Transcutaneous monitor approximates PaCO(2) but not PaO(2) in anesthetized rabbits

ObjectiveTo compare the accuracy of transcutaneous (tc) to arterial partial pressure of carbon dioxide (PaCO₂) and partial pressure of oxygen (PaO₂) in anesthetized rabbits.Study designProspective, randomized, experimental study.AnimalsEight healthy adult female New Zealand white rabbits weighing 4.05 ± 0.30 kg.MethodsIsoflurane anesthetized rabbits received six treatments in random order; PaCO₂ < 35, 35-45, and >45 mmHg and PaO₂ < 80, 100-200, >200 mmHg. Arterial and transcutaneous measurements were taken after 15 minutes of stabilization at each condition. Linear regression, correlation and Bland-Altman analysis were performed to compare PtcCO₂ to PaCO₂ and PtcO₂ to PaO₂.ResultsOver a range of measured PaCO₂ values from 21 to 67 mmHg (n = 24) mean bias for PtcCO₂ was -1 mmHg and the 95% limits of agreement were -7 to 5 mmHg. The correlation between PtcCO₂ and PaCO₂ was strong with R² value of 0.9454. Over the entire range of measured PaO₂ values (46-508 mmHg) mean bias for PtcO₂ was -61 mmHg and the 95% limits of agreement were -226 to 104 mmHg. Correlation was poor with R² = 0.5969. Comparing PtcO₂ to PaO₂ over a narrower range [PaO₂ < 150 mmHg (n = 13)] improved the correlation, with an R² value of 0.8518, mean bias of -7 mmHg and 95% limits of agreement from -33 to 19 mmHg.Conclusions and clinical relevanceIn healthy anesthetized rabbits, PtcCO₂ closely approximated PaCO₂. In contrast PtcO₂ underestimated PaO₂, particularly at high values. The PtcCO₂ sensor may be a useful noninvasive way to assess adequacy of ventilation in anesthetized rabbits.     

Use of hepatobiliary scintigraphy in the diagnosis of extrahepatic biliary obstruction in dogs and cats: 25 cases (1982-1989).

Twenty-five animals (21 dogs and 4 cats) in which hepatobiliary scintigraphy (HBS) was performed between 1982 and 1989 were included in a retrospective study to determine the utility of HBS for diagnosis of extrahepatic biliary obstruction. Final diagnoses, which were based on liver biopsy results and surgical findings in all animals, were hepatocellular disease alone (n = 17), hepatocellular disease and extrahepatic biliary obstruction (n = 7), and normal liver (n = 1). Hepatobiliary scintigraphy was performed by use of 99mTc-diisopropyl iminodiacetic acid in all cases. All 7 cases of extrahepatic biliary obstruction were confirmed at surgery. In animals with biliary obstruction, HBS failed to demonstrate radiolabel within either the gallbladder or intestine at any time. Using nonvisualization of the intestine by 180 minutes as the scintigraphic criterion for diagnosis of biliary obstruction, sensitivity was 83% and specificity was 94% in this series. Hepatobiliary scintigraphy was concluded to be an accurate indicator of extrahepatic biliary obstruction in this group of animals. High serum bilirubin concentration at the time HBS was performed did not appear to reduce the diagnostic usefulness of the scintigraphic findings.     

ABSTRACTS

Use of hepatobiliary scintigraphy in the diagnosis of extrahepatic biliary obstruction in dogs and cats
Evaluation of rhinoscopy and rhinoscopy-assisted mucosal biopsy in diagnosis of nasal disease in dogs     

Continuous positive airway pressure administered via face mask in tranquilized dogs

Objective – To evaluate the tolerance of a continuous positive airway pressure (CPAP) mask in tranquilized dogs and compare PaO₂ in arterial blood in dogs receiving oxygen with a regular face mask or CPAP mask set to maintain a pressure of 2.5 or 5 cm H₂O. Design – Prospective, randomized clinical study. Setting – University teaching hospital. Animals – Sixteen client‐owned dogs without evidence of cardiopulmonary disease were studied. Interventions – Eight animals were randomly assigned to each of 2 treatment groups: group A received 2.5 cm H₂O CPAP and group B received 5 cm H₂O CPAP after first receiving oxygen (5 L/min) by a regular face mask. Animals were tranquilized with acepromazine 0.05 mg/kg, IV and morphine 0.2 mg/kg, IM. An arterial catheter was then placed to facilitate blood sampling for pHa, PaO₂, and PaCO₂ determinations before and after treatments. Direct mean arterial pressure, heart rate, respiratory rate, and temperature were also recorded after each treatment. Measurements and Main Results – CPAP administration was well tolerated by all animals. The mean arterial pressure, heart rate, respiratory rate, temperature, PaCO₂, and pHa, did not differ at any time point between groups. Differences were seen in oxygenation; in group A, PaO₂ significantly increased from a mean of 288.3±47.5 mm Hg with a standard mask to a mean of 390.3±65.5 mm Hg with the CPAP mask and in group B, PaO₂ increased similarly from 325.0±70.5 to 425.2±63.4 mm Hg (P<0.05); no differences were detected between the 2 CPAP treatments. Conclusions – In healthy tranquilized dogs noninvasive CPAP is well tolerated and increases PaO₂ above values obtained when using a regular face mask.     

Postoperative oxygenation in healthy dogs following mechanical ventilation with fractions of inspired oxygen of 0.4 or >0.9

ObjectiveTo evaluate arterial oxygenation during the first 4 postoperative hours in dogs administered different fractions of inspired oxygen (FiO₂) during general anesthesia with mechanical ventilation.Study designProspective, randomized clinical trial.AnimalsA total of 20 healthy female dogs, weighing >15 kg and body condition scores 3–7/9, admitted for ovariohysterectomy.MethodsDogs were randomized to breathe an FiO₂ >0.9 or 0.4 during isoflurane anesthesia with intermittent positive pressure ventilation. The intraoperative PaO₂:FiO₂ ratio was recorded during closure of the linea alba. Arterial blood was obtained 5, 60 and 240 minutes after extubation for measurement of PaO₂ and PaCO₂ (FiO₂ = 0.21). Demographic characteristics, duration of anesthesia, PaO₂:FiO₂ ratio and anesthetic agents were compared between groups with Wilcoxon tests. The postoperative PaO₂, PaCO₂, rectal temperature, a visual sedation score and events of hypoxemia (PaO₂ < 80 mmHg) were compared between groups with mixed-effects models or generalized linear mixed models.ResultsGroups were indistinguishable by demographic characteristics, duration of anesthesia, anesthetic agents administered and intraoperative PaO₂:FiO₂ ratio (all p > 0.08). Postoperative PaO₂, PaCO₂, rectal temperature or sedation score were not different between groups (all p > 0.07). During the first 4 postoperative hours, hypoxemia occurred in three and seven dogs that breathed FiO₂ >0.9 or 0.4 during anesthesia, respectively (p = 0.04).Conclusions and clinical relevanceThe results identified no advantage to decreasing FiO₂ to 0.4 during anesthesia with mechanical ventilation with respect to postoperative oxygenation. Moreover, the incidence of hypoxemia in the first 4 hours after anesthesia was higher in these dogs than in dogs breathing FiO₂ >0.9.     

Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia

ObjectiveTo determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses.Study designProspective randomized clinical study.AnimalsTwenty client‐owned healthy horses aged 5 ± 2 years, weighing 456 ± 90 kg.MethodsIn the control group (CG; n = 10) weaning was performed by a gradual decrease in respiratory rate (f_R) and in the PSV group (PSVG; n = 10) by a gradual decrease in f_R with PSV. The effect of weaning was considered suboptimal if PaCO₂ > 50 mmHg, arterial pH < 7.35 plus PaCO₂ > 50 mmHg or PaO₂ < 60 mmHg were observed at any time after disconnection from the ventilator until 30 minutes after the horse stood. Threshold values for each index were established and the predictive power of these values was tested.ResultsPressure support ventilation group (PSVG) had (mean ± SD) pH 7.36 ± 0.02 and PaCO₂ 41 ± 3 mmHg at weaning and the average lowest PaO₂ 69 ± 6 mmHg was observed 15 minutes post weaning. The CG had pH 7.32 ± 0.02 and PaCO₂ 57 ± 6 mmHg at weaning and the average lowest PaO₂ 48 ± 5 mmHg at 15 minutes post weaning. No accuracy in predicting weaning effect was observed for f_R (p = 0.3474), minute volume (p = 0.1153), SaO₂ (p = 0.1737) and PaO₂/PAO₂ (p = 0.1529). A high accuracy in predicting an optimal effect of weaning was observed for V_T > 10 L (p = 0.0001), f_R/V_T ratio ≤ 0.60 breaths minute^?1 L^?1 (p = 0.0001), V_T/bodyweight > 18.5 mL kg^?1 (p = 0.0001) and PaO₂/FiO₂ > 298 (p = 0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for V_T < 10 L (p = 0.0001), f_R/V_T ratio ≥ 0.60 breaths minute^?1 L^?1 (p = 0.0001) and Pe′CO₂ ≥ 38 mmHg (p = 0.0001) at weaning.Conclusions and clinical relevancePressure support ventilation (PSV) weaning had a better respiratory outcome. A higher V_T, V_T/body weight, PaO₂/FiO₂ ratio and a lower f_R/V_T ratio and Pe′CO₂ were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia.     

Effects of Carbon Dioxide Insufflation and Body Position on Blood Gas Values in Horses Anesthetized for Laparoscopy

The objective of the study was to describe the effects of carbon dioxide pneumoperitoneum and Trendelenburg position on arterial blood gas values in horses anesthetized for laparoscopy. The study design was a prospective case series using 14 healthy adult horses anesthetized for elective laparoscopic surgery. All horses in the study were maintained under anesthesia with halothane in oxygen with intermittent positive-pressure ventilation. A pneumoperitoneum of 15 mmHg or less was achieved with carbon dioxide, and horses were tilted to a 35-degree Trendelenburg position to allow the completion of laparoscopic cryptorchidectomy (n = 13) or ovariectomy (n = 1). Heart rate, mean arterial pressure, and arterial blood gases were recorded at six time intervals throughout the procedure. Results of the study indicated a pH that decreased and partial pressure of carbon dioxide (PaCO₂) and mean arterial pressure that increased over time and differed significantly from baseline during Trendelenburg position. Partial pressure of oxygen (PaO₂) was significantly lower than baseline after assumption of Trendelenburg position and did not improve on return to normal recumbency and abdominal pressure. As body weight increased, pH and PaO₂ decreased and PaCO₂ increased. We concluded that horses placed in Trendelenburg position have changes that are transient, with the exception of PaO₂. Heavier horses have a greater change in pH, PaCO₂, and PaO₂ than lighter horses during abdominal insufflation and Trendelenburg position. The changes incurred during CO₂ abdominal insufflation and Trendelenburg position are transient, with the exception of a decreased PaO₂. Heavy horses undergoing abdominal insufflation and Trendelenburg position should be closely monitored for critical cardiopulmonary values.     

Comparative effects of three different ventilatory treatments on arterial blood gas values and oxygen extraction in healthy anaesthetized dogs

ObjectiveTo compare the effect of invasive continuous positive airway pressure (CPAP), pressure-controlled ventilation (PCV) with positive end-expiratory pressure (PEEP) and spontaneous breathing (SB) on PaO₂, PaCO₂ and arterial to central venous oxygen content difference (CaO₂-CcvO₂) in healthy anaesthetized dogs.Study designProspective randomized crossover study.AnimalsA group of 15 adult male dogs undergoing elective orchidectomy.MethodsDogs were anaesthetized [buprenorphine, medetomidine, propofol and isoflurane in an air oxygen (FiO₂= 0.5)]. All ventilatory treatments (CPAP: 4 cmH₂O; PCV: 10 cmH₂O driving pressure; PEEP, 4 cmH₂O; respiratory rate of 10 breaths minute^–1 and inspiratory-to-expiratory ratio of 1:2; SB: no pressure applied) were applied in a randomized order during the same anaesthetic. Arterial and central venous blood samples were collected immediately before the start and at 20 minutes after each treatment. Data were compared using a general linear mixed model (p < 0.05).ResultsMedian PaO₂ was significantly higher after PCV [222 mmHg (29.6 kPa)] than after CPAP [202 mmHg (26.9 kPa)] and SB [208 mmHg (27.7 kPa)] (p < 0.001). Median PaCO₂ was lower after PCV [48 mmHg (6.4 kPa)] than after CPAP [58 mmHg (7.7 kPa)] and SB [56 mmHg (7.5 kPa)] (p < 0.001). Median CaO₂-CcvO₂ was greater after PCV (4.36 mL dL^–1) than after CPAP (3.41 mL dL^–1) and SB (3.23 mL dL^–1) (p < 0.001). PaO₂, PaCO₂ and CaO₂-CcvO₂ were no different between CPAP and SB (p > 0.99, p = 0.697 and p = 0.922, respectively).Conclusions and clinical relevanceCPAP resulted in similar arterial oxygenation, CO₂ elimination and tissue oxygen extraction to SB. PCV resulted in improved arterial oxygenation and CO₂ elimination. Greater oxygen extraction occurred with PCV than with CPAP and SB, offsetting its advantage of improved arterial oxygenation. The benefit of invasive CPAP over SB in the healthy anaesthetized dog remains uncertain.     

The incidence of thoracic trauma in dogs with skeletal injury

One hundred dogs with skeletal injury were evaluated for co-existing thoracic abnormalities. Parameters used to assess thoracic trauma were physical examination, thoracic radiographs, electrocardiograms and arterial blood gas PaO₂. Thoracic abnormalities were found in 57 per cent of the dogs. Within this group, 77 per cent had abnormal thoracic radiographs, 44 per cent had abnormal low PaO₂, and 30 per cent had cardiac arrhythmias. No clinical signs suggestive of thoracic injury were found on physical examination in 79 per cent of the dogs with thoracic lesions.     

Cholangitis and Cholangiohepatitis in Dogs: A Descriptive Study of 54 Cases Based on Histopathologic Diagnosis (2004–2014)

Background

Cholangitis in dogs appears to be more common than previously thought, but understanding of the disease remains incomplete.

Objective

To describe a population of dogs with cholangitis or cholangiohepatitis.

Animals

Fifty‐four client‐owned dogs with cholangitis or cholangiohepatitis.

Methods

Medical records of dogs with cholangitis or cholangiohepatitis confirmed by histopathology between January 2004 and December 2014 were identified using a computer‐based search and retrospectively reviewed.

Results

Clinical signs included vomiting (72.2%), lethargy (70.4%), and inappetence (64.8%). Most dogs (49/50) had increased liver enzyme activities, hyperbilirubinemia (32/50), and hypercholesterolemia (24/43). Ultrasonographic abnormalities of the hepatobiliary system were seen in 84% of cases. On histopathology, 53 of 54 affected dogs had neutrophilic cholangitis (NC) or cholangiohepatitis, whereas 1 dog had lymphocytic cholangitis. Most cases (42/54) were chronic. Evidence of concurrent biliary disease (46.2%) and biliary tract obstruction (42.6%) was common. Seventeen of 36 biliary and 11 of 25 liver cultures were positive for bacterial growth; Escherichia coli and Enterococcus spp. were most common. Median patient survival was 671 days (95% confidence interval [CI]: 114–1,426). On Cox regression, dogs that did not have a cholecystectomy performed had a 2.1 greater hazard for death (P = 0.037; 95% CI: 1.0–4.3) compared to cholecystectomized dogs. Dogs >13 years old had a 5.0 greater hazard for death (P = 0.001; 95% CI: 1.9–13.2) compared to younger dogs.

Conclusions and Clinical Significance

Chronic NC or cholangiohepatitis was most common. Cholecystitis and biliary tract obstruction often occurred in conjunction with cholangitis. Cholecystectomized dogs had decreased risk of death; thus, cholecystectomy may improve patient outcome.     

Pulsed delivery of inhaled nitric oxide counteracts hypoxaemia during 2.5 hours of inhalation anaesthesia in dorsally recumbent horses

Objective The study aimed to investigate the effect of varying pulse lengths of inhaled nitric oxide (iNO), and 2.5 hours of continuous pulse‐delivered iNO on pulmonary gas exchange in anaesthetized horses. Study Design Experimental study. Animals Six Standardbred horses. Methods Horses received acepromazine, detomidine, guaifenesin, thiopentone and isoflurane in oxygen, were positioned in dorsal recumbency and were breathing spontaneously. iNO was on average pulsed during the first 20, 30, 43 or 73% of the inspiration in 15 minute steps. The pulse length that corresponded to the highest (peak) partial pressure of arterial oxygen (PaO₂) in the individual horses was determined and delivered for a further 1.5 hours. Data measured or calculated included arterial and mixed venous partial pressures of O₂ and CO₂, heart rate, respiratory rate, expired minute ventilation, pulmonary and systemic arterial mean pressures, cardiac output and venous admixture. Data (mean ± SD) was analysed using anova with p < 0.05 considered significant. Results Although the pulse length of iNO that corresponded to peak PaO₂ varied between horses, administration of all pulse lengths of iNO increased PaO₂ compared to baseline. The shortest pulse lengths that resulted in the peak PaO₂ were 30 and 43% of the inspiration. Administration of iNO increased PaO₂ (12.6 ± 4.1 kPa [95 ± 31 mmHg] at baseline to a range of 23.0 ± 8.4 to 25.3 ± 9.0 kPa [173 to 190 mmHg]) and PaCO₂ (8.5 ± 1.2 kPa [64 ± 9 mmHg] to 9.8 ± 1.5 kPa [73 ± 11 mmHg]) and decreased venous admixture from 32 ± 6% to 25 ± 6%. The increase in PaO₂ and decrease in venous admixture was sustained for the entire 2.5 hours of iNO delivery. Conclusions The improvement in arterial oxygenation during pulsed delivery of iNO was significant and sustained throughout 2.5 hours of anaesthesia. Clinical relevance Pulsed iNO potentially could be used clinically to counteract hypoxemia in anaesthetized horses.     

Partial pressure of end-tidal CO2 sampled via an intranasal catheter as a substitute for partial pressure of arterial CO2 in dogs

Objective: To demonstrate correlation and clinical usefulness of the partial pressure of end‐tidal CO₂ (ETCO₂) measurement by nasal catheter placement in sedated dogs with and without concurrent nasal oxygen administration as a substitute for partial pressure of arterial CO₂ (PaCO₂). Design: Prospective, cross‐over trial. Setting: University of Saskatchewan veterinary research laboratory. Animals: Six cross‐breed dogs with a mean (±SD) weight of 29.1±4.03 kg. Interventions: All dogs were sedated with 5 μg/kg medetomidine intravenously (IV) and an arterial catheter was placed in a dorsal pedal artery for removal of blood for gas analysis. A nasal catheter was placed in the ventral meatus and connected to a capnometer for ETCO₂ measurements in all dogs. Dogs receiving supplemental nasal oxygen had a second nasal catheter placed in the contralateral naris. Measurements and main results: In the group without nasal oxygen supplementation, the ETCO₂ measurement underestimated (negative bias) the PaCO₂ by ?2.20 mmHg with limits of agreement (95% confidence interval) of ?5.79, 1.39 mmHg. In the group receiving oxygen supplementation, ETCO₂ measurement underestimated (negative bias) the PaCO₂ by ?2.46 mmHg with limits of agreement (95% confidence interval) of ?8.42, 3.50 mmHg. Conclusions: The results of this study demonstrate that ETCO₂ monitoring via a nasal catheter provides a clinically acceptable substitute to arterial blood gas analysis as a means of monitoring ventilation in healthy, sedated dogs. The limits of agreement were within acceptable limits with and without concurrent insufflation of oxygen.     

Ultrasonography and surgery of canine biliary diseases

Findings of hepatic and gallbladder ultrasonography were analyzed in 12 dogs with gallbladder and/or extrahepatic biliary tract obstruction and compared with the results of exploratory laparotomy. Hepatic ultrasonography demonstrated normal liver in 2 dogs and hepatic abnormalities in 10 animals. The following ultrasonographic diagnoses were established compared to surgical findings: gallbladder obstruction caused by bile sludge (correct/incorrect: 1/2, surgical diagnosis: choleliths in one case), gallbladder obstruction caused by neoplasm (0/1, surgical diagnosis: mucocele), gallbladder and extrahepatic biliary tract obstruction due to choleliths (3/3), extrahepatic biliary tract obstruction caused by pancreatic mass (1/1) and small intestinal volvulus (1/1). Bile peritonitis caused by gallbladder rupture (4/4) was correctly diagnosed by ultrasound, aided with ultrasonographically-guided abdominocentesis and peritoneal fluid analysis. Rupture of the gallbladder should be suspected in the presence of a small, echogenic gallbladder or in the absence of the organ together with free abdominal fluid during ultrasonography. Laparotomy was correctly indicated by ultrasonography in all cases. However, the direct cause of obstruction could not be determined in 2 of the 12 dogs by ultrasonography alone.     

Arterial blood gas tensions during recovery in horses anesthetized with apneustic anesthesia ventilation compared with conventional mechanical ventilation

ObjectiveTo compare PaO₂ and PaCO₂ in horses recovering from general anesthesia maintained with either apneustic anesthesia ventilation (AAV) or conventional mechanical ventilation (CMV).Study designRandomized, crossover design.AnimalsA total of 10 healthy adult horses from a university-owned herd.MethodsDorsally recumbent horses were anesthetized with isoflurane in oxygen [inspired oxygen fraction = 0.3 initially, with subsequent titration to maintain PaO₂ ≥ 85 mmHg (11.3 kPa)] and ventilated with AAV or CMV according to predefined criteria [10 mL kg^–1 tidal volume, PaCO₂ 40–45 mmHg (5.3–6.0 kPa) during CMV and < 60 mmHg (8.0 kPa) during AAV]. Horses were weaned from ventilation using a predefined protocol and transferred to a stall for unassisted recovery. Arterial blood samples were collected and analyzed at predefined time points. Tracheal oxygen insufflation at 15 L minute^–1 was provided if PaO₂ < 60 mmHg (8.0 kPa) on any analysis. Time to oxygen insufflation, first movement, sternal recumbency and standing were recorded. Data were analyzed using repeated measures anova, paired t tests and Fisher’s exact test with significance defined as p < 0.05.ResultsData from 10 horses were analyzed. Between modes, PaO₂ was significantly higher immediately after weaning from ventilation and lower at sternal recumbency for AAV than for CMV. No PaCO₂ differences were noted between ventilation modes. All horses ventilated with CMV required supplemental oxygen, whereas three horses ventilated with AAV did not. Time to first movement was shorter with AAV. Time to oxygen insufflation was not different between ventilation modes.ConclusionsAlthough horses ventilated with AAV entered the recovery period with higher PaO₂, this advantage was not sustained during recovery. Whereas fewer horses required supplemental oxygen after AAV, the use of AAV does not preclude the need for routine supplemental oxygen administration in horses recovering from general anesthesia.     

Evaluation of lung ventilation distribution using electrical impedance tomography in standing sedated horses with capnoperitoneum

ObjectiveTo determine changes in distribution of lung ventilation with increasing intra-abdominal pressure (IAP) from carbon dioxide (CO₂) insufflation in standing sedated horses.Study designProspective experimental study.AnimalsA group of six healthy adult horses.MethodsEach horse was sedated with acepromazine, detomidine and butorphanol and sedation maintained with a detomidine infusion. The horse was restrained in a stocks system and a 32 electrode electrical impedance tomography (EIT) belt was wrapped around the thorax at the fifth–sixth intercostal space. EIT images and arterial blood samples for PaO₂ and PaCO₂, pH and lactate concentration were obtained during capnoperitoneum at 0 (baseline A), 5, 8 and 12 mmHg as IAP increased and at 8, 5, 0 (baseline B) mmHg as IAP decreased. At each IAP, after a 2 minute stabilization period, EIT images were recorded for ≥ 2 minutes to obtain five consecutive breaths. Statistical analysis was performed using anova for repeated measures with Geisser-Greenhouse correction and a Tukey’s multiple comparison test for parametric data. The relationship between PaO₂ and the center of ventilation in the ventral-dorsal (CoV-VD) and right-left (CoV-RL) directions or total impedance change as a surrogate for tidal volume (ΔZV_T) were tested using linear regression analysis. Significance was assumed when p ≤ 0.05.ResultsThere were no significant changes in CoV-VD, CoV-RL, PaO₂, PaCO₂, lactate concentration, pH, heart rate and respiratory rate with targeted IAP. There was a significant decrease in ΔZV_T compared with baseline A at 5 mmHg IAP as IAP was increased.Conclusions and clinical relevanceCapnoperitoneum causes a significant decrease in ΔZV_T in standing sedated horses with increasing IAP.     

Arterial blood gases and acid-base balance in geriatric dogs

To compare arterial blood gas pressures and acid-base balance in geriatric and young adult dogs, 23 clinically healthy aged dogs (>10 years old) and 16 young adult dogs (two to four years old) were studied. Blood gases (PaO₂ and PaCO₂), pH, Na, K, Ca and Cl were measured in arterial blood samples using selective electrodes. Haemoglobin was quantified with a co-oximeter. Total proteins and phosphorus were measured by spectrophotometry in plasma. The alveolar to arterial PO₂ gradient (P(A-a)O₂), bicarbonate, anion gap and the base excess of blood were calculated. Quantitative analysis of acid-base balance was carried out by calculating unidentified anions. Old dogs had significantly higher P(A-a)O₂ than young dogs (2·5±0·3 versus 1·4±0·3 KPa). Although the differences were not significant, aged dogs also had a lower PaO₂. No differences were detected in PaCO₂, pH, Na, K, Ca, Cl, haemoglobin, phosphorus, bicarbonate and base excess of blood. Plasma proteins were higher in old dogs than in young dogs (7·1±0·2 versus 6·5±0·2 g dl⁻¹). Anion gap was increased in aged dogs; however, no changes were found in unidentified anions. In conclusion, an increase in P(A-a)O₂ has been identified in a group of geriatric dogs. No major changes have been found in the acid-base balance of aged dogs.     

The assessment of corrective surgery for canine laryngeal paralysis by blood gas analysis: a review of thirty-five cases

Arterial blood samples were collected under sedation, from the femoral artery of 35 dogs suffering from laryngeal paralysis. Pre-operatively, the dogs showed a moderate degree of arterial hypoxaemia (mean PaO₂ 77 mmHg), with the worst affected clinically showing the most severe hypoxia. Following corrective surgery there was a significant improvement in PaO₂ tensions (90 mmHg). A group of 20 control dogs were also sedated and sampled. Their mean arterial oxygen tension was 91 mmHg, indicating that the pre-operative hypoxaemia found in the dogs with laryngeal paralysis was not the result of sedation.     

ULTRASONOGRAPHIC EVALUATION OF GALLBLADDER WALL THICKNESS IN CATS

Ultrasonography of the gallbladder and biliary tract was performed on 42 cats: 22 clinically healthy cats (group A) and 20 cats with hepatobiliary disease and post mortem confirmation of gallbladder abnormalities (group B). The gallbladder wall was visible in 9 of 22 cats in group A and all 20 cats in group B. Additional gallbladder findings in group B included shape anomalies, biliary tract obstruction, wall thickening, polyps, neoplasia, and biliary sludge. Ultrasonographic evaluation of abdominal organs identified pancreatic disease as the predominant pathological cause of extrahepatic biliary obstruction. Hepatic parenchymal involvement was noted with inflammation and thickening of the gallbladder wall. Histologically, gallbladder walls were characterized by mucous gland hyperplasia, inflammation, infiltration, edema, epithelial detachment, and/or neoplasia. Ultrasonographic and histologic gallbladder wall measurements of 20 cats in group B agreed within 0.4 mm and all cats with a gallbladder wall thickness > or =1.0 mm had histopathologic abnormalities of the wall. Serum biochemical analysis revealed elevations of one or more parameters in all cats of group B, but was non-specific for a gallbladder lesion. The results of this study indicate that a visible, echogenic gallbladder wall can be considered a normal variant and is not always associated with hepatobiliary disease. Ultrasonography is accurate in measuring gallbladder wall thickness. Wall thickness greater than 1 mm is accurate in predicting gallbladder disease in cats, while a thickness less than 1 mm cannot rule out mild or chronic inflammation.     

ULTRASONOGRAPHIC ASSESSMENT OF SINCALIDE-INDUCED CANINE GALLBLADDER EMPTYING: AN AID TO THE DIAGNOSIS OF BILIARY OBSTRUCTION WINNER OF THE 1991 RESIDENT-AUTHORED PAPER AWARD SPONSORED BY THE AMERICAN COLLEGE OF VETERINARY RADIOLOGY

Gallbladder emptying studies using ultrasonography were performed on ten normal dogs, one normal control dog, three dogs with biliary obstruction and three dogs with nonobstructive hepatobiliary disease. An intravenous bolus of a synthetic cholecystokinin was used to induce emptying. The normal canine gallbladder emptied at least 40% of its volume within one hour of synthetic cholecystokinin (0.04 μg/kg) administration. Maximum response was seen within 5 to 20 minutes. The gallbladder in icteric dogs with nonobstructive hepatobiliary disease (1 cholecystitis, 1 cholangitis, 1 cholangiohepatitis) also emptied at least 40% of its volume within one hour. The obstructed gallbladder (1 chronic pancreatitis, 1 acute pancreatitis, 1 pancreatic mass) emptied less than 20% within one hour. A significant difference (p>0.05) in the maximum percent gallbladder emptying was found between the dogs with biliary obstruction and nonobstructed, icteric dogs. No side effects to the synthetic cholecystokinin were observed.