Serial venous lactate measurement following gastrointestinal surgery in horses

BackgroundProspective clinical study of blood lactate concentration in horses undergoing colic surgery is needed to determine utility in outcome prediction.ObjectivesTo evaluate venous lactate measurements in horses following colic surgery, including immediately after anesthetic recovery and daily throughout hospitalization, as well as to determine if lactate concentrations were significantly higher in horses that developed postoperative complications or did not survive to hospital discharge.MethodsHorses > 1 year of age undergoing surgery for colic and recovered from general anesthesia were sampled. A portable lactate meter was used to measure venous samples collected immediately following anesthetic recovery and daily throughout hospitalization. Complications arising during hospitalization and survival to hospital discharge were recorded.ResultsFifty one horses were enrolled, ranging in age from 2 to 29 years. Lactate concentration immediately following anesthetic recovery was higher in horses that developed complications during hospitalization (p = 0.046). The odds of developing complications postoperatively were doubled for horses with a venous lactate concentration > 5 mmol/L. Lactate measurements in non-survivors were significantly higher compared to survivors by 96 h postoperatively (p < 0.006).ConclusionsHigher venous lactate concentrations in the postoperative colic period were associated with an increased risk of complications and death. Results suggest horses with higher venous lactate measurements in recovery are more likely to have postoperative complications, with the odds of developing complications doubled for horses with a venous lactate > 5 mmol/L. Evaluation of venous lactate could provide information on prognosis in the postoperative period for horses with surgical colic.     

Clinical evaluation of balanced anesthesia using infusion of midazolam–ketamine–medetomidine in combination with inhalation of sevoflurane (MKM–OS anesthesia) in horses

MKM–OS anesthesia provides general anesthesia with minimum cardiovascular depression in experimental horses. The purpose of this study was to evaluate the effect of MKM–OS anesthesia in clinical cases. Sixty‐eight horses were anesthetized with MKM–OS anesthesia for selective or emergency surgery. The horse physical status was categorized based upon the American Society of Anesthesiologists (ASA) classification scheme. Forty‐four horses were classified as ASA I or II (low‐risk; 30 soft tissue, eight ophthalmic, and six orthopedic surgeries) and 24 horses were classified as ASA III to V (high‐risk; 24 emergency colic surgeries). All horses were administered medetomidine (0.005 mg kg^–1 IV) as premedication and anesthetized with ketamine (2.5 mg kg^–1 IV) and midazolam (0.04 mg kg^–1 IV). The horses were orotracheally intubated and connected to a large animal breathing circuit that delivered oxygen‐sevoflurane and administered the midazolam (0.8 mg mL^–1)‐ketamine (40 mg mL^–1)‐medetomidine (0.05 mg mL^–1) drug combination at a rate of 0.025 mL kg^–1 hour^–1. Surgical anesthesia was maintained by controlling the dial setting of the sevoflurane vaporizer and achieved by delivering 1.6–1.8% of end‐tidal sevoflurane concentration. All horses were mechanically ventilated during anesthesia. Hypercapnia and hypoxia were not sufficiently improved in high‐risk horses (PaCO₂; low‐risk 45–53 mm Hg versus high‐risk 56–60 mm Hg, p < 0.01: PaO₂ low‐risk 248–388 mm Hg versus high‐risk 95–180 mm Hg, p < 0.01). Heart rate was significantly higher in high‐risk horses (low‐risk 37–42 bpm versus high‐risk 44–73 bpm, p < 0.01). Dobutamine infusion was required in five low‐risk (11%) and 17 high‐risk horses (68%) to maintain mean arterial blood pressure >70 mm Hg. Eleven high‐risk horses died during the perioperative period (three euthanized during surgery, two died during recovery, six died after recovery). The quality of recovery was good in low‐risk horses and good to satisfactory in high‐risk horses. MKM–OS anesthesia provided excellent surgical anesthesia with minimal to mild cardiovascular depression in low risk‐horses and mild to moderate cardiovascular depression in high risk‐horses. The possibility of preserve cardiovascular function could be the advantage of MKM–OS anesthesia in high‐risk horses.     

Pulmonary gas exchange and plasma lactate in horses with gastrointestinal disease undergoing emergency exploratory laparotomy: a comparison with an elective surgery horse population

Objective: To characterize pulmonary gas exchange and arterial lactate in horses with gastrointestinal disease undergoing anesthesia, compared with elective surgical horses, and to correlate these variables with postoperative complications and mortality. Study Design: Prospective clinical study. Animals: Horses undergoing emergency laparotomy for acute intestinal disease (n=50) and healthy horses undergoing elective surgery in dorsal recumbency (n=20). Methods: Arterial blood gas analysis was performed at predetermined intervals on horses undergoing a standardized anesthetic protocol. Alveolar–arterial oxygen gradient was calculated. Predictive factors for postoperative complications and death in colic horses were determined. Results: Arterial oxygen tension (P_aO₂) varied widely among horses in both groups. P_aO₂ significantly increased in the colic group after exteriorization of the ascending colon. P_aO₂ and alveolar–arterial oxygen gradient were not significantly different between groups, and neither were correlated with horse outcome. Arterial lactate in recovery ≥5 mmol/L was associated with a 2.25 times greater relative risk of complications and lactate ≥7 mmol/L was associated with a 10.5 times higher relative risk of death. Conclusion: Colic horses in this population were not more likely to be hypoxemic than elective horses, nor was gas exchange impaired to a greater degree in colic horses relative to controls. Arterial lactate sampled immediately after anesthetic recovery was predictive for postoperative complications and death.     

Use of the Anderson Sling suspension system for recovery of horses from general anesthesia

OBJECTIVE: To describe a sling recovery system (Anderson Sling) for horses and to evaluate outcome of high-risk horses recovered from general anesthesia by a sling. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Horses (n=24) recovered from general anesthesia. METHODS: Complete medical and anesthetic records (1996-2003) for horses recovered from general anesthesia using the Anderson Sling system were evaluated retrospectively. Information retrieved included anesthetic protocol, surgical procedure, recovery protocol, recovery time, and quality of the recovery. Horses were recovered from anesthesia supported by the Anderson Sling in a standing position within a traditional padded equine recovery stall. RESULTS: Twenty-four horses had 32 assisted recoveries; 31 events were successful. No complications associated with the sling or recovery system protocol occurred. One horse was intolerant of the sling's support and was reanesthetized and recovered successfully using head and tail ropes. CONCLUSION: The Anderson Sling recovery system is an effective and safe way to recover horses that are at increased risk for injury associated with adverse events during recovery from general anesthesia. CLINICAL RELEVANCE: The Anderson Sling system should be considered for assisted recovery of equine patients from general anesthesia.     

A comparison of anesthetic risk factors and outcomes in light and draft horses

As a result of anatomic and physiologic differences, draft breeds may be at greater risk of developing anesthetic complications. The aim of the study was to evaluate and compare anesthetic management of draft (DR) and light (LT) horses. A case‐matched retrospective study of 371 clinical case records of DR (124 cases) and LT (247 cases) horses presented for general anesthesia between 1991 and 1998 was performed. Data were tabulated and comparisons were made using Student's t‐test (significance p < 0.05). Prior to induction, there were significant differences in mean body weight, rectal temperature, PCV, RBC, and serum TP concentration between DR and LT breeds. There were differences in mean doses of pre‐operative butorphanol (LT 21 µg kg^?1; DR 17 µg kg^?1), induction guaifenesin (LT 99 mg kg^?1; DR 88 mg kg^?1), and intraoperative ketamine (LT 0.35 mg kg^?1; DR 0.56 mg kg^?1) required. There were no significant differences in the mean doses of pre‐operative xylazine, detomidine, or induction barbiturate administered. The mean, average, and maximum concentrations of inspired halothane were significantly higher for DR than for LT horses. Draft horses received 33% less intraoperative IV fluids (8.2 mL kg^?1 hour^?1) than LT horses. Mean anesthetic duration, time to extubation, and standing recovery were not significantly different. Induction complications were not reported for either group. Rates of occurrence of intraoperative bradycardia, hypercarbia, hypoxemia, and metabolic acidosis (SBE, TCO₂, and bicarbonate concentration) did not differ significantly. Average MAP was greater in DR horses, but neither the degree nor the mean duration of hypotension differed between DR and LT horses. Mean PaO₂ was significantly lower in DR (246 mm Hg, 32.8 kPa) than in LT (305 mm Hg, 40.7 kPa) breeds. Draft horses were at greater relative risk of hypoventilation than LT horses. The greater MAP and requirement for halothane and intraoperative ketamine may indicate problems in achieving and maintaining a surgical plane of anesthesia. Draft horses may be at a greater risk of ventilation–perfusion mismatching.     

Mortality outcomes based on ASA grade in avian patients undergoing general anesthesia

BackgroundThe American Society of Anesthesiologists physical status classification system is commonly used in all fields of veterinary medicine, with higher grades correlated with increased mortality in non-avian companion animals, but little evidence is available for avian species. This study aims to investigate whether prospective ASA grade is a reliable predictor of mortality in avian species undergoing general anesthesia.MethodsAnesthetic records for avian patients undergoing inhalational isoflurane anesthesia were retrospectively examined to assess mortality outcomes during and up to 48 hours after cessation of anesthesia. Prospective ASA grade assigned at the time of anesthesia was used to categorize anesthetized patients.ResultsA total of 1820 anesthetic records were included over a 3-year period. A total of 81 patients (4.45%) died during anesthesia or within 48 hours of cessation of anesthesia. Patients assigned an ASA grade of 1 had a mortality rate of 0% (95% confidence interval [CI] 0.0–0.2), and patients assigned an ASA grade of 2 had a mortality rate of 0.6% (CI 0.2–1.3%). Patients assigned ASA grades 3, 4, and 5 had mortality rates of 5.9% (CI 4.3–8.0), 18.8% (CI 13.4–25.7) and 50.0% (CI 29.9–70.1) respectively. Patients assigned an ASA grade of 3 were found to have 11.5 times the odds of a mortality event (95% CI 5.0–31.8) compared to ASA grades 1 and 2. A further increase in odds of 40.0 times (CI 16.9–113.8) was identified in patients assigned an ASA grade of 4, and 185.2 (CI 57.6–668.1) identified in patients assigned an ASA grade of 5. Age, sex and weight were shown to have no statistically significant impact on odds of death. Investigation into timing of death showed that the majority of patients died following cessation of general anesthesia (81.48%), with the highest mortality rate occurring between 0 and 3 hours postgeneral anesthesia.Conclusions and clinical relevanceThis study indicates that patients assigned ASA grades of 3 or greater are at higher odds of death compared to those assigned ASA grades 1 or 2. The odds of death increased with increasing ASA grades. The highest mortality rate was identified within 0–3 hours of cessation of general anesthesia.     

Demographic,preoperative and anaesthesia-related risk factors for unsatisfactory recovery quality in horses undergoing emergency abdominal surgery

ObjectiveTo determine demographic, preoperative and anaesthesia-related variables that may be associated with unsatisfactory recovery quality in horses undergoing emergency abdominal surgery (colic) in an equine teaching hospital.Study designRetrospective case series.AnimalsA total of 313 horses.MethodsThe anaesthetic records of horses admitted for surgical treatment of colic between 2005 and 2018 were examined. Overall quality of recovery was assessed as dangerous, poor, fair, good or excellent. The following categories were constructed as a dichotomic variable: unsatisfactory recovery (poor and dangerous recoveries) and satisfactory recovery (excellent, good and fair recoveries). Univariable and multivariable analyses were performed to evaluate the association between all studied variables and recovery.ResultsAll recoveries were unassisted. Unsatisfactory recovery quality totalled 17.2% (3.5% and 13.7% were dangerous and poor recoveries, respectively), whereas satisfactory recoveries totalled 82.8% (26.2%, 40.9% and 15.7% were fair, good and excellent recoveries, respectively). Univariable analysis showed that unsatisfactory recoveries were associated with high preoperative packed cell volume, pain behaviour, poor premedication and induction quality, high intraoperative mean heart rate, low mean arterial blood pressure, dobutamine dose ≥1.5 μg kg^–1 minute^–1, non-administration of romifidine, long anaesthesia time and prolonged time to stand. The multivariable model showed that factors strongly associated with unsatisfactory recovery quality were dobutamine dose ≥1.5 μg kg^–1 minute^–1 [adjusted odds ratio (AOR) = 6.60; 95% confidence interval (CI), 2.91–14.96], poor premedication quality (AOR=4.60; 95% CI, 1.73–12.23) and a time to stand > 70 minutes (AOR=2.59; 95% CI, 1.13–5.91).Conclusions and clinical relevanceOur study shows that high dobutamine requirements, poor premedication quality and a prolonged time to stand are risk factors for unsatisfactory recovery quality in horses undergoing anaesthesia for colic surgery. Addressing these factors may enable clinicians to improve the quality of recovery phase.     

Questionnaire on the process of recovering horses from general anesthesia and associated personnel injury in equine practice

ObjectiveTo collect data about the current practice of recovering horses from general anesthesia and recovery personnel safety.Study designOnline survey.MethodsAn online questionnaire, including questions on general demographic data, recovery drugs, modality and characteristics of equine recovery and morbidity and mortality, was designed and distributed via e-mail to equine practitioners worldwide.ResultsPractitioners from 22 countries completed 373 questionnaires; 53% of the participants were board-certified equine surgeons, and the remainder were board-certified anesthesiologists (18%), large animal residents (8%), general practitioners (7%), large animal interns (6%), anesthesia residents (4.5%) and veterinary technicians (1.6%). Respondents were employed by academia (58%) or private practice (42%). Of the respondents employed at a university, 93% had a board-certified anesthesiologist on staff compared with 7% of respondents employed at a private practice. Most of the respondents assist horses during recovery, with 23% assisting every recovery and 44% assisting recovery in the majority of cases. Reasons for choosing to assist horses during recovery were: orthopedic procedures (57%), neurological deficits (49%), bad health (47%), history of poor recovery (44%), foals (42%), draft breeds (30%), magnetic resonance imaging (17%) and computed tomography (16%). Unacceptable recoveries were reported by 77% of participants. Commonly reported complications during recovery with any method were: orthopedic injury (66%), myopathy (54%), skin abrasion (53%) and airway obstruction (37%). The incidences of unacceptable quality of recovery (p = 0.09) or personnel injury (p = 0.56) were not different between assisted and nonassisted recoveries; however, more equine fatalities were reported for assisted recoveries (p < 0.006). Practitioners in academia reported more unacceptable recoveries (p < 0.0007) and personnel injuries (p < 0.002) compared with those in private practice.ConclusionsThe method of recovery differs among hospitals. Recovery personnel injuries associated with assisting horses during recovery are an important and previously unreported finding.     

A retrospective evaluation of the effect of perianesthetic hydromorphone administration on the incidence of postanesthetic signs of colic in horses

ObjectiveTo describe the incidence of postanesthetic signs of colic (PASC) in horses and determine if perianesthetic administration of hydromorphone was associated with an increased risk of PASC.Study designRetrospective, cohort study.AnimalsA total of 409 horses.MethodsAnesthesia and clinical records of horses admitted for various procedures from July 2018 to September 2019 were reviewed. Signs of colic and interventions were recorded up to 48 hours after anesthesia. A binomial logistic regression model was used to evaluate the association between the type of surgery, administration of hydromorphone, the duration of anesthesia and the incidence of PASC.ResultsOverall, 25 (6.1%) horses developed PASC within 48 hours of general anesthesia. Of 60 horses that underwent colic surgery, 16 (26.7%) developed PASC. Of 349 horses that underwent noncolic procedures, nine (2.6%) developed PASC. Thus, the incidence of PASC was higher in horses that underwent colic surgery than in horses that underwent noncolic procedures [odds ratio (OR) = 13.74 (5.73–32.95)]. No effect of hydromorphone on the incidence of PASC was identified [OR = 1.61 (0.71–3.62)]. Longer procedures (>2 hours) were identified as an independent risk factor for PASC [OR = 4.13 (1.52–11.22)].ConclusionsNo association between hydromorphone and an increase in the incidence of PASC was identified. Anesthesia for colic surgery and duration of anesthesia were associated with an increased risk of PASC.Clinical relevanceHydromorphone did not increase the incidence of PASC in this population.     

Effects of intravenous ethyl pyruvate on cardiopulmonary variables and quality of recovery from anesthesia in horses

ObjectiveTo determine the effects of intravenous ethyl pyruvate, an anti-inflammatory with putative benefits in horses with endotoxemia, on cardiopulmonary variables during anesthesia and the quality of anesthetic recovery.Study designRandomized, crossover, blinded experimental design.AnimalsA total of six healthy Standardbred geldings, aged 13 ± 3 years and weighing 507 ± 66 kg (mean ± standard deviation).MethodsHorses were anesthetized for approximately 90 minutes on two occasions with a minimum of 2 weeks apart using xylazine for sedation, ketamine and diazepam for induction, and isoflurane in oxygen for maintenance. Lactated Ringer’s solution (LRS; 10 mL kg^–1 hour^–1) was administered during anesthesia. Treatments were randomized and administered starting approximately 30 minutes after induction of anesthesia and infused over 60 minutes: LRS (1 L) or ethyl pyruvate (150 mg kg^–1 in 1 L LRS). Invasive arterial pressures, heart rate, respiratory rate and end-tidal carbon dioxide tensions were recorded every 5 minutes for the duration of anesthesia. Arterial blood gases, glucose and lactate concentrations were measured every 20 minutes. Anesthetic recovery was video recorded, stored, and subsequently rated by two individuals blinded to treatments. Total recovery time, time to extubation, number of attempts and time to sternal recumbency, number of attempts to stand and time to stand were recorded. Quality of recovery was analyzed. Data between treatments and within a treatment were assessed using two-way repeated-measures anova and a Pearson correlation coefficient, significant at p < 0.05.ResultsAll horses completed the study. No significant differences were detected between the ethyl pyruvate and LRS treatments for either the cardiopulmonary variables or quality of recovery from anesthesia.Conclusions and clinical relevanceThe results suggest that intravenous ethyl pyruvate can be administered to healthy anesthetized horses with minimal impact on the cardiopulmonary variables studied or the quality of recovery from anesthesia.     

Evaluation of surgical treatment for signs of acute abdominal pain in draft horses: 72 cases (1983-2002)

OBJECTIVE: To determine whether heavy (> or = 680 kg [> or = 1,500 lb]) draft horses undergoing surgical treatment for acute signs of abdominal pain were at a greater risk for anesthetic and postoperative complications and lower postoperative survival rates than light (< 680 kg) draft horses. DESIGN: Retrospective case series. ANIMALS: 72 draft horses. PROCEDURES: Medical records of draft horses that underwent exploratory celiotomy for signs of acute abdominal pain from October 1983 to December 2002 were reviewed. Medical records of draft horses in which a celiotomy was performed for correction of reproductive abnormalities were not included in the study. RESULTS: When compared with light draft horses, heavy draft horses had longer durations of anesthesia, more postoperative complications, and lower survival rates. Seventy-six percent of horses that recovered from anesthesia had postoperative complications. Postoperative complications associated with low survival rates included myopathy and neuropathy, ileus, diarrhea, and endotoxemia. All horses with postoperative myopathy and neuropathy died or were euthanized. The short-term survival rate for horses that recovered from anesthesia was 60%. Horses undergoing small intestinal surgery had a worse prognosis for short-term survival than those undergoing large intestinal surgery. The survival rate for horses for which long-term (> 1 year) follow-up information was available was 50%. CONCLUSIONS AND CLINICAL RELEVANCE: Draft horses weighing > 680 kg that underwent surgery because of acute signs of abdominal pain had longer durations of anesthesia, more postoperative complications, and higher mortality rates than draft horses weighing < 680 kg.     

Multivariate analysis of factors associated with post-anesthetic times to standing in isoflurane-anesthetized horses: 381 cases

Objective  To identify anesthesia-related variables which may independently predict time to standing in horses anesthetized with ketamine/diazepam/isoflurane.
Study design  Retrospective case series.
Animals  Three hundred and eighty-one horses.
Methods  Case records were searched for the years 2000–2003 and 381 horses older than 12 months which weighed at least 200 kg were identified. Data were extracted from the records, and only horses that were anesthetized with xylazine, ketamine, diazepam and isoflurane were included in the analysis. Multiple linear regression was used to relate time to standing with demographic, intraoperative and anesthetic variables.
Results  Most (326; 86%) horses recovered unassisted and 55 (14%) were assisted in recovery. The model for unassisted recovery had an R ² of 0.228 with colic ( p  < 0.0001), anesthesia duration ( p  < 0.02), temperature nadir ( p  < 0.02) and duration of hypotension ( p  < 0.0001) being significant predictors of time to standing. The final model for predicting assisted recovery time had an R ² of 0.314 with emergency status ( p  < 0.0001), warm-blood breed ( p  < 0.04) and intraoperative administration of ketamine ( p  < 0.004) being the significant predictor.
Conclusions and clinical relevance  Variables which could be impacted by the anesthetist which would result in a faster time to standing include duration of anesthesia, hypothermia and intraoperative hypotension. However, the contribution of anesthesia factors explained <23% of the variability in recovery time, suggesting that other, more important factors contribute to anesthesia recovery time in horses.     

Use of Propofol–Xylazine and the Anderson Sling Suspension System for Recovery of Horses from Desflurane Anesthesia

Objective— To characterize the behavior of horses recovering in the Anderson Sling Suspension System after 4 hours of desflurane anesthesia and postdesflurane intravenous (IV) administration of propofol and xylazine. Study Design— Experimental study. Animals— Healthy horses (n=6), mean±SEM age 12.3±1.8 years; mean weight 556±27 kg. Methods— Each horse was anesthetized with xylazine, diazepam, and ketamine IV and anesthesia was maintained with desflurane in O₂. At the end of 4 hours of desflurane, each horse was positioned in the sling suspension system and administered propofol–xylazine IV. Recovery events were quantitatively and qualitatively assessed. Venous blood was obtained before and after anesthesia for biochemical and propofol analyses. Results— Anesthetic induction and maintenance were without incident. Apnea commonly accompanied propofol administration. All horses had consistent recovery behavior characterized by a smooth, careful, atraumatic return to a standing posture. Conclusions— Results of this study support careful, selective clinical use of desflurane, propofol–xylazine, and the Anderson Sling Suspension System to atraumatically transition horses with high anesthetic recovery risk to a wakeful standing posture. Clinical Relevance— Technique choices to facilitate individualized, atraumatic recovery of horses from general anesthesia are desirable. Use of IV propofol and xylazine to transition horses from desflurane anesthesia during sling recovery to standing posture may facilitate improved recovery management of high‐injury risk equine patients requiring general anesthesia.     

Perianesthetic development of diaphragmatic hernia in a horse with equine pituitary pars intermedia dysfunction (PPID)

A 21-year-old Thoroughbred gelding with a history of equine pituitary pars intermedia dysfunction (PPID) presented with priapism of 2 days’ duration. The horse received a caudal morphine epidural and then underwent corpus cavernosum lavage and phallectomy under general anesthesia. The patient’s recovery featured multiple unsuccessful attempts to stand and his respiratory distress persisted for several hours until he acutely developed severe colic and was euthanized. Necropsy findings revealed a pituitary adenoma of the pars intermedia, bilateral adrenal cortical hyperplasia, and diaphragmatic herniation. This report suggests that horses with PPID may present a greater risk for diaphragmatic hernia under general anesthesia or during procedures placing stress on the diaphragm, including anesthetic recovery.     

RESEARCH PAPER: Evaluation of cardiovascular,respiratory and biochemical effects,and anesthetic induction and recovery behavior in horses anesthetized with a 5% micellar microemulsion propofol formulation

ObjectiveTo characterize cardiovascular, respiratory and biochemical effects and recovery behavior associated with a 3‐hour continuous infusion of a micellar microemulsion propofol formulation in horses.Study designProspective experimental trial.AnimalsSix healthy adult horses, 9 ± 2 years old and weighing 557 ± 14 kg.MethodsAll horses received xylazine (1 mg kg^?1, IV) 5 minutes prior to anesthetic induction. Each horse was anesthetized on two occasions with a 5% micellar microemulsion propofol formulation (2 mg kg^?1, IV); first as a single bolus (phase I) and then as a 3‐hour continuous infusion (phase II). Propofol pharmacokinetics were obtained from phase I and used to determine the starting infusion rates in phase II. Anesthetic induction and recovery characteristics were quantitatively and qualitatively assessed. Cardiovascular, respiratory and biochemical parameters were monitored during anesthesia and recovery.ResultsInduction quality varied, ranging from good to poor. Standing and overall recovery quality scores were consistently excellent in phase I but more variability was observed among horses in phase II. Heart rate (HR) and mean arterial pressure (MAP) were adequately maintained but marked hypoventilation developed. There were only minimal changes in blood biochemical analytes following anesthesia.Conclusions and clinical relevanceThe micellar microemulsion propofol formulation, administered as a 3‐hour continuous infusion, showed similar results compared to those previously described with a commercially available propofol preparation. However, based on present findings, use of propofol as a primary anesthetic in horses for prolonged periods of anesthesia requires further study to determine the limits of safety and clinical applicability.     

Oxidative Stress Associated With Spasmodic,Flatulent, and Impaction Colic in Draft Horses

The aim of the present study was to evaluate the oxidative stress level and antioxidant trace elements status associated with spasmodic, flatulent, and impaction colic in draft horses. For this purpose, venous blood samples were obtained from 20 randomly selected clinically healthy draft horses (control group) and 60 draft horses with different types of colic (spasmodic colic, n = 20; flatulent colic, n = 20; and impaction colic, n = 20). In horses with flatulent and impaction colic, there was a significant (P < .05) decrease in the total antioxidant capacity and activity of reduced glutathione (GSH) and catalase (CAT) as well as level of selenium, copper, zinc, and iron. However, there was a significant (P < .05) increase in the activity of superoxide dismutase (SOD) and in the level of malondialdehyde (MDA), interleukin-6 (IL-6), and manganese. Meanwhile, glutathione reductase (GR) was significantly (P < .05) increased in flatulent colic and significantly (P < .05) decreased in impaction colic. The oxidative stress index (OSI) was significantly (P < .05) increased in horses with flatulent and impaction colic. In horses with flatulent colic, there was a negative correlation between CAT and SOD (r = −0.446), MDA and zinc (r = −0.450), and IL-6 and zinc (r = −0.470). However, those with impaction colic, a negative correlation was recorded between CAT and MDA (r = −0.602), copper and GSH (r = −0.474), iron and GR (r = −0.511), and OSI and GR (r = −0.662). The results of the present study indicate that oxidative stress, with alteration of antioxidant trace element levels, is a feature of flatulent and impaction colic in draft horses.     

Management and complications of anesthesia for transvenous electrical cardioversion of atrial fibrillation in horses: 62 cases (2002-2006)

OBJECTIVE: To describe management of anesthesia for transvenous electrical cardioversion (TVEC) in horses and report perianesthetic complications. DESIGN: Retrospective case series. ANIMALS: 62 horses with atrial fibrillation and without underlying cardiac disease and 60 horses without atrial fibrillation. PROCEDURES: Medical records of horses with atrial fibrillation anesthetized for TVEC were reviewed, as were records of horses without atrial fibrillation anesthetized for magnetic resonance imaging (MRI). The TVEC group horses were compared with MRI group horses for incidence of intraoperative bradycardia and use of inotropic drugs. Data obtained included patient signalment, weight, duration of anesthesia, heart rate and arterial blood pressure during anesthesia, anesthetic drugs administered, mode of ventilation, perioperative complications, and quality of recovery. RESULTS: The TVEC group horses were > 1 year of age and were predominantly Standardbreds. The TVEC group horses underwent a total of 76 anesthetic episodes. For 40 (52.6%) anesthetic episodes, horses received xylazine only for premedication, and for 26 (34.2%) anesthetic episodes, horses received xylazine and butorphanol. Induction of anesthesia consisted of ketamine administration in various combinations with diazepam and guaifenesin for 74 (97.4%) anesthetic episodes and ketamine alone for 2 (2.6%). Bradycardia in horses was encountered during 15 of 76 (19.7%) anesthetic episodes. Minor signs of possible postanesthetic myopathy occurred following 6 (7.9%) anesthetic episodes. No significant difference was found between TVEC and MRI group horses regarding incidence of bradycardia and inotropic drug administration. CONCLUSIONS AND CLINICAL RELEVANCE: Short-duration anesthesia for TVEC of atrial fibrillation in horses without underlying cardiac disease was a safe procedure.     

Comparison of four drug combinations for total intravenous anesthesia of horses undergoing surgical removal of an abdominal testis

OBJECTIVE: To evaluate anesthetic effects of 4 drug combinations used for total intravenous anesthesia of horses undergoing surgical removal of an abdominal testis. DESIGN: Clinical trial. ANIMALS: 32 healthy cryptorchid horses. PROCEDURE: Horses were sedated with xylazine and butorphanol and were randomly assigned to 1 of 4 groups: induction of anesthesia with ketamine and diazepam and maintenance with bolus administration of ketamine and xylazine (KD/KX); induction and maintenance of anesthesia with bolus administration of tiletamine-zolazepam, ketamine, and detomidine (TKD); induction and maintenance of anesthesia with continuous infusion of xylazine, guaifenesin, and ketamine; and induction and maintenance of anesthesia with continuous infusion of guaifenesin and thiopental. Horses that moved 3 consecutive times in response to surgical stimulation or for which surgery time was > 60 minutes were administered an inhalant anesthetic, and data from these horses were excluded from analysis. RESULTS: Quality of induction was not significantly different among groups. Muscle relaxation and analgesia scores were lowest for horses given KD/KX, but significant differences among groups were not detected. Horses anesthetized with TKD had a significantly greater number of attempts to stand, compared with the other groups, and mean quality of recovery from anesthesia for horses in the TKD group was significantly worse than for the other groups. Anesthesia, surgery, and recovery times were not significantly different among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that all 4 drug combinations can be used to induce short-term anesthesia for abdominal cryptorchidectomy in horses. However, horses receiving TKD had a poorer recovery from anesthesia, often requiring assistance to stand.