Effect of Synthetic Colloids on Refractometric Readings of Total Solids

Veterinary patients are treated with colloid solutions for plasma volume expansion and maintenance of plasma colloid oncotic pressure (COP). In practice COP is usually extrapolated from measurement of albumin, total protein, or refractometric total solids (TS) as an estimate of total protein. The objective of this study was to determine if refractometer readings accurately reflect levels of synthetic colloid in the blood. Serial dilutions of synthetic colloids Dextran 70 and hetastarch into 2.5% and 5% human serum albumin (HSA) were prepared, and COP and TS measurements were performed. Synthetic colloids were found to produce a significant increase in measured COP, without a significant change in refractometric TS readings. Measured COP correlated well with concentration of synthetic colloid. In clinical patients, treatment of decreased COP with synthetic colloids should be monitored by direct measurement of COP or by observing resolution of clinical signs of hypovolemia or edema. (Vet Emerg & Crit Care, 1998; 8: 21–26)     

Comparison of whole blood and plasma colloid osmotic pressure in healthy dogs

Objective – To determine the difference between colloid osmotic pressure (COP) values determined from plasma versus those determined from whole blood. Design – Prospective observational study. Settings – University veterinary teaching hospital. Animals – Fifty‐three healthy dogs. Interventions – None. Measurements and Main Results – Whole blood and plasma COP, CBC, plasma biochemistry. In all dogs, plasma COP values were significantly lower (P=0.02) than whole blood COP, with a mean of difference of 0.5 mm Hg. The mean and median whole blood COP was 21.75 and 21.4 mm Hg, respectively, with a range of 17.9–27.1 mm Hg. The mean and median plasma COP was 21.2 and 20.9 mm Hg with a range of 16.7–28.9 mm Hg. Conclusions – While significant difference exists between plasma and whole blood COP, the individual values are within expected reference intervals for dogs (21–25 mm Hg). Using either sample appears to provide the same information in clinically healthy dog; however, it is recommended that clinicians utilize the same sample type for comparison in an individual patient.     

Colloid osmotic pressure after hemorrhage and replenishment with Oxyglobin Solution, hetastarch, or whole blood in pregnant sheep

Objective To compare plasma colloid osmotic pressure (COP) of both maternal and fetal blood, before and after hemorrhage, and replenishment with Oxyglobin Solution (Biopure Corporation, Cambridge, MA, USA), hetastarch or whole blood in pregnant ewes. Study design Prospective, randomized study. Animals A total of 17 adult Rambouillet ewes at 131 (128–133) [median (minimum, maximum)] days gestation, weighing 56 (46, 63) kg. Methods Ewes and fetuses were chronically instrumented with catheters in a maternal jugular vein, maternal carotid artery and fetal femoral artery. Twenty milliliters per kilograms of blood were removed from each ewe over 1 hour. The ewes were then given 20 mL kg^?1 of either Oxyglobin Solution (n = 5), hetastarch (n = 6), or autologous whole blood (n = 6) IV. Maternal plasma COP was measured before hemorrhage, after hemorrhage, after replenishment, and 1 and 2 hours later. Fetal plasma COP was measured after maternal hemorrhage and 2 hours after maternal volume replenishment. Results Median COP of all ewes before hemorrhage was 20 (16, 24) mm Hg and after hemorrhage (p < 0.05), decreased to 16 (11, 19) mm Hg. After volume replenishment, the COP of the Oxyglobin Solution group was 22 (21, 25) mm Hg, the autologous whole blood group was 17 (16, 22) mm Hg and the hetastarch group was 20 (17, 21) mm Hg. The COP of the Oxyglobin Solution group was significantly greater (p < 0.05) than the COP of the hetastarch group immediately and 60 minutes after volume replenishment, and greater (p < 0.05) than that of the autologous whole blood group at 60 minutes after volume replenishment. The COP of all the fetuses after maternal hemorrhage was 16 (12, 19) mm Hg and at 120 minutes after maternal volume replenishment was 15 (11, 18) mm Hg. There were no differences in COP between or within any of the fetal groups. Conclusions When used to treat blood loss, Oxyglobin Solution increases plasma COP more than an equal volume of hetastarch in the first hour following administration. Maternal administration of Oxyglobin Solution did not alter fetal COP. Clinical relevance Oxyglobin Solution is a more potent colloid than hetastarch. Oxyglobin Solution did not appear to translocate fluid from the fetal to maternal circulation.     

Measurement of plasma colloid osmotic pressure in normal thoroughbred neonatal foals

A normal plasma colloid osmotic pressure (COP) interval was established for foals and compared to values for adult horses. Plasma samples were obtained from 38 Thoroughbred foals that had normal findings on postfoaling examination and 10 healthy Thoroughbred adult horses. Samples were analyzed using a commercially available colloid osmometer. Fifty samples were obtained from 38 foals. Twelve foals had 2 samples taken, 1 during the 1st 24 hours of life and the 2nd between 24 and 72 hours of life. For foals with 2 samples, only 1 randomly selected value was used in group analysis. Total plasma protein, albumin, and globulin concentrations were measured on all samples from foals. The mean measured plasma COP for foals was 18.8 +/- 1.9 mm Hg for the 38 samples analyzed. Measured plasma COP did not differ significantly over the time period examined for either the 12 paired samples (P = .13) or with regression analysis of the 38 samples (P = .13). Calculation of mean COP, based on previously published quadratic equations using total protein, albumin, and globulin concentrations, underestimated mean measured foal COP values except for when total protein measured by refractometer was used in the Landis-Pappenheimer equation. In conclusion, the plasma COP interval (95% CI: 15.0 mm Hg, 22.6 mm Hg) obtained for healthy foals in this study was found to be lower than that of healthy adult Thoroughbreds (20.6 +/- 0.7 mm Hg, P = .006).     

The Use of Hetastarch as Adjunct Therapy in 26 Dogs With Hypoalbuminemia: A Phase Two Clinical Trial

The purpose of this study was to evaluate the safety and efficacy of the synthetic colloid hetastarch in dogs with hypoalbuminemia. Individual doses of hetastarch ranged from 9 to 27 mL/kg, and multiple doses were used frequently. Total doses ranged from 9 to 59 mL/kg. Colloid oncotic pressure was measured in 13 dogs before and after treatment. Mean colloid oncotic pressure ± SD was 9.32 ± 2.35 mm Hg before treatment and 16.41 ±1.61 mm Hg in 8 healthy pet dogs used as controls. The difference in these values was significant ( P < .001). There was a significant increase in mean colloid oncotic pressure after the first dose of hetastarch, but there was no relationship between the dose of hetastarch and the magnitude of increase in colloid oncotic pressure. Peripheral edema or body cavity transudates resolved or decreased in 83% of the dogs despite concurrent use of crystalloid fluid therapy. There was also no relationship between the dose of hetastarch and resolution of edema. Worsening of the results from coagulograms occurred in 5 of 18 dogs, and included increased prothrombin time (n = 1), increased partial thromboplastin time (n = 5), and decreased platelet count (n = 3). Bleeding that occurred in 3 dogs could not be directly attributed to the hetastarch. There was no relationship between the dose of hetastarch and worsening of the values in the coagulograms.     

In Vitro Model for Testing Novel Implants for Equine Laryngoplasty

Objective— To develop an in vitro laryngeal model to mimic airflow and pressures experienced by horses at maximal exercise with which to test laryngoplasty techniques.
Study Design— Randomized complete block.
Sample Population— Cadaveric equine larynges (n=10).
Methods— Equine larynges were collected at necropsy and a bilateral prosthetic laryngoplasty suture was placed with #5 Fiberwire^™ suture to achieve bilateral maximal arytenoid abduction. Each larynx was positioned in a flow chamber and subjected to static flow and dynamic flow cycling at 2 Hz. Tracheal pressure and flow, and pressure within the flow chamber were recorded at a sampling frequency of 500 Hz. Data obtained were compared with the published physiologic values for horses exercising at maximal exercise.
Results— Under static flow conditions, the testing system produced inspiratory tracheal pressures (mean±SEM) of −33.0±0.98 mm Hg at a flow of 54.48±1.8 L/s. Pressure in the flow chamber was −8.1±2.2 mm Hg producing a translaryngeal impedance of 0.56±0.15 mm Hg/L/s. Under dynamic conditions, cycling flow and pressure were reproduced at a frequency of 2 Hz, the peak inspiratory (mean±SEM) pharyngeal and tracheal pressures across all larynges were −8.85±2.5 and −35.54±1.6 mm Hg, respectively. Peak inspiratory flow was 51.65±2.3 L/s and impedance was 0.57±0.06 mm Hg/L/s.
Conclusions— The model produced inspiratory pressures similar to those in horses at maximal exercise when airflows experienced at exercise were used.
Clinical Relevance— This model will allow testing of multiple novel techniques and may facilitate development of improved techniques for prosthetic laryngoplasty.     

Amlodipine: A Randomized, Blinded Clinical Trial in 9 Cats with Systemic Hypertension

The efficacy of amlodipine (AML) was tested in hypertensive cats in a placebo-controlled, randomized, blinded clinical trial. Five cats were randomized to receive 0.625 mg AML once daily and 4 cats to receive placebo (PLA) once daily. The average systolic blood pressure (SBP) recorded by the Doppler method on day 0 was 212 ± 21 mm Hg in the AML group and 216 ± 32 mm Hg in the PLA group. On day 7, the cats receiving AML had a significantly lower average daily SBP (160 ± 30 mm Hg) but SBP in the PLA group was unchanged (207 ± 31 mm Hg). On day 7, all cats receiving PLA and one cat receiving AML were crossed over to the other group because of inadequate response. Blood pressure did not decrease adequately in 3 cats by day 14 (7 days of PLA and 7 days AML) and the treatment code was broken. Each of these cats was subsequently administered 1.25 mg AML daily. Cats requiring 1.25 mg AML once daily (6.1 kg ± 0.7 kg) weighed significantly more than cats that responded to 0.625 mg AML once daily (4.1 ± 0.7 kg). The average daily SBP recorded in the 6 cats that completed the study was significantly lower after 16 weeks of treatment (152 ± 14 mm Hg) compared to day 0 (221 ± 24 mm Hg). Three cats were euthanized before completion of the study. All 3 cats were responders to AML on day 7. SBPs measured 24 hours after AML administration were similar to the average daily SBP, suggesting that AML effectively controlled SBP for a 24-hour period. AML was shown to be an effective once-daily antihypertensive agent when administered to cats at a dosage of 0.18 ± 0.03 mg/kg sid.     

Evaluation of hemostatic analytes after use of hypertonic saline solution combined with colloids for resuscitation of dogs with hypovolemia.

The effects of hypertonic saline solution (HTSS) combined with colloids on hemostatic analytes were studied in 15 dogs. The analytes evaluated included platelet counts, one-stage prothrombin time, activated partial thromboplastin time, von Willebrand's factor antigen (vWf:Ag), and buccal mucosa bleeding times. The dogs were anesthetized, and jugular phlebotomy was used to induced hypovolemia (mean arterial blood pressure = 50 mm of Hg). Treatment dogs (n = 12) were resuscitated by infusion (6 ml/kg of body weight) of 1 of 3 solutions: HTSS combined with 6% dextran 70, 6% hetastarch, or 10% pentastarch. The control dogs (n = 3) were autotransfused. Hemostatic analytes were evaluated prior to induction of hypovolemia (baseline) and then after resuscitation (after 30 minutes of sustained hypovolemia) at 0.25, 0.5, 1, 6 and 24 hours. All treatment dogs responded rapidly and dramatically to resuscitation with hypertonic solutions. Clinically apparent hemostatic defects (epistaxis, petechiae, hematoma) were not observed in any dog. All coagulation variables evaluated, with the exception of vWf:Ag, remained within reference ranges over the 24-hour period. The vWf:Ag values were not statistically different than values from control dogs, and actual values were only slightly lower than reference ranges. Significant (P < or = 0.04) differences were detected for one-stage prothrombin time, but did not exceed reference ranges. The results of this study suggested that small volume HTSS/colloid solutions do not cause significant alterations in hemostatic analytes and should be considered for initial treatment of hypovolemic or hemorrhagic shock.     

Crystalloids versus colloids: implications in fluid therapy of dogs with intestinal obstruction

Responses of jejunal transcapillary and transmucosal fluid fluxes to IV infusion of crystalloid or colloid solutions were evaluated in 12 dogs. One isolated intestinal segment in each dog was used as the control segment, and 2 segments were distended to a intraluminal hydrostatic pressure of 10 cm of H2O. The artery supplying 1 of the 2 distended (autoperfused) segments was cannulated and perfused with blood from the femoral artery. One of the 2 distended segments was autoperfused from the femoral artery. Intraluminal pressure was increased in the autoperfused segment and in 1 other segment for three, 20-minute periods after administration of the crystalloid or colloid solution. Net transmucosal fluid flux was estimated, using a volume recovery method. In each autoperfused segment, blood flow, capillary pressure, lymph flow, and plasma protein and lymph protein concentrations were measured during each 20-minute distention period. Systemic arterial pressure was monitored throughout the procedure. Plasma and tissue oncotic pressures were calculated from the plasma protein and lymph protein concentrations. Total vascular resistance and precapillary and postcapillary resistances were determined. Capillary pressure increased after infusion with colloids and crystalloids, with the effects being more prolonged in the colloid group. Plasma oncotic pressure transiently increased after infusion with colloids and decreased after infusion with crystalloids. Lymph flow increased only in crystalloid-treated dogs. Due to alterations in transcapillary fluid filtration, crystalloids induced a net loss of fluid into the intestinal lumen, whereas the fluid absorptive capacity of the jejunum was unaltered by colloid treatment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Changes in colloid osmotic pressure as a function of anesthesia and surgery in the presence and absence of isotonic fluid administration in dogs

Objective  To determine how a combination of anesthetic drugs; including pre-medication, induction agents and inhalational agents; affect colloid osmotic pressure (COP) in the presence and absence of isotonic fluid administration. Secondarily, to determine if changes in total plasma protein (TPP) correlate with COP in anesthetized patients.
Study Design  Prospective, randomized clinical study.
Animals  Ten female dogs, 4 months to 4 years of age and >8 kg undergoing elective ovariohysterectomy.
Methods  All dogs were anesthetized in a similar fashion. After induction, five dogs received lactated ringer's solution (LRS) at 10 mL kg⁻¹ hour⁻¹ and five dogs received no fluid therapy during anesthesia. Blood samples were collected prior to pre-medication, prior to induction, immediately post-induction/prior to the inhalational agent, 30 minutes post-induction, at the time of recovery and 45 minutes post-discontinuation of inhalant. TPP and COP were measured from each sample.
Results  Administration of fluids resulted in a decrease in COP and TPP over time that did not return to baseline by 45 minutes after recovery. Anesthesia without the administration of fluids also resulted in a significant decrease in COP over time, that was rebounding by recovery (but still significantly less than baseline). TPP had variable correlation with COP at different time points with or without fluid administration.
Conclusions and clinical relevance  Anesthetic drugs alter COP similarly in the presence and absence of isotonic fluids. These changes in COP did not have a simple relationship to TPP and so the latter could not be used to predict COP in this patient population.     

Measurement of plasma colloid osmotic pressure in neonatal foals under intensive care: comparison of direct and indirect methods and the association of COP with selected clinical and clinicopathologic variables

Objectives: To describe and compare admission colloid osmotic pressure (COP) measurement using both direct and indirect methods in neonatal foals under intensive care, and to evaluate for associations between COP and clinical/clinicopathologic parameters. Design: Prospective study. Setting: Intensive care unit at a veterinary medical teaching hospital. Animals: Twenty‐six critically ill neonatal foals were studied. A control group consisted of 9 clinically healthy neonatal foals. Interventions: Clinicopathologic data were collected at the time of admission. COP was measured directly using a colloid osmometer. Indirect COP was calculated using equations by both Landis–Pappenheimer (L–P) and Thomas and Brown. Measurements and main results: Measured admission COP values were 17.1±4.3 and 17.7±2.4 mmHg in critically ill and control foals, respectively, and these values were not significantly different. Critically ill foals with blood lactate concentrations >3 mmol/L had lower COP values than those with lactate ≤3 mmol/L. There was close agreement between indirect COP values calculated using the L–P equation and direct COP values measured in control foals (mean error=0.0±1.3 mmHg; R²=0.87). However, indirect values were not as predictive of direct COP in critically ill foals (mean error=0.8±3.8 mmHg; R²=0.64). As COP values increased, the indirect method tended to overestimate COP, whereas at lower values it slightly underestimated COP. Conclusion: While the L–P equation was a close approximation of direct COP in healthy foals, direct measurements of oncotic pressure cannot be replaced for monitoring of critically ill foals. Critically ill foals with higher lactate concentrations had lower COP values, suggesting a possible relationship between COP and lactate.     

Effect of Preoperative Erythromycin or Dexamethasone/Vitamin C on Postoperative Abomasal Emptying Rate in Dairy Cows Undergoing Surgical Correction of Abomasal Volvulus

Objective— To determine the effects of preoperative erythromycin or combined dexamethasone/vitamin C treatment on postoperative abomasal emptying rate in cows undergoing surgical correction of abomasal volvulus (AV).
Study Design— Prospective, controlled, clinical study using a convenience sample.
Animals— Lactating Holstein–Friesian cows (n=45) with AV were alternately assigned to 3 groups (n=15): group C: untreated (control); group E: erythromycin (10 mg/kg intramuscularly [IM]); group D: dexamethasone (0.02 mg/kg intravenously [IV]) and vitamin C (10 mg/kg IV).
Methods— Drugs were administered 1 hour before surgical correction of AV. d -xylose solution (50%, 0.5 g/kg body weight) was injected into the abomasal lumen during surgery. Jugular venous blood samples for determination of serum d -xylose concentration were periodically obtained. Time to maximal serum d -xylose concentration (T_max-model) was pharmacokinetically determined.
Results— Abomasal emptying rate was significantly ( P <0.05) faster in group E (T_max-model=182±69 min; mean±SD) than in group C cows (T_max-model=237±64 min). Abomasal emptying rate was similar in group D (T_max-model=196±47 min) and group C. Both treatments improved postoperative milk yield within 1 day after surgery.
Conclusion— Preoperative injection of erythromycin (10 mg/kg IM) is an effective method for ameliorating postoperative abomasal hypomotility in cows with AV.
Clinical Relevance— Parenteral erythromycin can be recommended for preoperative treatment of cows with AV.     

Determination of cardiac output in neonatal foals by ultrasound velocity dilution and its comparison to the lithium dilution method

Objective – To compare cardiac output (CO) measured by use of lithium dilution (LiDCO) and ultrasound velocity dilution (UDCO) in conditions of high, intermediate, and low CO in anesthetized foals.
Design – Original prospective study.
Setting – University teaching hospital.
Animals – Six foals 1–3 days of age (38–45 kg).
Interventions – Neonatal foals were anesthetized and instrumented to measure direct blood pressure, heart rate, arterial blood gases, and CO. The CO was measured by use of LiDCO and UDCO techniques. Measurements were obtained from each foal at baseline and during low, intermediate, and high CO states. Measurements were converted to cardiac index (cardiac index=CO/body weight) values for statistical analysis. Agreement between the 2 methods was determined using Bland and Altman analysis and concordance correlation coefficients.
Measurements and Main Results – LiDCO determinations of CO ranged between 4.0 and 14.0 L/min resulting in cardiac index ranging between 75.5 and 310 mL/kg/min. There was no significant effect of blood pressure variation on bias or relative bias ( P =0.62 and 0.93, respectively). The mean bias and relative bias of UDCO (±SD) compared with LiDCO were −20.1±39.2 mL/kg/min and −7.7±23.4%, respectively. Concordance correlation coefficient between LiDCO and UDCO was 0.833.
Conclusions – When compared with LiDCO, the UDCO technique has acceptable clinical utility for measuring CO in healthy anesthetized newborn foals.     

Balloon Dilation of Congenital Subaortic Stenosis in the Dog

Balloon dilation during cardiac catheterization was evaluated for the treatment of congenital subaortic stenosis (SAS) in nine dogs. Under general anesthesia, bilateral cardiac catheterization was performed through the right jugular vein and carotid artery. Thermodilution cardiac output, and left ventricular and aortic root pressures and angiograms were obtained before and after balloon dilation. Balloons measuring 18–20 mm in diameter and 30–40 mm in length were positioned across the stenosis and three inflations 4–5 minutes apart were performed. There was no significant change in cardiac output, aortic pressure, or degree of aortic regurgitation after balloon dilation. For the entire group balloon dilation resulted in significant decreases in left ventricular systolic pressure (-61.2 ± 37.2 mm Hg [mean change ± SD], range -14 to -123), mean systolic pressure gradient (-39.6 ± 24.4 mm Hg, range –8.4 to -72.2), and peak systolic pressure gradient (-64.3 ± 46.5 mm Hg, range –17 to –143). Calculated left ventricular outflow cross-sectional area increased significantly (+.4 ± .5 cm², range –.06 to + 1.30). Clinical signs improved in the five symptomatic dogs. Individual hemodynamic responses varied widely, but the magnitude of improvement correlated with the severity of obstruction. Three dogs showed a decrease of 60% or greater (≥100 mm Hg), and six dogs showed a decrease of 25–50% (17–71 mm Hg) in peak systolic gradient after balloon dilation. Complications were frequent but most were transient and manageable. These preliminary results suggest that balloon dilation can acutely decrease outflow resistance in dogs with SAS and may be effective therapy for some affected dogs.     

Direct colloid osmometry in healthy New World camelids

Background: Direct colloid osmometry provides an objective assessment of the oncotic effects of crystalloid or colloidal fluid therapy, which is especially useful in monitoring fluid therapy of critically ill camelids due to their tendency toward nonspecific hypoproteinemia with increased risk of developing edema and ascites. Objectives: The aims of this study were to measure colloid osmotic pressure (COP) of alpacas and llamas, determine its correlation with concentrations of total protein (TP) and total solids (TS), as well as both albumin (A) and globulin (G) concentrations in the same model (A+G), and evaluate the effects of sample type and storage conditions on COP. Methods: Blood was collected from clinically healthy alpacas (n=23) and llamas (n=22) into heparin tubes. COP of fresh whole blood (COP_FB) and plasma (COP_FP) was determined using a membrane osmometer. For 20 alpacas, COP of refrigerated whole blood (COP_RB) and frozen plasma (COP_FrP) was also measured. Correlations between COP_FB and TS, TP, and A+G concentrations were assessed by simple and multiple regression analysis to model potential predictors. Results: Median COP_FB from alpacas (24.6 mmHg, range 19.3–28.1) was not significantly different from that of llamas (25.3 mmHg, range 22.5–33.7). Sample type or storage conditions did not affect COP. Measured COP had a strong positive linear correlation with TS, TP, and A+G concentrations in alpacas (r²=.7, .74, and .88, respectively). In llamas, COP correlated best with TS concentration (r²=.59), whereas correlation with TP and A+G concentrations was poor (r²=.19 and .25, respectively). Conclusion: COP can be measured using heparinized whole blood or plasma, either fresh or stored. Direct measurement is recommended whenever quantitative knowledge of COP is required in clinical or research setting. Further studies are needed to verify if the poor association of COP with TP found in this study can be generalized to llamas.     

Colloid replacement in the ICU

Colloids are fluids containing large molecular weight molecules that do not readily cross the capillary membrane. Colloid replacement is becoming increasingly more common in the equine intensive care unit. Advantages of colloid therapy include improved oncotic pressure, rapid intravascular volume replacement, and improved microvascular perfusion. Edema formation is minimized through the use of colloids, rather than crystalloids, in the volume resuscitation of hypoproteinemic animals. Available colloids include both natural (biologic) and synthetic formulations. Plasma is the most common biologic colloid utilized in horses, and offers the advantage of providing a broad range of proteins in addition to its principle colloid, albumin. These additional proteins include coagulation factors, antithrombin, and immunoglobulins. The most widely used synthetic colloid in horses is hydroxyethyl starch (hetastarch). Side effects of hetastarch include dose-dependent effects on coagulation, primarily because of decreases in factor VIII and von Willebrand factor concentrations. Other synthetic or semisynthetic colloids include pentastarch, dextrans, and a polymerized ultrapurified bovine hemoglobin product. Monitoring of patients receiving colloid therapy should include direct colloid osmometry. Indirect estimates of colloid osmotic pressure are not reliable in critically ill patients and in those receiving synthetic colloids. Total protein measurements do not account for the oncotic contribution of synthetic colloids.     

Clinical comparison of three methods to measure blood pressure in nonsedated dogs

OBJECTIVE: To determine arterial blood pressure in client-owned dogs, using direct arterial puncture, oscillometry, and Doppler ultrasonography in a clinical setting. DESIGN: Prospective study. ANIMALS: 8 clinically normal client-owned dogs. PROCEDURE: Blood pressures of nonsedated dogs were measured simultaneously, using each of the 3 methods. Mean values obtained were compared with published mean values. Ability of noninvasive methods (Doppler ultrasonography and oscillometry) to accurately predict results of the invasive method, and relationships between blood pressure and age, body weight, and degree of patient anxiety were determined. RESULTS: Calculated ranges of values (mean +/- 2 SD) determined by direct arterial puncture were: systolic pressure, 114 to 194 mm Hg; diastolic pressure, 66 to 102 mm Hg; and mean pressure, 85 to 129 mm Hg. Ranges determined by use of oscillometry were: systolic, 110 to 190 mm Hg; diastolic, 35 to 107 mm Hg; and mean, 78 to 138 mm Hg. Ultrasonographic and oscillometric values did not accurately predict direct values, but mean values of systolic and mean pressures were similar among methods. Relationships were not detected between age or body weight and blood pressure. Significant differences in blood pressure were not detected between anxious and nonanxious dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Mean values of systolic, diastolic, and mean arterial blood pressure measured in nonsedated client-owned dogs, using invasive and noninvasive methods in a clinical setting, are comparable with those determined for acclimatized, trained, or sedated dogs. However, results of noninvasive methods may not accurately reflect direct values.     

Anesthesia in Sheep With Propofol or With Xylazine-Ketamine Followed by Halothane

Objective- This study evaluates the clinical usefulness and anesthetic effect of propofol, and compares these effects with those of xylazine-ketamine-halothane anesthesia in sheep.
Study Design- Prospective, randomized, clinical trial. Animals or Sample Population- Fourteen healthy adult male sheep.
Methods- Sheep were randomly assigned to two different drug regimens: (1) Bolus injection of propofol (3 mg/kg, intravenously [IV]) followed by continuous intravenous infusion and (2) xylazine (0.11 mg/kg, IV) and ketamine (2.2 mg/kg, IV) for induction followed by halothane anesthesia. Heart rate, respiratory rate, and arterial blood pressures were monitored during anesthesia. Venous blood samples were collected for blood gas analysis. Quality of induction and recovery were also recorded.
Results- The average dose of propofol used to induce and maintain anesthesia was 6.63 ±2.06 mg/kg and 29.3 ±11.7 mg/kg/hr (0.49 ±0.20 mg/kg/min), respectively. The duration of propofol anesthesia was 45.3 ±13.2 minutes and recovery to standing occurred in 14.7 ±5.7 minutes. Sheep receiving xylazine-ketamine-halothane were anesthetized for 35.9 ±4.0 minutes and recovery to standing occurred within 28.5 ±7.5 minutes. Sheep anesthetized with propofol had a significantly higher heart rate, diastolic blood pressure and Pvo₂, and a lower Pvco₂ at 30 minutes and lower BE at 15 and 30 minutes than sheep anesthetized with xylazine-ketamine-halothane.
Conclusions- Propofol anesthesia was characterized by a smooth induction, effective surgical anesthesia and rapid recovery which was comparable to anesthesia with xylazine-ketamine-halothane.
Clinical Relevance- Propofol may be indicated in situations when it is desirable to maintain anesthesia with an intravenous infusion followed by a rapid recovery in healthy sheep.     

Use of a wireless system to measure invasive arterial blood pressure in ponies – preliminary study

Objective  To evaluate the feasibility and functionality of intra-carotid wireless device implantation in ponies, and to investigate its short-term complications.
Study design  Prospective preliminary study.
Animals  Five mixed breed, adult, intact male ponies weighing 104 ± 28.8 kg (mean ± SD) underwent surgery. Arterial blood pressure data were continuously collected from four animals.
Methods  General anesthesia was induced on two consecutive days. On the first day, an intra-arterial wireless device was implanted in the right carotid artery. On the next day, a transcutaneous intra-arterial catheter was placed in the left facial artery. Data from both sources were collected. Post-mortem examination was performed.
Results  Surgical time was 27.1 ± 11.85 minutes. All catheters remained in place with some extra vascular migration. Complications included mild seroma and hematoma.
Conclusion  The wireless system allowed continuous monitoring in ponies throughout anesthesia and at rest and may allow for the recording of arterial blood pressure and heart rate when it would be difficult to achieve with a conventional system (e.g. during recovery from anesthesia).
Clinical relevance  The wireless invasive blood pressure monitor may allow continuous measurements when only intermittent measurements would be feasible with a wired system.     

Evaluation of an indirect oscillometric blood pressure monitor in normotensive and hypotensive anesthetized dogs

Objective – To determine the accuracy and precision of an oscillometric noninvasive blood pressure device as a predictor of invasive direct blood pressure in healthy anesthetized hypotensive and normotensive dogs. Design – Prospective observational study. Setting – University teaching hospital. Animals – Eight crossbred adult dogs. Interventions – Anesthesia was induced with propofol and maintained with isoflurane. A catheter was placed in the dorsal pedal artery to record systolic, mean, and diastolic arterial blood pressures (aSAP, aMAP, and aDAP, respectively). The noninvasive blood pressure device cuff was placed around the contralateral front limb to record noninvasive systolic, mean, and diastolic blood pressure (nSAP, nMAP, and nDAP). Two states of blood pressure (BP) were studied: baseline state was established by keeping end‐tidal isoflurane concentration at 1.2±0.1%. The hypotensive state was achieved by maintaining the same isoflurane concentration while withdrawing approximately 40% of the animal's blood volume until aMAP was stable at approximately 40 mm Hg. At the end of the study, blood was returned to the animal and it was allowed to recover from anesthesia. Measurements and Main Results – Agreement between the direct and indirect BP measurements was determined by the Bland‐Altman method. The SAP and MAP but not DAP bias varied significantly between each BP state. Normotensive absolute biases (mean [SD]) for SAP, MAP, and DAP were ?14.7 mm Hg (15.5 mm Hg), ?16.4 mm Hg (12.1 mm Hg), and ?14.1 mm Hg (15.8 mm Hg), respectively. Absolute biases during the hypotensive state for SAP, MAP, and DAP were ?32 mm Hg (22.6 mm Hg), ?24.2 mm Hg (19.5 mm Hg), and ?16.8 mm Hg (17.2 mm Hg), respectively. Conclusion – The oscillometric device was not reliably predictive of intra‐arterial BP during hypotension associated with acute hemorrhage.