The effect of four anesthetic protocols on splenic size in dogs

Objective To characterize the effects of four anesthetic protocols on the size of the spleen during surgery in dogs. Study design Prospective experimental trial. Animals Twenty‐four beagle dogs, 1.1 ± 0.3 years of age and weighing 10.9 ± 2.7 kg. Methods Dogs were allocated to receive one of four anesthetic protocols: 1 – pre‐medication with acepromazine and butorphanol, induction with thiopental; 2 – pre‐medication with acepromazine and butorphanol, induction with propofol; 3 – pre‐medication with medetomidine and butorphanol, induction with propofol; and 4 – pre‐medication with medetomidine and butorphanol, induction with ketamine and diazepam. Anesthesia was then maintained with halothane. At laparotomy, the spleen length, width, and height were measured, these were measured again just prior to closure of the abdomen. Splenic area and volume were calculated. Hematocrit and total serum protein (TSP) were measured before and after induction and during laparotomy. Results Splenic volume was greatest after protocol 4 (161.2 ± 40.2 cm³; p < 0.05) and was least after protocol 2. The differences in volume were because of differences in length, width, and height between groups. There was no significant change in area, length, or width over the study period. Hematocrit decreased significantly in all dogs but at different times. The decrease occurred after pre‐medication if acepromazine was administered, at induction following protocol 3 and during surgery following protocol 4. Conclusions If splenic volume is to be minimized during surgery, then acepromazine and propofol should be used in the anesthetic protocol. The administration of medetomidine, diazepam, and ketamine will produce a greater splenic volume. Lack of correlation between hematocrit and spleen size following the anesthetic protocols studied suggests sequestration of red blood cells in nonsplenic sites.     

Evaluation of coagulation markers in the plasma of healthy cats and cats with asymptomatic hypertrophic cardiomyopathy

BACKGROUND: Thrombosis and arterial thromboembolism are frequent complications of feline cardiomyopathy, especially when associated with left atrial enlargement. Markers of activated coagulation may be used to evaluate the coagulation status of cats with hypertrophic cardiomyopathy (HCM) in relation to left atrial size. OBJECTIVES: The objective of this study was to compare plasma concentrations of thrombin-antithrombin complex (TAT), D-dimer, and fibrin degradation products (FDP) between clinically healthy cats and cats with HCM. Prothrombin time (PT), activated partial thromboplastin time (aPTT), and antithrombin activity were also compared and the association between left atrial (LA) size and coagulation results in cats with HCM was evaluated. METHODS: Blood samples from 19 clinically healthy cats and 20 cats with HCM were obtained. All cats with HCM were asymptomatic and had no signs of heart failure. LA diameter and LA to proximal aortic (Ao) diameter ratio (LA:Ao) were determined by echocardiography. RESULTS: Reference intervals for D-dimer and TAT concentrations in plasma of healthy cats were established as 0.09-0.32 microg/mL and 2.0-20.0 microg/L, respectively. TAT, D-dimer, and FDP concentrations were increased in 5, 3, and 2 cats with HCM, respectively. TAT and D-dimer concentrations, and PT and aPTT were not significantly different between groups. Antithrombin activity was significantly decreased in cats with HCM (P=.03) despite marked range overlap. LA and LA:Ao were not correlated with coagulation results. CONCLUSIONS: Laboratory evidence of hypercoagulability was found in 45% of cats with HCM. Left atrial size was not associated with laboratory evidence of hypercoagulability. Association between coagulation markers and risk of thrombosis has yet to be evaluated in cats with HCM.     

Seasonal and circadian variation in presentation of cats with congestive heart failure

Objective– To determine if cats with congestive heart failure (CHF) are presented to a referral clinic more frequently during different seasons, months, days, or times. Design– Retrospective study. Setting– University small animal hospital. Animals– One hundred and eighty‐six cats with CHF. Interventions– None. Measurements and Main Results– The medical records of 186 cats, presented for 238 episodes of CHF between July 1, 1997 and June 30, 2002, were reviewed. An episode of CHF was defined as documented clinical evidence of pulmonary edema, pleural effusion, pericardial effusion, or ascites attributed to a cardiac origin by a board‐certified cardiologist. Chi‐square tests revealed statistically significant differences in presentation between different days of the week, with Thursday being the most common day, and between different hours of the day, with the peak between 10 am to 4 pm . Evaluation of presentation for CHF by season of the year identified more cats in December, January, and February although this did not achieve statistical significance. No significant difference was identified for presentation based on the day of the month or the month of the year. Conclusions– In this population of cats, there was daily, weekly and, possibly, seasonal variation in the frequency of presentation of cats with CHF. Additional studies are warranted to confirm these findings and to determine the cause for these differences.     

Influence of detomidine and xylazine on spleen dimensions and on splenic response to epinephrine infusion in healthy adult horses

ObjectiveTo compare the changes in splenic length and thickness and in packed cell volume (PCV) following detomidine or xylazine administration and subsequent epinephrine infusion. Hypothesis: Spleen relaxation occurs following xylazine or detomidine administration and interferes with subsequent splenic contractile response to epinephrine.Study designRandomized non‐blinded crossover experimental study.Animals6 healthy adult mares.MethodsThe mares received an intravenous (IV) epinephrine infusion (1 μg kg^?1minute^?1 over 5 minutes) one hour after IV administration of detomidine (0.01 mg kg^?1), xylazine (0.5 mg kg^?1) or no drug (control), with a withdrawal period of at least 7 days between experiments. The splenic length measured in two different axes, the splenic thickness, and the PCV were measured prior to sedation (T0), 30 minutes later, and at 5‐minute intervals from the start of the epinephrine infusion (T1) until T1 + 40 minutes. Changes from base‐line and between treatments were compared using a two‐way anova for repeated measures. Significance was set at p < 0.05.ResultsSplenic length was significantly increased and PCV was significantly decreased after detomidine administration compared to baseline. Epinephrine infusion resulted in a significant decrease in splenic length and thickness, and a significant increase in PCV, irrespective of prior treatment with detomidine or xylazine.ConclusionsDetomidine administration was followed by a sonographically detectable increase of splenic length. Neither detomidine nor xylazine interfered with the ability of the spleen to contract following subsequent administration of an epinephrine infusion given one hour later.Clinical relevancePrevious sedation with alpha‐2 agonists does not preclude the efficiency of epinephrine as a medical treatment of left dorsal displacement of the large colon, but further investigations are required with other drug doses and different time intervals between administrations.     

Evaluation of the radiographic liver length/11th thoracic vertebral length ratio as a method for quantifying liver size in cats

Abdominal radiography is a standard diagnostic test for cats with suspected liver disease, however, absolute measurements of radiographic liver size can be affected by other factors such as positioning, radiographic technique, and obesity. This prospective and retrospective, analytical, cross‐sectional study evaluated the liver length/11th thoracic vertebral length (LL/T11) ratio as a method for minimizing these outside effects. In a prospectively recruited sample of 25 clinically healthy cats, measurements of radiographic LL/T11 ratio were compared with CT measurements of liver volume. Effects of radiographic technical factors (body posture, recumbency state, and beam center to LL/T11 ratio) and observer were also tested. In a retrospectively recruited sample of 324 cats with no evidence of liver disease, radiographic measurements of the LL/T11 ratio were performed using right lateral radiographs and compared among signalment groups (age, sex, body weight, and body condition score). There was a strong significant correlation between the LL/T11 ratio and CT liver volume (P < .001), and this ratio was not affected by radiographic technical factors. The reference value of the LL/T11 ratio was 4.22 ± 0.54 and the LL/T11 ratio did not differ among signalment groups. Findings supported the use of the LL/T11 ratio as a novel quantitative index of radiographic liver size in cats. Future studies in clinically affected cats are needed to further validate this method.     

Evaluation of plasma antithrombin activity and D-dimer concentration in populations of healthy cats, clinically ill cats, and cats with cardiomyopathy

BACKGROUND: Current coagulation tests lack sensitivity and detect disseminated intravascular coagulation (DIC) only when it is severe. Measurement of antithrombin (AT) activity and D-dimer concentration permits early diagnosis and more precise classification of coagulopathies in some species. OBJECTIVES: The objectives of this study were to validate and determine the diagnostic utility of a chromogenic AT assay and an immunoturbidimetric D-dimer assay for the diagnosis of DIC in cats. METHODS: Citrated plasma samples were collected from 30 healthy cats, 30 ill cats, and 13 cats with cardiomyopathy. Partial thromboplastin time, prothrombin time, fibrin(ogen) degradation products, platelet concentration, and erythrocyte morphology were determined on all samples to document the presence or the absence of DIC. AT activity and D-dimer concentration were then measured. RESULTS: The chromogenic AT assay was linear and precise. Mean AT activity was higher in ill cats and cats with cardiomyopathy compared with healthy cats, but the difference was only significant in ill cats (P = .003). Seven cats met the criteria for DIC. Of the cats with DIC, 2 had decreased AT activity, 1 had increased AT activity, and 4 had AT activities within normal limits. The immunoturbidimetric D-dimer assay did not appear to accurately measure feline D-dimer. CONCLUSIONS: The chromogenic AT assay appeared to measure AT in cats but was not useful for the diagnosis of DIC. AT may be an acute phase reactant in cats. The immunoturbidimetric D-dimer assay was not useful for the diagnosis of DIC in cats.     

Color and power Doppler ultrasonography for characterization of splenic masses in dogs

Benign and malignant splenic masses can appear similar on B-mode imaging, making ultrasound sensitive but not specific in their diagnosis. Our goal was to characterize color and/or power Doppler characteristics of vasculature within and adjacent to a splenic mass, which would distinguish benign vs. malignant lesions. The hypothesis was that malignant splenic masses will have altered vascular patterns compared with benign masses. Color and power Doppler cineloops evaluating the vasculature within the mass and normal splenic parenchyma were obtained in sagittal and transverse planes using a standardized protocol. Categories of evaluation included presence of peritoneal effusion, a large aberrant or tortuous vessel within the mass, relative blood flow within the mass compared with normal parenchyma, and path of vessels in the adjacent parenchyma entering into the mass. All patients had histopathologic or definitive cytologic diagnosis. Thirty-one dogs were included. There were 13 malignant masses and 18 were benign. Peritoneal effusion was significantly associated with malignancy (P = 0.0007). Presence of an aberrant or tortuous vessel within the mass was nearly significant (P = 0.059). There was no significant difference in any of the color or power Doppler blood flow evaluations. Ultrasonographic findings of a splenic mass and peritoneal effusion may indicate malignancy. The presence of an aberrant vessel within a splenic mass could suggest malignancy; however more data are needed.     

Diuretic effects of fenoldopam in healthy cats

Objective: To determine the effect of fenoldopam infusion on urine output, sodium excretion, creatinine clearance, and indirect blood pressure in healthy cats. Design: Prospective study. Setting: Veterinary medical teaching hospital. Animals: Eight purpose‐bred cats, 2–4 years old. Interventions: None. Measurements: Urine output was measured hourly for 12 hours before and after fenoldopam administration. Sodium excretion, modified creatinine clearance, and fractional sodium excretion were measured before and following fenoldopam administration. Urine specific gravity, central venous pressure, and systolic blood pressure were measured every 4 hours during the experiment. Main results: Compared with pre‐infusion values, urine output, sodium excretion, and fractional excretion of sodium increased significantly 6 hours after initiation of fenoldopam infusion. This increase was sustained throughout the observation period. The modified creatinine clearance decreased significantly following 2 hours of fenoldopam infusion, but increased significantly by 6 hours after infusion, the time of peak urine output. Changes in urine specific gravity mirrored changes in fractional sodium excretion, whereas the central venous pressure mirrored changes in modified creatinine clearance. The diuretic effect in cats was prevented when a dopamine receptor blocking agent was administered before fenoldopam infusion. Conclusion: Fenoldopam at a dose of 0.5 μg/kg/min induces diuresis in cats in a delayed manner. This increase appears to be due, in part, to dopamine receptor‐induced natriuresis. Changes in glomerular filtration rate may also occur.     

Shear wave elastography evaluation of cats with chronic kidney disease

Chronic kidney disease (CKD) is a major health condition in cats that can lead to poor quality of life and financial implications for therapy. Currently staging and identification of CKD is limited by diagnostic testing such as creatinine and urine-specific gravity, which do not change until late in the disease course. Other methods to evaluate CKD would be valuable in the clinical setting. Shear wave elastography is one novel ultrasound method, which has shown promise in identifying increases in tissue stiffness and identifying CKD in people. As CKD is often histologically characterized by tubulointerstitial fibrosis, shear wave elastography has the potential to identify CKD and differentiate between stages of CKD in cats. This prospective observational case-control study with 78 cats found no difference in shear wave velocities between groups (P = 0.33), a contradictory finding to one prior publication. There was no effect of weight (P = 0.65), nor the presence of mineralization (P = 0.31) or infarction (P = 0.52) on cortical shear wave velocities. There was a significant effect of age on shear wave velocity (P = 0.018) where velocities increased with age. The intraclass correlation coefficient was only moderate (0.62). Possible reasons for the difference in results between our work and that published prior, include differences in methodology and differences in instrumentation. Variability in measurements in our population may be due to the effects of respiratory motion or limitations in shear wave elastography software. As such, shear wave elastography is not currently recommended as a tool to evaluate CKD in cats and further work is necessary.     

Clinical evaluation of medetomidine, a novel sedative and analgesic drug for dogs and cats

Medetomidine, a potent alpha 2-adrenoceptor agonist, was investigated in open, multicenter clinical trials with patients of various canine and feline breeds (1736 dogs and 678 cats). The purpose of the study was to find an optimal dose of medetomidine for sedation and analgesia in clinical practice and to study how well the intended procedure could be performed under the influence of the drug. The mean dose (i.m.) of medetomidine used for examinations, clinical procedures and minor surgical interventions was 40 micrograms/kg, and for radiography 30 micrograms/kg. In cats the dose was 80-110 micrograms/kg. On the doses chosen, almost all animals were recumbent and 72% of the dogs and 85% of the cats were in a slight anaesthetic stage, unable to rise. The evaluation of the overall suitability of medetomidine (% of cases) in different indications was "very satisfactory" or "satisfactory" in 95% of dogs and 81-96% of cats. Side effects reported were limited almost exclusively to vomiting and muscle jerking in dogs (12% and 0.5% of the cases) and to vomiting in cats (65%). Medetomidine seems to suffice for pharmacological restraint of dogs and cats. The concomitant use of medetomidine (80-100 micrograms/kg) and ketamine (7 mg/kg) in cats (n = 295) provided a good anaesthesia (20-40 min). The recovery was smooth. The present study shows that medetomidine provides an effective level of sedation and analgesia for clinical use.     

Sedative and physiological effects of brimonidine tartrate ophthalmic solution in healthy cats

Objective

To determine the effects of brimonidine tartrate ophthalmic solution on sedation, heart rate (HR), respiratory frequency (f_R), rectal temperature (RT) and noninvasive mean arterial pressure (MAP) in healthy cats.