtained hourly for 12 hours. Twenty-four hours later, baseline measurements were again obtained, and horses were given black walnut extract. Measurements were obtained hourly for 12 hours or until development of Obel grade-3 laminitis. At this time, 5 horses were treated with phenylbutazone, and the other 5 were treated with phenylbutazone and glyceryl trinitrate, and measurements were obtained hourly for an additional 12 hours. RESULTS: LMBF was significantly decreased 1 and 2 hours after administration of the black walnut extract but then returned to near-baseline values for the next 6 hours. Eight hours after extract administration, there was a second significant decrease in LMBF that persisted until the end of the study. Glyceryl trinitrate had no effect on LMBF. Clinical signs of laminitis developed 8 to 12 hours after extract administration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in horses with black walnut-induced laminitis, there is an early decrease in LMBF followed by reperfusion prior to onset of clinical signs. Treatment with glyceryl trinitrate after development of clinical signs of laminitis did not have a significant effect on LMBF.