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1.

Objectives

To assess the ability of electrocardiography (ECG) to predict left ventricular hypertrophy (LVH) in the cat and to investigate the prognostic value of selected ECG variables in cats with LVH.

Animals

Fifty-seven privately owned cats: 22 clinically healthy cats and 35 cats with LVH.

Material and methods

This is a clinical cohort study. Echocardiographic diagnosis and surface ECG were available. Electrocardiography analysis included rhythm diagnosis and specific electrocardiographic measurements. In cats with LVH, cause of death and outcome data were recorded and analyzed using Kaplan–Meier curves.

Results

The presence of arrhythmia had sensitivity and specificity of 31% and 100%, respectively, for identifying LVH. Among ECG measurements, duration of QT interval (QT) and QT interval corrected for heart rate (QTc) was statistically different between healthy cats and cats with LVH (p = 0.007). Overall, the most accurate cutoffs to identify LVH were QT > 170 ms (sensitivity and specificity 48.3% and 91%, respectively) and QTc > 188 ms (sensitivity and specificity 62% and 77%, respectively). In healthy cats, the highest QT and QTc values were 180 ms and 200 ms, respectively. Mean survival time was 58 days and indeterminable for cats with QT > 180 ms and QT ≤ 180 ms, respectively (p = 0.042) and 125 days and indeterminable for cats with QTc > 200 ms and QTc ≤ 200 ms, respectively (p = 0.017).

Conclusions

Arrhythmias as well as prolonged QT and QTc are useful ECG parameters in identifying LVH and predicting survival in affected cats.  相似文献   

2.

Objective

Myxomatous mitral valve disease (MMVD) induces progressive left atrial (LA) enlargement. The LA modulates left ventricular filling and performance through its reservoir, conduit, and contractile function. Assessment of LA size and function may provide valuable information on the level of cardiac compensation. Left atrial function in dogs with naturally occurring MMVD remains largely unexplored. The objective of this study was to evaluate LA volume and function in dogs with naturally occurring MMVD.

Animals

This prospective study included 205 client-owned dogs of different breeds, 114 healthy dogs, and 91 dogs with MMVD of different disease severities.

Methods

Using two-dimensional echocardiography, the biplane area-length method was applied to assess LA volume and calculate volumetric indices of LA reservoir, conduit, and contractile function.

Results

Left atrial volume and LA stroke volume increased, whereas LA reservoir and contractile function decreased with increasing disease severity. A maximal LA volume <2.25mL/kg was the optimal cut off identified for excluding congestive heart failure in dogs with chronic MMVD with a sensitivity of 96% and a specificity of 100%. An active LA emptying fraction <24% and/or a LA expansion index <126% were suggestive of congestive heart failure in dogs with chronic MMVD with a sensitivity of 77% and a specificity of 89% and a sensitivity of 82% and a specificity of 82%, respectively.

Conclusion

Dogs with MMVD appear to have larger LA volumes with poorer LA function. Deteriorating LA function, characterized by a decreasing reservoir and active contractile function, was evident in dogs with MMVD with increasing disease severity.  相似文献   

3.

Introduction

To determine the biologic variability of N-terminal pro-brain natriuretic peptide (NTproBNP) in healthy dogs and dogs with various stages of myxomatous mitral valve disease (MMVD).

Animals

Thirty-eight privately owned dogs: 28 with MMVD and 10 healthy controls.

Materials and methods

Prospective clinical study with comprehensive evaluation used to group dogs as healthy or into three stages of MMVD based on current guidelines. NTproBNP was measured hourly, daily, and weekly. For each group, analytical (CVA), within-subject (CVI), and between-subject (CVG) coefficients of variability were calculated in addition to percent critical change value (CCV) and index of individuality (IoI).

Results

For healthy dogs, calculated NTproBNP values were: CVA = 4.2%; CVI = 25.2%; CVG = 49.3%; IoI = 0.52, and CCV = 70.8%. For dogs with MMVD, calculated NTproBNP values were: CVA = 6.2%; CVI = 20.0%; CVG = 61.3%; IoI = 0.34, and CCV = 58.2%.

Conclusions

Biologic variability affects NTproBNP concentrations in healthy dogs and dogs with MMVD. Monitoring serial individual changes in NTproBNP may be clinically relevant in addition to using population-based reference ranges to determine changes in disease status.  相似文献   

4.

Introduction

Left ventricular (LV) and left atrial (LA) enlargement affect management and outcome of dogs with cardiac disease. Short-axis, two-dimensional echocardiographic (2DE) images, indexed to the aorta (Ao), are frequently used to identify cardiomegaly. Long-axis images offer complementary views of the left heart.

Animals

Eighty healthy dogs and 25 dogs with MMVD.

Methods

Healthy dogs were prospectively recruited to determine reference intervals (Clinical Laboratory Standards Institute methodology) for long-axis ratios. Measurement variability and repeatability were quantified by intraclass correlation coefficient and coefficient of variation. Mean long-axis ratios from dogs with MMVD were compared with healthy dogs (unpaired t-test). In addition, the proportion of MMVD dogs exceeding the 97.5 percentile by LV/Ao and a conventional, allometric method were compared (McNemar’s test).

Results

Two-dimensional echocardiographic long-axis reference intervals were as follows: left ventricular to aortic dimension (LV/Ao) 1.8–2.5; left atrial to aortic dimension (LA/Ao) 1.8–2.4, and left atrial to left ventricular dimension (LA/LV) 0.9–1.1. Intraobserver and interobserver measurement agreement was good-to-excellent (intraclass correlation coefficients ≥0.84), and day-to-day variability was low (coefficient of variations <4%). Left ventricular to aortic dimension, LA/Ao, and LA/LV were significantly greater in canine MMVD compared with healthy dogs (p<0.001). The percentages of MMVD dogs demonstrating LV dilatation by LV/Ao and conventional method were 68% and 36%, respectively (p=0.043, 95% confidence interval for difference 7.9%, 56.1%).

Conclusions

Simple 2DE long-axis ratios of LV/Ao, LA/Ao, and LA/LV are repeatable and demonstrate clinical utility for identifying LV and LA enlargement in dogs with MMVD.  相似文献   

5.

Introduction

Left atrial (LA) function can provide useful information in dogs with myxomatous mitral valve disease (MMVD). Recently, we have demonstrated the feasibility of measuring LA longitudinal deformation using speckle-tracking echocardiography (STE) to estimate LA function in healthy dogs. Whether LA strain and strain rate variables provide additional information about LA function and clinical cardiac status in dogs with MMVD remains unexplored.

Animals

Ninety-six client-owned dogs of different breeds with MMVD were prospectively enrolled.

Methods

LA longitudinal deformation was evaluated in each dog by STE and different STE variables were used to assess LA function.

Results

No STE variables differed between American College of Veterinary Internal Medicine Stage B1 and B2 dogs but were lower in Stage C dogs. Peak atrial longitudinal average strain < 27.9%, left-atrial-to-aortic ratio > 2.2 and peak atrial contraction average strain < 7.25% discriminated symptomatic MMVD dogs by receiver operating characteristic analysis with sensitivity and specificity of 100% and 100% (95% confidence interval [CI] 91–100%), 92% (95% CI 78–98%) and 98% (95% CI 87–100%), 100% (95% CI 91–100%) and 95% (95% CI 83–99%), respectively. In 12 dogs with similar left-atrial-to-aortic ratio, peak atrial longitudinal average strain and peak atrial contraction average strain differentiated dogs with subclinical disease from those with congestive heart failure (CHF).

Conclusion

Dogs with MMVD in CHF appear to have lower LA longitudinal strain and strain rate variables compared with dogs with subclinical disease. Further studies are needed to establish if our initial findings can provide useful information for the diagnosis, treatment, and prognosis of dogs with MMVD.  相似文献   

6.

Objectives

To provide reference intervals for 2-dimensional linear and area-based estimates of left atrial (LA) function in healthy dogs and to evaluate the ability of estimates of LA function to differentiate dogs with subclinical myxomatous mitral valve disease (MMVD) and similarly affected dogs with congestive heart failure (CHF).

Animals

Fifty-two healthy adult dogs, 88 dogs with MMVD of varying severity.

Methods

Linear and area measurements from 2-dimensional echocardiographs in both right parasternal long and short axis views optimized for the left atrium were used to derive estimates of LA active emptying fraction, passive emptying fraction, expansion index, and total fractional emptying. Differences for each estimate were compared between healthy and MMVD dogs (based on ACVIM classification), and between MMVD dogs with subclinical disease and CHF that had similar LA dimensions. Diagnostic utility at identifying CHF was examined for dogs with subclinical MMVD and CHF. Relationships with bodyweight were assessed.

Results

All estimates of LA function decreased with increasing ACVIM stage of mitral valve disease (p<0.05) and showed negative relationships with increasing LA size (all r2 values < 0.2), except for LA passive emptying fraction, which did not differ or correlate with LA size (p=0.4). However, no index of LA function identified CHF better than measurements of LA size. Total LA fractional emptying and expansion index showed modest negative correlations with bodyweight.

Conclusions

Estimates of LA function worsen with worsening MMVD but fail to discriminate dogs with CHF from those with subclinical MMVD any better than simple estimates of LA size.  相似文献   

7.

Objectives

To evaluate whether tricuspid annular plane systolic excursion (TAPSE) can be normalized to aortic valve (Ao) measurements in dogs. To determine TAPSE:Ao reference intervals for healthy dogs and examine diagnostic performance of TAPSE:Ao in dogs with pulmonary hypertension (PH).

Animals

One hundred and thirty-seven healthy adult dogs; 115 dogs with myxomatous mitral valve disease (MMVD) but no PH; 91 dogs with PH.

Methods

A combined prospective and retrospective study. Full echocardiographic evaluations were performed on all dogs; TAPSE was indexed to Ao to produce a unitless TAPSE:Ao. Reference intervals for TAPSE:Ao were generated, and TAPSE:Ao was regressed on tricuspid regurgitant jet velocity in dogs with PH and on LA:Ao in dogs with MMVD without PH. Diagnostic test analysis was used to examine the ability of TAPSE:Ao to identify severe PH. An adjusted TAPSE:Ao (TAPSE:Ao(adj)) was derived to account for MMVD in dogs with PH.

Results

The ratio, TAPSE:Ao, removed the effect of bodyweight from TAPSE measurements. Healthy dogs had TAPSE:Ao > 0.65. The ratio, TAPSE:Ao, showed a linear negative relationship with tricuspid regurgitation velocity and positive relationship with LA:Ao. The adjusted ratio, TAPSE:Ao(adj), increased the sensitivity of diagnosis of PH in dogs with moderate-severe MMVD without affecting the diagnosis of PH in dogs with PH and with no or mild MMVD.

Conclusions

The ratios, TAPSE:Ao and TAPSE:Ao(adj), are a bodyweight-independent means of assessing right ventricular systolic function in dogs and for identifying severe PH in dogs with or without MMVD.  相似文献   

8.

Objective

To assess the reaction of client-owned dogs to intravenous (IV) catheter placement after applying a local anaesthetic (EMLA) or placebo cream for either 30 or 60 minutes.

Study design

Prospective, randomized, blinded, placebo-controlled, clinical trial.

Animals

A total of 202 client-owned dogs of various breeds.

Methods

With owner consent, dogs were randomly allocated to one of four treatment groups: EMLA 60 minutes, EMLA 30 minutes, Placebo 60 minutes and Placebo 30 minutes. After the cream was applied for the allocated time, an IV catheter was placed and the behavioural reaction of the dog was scored. The reaction score was analysed using a Kruskal–Wallis test followed by Mann–Whitney U tests of the multiple pairwise comparisons, with Bonferroni correction.

Results

A large number of dogs, even in the placebo groups, did not react to IV catheter placement. However, the Kruskal–Wallis test showed an overall difference between treatment groups (χ2 = 11.029, df = 3, p = 0.012). The pairwise comparisons showed a lower overall reaction score in the EMLA 60 group than in the EMLA 30 and Placebo 60 groups (adjusted p = 0.018 and adjusted p = 0.044, respectively).

Conclusions and clinical relevance

This study shows that EMLA cream applied for 60 minutes reduces the behavioural reaction of dogs to IV catheter placement; therefore, this intervention can be advocated for routine use in veterinary medicine to enhance the welfare of dogs undergoing IV catheter placement.  相似文献   

9.

Introduction

Aldosterone breakthrough (ABT) is the condition in which angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers fail to effectively suppress the activity of the renin angiotensin aldosterone system. The objective of this study was to determine if ABT occurs in dogs with naturally occurring myxomatous mitral valve disease receiving an ACEI, using the urine aldosterone to creatinine ratio (UAldo:C) as a measure of renin angiotensin aldosterone system activation.

Animals, Materials and Methods

This study includes 39 dogs with myxomatous mitral valve disease. A UAldo:C cut-off definition (derived from a normal population of healthy, adult, and client-owned dogs) was used to determine the prevalence of ABT in this population. Spearman analysis and univariate logistic regression were used to evaluate the relationship between UAldo:C and ABT (yes/no) and eight variables (age, serum K+ concentration, serum creatinine concentration, ACEI therapy duration and ACEI dosage, furosemide therapy duration and furosemide dosage, and urine sample storage time). Finally, the UAldo:C in dogs receiving spironolactone, as part congestive heart failure (CHF) therapy, was compared to dogs with CHF that were not receiving spironolactone.

Results

The prevalence of ABT was 32% in dogs with CHF and 30% in dogs without CHF. There was no relationship between either the UAldo:C or the likelihood of ABT and the eight variables. Therapy with spironolactone lead to a significant elevation of the UAldo:C.

Discussion

Using the UAldo:C and a relatively stringent definition of ABT, it appears that incomplete RAAS blockade is common in dogs with MMVD receiving an ACEI. The prevalence of ABT in this canine population mirrors that reported in humans. While the mechanism of ABT is likely multifactorial and still poorly understood, the proven existence of ABT in dogs offers the potential to improve the prognosis for MMVD with the addition of a mineralocorticoid receptor blocker to current therapeutic regimens.

Conclusions

Approximately 30% of dogs being treated for heart disease and CHF satisfied the definition of ABT. Identifying patient subpopulations experiencing ABT may help guide future study design and clinical decision-making.  相似文献   

10.

Objective

To assess the temporal effects of a single fentanyl intravenous (IV) bolus on the minimum anesthetic concentration (MAC) of isoflurane in chickens and to evaluate the effects of this combination on heart rate (HR) and rhythm, systemic arterial pressures (sAP) and ventilation.

Study design

Prospective experimental trial.

Animals

Seventeen adult chickens weighing 1.8 ± 0.2 kg.

Methods

Individual isoflurane MAC for 17 chickens was previously determined using the bracketing method. Chickens were anesthetized with isoflurane to evaluate the effects of a single IV fentanyl bolus (10 or 30 μg kg?1) on isoflurane MAC over time using the up-and-down method. Ventilation was controlled. The isoflurane MAC reduction was estimated by logistic regression at 5 and 15 minutes after fentanyl administration. In the second phase, seven chickens were anesthetized with isoflurane, and fentanyl was administered (30 μg kg?1) IV over 1 minute during spontaneous ventilation and HR and rhythm, sAP and ventilation variables were measured.

Results

At 5 minutes after IV administration of fentanyl (10 or 30 μg kg?1), isoflurane MAC was significantly reduced by 17.6% (6.1–29.1%) [logistic regression estimate (95% Wald confidence interval)] and 42.6% (13.3–71.9%), respectively. Isoflurane MAC reduction at 15 minutes after IV administration of fentanyl (10 or 30 μg kg?1) was 6.2% (?0.6 to 12.9%) and 13.2% (?0.9 to 27.3%), respectively; however, this reduction was not significant. No clinically significant cardiopulmonary changes or arrhythmias were detected after the administration of fentanyl (30 μg kg?1).

Conclusions and clinical relevance

Administration of a single fentanyl bolus induced a dose-dependent and short-lasting reduction in isoflurane MAC. The higher dose induced no significant cardiopulmonary depression in isoflurane-anesthetized chickens during spontaneous ventilation. In chickens anesthetized with isoflurane, the clinical usefulness of a single fentanyl bolus is limited by its short duration of effect.  相似文献   

11.

Objective

To evaluate an ultrasound-guided technique for adductor canal (AC) block by describing the distribution of methylene blue around the AC, popliteal fossa, saphenous, tibial and common fibular nerves in dog cadavers.

Study design

Prospective experimental trial.

Animals

Ten mixed breed canine cadavers weighing 28.55 ± 3.94 kg.

Methods

Ultrasound scans of the AC were performed bilaterally in 10 canine cadavers. A high-frequency linear transducer was placed on the long axis of the pectineus muscle and using an in-plane technique, an insulated needle was introduced at a proximal to distal direction into the AC. Methylene blue 0.1% (0.3 mL kg?1) was administered followed by dissection. The presence of dye over the target nerves for ≥2 cm was considered successful distribution. Three of 10 cadavers were submitted to computed tomography (CT) and one of them to magnetic resonance (MR) evaluation.

Results

Methylene blue reached the AC in 20 (100%) and the popliteal fossa in 17 (85%) pelvic limbs. Staining was successful in the saphenous nerve (4.0 ± 1.57 cm) in 11 (55%) limbs, tibial nerve (2.65 ± 0.8 cm) in six (30%) and common fibular nerve (2.7 ± 0.9 cm) in four (20%). There was no evidence of staining around the motor branches of the femoral nerve. No intraneural or intravascular dye spread was found during dissections. Contrast distribution to the popliteal fossa was observed in three limbs (50%) in CT and in one (50%) MR image.

Conclusions and clinical relevance

Although the tibial and common fibular nerves were not stained as often as the saphenous nerve, dye was encountered throughout the popliteal fossa near the nerves. The AC block may be useful for intra and postoperative analgesia in stifle surgery with minimal femoral motor dysfunction. However, further study is required to confirm its efficacy and safety in vivo.  相似文献   

12.

Objective

To investigate the clinical and physiological effects of intravenous (IV) alfaxalone alone or in combination with buprenorphine, butorphanol or tramadol premedication in marmosets.

Study design

Prospective, randomized, blinded, crossover design.

Animals

Nine healthy marmosets (391 ± 48 g, 3.7 ± 2.2 years old).

Methods

Meloxicam 0.20 mg kg?1 subcutaneously, atropine 0.05 mg kg?1 intramuscularly (IM) and either buprenorphine 20 μg kg?1 IM (BUP-A), butorphanol 0.2 mg kg?1 IM (BUT-A), tramadol 1.5 mg kg?1 IM (TRA-A) or no additional drug (control) were administered to all marmosets as premedication. After 1 hour, anaesthesia was induced with 16 mg kg?1 alfaxalone IV. All animals received all protocols. The order of protocol allocation was randomized with a minimum 28 day wash-out period. During anaesthesia, respiratory and pulse rates, rectal temperature, haemoglobin oxygen saturation, arterial blood pressure, palpebral and pedal withdrawal reflexes and degree of muscle relaxation were assessed and recorded every 5 minutes. Quality of induction and recovery were assessed. Duration of induction, immobilization and recovery were recorded. Blood samples were analysed for aspartate aminotransferase, creatine kinase and lactate dehydrogenase concentrations. The protocols were compared using paired t tests, Wilcoxon's signed-rank test with Bonferroni's corrections and linear mixed effect models where appropriate.

Results

Out of nine animals, apnoea was noted in eight animals administered protocol BUP-A and two animals administered protocol BUT-A. With TRA-A and control protocols, apnoea was not observed. No other significant differences in any of the parameters were found; however, low arterial blood pressures and hypoxia occurred in TRA-A.

Conclusions and clinical relevance

Our study employing different premedications suggests that the previously published dose of 16 mg kg?1 alfaxalone is too high when used with premedication because we found a high incidence of complications including apnoea (BUP-A), hypotension and hypoxaemia (TRA-A). Appropriate monitoring and countermeasures are recommended.  相似文献   

13.

Introduction

Heart-base tumors are increasingly treated with radiotherapy, yet safety and efficacy are incompletely understood. This case series describes outcomes after stereotactic body radiation therapy (SBRT) for presumed chemodectoma.

Animals

Six pet dogs.

Methods

A retrospective study was performed, including dogs with a clinical diagnosis of chemodectoma and treatment with three-fraction SBRT (30 Gy total).

Results

Heart-base tumors, presumed or confirmed to be chemodectomas, were diagnosed via histopathology or imaging. Treatment was delivered with intensity modulation and cone-beam computed tomography–based image guidance, using a linear accelerator and robotic couchtop. Intrafraction respiratory motion was managed with either neuromuscular blockade and breath-holding (n = 3) or high-frequency jet ventilation (n = 3); mean total anesthesia times for each technique were 165 and 91 min per fraction, respectively. Four tumors were assessed after SBRT; tumor volume decreased by 30–76%. Possible treatment-related complications included cough, tachyarrhythmias, and congestive heart failure. Two dogs experienced sudden death 150 and 294 days after SBRT. Three dogs are alive 408–751 days after SBRT, and one dog died of unrelated disease 1,228 days after SBRT.

Conclusions

This SBRT protocol resulted in rapid tumor volume reduction, and jet ventilation effectively reduced treatment delivery times. However, cardiac arrhythmias (presumably tumor or treatment associated) and sudden death were common after SBRT. Therefore, SBRT is a potentially useful treatment but may not be appropriate for dogs with incidentally diagnosed, slowly growing tumors, which are not causing cardiovascular disturbances. Longer follow-up and larger case numbers are needed to more completely define safety and impact of treatment on long-term survivability.  相似文献   

14.

Objectives

To determine feasibility and repeatability of measuring the anatomic regurgitant orifice area (AROA) using real-time three-dimensional transthoracic echocardiography (RT3DE) in dogs with myxomatous mitral valve disease (MMVD), and to investigate differences in the AROA of dogs with different disease severity and in different American College of Veterinary Internal Medicine (ACVIM) stages.

Animals

Sixty privately-owned dogs diagnosed with MMVD.

Methods

The echocardiographic database of our institution was retrospectively searched for dogs diagnosed with MMVD and RT3DE data set acquisition. Dogs were classified into mild, moderate, or severe MMVD according to a Mitral Regurgitation Severity Score (MRSS), and into stage B1, B2 or C according to ACVIM staging. The RT3DE data sets were imported into dedicated software and a short axis plane crossing the regurgitant orifice was used to measure the AROA. Feasibility, inter- and intra-observer variability of measuring the AROA was calculated. Differences in the AROA between dogs in different MRSS and ACVIM stages were investigated.

Results

The AROA was measurable in 60 data sets of 81 selected to be included in the study (74%). The inter- and intra-observer coefficients of variation were 26% and 21%, respectively. The AROA was significantly greater in dogs with a severe MRSS compared with dogs with mild MRSS (p=0.045). There was no difference between the AROA of dogs in different ACVIM clinical stages.

Conclusions

Obtaining the AROA using RT3DE is feasible and might provide additional information to stratify mitral regurgitation severity in dogs with MMVD. Diagnostic and prognostic utility of the AROA deserves further investigation.  相似文献   

15.

Objective

To determine the anti-inflammatory efficacy of choline in vivo and in vitro and to investigate the anti-inflammatory mechanisms of choline.

Study design

Randomized, controlled studies.

Animals

In vivo trials used 16 Romney sheep. In vitro experiments utilized RAW 264.7 mouse macrophage cells.

Methods

Hypoxaemia induced in 16 sheep by intravenous (IV) injection of 50 μg kg–1 xylazine, an α-2 agonist, was measured in sheep at 0, 1 and 4 minutes using arterial blood gas analysis with and without 50 mg kg–1 IV choline chloride premedication. Cell culture studies used enzyme-linked immunosorbent assay to measure the release of tumour necrosis factor (TNF-α) from lipopolysaccharide (LPS) stimulated macrophages with and without choline chloride premedication. TNF-α release was compared to thalidomide suppressed and untreated cells.

Results

Choline premedication in sheep mitigated a reduction in arterial partial pressure of oxygen (PaO2) but did not prevent development of clinically significant hypoxaemia. Decrease in mean PaO2 of choline treated sheep was 6.36 kPa (47.7 mmHg) compared to 9.81 kPa (73.6 mmHg) in control sheep. In vitro studies demonstrate that choline administered concurrent with LPS activation did not significantly suppress TNF-α expression but that treatment of cells with choline 10 minutes prior to LPS activation did significantly suppress TNF-α expression. Choline pretreated cells expressed 23.99 ± 4.52 ng mg–1 TNF-α while LPS only control cells expressed 33.83 ± 3.20 ng mg–1.

Conclusions

Choline is able to prevent macrophage activation in vitro when administered prior to LPS activation and may reduce hypoxaemia in sheep developing pulmonary oedema after xylazine administration. This effect requires premedication with choline.

Clinical relevance

Pharmacological manipulation of autonomic inflammatory responses holds promise for the treatment of inflammation. However, the complex cellular mechanisms involved in this reflex means that an adequate therapy should approach multiple pathways and mechanisms of the inflammatory response.  相似文献   

16.

Objective

To evaluate and compare the analgesic effects of a combination of lidocaine and xylazine to lidocaine or xylazine administered alone for epidural anesthesia in Egyptian water buffalo (Bubalus bubalis).

Study design

Prospective, randomized, ‘blinded’, crossover experimental study.

Animals

A total of 12 female Egyptian water buffalo.

Methods

Buffalo were randomly assigned to one of three epidural treatments administered through the sacrococcygeal joint: a local anesthetic (2% lidocaine, 0.22 mg kg?1), an alpha-2-adrenergic agonist (xylazine, 0.1 mg kg?1) or a combination of both drugs in a crossover fashion with a 14 day washout period. The total volume of each treatment was fixed at 7.0 mL by adding 0.9% NaCl. Onset, maximal effect, and duration of epidural anesthesia were recorded.

Results

Caudal epidural anesthesia was easily performed, and all three treatments produced local anesthesia of the tail and perineal structures of standing buffalo. Onset of epidural anesthesia was faster (p < 0.05) with lidocaine (3.4 ± 0.9 minutes) than with xylazine (9.1 ± 1.1 minutes) or lidocaine-xylazine (6.4 ± 1.1 minutes). The maximal effect of epidural anesthesia was reached faster (p < 0.05) with lidocaine (5.9 ± 0.64 minutes) than xylazine (14.4 ± 1.1 minutes) or lidocaine-xylazine (12.9 ± 0.64 minutes). The duration of epidural anesthesia was longer (p < 0.05) with lidocaine-xylazine (145.8 ± 3.3 minutes) than either lidocaine (118.4 ± 2.7 minutes) or xylazine (102.1 ± 3.7 minutes) administered alone. None of the treatments produced ataxia.

Conclusions and clinical relevance

Caudal epidural anesthesia was easily performed in Egyptian water buffalo by administering a local anesthetic, an alpha-2-adrenergic agonist or a combination of both drugs through the sacrococcygeal joint. Administering a combination of lidocaine and xylazine provided a longer duration of anesthesia than either drug used alone. Epidural xylazine provided a useful level of systemic sedation without ataxia.  相似文献   

17.
18.

Objective

To determine the effect of oral trazodone on the minimum alveolar concentration (MAC) of isoflurane in dogs.

Study design

Prospective blinded, single-observer, randomized crossover experimental study.

Animals

Six adult (age 6.8 ± 1.6 months) healthy dogs (three males and three females), weighing 24.8 ± 3.4 kg (mean ± standard deviation).

Methods

Each dog was anesthetized twice with a minimum of 7 days between anesthetic episodes. Dogs were randomly assigned to be administered two treatments in a crossover design: premedication with trazodone (8 mg kg?1; TRAZ–ISO) orally 2 hours prior to an anesthetic episode or no (ISO). Dogs were anesthetized with intravenous propofol (6 mg kg?1) and isoflurane in >95% oxygen. Isoflurane MAC was determined using an iterative bracketing technique with electrodes placed in the buccal mucosa. Hemodynamic variables were compared at the lowest end-tidal isoflurane concentration at which each dog did not respond. A paired t test was used to assess the effect of treatment on outcome variables with significance set to a value of p < 0.05.

Results

The MAC concentration (mean ± standard deviation) in dogs administered TRAZ–ISO was 0.85 ± 0.17% compared with 1.02 ± 0.11% in those administered ISO (p = 0.01, 95% confidence interval ?0.25 to ?0.05), resulting in a mean MAC reduction of 17 ± 12%. There were no differences in hemodynamic variables between treatments.

Conclusions and clinical relevance

Premedication of dogs with oral trazodone (8 mg kg?1) 2 hours prior to anesthetic induction has a significant isoflurane MAC sparing effect with no significant observed hemodynamic benefit.  相似文献   

19.

Objective

To test the efficacy of intraoperative intrafragmentary administration of bupivacaine (haematoma block) in controlling postoperative pain in dogs undergoing osteosynthesis of long-bone isolated diaphyseal fractures.

Study design

Randomized, ‘blinded’, placebo-controlled, prospective study.

Animals

A total of 23 client-owned dogs with isolated long-bone fractures.

Methods

Dogs were allocated randomly to two groups: bupivacaine group (B) or placebo group (P). Group B dogs (n = 11) were administered an intraoperative intrafragmentary injection of 0.5% bupivacaine (1.1 mg kg–1) just before fracture fixation, whereas group P dogs (n = 12) were administered normal saline. Postoperative pain evaluations using the University of Melbourne Pain Scale (UMPS) and algometer were performed upon arrival to the recovery room and 1, 2, 4, 6, 8, 20 and 32 hours later. Algometer measurements were performed on: the incision site, a healthy region near the fracture line and the contralateral healthy limb. When the pain score exceeded 14 points in the UMPS, rescue analgesia was administered. The time-standardised area under the curve (AUCst) was used to compare UMPS scores and mechanical pain thresholds between the two groups.

Results

None of the group B dogs required rescue analgesia, whereas eight of the 12 group P dogs did (p = 0.001). The pain threshold AUCst at the incision line was higher in group B [16.3 (2.9–41.6) N] than in group P [5.6 (2.5–17.4) N] (p = 0.029). The mean UMPS score AUCst was lower in group B (3.7 ± 1.8) than in group P (9.4 ± 4.6) (p = 0.016). In a small number of animals of both groups that were evaluated radiologically, adequate bone healing was noted.

Conclusions and clinical relevance

An intraoperative bupivacaine haematoma block is a simple, quick and effective method that can be used to aid in postoperative pain control in dogs submitted to long-bone osteosynthesis.  相似文献   

20.

Objective

To compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit (ICU).

Study design

Prospective, randomized, blinded, clinical trial.

Animals

A total of 29 client-owned dogs.

Methods

Dogs prescribed a μ-opioid agonist infusion for postsurgical or medical pain were randomized to be administered either hydromorphone (0.025 or 0.05 mg kg?1 bolus, followed by a 0.03 mg kg?1 hour?1 infusion) or fentanyl (2.5 or 5 μg kg?1 bolus, followed by a 3 μg kg?1 hour?1 infusion). The technical staff and clinicians were blinded as to which drug was administered. Pain scores, using the Colorado State University Canine Acute Pain Scale, sedation scores and nausea scores were assigned at regular intervals and compared between groups. Dose escalation and de-escalation of the study drug were performed according to set protocols. Adverse clinical signs and all other medications administered were recorded and compared between groups. The study drug was discontinued if the animal remained painful despite dose escalations, or if adverse effects were noted.

Results

The pain scores were of low magnitude and were not significantly different between groups. The use of concurrent analgesia, sedation/anxiolytic medications and antacid/antiemetic medications was not different between groups. Sedation and nausea scores were not statistically different between groups.

Conclusions and clinical relevance

Hydromorphone and fentanyl CRIs appear to be equally effective for adequate pain relief in dogs, with no significant differences in adverse effects. Therefore, either drug may be chosen for control of postsurgical or medical pain in an ICU setting.  相似文献   

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