The hemodynamic effects of intrathecal oxytocin in normal dogs

OBJECTIVE: To evaluate the hemodynamic effects produced by intrathecal administration of oxytocin in healthy isoflurane-anesthetized dogs. STUDY DESIGN: Prospective single-dose trial. ANIMAL POPULATION: Six healthy purpose-bred adult dogs weighing between 7.3 and 14.5 kg. METHODS: Dogs were anesthetized with isoflurane and instrumented. Oxytocin at a dosage of 1.6 microg/kg was administered intrathecally at the cisternal space at time 0. Hemodynamic data were recorded immediately before and at 1, 5, 15, 30, and 60 minutes after oxytocin administration. Statistical analysis included an analysis of variance (ANOVA) for repeated measures over time. A P < .05 was considered significant. RESULTS: Baseline values +/- standard error of the mean for heart rate, mean arterial pressure, central venous pressure, cardiac output, systemic vascular resistance, mean pulmonary arterial pressure, pulmonary arterial occlusion pressure, and pulmonary vascular resistance were 101 +/- 11 beats/minute, 76 +/- 7 mm Hg, 4 +/- 4 mm Hg, 1.9 +/- 0.7 L/min, 3834 +/- 2556 dynes x sec/cm5, 14 +/- 3 mm Hg, 4 +/- 2 mm Hg, and 430 +/- 201 dynes x sec/cm5, respectively. Variations from the baseline values were seen in all parameters after intrathecal oxytocin administration, but no statistically significant differences were found. CONCLUSION: The intrathecal injection of 1.6 microg/kg of oxytocin is associated with minimal hemodynamic effects during isoflurane anesthesia. CLINICAL RELEVANCE: This study revealed no clinically significant deleterious effects from the intrathecal administration of oxytocin, and investigations into its use as a perioperative analgesic are therefore warranted.     

Relationships between velocities of pulmonary venous flow and plasma concentrations of atrial natriuretic peptide in healthy dogs

OBJECTIVE: To investigate the relationship between velocities of pulmonary venous flow (PVF) and plasma concentrations of atrial natriuretic peptide (ANP) in healthy dogs. ANIMALS: 7 healthy Beagles. PROCEDURES: Dogs were anesthetized, intubated, and positioned in left lateral recumbency. Lactated Ringer's solution was infused (200 mL/kg/h) for 60 minutes via a cephalic vein. Transmitral flow and PVF velocities were measured echocardiographically by use of the apical 4-chamber view. Pulmonary capillary wedge pressure (PCWP) and ANP concentrations were determined. RESULTS: IV infusion significantly increased heart rate and PCWP. Similarly, the ANP concentration significantly increased from baseline (before infusion of lactated Ringer's solution) values. Transmitral flow velocities were significantly increased, although the ratio of velocity of the flow during early ventricular diastole (E wave) to velocity of the atrial flow (A wave; E:A ratio) was unchanged. Regarding the PVF velocities, forward flow during ventricular systole (S wave) and retrograde flow during atrial contraction were significantly increased, whereas velocity of the forward flow during ventricular diastole (D wave) was unchanged. Ratio of the velocity of the S wave to velocity of the D wave was increased significantly, and this ratio was significantly correlated with PCWP or ANP concentration. However, the E:A ratio was not correlated with PCWP or ANP concentration. CONCLUSIONS AND CLINICAL RELEVANCE: PVF velocities were strongly correlated with PCWP and plasma ANP concentration in clinically normal dogs. Therefore, PVF velocities may serve as a sensitive indicator and provide additional information for monitoring acute preloading conditions and estimating atrial filling abnormalities in dogs.     

Assessment of acid-base status and plasma lactate concentrations in arterial,mixed venous,and portal blood from dogs during experimental hepatic blood inflow occlusion

OBJECTIVE: To determine the effects of extended experimental hepatic blood flow occlusion (ie, portal triad clamping [PTC]) in dogs by measuring acid-base status and plasma lactate concentrations in arterial, mixed venous, and portal blood and evaluating the relationship between metabolic and concurrent hemodynamic changes. ANIMALS: 6 healthy Beagles. PROCEDURE: During anesthesia with isoflurane, cardiac output and arterial blood pressure were measured. Arterial, mixed venous, and portal blood samples were collected simultaneously for blood gas analyses and plasma lactate measurements before PTC and at 8-minute intervals thereafter. RESULTS: PTC resulted in severe hemodynamic and metabolic alterations. Eight minutes after PTC, significant decreases in cardiac index from a baseline value of 3.40 +/- 0.27 to 1.54 +/- 0.26 L/min/m2 and in mean arterial blood pressure from a baseline value of 74 +/- 6 to 43 +/- 6 mm Hg were recorded. After PTC, results indicative of lactic acidosis were found in portal blood at 16 minutes, in mixed venous at 32 minutes, and in arterial blood at 48 minutes. Significant differences in measured variables were also found between arterial and portal blood samples, between mixed venous and portal blood samples, and between arterial and mixed venous blood samples after PTC, compared with differences at baseline. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of mixed venous blood is preferable to analysis of arterial blood in the assessment of metabolic derangement. In a clinical setting, occluded portal blood is released to the systemic circulation, and the degree of reperfusion injury may depend on the metabolic status of pooled portal blood.     

Cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia

OBJECTIVE: To measure cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia. DESIGN: Prospective case series. ANIMALS: 8 dogs with splenic or hepatic tumors. PROCEDURES: Dogs were anesthetized and underwent abdominal laparotomy. End-tidal isoflurane concentration, heart rate, arterial blood pressures, cardiac output, arterial pH, blood gas partial pressures, PCV, and plasma total protein concentration were measured at set intervals before, during, and after surgery. Cardiac index, stroke index, and systemic vascular resistance index were calculated. RESULTS: End-tidal isoflurane concentration was lowest before and after surgery. Heart rate did not change significantly throughout the anesthetic period. Arterial blood pressures and systemic vascular resistance index were highest shortly after surgery began; cardiac index and stroke volume index did not change significantly during surgery but increased significantly after surgery ended. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that in dogs undergoing laparotomy because of abdominal neoplasia, changes in arterial blood pressures were not necessarily indicative of qualitatively similar changes in cardiac index.     

NONINVASIVE ESTIMATION OF CENTRAL VENOUS PRESSURE IN ANESTHETIZED DOGS BY MEASUREMENT OF HEPATIC VENOUS BLOOD FLOW VELOCITY AND ABDOMINAL VENOUS DIAMETER

Determination of central venous pressure (CVP) is relevant to patients with right heart disease, hypovolemia, and following intravenous fluid therapy. We hypothesized that changes in CVP in dogs could be predicted by measurements of hepatic vein diameter, caudal vena cava (CVC) diameter, and hepatic venous flow velocities. Nine healthy American Foxhounds were anesthetized. Following baseline recordings, intravenous fluids were administered to increase CVP. Volume administration created treatment periods with CVP ranges of 5, 10, 15, 20, and 25 mm Hg. Flow velocities in the right medial hepatic vein were recorded using pulsed wave Doppler ultrasound. Hepatic vein, CVC, and aorta diameters were determined with B‐mode ultrasound. Variables were compared across the treatment periods by ANOVA for repeated measures. Relationships between CVP, Doppler, and B‐mode variables were evaluated using Spearman's rank correlations, multiple linear regression, and repeated measures linear regression. The a‐, S‐ and v‐wave velocities were augmented significantly with volume loading. The best part (semipartial) correlation coefficients predicting increasing CVP were identified with v‐wave velocity (0.823), S‐wave velocity (?0.800), CVC diameter (0.855), and hepatic vein diameter (0.815). Multiple linear regression indicated that CVP in this study could be predicted best by a combination of CVC and hepatic vein diameter and the v‐wave velocity (r=0.928). Ultrasound imaging identified gallbladder and pancreatic edema consistently, likely related to acute volume loading. These findings may be applicable in the assessment of volume status, dogs with right heart disease, and during serial monitoring of dogs receiving fluid or diuretic therapy.     

Estimation of left ventricular filling pressure by use of Doppler echocardiography in healthy anesthetized dogs subjected to acute volume loading

OBJECTIVE: To identify Doppler echocardiographic (DE) variables that correlate with left ventricular filling pressure (LVFP). ANIMALS: 7 healthy dogs (1 to 3 years old). PROCEDURES: Dogs were anesthetized and instrumented to measure left atrial pressure (LAP), left ventricular pressures, and cardiac output. Nine DE variables of LVFP derived from diastolic time intervals, transmitral and pulmonary venous flow, and tissue Doppler images were measured over a range of hemodynamic states induced by volume loading and right atrial pacing. Associations between simultaneous invasive measures of LVFP and DE measures of LVFP were determined by use of regression analysis. Receiver operating characteristic analysis was used to predict increases in mean LAP on the basis of DE variables. RESULTS: Mean LAP was correlated with several DE variables: the ratio between peak velocity during early diastolic transmitral flow and left ventricular isovolumic relaxation time (peak E:IVRT) during sinus rhythm and during right atrial pacing, IVRT, the ratio between late diastolic transmitral flow velocity and pulmonary venous flow duration, and the interval between onset of early diastolic mitral annulus motion and onset of early diastolic transmitral flow. Cutoff values of 2.20 and 2.17, for peak E:IVRT in dogs with sinus rhythm and atrial pacing predicted increases in mean LAP (> or = 15 mm Hg) with sensitivities of 90% and 100% and specificities of 92% and 100%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Doppler echocardiography can be used to predict an increase in LVFP in healthy anesthetized dogs subjected to volume loading.     

Aortic ejection velocity in healthy Boxers with soft cardiac murmurs and Boxers without cardiac murmurs: 201 cases (1997-2001)

OBJECTIVE: To determine aortic ejection velocity in healthy adult Boxers with soft ejection murmurs without overt structural evidence of left ventricular outflow tract obstruction and in healthy Boxers without cardiac murmurs. DESIGN: Retrospective study. ANIMALS: 201 Boxers. PROCEDURE: Dogs were examined independently by 2 individuals for evidence of a cardiac murmur, and a murmur grade was assigned. Maximal instantaneous (peak) aortic ejection velocity was measured by means of continuous-wave Doppler echocardiography from a subcostal location. Forty-eight dogs were reexamined approximately 1 year later. RESULTS: A soft (grade 1, 2, or 3) left-basilar ejection murmur was detected in 113 (56%) dogs. Overall median aortic ejection velocity was 1.91 m/s (range, 1.31 to 4.02 m/s). Dogs with murmurs had significantly higher aortic ejection velocities than did those without murmurs (median, 2.11 and 1.72 m/s, respectively). Auscultation of a murmur was 87% sensitive and 66% specific for the identification of aortic ejection velocity > 2.0 m/s. An ejection murmur and aortic ejection velocity > 2.0 m/s were identified in 73 (36%) dogs. For most dogs, observed changes in murmur grade and aortic ejection velocity during a follow-up examination 1 year later were not clinically important. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that ejection murmurs were common among healthy adult Boxers and that Boxers with murmurs were likely to have high (> 2.0 m/s) aortic ejection velocities. The cause of the murmurs in these dogs is unknown.     

Effect of positive end-expiratory pressure on oxygen delivery during 1-lung ventilation for thoracoscopy in normal dogs

OBJECTIVE: To evaluate the effect of positive end-expiratory pressure (PEEP) on oxygen delivery (DO(2)) with 1-lung ventilation during thoracoscopy in normal anesthetized dogs. STUDY DESIGN: Prospective, controlled experimental study. ANIMALS: Eight, adult, intact Walker Hound dogs weighing 25.6-29.2 kg. METHODS: Anesthetized dogs had 1-lung ventilation during an open-chest condition. A Swan-Ganz catheter was used to measure pulmonary hemodynamic variables and to obtain mixed venous blood samples for blood gas analysis. A dorsal pedal catheter was used for measurement of systemic arterial pressure and to obtain arterial blood samples for blood gas analysis. Oxygen delivery was calculated and used to assess the effect of 0, 2.5, and 5 cm H(2)O PEEP during 1-lung ventilation on cardiopulmonary function. Each dog was its own control at 0 cm H(2)O PEEP. A randomized block ANOVA for repeated measures was used to evaluate the effect of the treatment on hemodynamic and pulmonary variables. RESULTS: Use of 5 cm H(2)O PEEP induced a significant augmentation in the arterial partial pressure of oxygen (PaO(2)). Shunt fraction (Q(s)/Q(t)), physiologic dead space (V(D)/V(T)), and the alveolar-arterial oxygen difference (P(A-a)O(2)) decreased significantly after 5 cm H(2)O PEEP, compared with 1-lung ventilation without PEEP. Use of 2.5 cm H(2)O PEEP had no significant effect on cardiopulmonary variables. Use of PEEP had no significant effect on arterial oxygen saturation (SaO(2)), DO(2), and hemodynamic variables in normal dogs. CONCLUSIONS: PEEP had no effect on DO(2) in normal dogs undergoing open-chest 1-lung ventilation because it had no adverse effect on hemodynamic variables. CLINICAL RELEVANCE: PEEP in normal dogs during open-chest 1-lung ventilation for thoracoscopy is not detrimental to cardiac output and can be recommended in clinical patients.     

Hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats

OBJECTIVE: To determine the hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats. ANIMALS: 12 healthy adult domestic shorthair cats. PROCEDURE: Cats were anesthetized by administration of isoflurane in oxygen. After instruments were inserted, end-tidal isoflurane concentration was set at 1.25 times the individual minimum alveolar concentration, and nitrous oxide was administered in a Latin-square design at 0, 30, 50, and 70%. Each concentration was administered for 25 minutes before measurements were obtained to allow for stabilization. Heart rate; systemic and pulmonary arterial pressures; central venous pressure; pulmonary artery occlusion pressure; cardiac output; body temperature; arterial and mixed-venous pH, PCO2, PO2, and hemoglobin concentrations; PCV; and total protein and lactate concentrations were measured before and during noxious stimulation for each nitrous oxide concentration. Arterial and mixed-venous bicarbonate concentrations and oxygen saturation, cardiac index, stroke index, rate-pressure product, systemic and pulmonary vascular resistance indices, left and right ventricular stroke work indices, arterial and mixed-venous oxygen contents, oxygen delivery, oxygen consumption, oxygen extraction ratio, alveolar-to-arterial oxygen difference, and venous admixture were calculated. RESULTS: Arterial pressure, central venous pressure, pulmonary arterial pressure, rate-pressure product, systemic and pulmonary vascular resistance indices, arterial PCO2, and PCV increased during administration of 70% nitrous oxide. Arterial and mixed-venous pH, mixed-venous PO2, and alveolar-to-arterial oxygen difference decreased during administration of 70% nitrous oxide. Results before and during noxious stimulation were similar. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of 70% nitrous oxide to isoflurane-anesthetized cats resulted in improved arterial pressure, which was related to a vasoconstrictive effect.     

Closed System Delivery of Halothane and Isoflurane with a Vaporizer in the Anesthetic Circle

Forty-four healthy dogs undergoing elective ovariohysterectomy were anesthetized with halothane or isoflurane delivered with an in-circuit vaporizer with closed system flow rates or an out-of-circuit vaporizer with semi-closed system flow rates. When dogs were anesthetized with halothane, there were no differences in heart rate, blood pressure, body temperature, respiratory rate, or lingual venous pH, PCO2, or PO2 during induction and maintenance. Lingual venous PO2 was significantly less but still within a clinically acceptable range when isoflurane was used in an in-circuit vaporizer. Recovery times tended to be longer with in-circuit vaporizers. The amount of anesthetic used was not affected by vaporizer location. In-circuit vaporizers were suitable for delivery of halothane or isoflurane to healthy dogs.     

Assessment of repeatability, reproducibility, and effect of anesthesia on determination of radial and longitudinal left ventricular velocities via tissue Doppler imaging in dogs

OBJECTIVE: To determine left ventricular free wall (LVFW) motions and assess their intra- and interday variability via tissue Doppler imaging (TDI) in healthy awake and anesthetized dogs. ANIMALS: 6 healthy adult Beagles. PROCEDURE: n the first part of the study, 72 TDI examinations (36 radial and 36 longitudinal) were performed by the same observer on 4 days during a 2-week period in all dogs. In the second part, 3 dogs were anesthetized with isoflurane and vecuronium. Two measurements of each TDI parameter were made on 2 consecutive cardiac cycles when ventilation was transiently stopped. The TDI parameters included maximal systolic, early, and late diastolic LVFW velocities. RESULTS: The LVFW velocities were significantly higher in the endocardial than in the epicardial layers and also significantly higher in the basal than in the mid-segments in systole, late diastole, and early diastole. The intraday coefficients of variation (CVs) for systole were 16.4% and 22%, and the interday CV values were 11.2% and 16.4% in the endocardial and epicardial layers, respectively. Isoflurane anesthesia significantly improved the intraday CV but induced a decrease in LVFW velocities, except late diastolic in endocardial layers and early diastolic in epicardial layers. CONCLUSIONS AND CLINICAL RELEVANCE: Left ventricular motion can be adequately quantified in dogs and can provide new noninvasive indices of myocardial function. General anesthesia improved repeatability of the procedure but cannot be recommended because it induces a decrease in myocardial velocities.     

Comparison of hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of anesthesia with isoflurane and halothane in horses undergoing arthroscopic surgery

OBJECTIVE: To compare hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of halothane and isoflurane in horses undergoing arthroscopic surgery. ANIMALS: 8 healthy adult horses. PROCEDURE: Anesthesia was maintained with isoflurane or halothane (crossover study). At 6 intervals during anesthesia and surgery, cardiopulmonary variables and related derived values were recorded. Recovery from anesthesia was assessed; gastrointestinal tract motility was subjectively monitored for 72 hours after anesthesia. Horses were administered chromium, and fecal chromium concentration was used to assess intestinal transit time. Venous blood samples were collected for clinicopathologic analyses before and 2, 24, and 48 hours after anesthesia. RESULTS: Compared with halothane-anesthetized horses, cardiac index, oxygen delivery, and heart rate were higher and systemic vascular resistance was lower in isoflurane-anesthetized horses. Mean arterial blood pressure and the dobutamine dose required to maintain blood pressure were similar for both treatments. Duration and quality of recovery from anesthesia did not differ between treatments, although the recovery periods were somewhat shorter with isoflurane. After isoflurane anesthesia, gastrointestinal motility normalized earlier and intestinal transit time of chromium was shorter than that detected after halothane anesthesia. Compared with isoflurane, halothane was associated with increases in serum aspartate transaminase and glutamate dehydrogenase activities, but there were no other important differences in clinicopathologic variables between treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with halothane, isoflurane appears to be associated with better hemodynamic stability during anesthesia, less hepatic and muscle damage, and more rapid return of normal intestinal motility after anesthesia in horses undergoing arthroscopic procedures.     

Hemodynamic Effects of Atropine and Glycopyrrolate in Isoflurane-Xylazine-Anesthetlzed Dogs

Alterations in parasympathetic tone are partially responsible for xylazine's hemodynamic effects. The purpose of this study was to evaluate and compare the hemodynamic changes caused by the administration of intravenous (IV) atropine or glycopyrrolate after IV xylazine in isoflurane-anesthetized dogs. Six healthy beagles (8.2 to 10.7 kg) were used in two trials separated by 7 days. Anesthesia was induced and maintained with isoflurane in 100% oxygen with controlled ventilation. Once constant end-tidal isoflurane (1.8%) and arterial partial pressure of carbon dioxide (35 to 45 mm Hg) values were reached, baseline data were recorded and xylazine (0.5 mg/kg, IV) was given. In trial 1 atropine (0.1 mg/kg, IV) was given 5 minutes after xylazine, and in trial 2 glycopyrrolate (0.025, mg/kg, IV), was given 5 minutes after xylazine. Hemodynamic variables were recorded 3 minutes after xylazine and 3 minutes after anticholinergic administration. In trial 2, bilateral vagotomies were performed 10 minutes after glycopyrrolate, and hemodynamic variables were recorded 3 minutes later. Heart rate, cardiac index, and stroke index decreased; arterial pressure and systemic vascular resistance increased after xylazine. Heart rate, cardiac index, and rate pressure product increased after anticholinergic administration. Significant differences between atropine and glycopyrrolate were not observed in any of the hemodynamic parameters. Similarly, significant differences between glycopyrrolate and bilateral vagotomy were not observed. The authors conclude that intravenous atropine and glycopyrrolate have equivalent hemodynamic actions during the increased pressure phase after IV xylazine in isoflurane-anesthetized dogs; that intravenous atropine and glycopyrrolate produce comparable increases in heart rate and that both may increase the risk of myocardial hypoxia associated with an increase in rate pressure product; and that vagal blockade produced by high-dose glycopyrrolate (.025 mg/kg, IV) is similar to that produced by bilateral vagotomy.     

Use of quantitative two-dimensional color tissue Doppler imaging for assessment of left ventricular radial and longitudinal myocardial velocities in dogs

OBJECTIVE: To determine left ventricular free wall (LVFW) radial and longitudinal myocardial contraction velocities in healthy dogs via quantitative 2-dimensional color tissue Doppler imaging (TDI). ANIMALS: 100 dogs. PROCEDURE: TDI was used by a single trained observer to measure radial and longitudinal myocardial movement in the LVFW. Radial myocardial velocities were recorded in segments in the endocardial and epicardial layers of the LVFW, and longitudinal velocities were recorded in segments at 3 levels (basal, middle, apical) of the LVFW. RESULTS: LVFW velocities were higher in the endocardial layers than in the epicardial layers. Left ventricular free wall velocities were higher in the basal segments than in the middle and apical segments. Radial myocardial velocity gradients, defined as the difference between endocardial and epicardial velocities, were (mean +/- SD) 2.5 +/- 0.8 cm/s, 3.8 +/- 1.5 cm/s, and 2.3 +/- 0.9 cm/s in systole, early diastole, and late diastole, respectively. Longitudinal myocardial velocity gradients, defined as the difference between basal and apical velocities, were 5.9 +/- 2.2 cm/s, 6.9 +/- 2.5 cm/s, and 4.9 +/- 1.7 cm/s in systole, early diastole, and late diastole, respectively. A breed effect was detected for several systolic and diastolic TDI variables. In all segments, systolic velocities were independent of fractional shortening. CONCLUSIONS AND CLINICAL RELEVANCE: LVFW myocardial velocities decreased from the endocardium to the epicardium and from base to apex, thus revealing intramyocardial radial and longitudinal velocity gradients. These indices could enhance conventional echocardiographic analysis of left ventricular function in dogs. Breed-specific reference intervals should be defined.     

Muscle hemodynamics in hereditary myopathy of Labrador retrievers

Morphologic lesions seen in six 8-month-old Labrador Retrievers with hereditary myopathy were predominantly small- and large-group atrophy of muscle cells of all fiber types. The dogs were intolerant of exercise and fatigued rapidly. An isolated gracilis muscle preparation was used to study the hemodynamic features of the microvasculature. Isogravimetric capillary pressure as well as arterial and venous pressures in the isolated gracilis muscle preparation obtained during maximal vasodilatation were within the range reported for healthy, mixed-breed dogs, as were precapillary, postcapillary, and total vascular resistances. Capillary filtration and osmotic reflection coefficients were not different from those reported in other studies on healthy dogs. All measurements and calculations were repeated during reperfusion, subsequent to a 4-hour period of global ischemia. Postischemic vascular responses were similar to the pattern previously reported in healthy dogs. These studies did not support the hypothesis of a vascular defect as a cause of hereditary myopathy in Labrador Retrievers.     

Hemodynamic Effects of Epidural Ketamine in Isoflurane-Anesthetized Dogs

Objective —The purpose of this study was to determine the hemodynamic effects of epidural ketamine administered during isoflurane anesthesia in dogs. Study Design —Prospective, single-dose trial. Animals —Six healthy dogs (five males, one female) weighing 25.3 ± 3.88 kg. Methods —Once anesthesia was induced, dogs were maintained at 1.5 times the predetermined, individual minimum alveolar concentration (MAC) of isoflurane. Dogs were instrumented and allowed to stabilize for 30 minutes before baseline measurements were recorded. Injection of 2 mg/kg of ketamine in 1 mL saline/4.5 kg body weight was then performed at the lumbosacral epidural space. Hemodynamic data were recorded at 5, 10, 15, 20, 30, 45, 60, and 75 minutes after epidural ketamine injection. Statistical analysis included an analysis of variance (ANOVA) for repeated measures over time. All data were compared with baseline values. A P < .05 was considered significant. Results —Baseline values ±standard error of the mean (X ± SEM) for heart rate, mean arterial pressure, mean pulmonary artery pressure, central venous pressure, pulmonary capillary wedge pressure, cardiac index, stroke index, systemic vascular resistance, pulmonary vascular resistance, and rate-pressure product were 108 ± 6 beats/min, 85 ± 10 mm Hg, 10 ± 2 mm Hg, 3 ± 1 mm Hg, 5 ± 2 mm Hg, 2.3 ± 0.3 L/min/m², 21.4 ± 1.9 mL/beat/m², 3386 ± 350 dynes/sec/cm⁵, 240 ± 37 dynes/sec/cm⁵, and 12376 ± 1988 beats/min±mm Hg. No significant differences were detected from baseline values at any time after ketamine injection. Conclusions —The epidural injection of 2 mg/kg of ketamine is associated with minimal hemodynamic effects during isoflurane anesthesia. Clinical Relevance —These results suggest that if epidural ketamine is used for analgesia in dogs, it will induce minimal changes in cardiovascular function.     

Intraoperative ultrasonography of the portal vein during attenuation of intrahepatic portocaval shunts in dogs

A method for intraoperative measurement of portal blood flow velocity with duplex Doppler ultrasonography in 7 dogs with congenital intrahepatic portosystemic shunts is described. The aims of the study were to determine whether intraoperative ultrasonography was an acceptable alternative to mesenteric portography in such dogs and to identify quantitative portal hemodynamic variables that might correlate with clinical outcome better than portal pressure does. Ultrasonographic measurements did not influence decision-making by the surgeon, who attenuated the shunt on the basis of appearance of the viscera and change in mean systemic arterial blood pressure. All dogs recovered without complications, and surgery was considered to be successful in all 7. Intraoperative B-mode ultrasonography provided real-time information about the anatomy of the shunt and the portal branches, suggesting that it may be a useful alternative to mesenteric portography. The time-averaged mean portal blood velocity ranged from 6.5 to 33.7 cm/s before shunt attenuation and from 5.0 to 9.5 cm/s after shunt attenuation. This narrow range of postligation velocities suggested that intraoperative ultrasonography might be an alternative to intraoperative portal pressure measurement.     

Effects of isoflurane on echocardiographic parameters in healthy dogs

Objective To study the echocardiographic effects of isoflurane at an end‐tidal concentration approximating 1.0 times the minimum alveolar concentration (MAC) in healthy unpremedicated dogs. Study design Prospective experimental trial. Animals Sixteen mature mongrel dogs of either sex weighing 11.06 ± 2.72 kg. Methods After performing a baseline echocardiogram in the awake animal, anesthesia was induced with increasing inspired concentrations of isoflurane via a face mask until tracheal intubation was possible. Following intubation, the end‐tidal concentration was decreased to 1.4% for the rest of the anesthetic period. Serial echocardiograms were recorded at 25, 40, and 55 minutes after the end‐tidal concentration was reached. Results No changes were observed in heart rate. However, significant decreases were seen in left ventricular end‐diastolic diameter (Mean maximal change: 13.8%), interventricular septal thickness during systole (15.2%), interventricular septal thickening fraction (72.2%), left ventricular free wall thickening fraction (63.5%), ejection fraction (39.9%), and fractional shortening (46.7%). In addition, peak flow velocities across mitral, pulmonic, and aortic valves were significantly lower than baseline values. Decreases were also observed in end‐diastolic left ventricular volume index (approximately 32.1% from the awake value), stroke index (58.2%), and cardiac index (55.3%) when compared with awake measurements. Conclusions and clinical relevance Our results indicate that 1 × MAC isoflurane caused significant myocardial depression in healthy dogs. These changes in myocardial function need to be considered carefully when isoflurane is to be used in dogs with poor cardiovascular reserve.     

Plasma Concentrations and Cardiovascular Influence of Lidocaine Infusions During Isoflurane Anesthesia in Healthy Dogs and Dogs With Subaortic Stenosis

Objective—To determine the plasma concentrations and cardiovascular changes that occur in healthy dogs and dogs with aortic stenosis that are given an infusion of lidocaine during isoflurane anesthesia. Study Design—Phase 1, controlled randomized cross-over trial; Phase 2, before and after trial Animals—Phase 1, 6 healthy dogs (4 female, 2 male) weighing 23.8 ± 7.4 kg; Phase 2, 7 dogs (4 female, 3 male) with moderate to severe subaortic stenosis (confirmed by Doppler echocardiography) weighing 31.1 ± 14.5 kg. Methods—After mask induction, intubation, and institution of positive pressure ventilation, instrumentation was performed to measure hemodynamic variables. After baseline, measurement at an end-tidal isoflurane concentration of 1.9% (phase 1) or 1.85% (phase 2), a loading dose infusion of lidocaine at 400 μg/kg/min was given. Phase 1: Maintenance doses of lidocaine were administered consecutively (40, 120, and 200 μg/kg/min) after the loading dose (given for 10, 10, and 5 minutes, respectively) in advance of each maintenance concentrations. Measurements were taken at the end of each loading dose and at 25 and 35 minutes during each maintenance level. The same animals on a different day were given dextrose 5% and acted as the control. Phase 2: Dogs were studied on a single occasion during an infusion of lidocaine at 120 μg/kg/ min given after the loading dose (10 minutes). Measurements occurred after the loading dose and at 25 and 35 minutes. A blood sample for lidocaine concentration was taken at 70 minutes. Data were compared using a one-way ANOVA for phase 1, and between phase 1 and 2. Statistical analysis for phase 2 was performed using a paired r-test with a Bonferroni correction. A P value ± .05 was considered significant. Results—Phase 1: Plasma lidocaine concentrations achieved with 40, 120, and 200 μg of lidocaine/kg/min were 2.70, 5.27, and 7.17 μg/mL, respectively. A significant increase in heart rate (HR) (all concentrations), central venous pressure (CVP), mean pulmonary areterial pressure (PAP), and a decrease in stroke index (SI) (200 μg/kg/min) were observed. An increase in systemic vascular resistance (SVR) and mean PAP, and a decrease in SI also followed the loading dose given before the 200 μg/kg/min infusion. No other significant differences from the control measurements, during dextrose 5% infusion alone, were detected. Phase 2: Plasma lidocaine concentrations achieved were 5.35, 4.23, 4.23, and 5.60 μg/mL at 10, 25, 35, and 70 minutes, respectively. They were not significantly different from concentrations found in our healthy dogs at the same infusions. A significant but small increase in CVP compared with baseline was noted after the loading dose. There were no significant differences from baseline shown in all other cardiovascular data. There were no statistically significant differences in any measurements taken during the lidocaine infusion between the dogs in phase 1 and phase 2. Dogs with aortic stenosis tended to have a lower cardiac index than healthy dogs at baseline (88 v 121 mL/kg/min) and during lidocaine infusion (81 v 111 mL/kg/min). A small, statistically significant difference in systolic PAP was present at baseline. Conclusions—There does not appear to be any detrimental cardiovascular effects related to an infusion of lidocaine at 120 μg/kg/min during isoflurane anesthesia in healthy dogs or dogs with aortic stenosis. The technique used in this study resulted in therapeutic plasma concentrations of lidocaine. Clinical Relevance—Methods shown in the study can be used in clinical cases to achieve therapeutic lidocaine levels without significant cardiovascular depression during isoflurane anesthesia.     

Hemodynamic Effects of Intravenous Midazolam-Xylazine-Butorphanol in Dogs

The hemodynamic effects of a mixture of midazolam (1.0 mg/kg), xylazine (0.44 mg/kg), and butorphanol (0.1 mg/kg) were evaluated in six adult dogs. The dogs were anesthetized with isoflurane for instrumentation. As the dogs returned to consciousness, baseline values were recorded and the midazolam-xylazine-butorphanol mixture and glycopyrrolate (0.01 mg/kg) were administered intravenously (IV). Hemodynamic data were recorded 3, 10, 20, 30, 40, 50, and 60 minutes after injection. Mean arterial pressure (AP), mean pulmonary arterial pressure (PAP), heart rate (HR), rate-pressure product (RPP), mean pulmonary capillary wedge pressure (PCWP), systemic vascular resistance (SVR), and right ventricular stroke work index (RVSWI) were increased significantly above baseline values. Cardiac output (CO), stroke volume (SV), cardiac index (CI), stroke index (SI), mean central venous pressure (CVP), and left ventricular stroke work index (LVSWI) were decreased significantly below baseline values. When administered IV at the dosages used in this study, midazolam-xylazine-butorphanol-glycopyrrolate induced profound acute alterations in several critical hemodynamic variables.