Effect of body position on cranial migration of epidurally injected methylene blue in recumbent dogs

OBJECTIVE: To determine the relationship between different body positions during recumbency on the cranial migration of epidurally injected methylene blue in canine cadavers. SAMPLE POPULATION: 21 fresh cadavers of clinically normal adult female mixed-breed dogs. PROCEDURE: Dogs were randomly assigned to the following 3 groups: dogs remaining in right lateral recumbency (n = 7), dogs rotated from left to right lateral recumbency (7), and dogs rotated from dorsal to right lateral recumbency (7). Each dog received an epidural injection of 0.05% methylene blue (0.1 mL/kg) at the lumbosacral space. A dorsal laminectomy of the vertebral column was made, and cranial extent of methylene blue in 4 quadrants (right lateral, left lateral, ventral, and dorsal) was determined by examining dura mater staining. RESULTS: No significant difference was found among groups in regard to body weight or body condition score. Epidural cranial migration of methylene blue in the right lateral quadrant was significantly greater in dogs that remained in right lateral recumbency than in dogs that were rotated from left to right lateral recumbency. No significant difference was found within groups for epidural cranial migration of methylene blue between each quadrant. No significant relationship was found between body weight or body condition score and epidural cranial migration of methylene blue. CONCLUSIONS AND CLINICAL RELEVANCE: Body positioning and amount of recumbency time influence cranial migration of epidurally injected methylene blue. If greater cranial migration of an epidurally administered drug is desired, placing the patient in lateral recumbency with the surgical site on the dependent side may precede surgery.     

Transvenous retrograde portography for identification and characterization of portosystemic shunts in dogs

Transvenous retrograde portography for identification and characterization of portosystemic shunts in dogs A method for transvenous retrograde portography (TRP) in dogs suspected to have a portosystemic shunt (PSS) and results in 20 dogs are described. For TRP, dogs were anesthetized and positioned in left lateral recumbency A dual-lumen balloon-tipped catheter was inserted into the right jugular vein and advanced into the azygos vein. The balloon was inflated to occlude the azygos vein, and contrast material was injected during fluoroscopic evaluation. The catheter was then positioned in the caudal vena cava just cranial to the diaphragm. The balloon was again inflated to occlude the vena cava, and contrast material was again injected. Once a shunt was identified, selective catheterization was attempted with a guide wire and angled catheter. A PSS was identified in 18 of the 20 dogs. In 10 of the 18, the shunt vessel could be selectively catheterized, allowing measurement of portal pressures while the shunt was occluded with the balloon. In 1 dog, results of TRP were normal, but subsequent exploratory celiotomy revealed a single extrahepatic PSS, which was surgically attenuated. The other dog in which results of TRP were normal did not have a macroscopic PSS. In dogs suspected to have a PSS, TRP may be a useful adjunctive diagnostic test that is less invasive than operative mesenteric vein portography and allows measurement of portal pressures before and after temporary shunt occlusion.     

Standard planes for ultrasonographic examination of the portal system in dogs

A scanning protocol for the systematic ultrasonographic examination of the portal system in dogs was developed. Seven planes were used to image the portal system. With the dogs in left lateral recumbency, 3 transverse planes obtained via the right intercostal spaces were used to visualize the portal vein and right portal branch, and a longitudinal plane obtained with the transducer caudal to the last right rib was used to visualize the portal bifurcation. With the dogs in dorsal recumbency, a longitudinal plane was used as an alternative method of visualizing the portal vein and its bifurcation. Finally, with the dogs in right lateral recumbency, longitudinal planes obtained with the transducer in the left flank were used to visualize the hepatic artery, the left renal vein, and the left testicular or ovarian vein. To diagnose or rule out portosystemic shunting, the right portal branch, the left testicular or ovarian vein, the portal vein immediately caudal to the portal bifurcation, and the portal vein at the level of the celiac artery should be examined with this scanning protocol.     

RADIOGRAPHIC HEART-VOLUME ESTIMATION IN NORMAL CATS

Heart volume mensuration was evaluated on conventional radiographs from eight normal cats in different body positions using computed tomography (CT). Heart volumes were calculated from orthogonal thoracic radiographs in ventral and dorsal recumbency and from radiographs exposed with a vertical X-ray beam in dorsal and lateral recumbency using the formula for an ellipsoid body. Heart volumes were also estimated with CT in ventral, dorsal, right lateral and left lateral recumbency. No differences between heart volumes from CT in ventral recumbency and those from CT in right and left lateral recumbency were seen. In dorsal recumbency, however, significantly lower heart volumes were obtained. Heart volumes from CT in ventral recumbency were similar to those from radiographs in ventral and dorsal recumbency and dorsal/left lateral recumbency. Close correlation was also demonstrated between heart volumes from radiographs in dorsal/ left lateral recumbency and body weights of the eight cats.     

Gastro-oesophageal reflux in halothane anaesthetized sheep. The effects of feeding and positioning

The frequency of gastro-oesophageal reflux (GOR) in sheep anaesthetized with halothane was reduced by withholding food and water for 24 hours. The total reflux volume increased. The effect of body position on GOR was studied by inclining the operating table at angles to the horizontal and positioning the head up or down on sand bags. The operative positions investigated were: right and left lateral recumbency with head down, dorsal recumbency with head down and right lateral recumbency with head up. Least GOR occurred when the sheep was in right lateral recumbency with a head up tilt and the body inclined at 20° from the horizontal. A cuffed oesophageal drainage tube increased the incidence of GOR but prevented the chances of the aspiration of rumen material.     

PNEUMOPERICARDIOGRAPHY IN THE NORMAL DOG

To define the normal radiographic anatomy of the canine heart and pericardial space as outlined by air, pneumopericardiography was performed in ten normal, anesthetized dogs using a percutaneously introduced pericardial catheter. Room air was injected to produce pneumopericardiums without causing cardiac tamponade, and radiographs were obtained using a vertical beam with the dogs positioned in right lateral (RLAT), left lateral(LLAT), dorsal (VD), and ventral (DV) recumbency. Selective and nonselective angiocardiography was used to confirm the identity of the outlined structures. The RLAT and LLAT positions provided more information than the DV or VD positions. Pericardial air consistently outlined a distinct interventricular sulcus and the recesses around the aorta and pulmonary artery. The right auricle, outlined along the cranial heart border ventral to the ascending aorta in both RLAT and LLAT positions, varied considerably in size. The RLAT position best outlined structures to the left of midline, including the left auricle, interventricular sulcus, outflow region of the right ventricle, and the origin of the pulmonary artery. The LLAT position best demonstrated structures to the right of midline, including the right atrium, proximal part of the cranial and caudal vena cavae, and ascending aorta. The considerable range of normal variation between dogs in this study must be considered in the interpretation of clinical pneumopericardiograms.     

Effect of body position on ultrasonographic estimations of bladder volume

A study was undertaken to determine the effect of body position on ultrasonographic bladder measurements and volume estimations. Of the 42 dogs studied, 15 were fresh canine cadavers without urological disease and the remaining 27 were undergoing investigations for disorders of the lower urinary tract. Bladder volume was estimated using a formula described previously. Irrespective of whether all dogs were considered together or only live animals were included, measurements made in dorsal recumbency tended to underestimate bladder volume while those made in right lateral recumbency resulted in overestimation. This was due to significant differences in all linear measurements, apart from width, between body positions. Measurements in right lateral recumbency were higher than those in dorsal recumbency. In all animals and in living dogs alone, bladder measurements in dorsal recumbency appeared to give a more accurate estimation of actual bladder volume.     

ULTRASONOGRAPHIC DIAGNOSIS OF CONGENITAL PORTOSYSTEMIC SHUNTS IN DOGS: RESULTS OF A PROSPECTIVE STUDY

The aims of this study were to determine if accurate diagnosis of congenital portosystemic shunt was possible using two dimensional, grey-scale ultrasonography, duplex-Doppler, and color-flow Doppler ultrasonography in combination, and to determine if dogs with congenital portosystemic shunts have increased or variable mean portal blood flow velocity. Eighty-two dogs with clinical and/or clinicopathologic signs compatible with portosystemic shunting were examined prospectively. Diagnosis of congenital portosystemic shunt was subsequently confirmed in 38 of these dogs using operative mesenteric portography: 14(37%) dogs had an intrahepatic shunt and 24(63%) had an extrahepatic shunt. Ultrasonography had a sensitivity of 95%, specificity of 98%, and accuracy of 94%. Ultrasonographic signs in dogs with congenital portosystemic shunts included small liver, reduced visibility of intrahepatic portal vessels, and anomalous blood vessel draining into the caudal vena cava. Correct determination of intra - versus extrahepatic shunt was made ultrasonographically in 35/38 (92%) dogs. Increased and/or variable portal blood flow velocity was present in 21/30 (70%) dogs with congenital portosystemic shunts. In one dog with an intrahepatic shunt the ultrasonographic diagnosis was based partly on finding increased mean portal blood flow velocity because the shunting vessel was not visible. Detection of the shunting vessel and placement of duplex-Doppler sample volumes were facilitated by use of color-flow Doppler. Two-dimensional, grey-scale ultrasonography alone is sufficient to detect most intrahepatic and extrahepatic shunts; sensitivity is increased by additional use of duplex-Doppler and color-flow Doppler. Increased and/or variable portal blood flow velocity occurs in the majority of dogs with congenital portosystemic shunts.     

A COMPUTED TOMOGRAPHIC STUDY OF VOLUME AND X-RAY ATTENUATION OF THE LUNGS OF BEAGLES IN VARIOUS BODY POSITIONS

The influence of body position on volume and x-ray attenuation of the lungs of three Beagles was investigated with computed tomography. In left and right lateral recumbency, the dependent lung had decreased volume and increased x-ray attenuation compared with ventral recumbency. Volume and x-ray attenuation of the nondependent lung, however, were unchanged. In dorsal recumbency, there was a vertical gradient of x-ray attenuation being increased dorsally and decreased ventrally compared with ventral recumbency where regional differences in x-ray attenuation were not found. Results indicate a risk of overlooking a mass in the dependent pulmonary parenchyma of dogs in lateral and dorsal recumbency. Regional differences in x-ray attenuation of the lungs of dogs can be avoided if the radiographs are obtained with the dog in ventral recumbency.     

THE CANINE LATERAL THORACIC RADIOGRAPH

Selected structures seen on right and left lateral thoracic radiographs of 12 dogs were evaluated for differences in position, size, and shape. The size and position of the cardiac silhouette were different when thoracic radiographs made in left and right lateral recumbency were compared. These changes were, however, considered insignificant. The position of the right cranial lobe bronchus relative to the left varied in right lateral recumbency and left lateral recumbency. The right cranial lung lobe was better aerated when dogs were positioned in left lateral recumbency.
Lesions seen in the caudal portion of the left cranial lung lobe or the right middle lobe were masked when the affected lobe was dependent, and enhanced when the affected lung lobe was non-dependent. It is believed that this difference occurred due to compression of the dependent lung with greater aeration of the non-dependent lung.     

Effect of body position on intraocular pressure in dogs without glaucoma

OBJECTIVE: To determine the effects of body position on intraocular pressure (IOP) in dogs without glaucoma. ANIMALS: 24 healthy dogs with no evidence of glaucoma. PROCEDURES: Dogs underwent ophthalmic examinations to ensure that no IOP-affecting ocular diseases were present. Each dog was sequentially placed in dorsal recumbency, sternal recumbency, and sitting position. For each of the 3 positions, IOP in the right eye was measured by use of an applanation tonometer immediately after positioning (0 minutes) and after 3 and 5 minutes had elapsed. The initial body position was randomly assigned; each position followed the other positions an equal number of times, and IOP measurements were initiated immediately after moving from one body position to the next. Proparacaine hydrochloride (0.5%) was applied to the right eye immediately prior to IOP measurements. RESULTS: Intraocular pressure was affected by body position. During the 5-minute examination, IOP decreased significantly in dogs that were dorsally recumbent or sitting but did not change significantly in dogs that were sternally recumbent. For the 3 positions, overall mean IOP differed significantly at each time point (0, 3, and 5 minutes). Mean IOP in dorsal recumbency was significantly higher than that in sternal recumbency at 0 and at 3 minutes; although the former was also higher than that in sitting position at 3 minutes, that difference was not significant. CONCLUSIONS AND CLINICAL RELEVANCE: Body position affects IOP in dogs. When IOP is measured in dogs, body position should be recorded and consistent among repeat evaluations.     

Cardiopulmonary effects of position in conscious cattle

The cardiopulmonary effects of 4 positions (standing, right lateral, left lateral, and dorsal recumbency) were evaluated in conscious cattle in which no sedatives or anesthetic drugs were given. Each position was maintained for 30 minutes, during which time there were no significant changes in heart rate, respiratory rate, mean arterial blood pressure, arterial pH, PaCO2, arterial base excess, or venous blood gas values. Significant decreases in PaO2 developed when cattle were in lateral positions and dorsal recumbency. Cardiac index was unchanged in all positions, except in dorsal recumbency at 30 minutes, when it was significantly decreased.     

INITIAL INFLUENCE OF RIGHT VERSUS LEFT LATERAL RECUMBENCY ON THE RADIOGRAPHIC FINDING OF DUODENAL GAS ON SUBSEQUENT SURVEY VENTRODORSAL PROJECTIONS OF THE CANINE ABDOMEN

Identification of the duodenum and potential abnormalities on survey abdominal radiographs is often difficult unless it contains gas. This study investigated the effect of patient positioning on the presence of duodenal gas in survey abdominal radiographs. One hundred dogs receiving a three‐view survey abdominal radiographic study were enrolled in a prospective, randomized study where all dogs were divided into two groups. Group A (n = 51) dogs had a left lateral projection first, followed by a ventrodorsal projection, ending with a right lateral projection. Group B (n = 49) dogs had a right lateral projection first, followed by a ventrodorsal projection, ending with a left lateral projection. The presence of gas within the duodenum and level of distribution of gas throughout the duodenum were recorded for all three projections. In addition, the presence or absence of duodenal pseudoulcers was evaluated on all three projections for each dog. The results for the two groups were compared using Chi‐square analysis with a P‐value of less than 0.05 being considered significant. Results showed that dogs first placed in left lateral recumbency were significantly more likely to have duodenal gas on the subsequent ventrodorsal and right lateral radiographic projections compared to dogs first placed in right lateral recumbency (P‐value < 0.0001). Pseudoulcers were seen in 11 dogs that had duodenal gas making the visualization of pseudoulcers on survey abdominal radiographs somewhat commonplace. This study emphasizes the benefit of using initial left lateral abdominal projections prior to other views for subsequent evaluation of the duodenum.     

Evaluation of radiographic liver size in twenty-seven normal deep-chested dogs

Radiographic liver size was established in 27 clinically normal deep-chested dogs. In addition, the influence on radiographic liver size of technical factors such as positioning, respiratory phase and position of the central X-ray beam was evaluated. Exact measurement was complicated by two facts. First, the outline of the ventral and caudoventral borders of the liver shadow was not clearly delineated in all dogs. Secondly, in some dogs merging of the silhouettes of liver and spleen was present. As a result in only 14 out of 27 dogs used for this study could exact measurements be made. In this group of deep-chested dogs, the liver shadow was better delineated in left lateral recumbency. In left lateral recumbency less merging of the silhouettes of liver and spleen was noticed. Normal radiographic liver length measured on right lateral views made on expiration and expressed as a ratio to the length of the 11 th thoracic vertebra varied between 4·8 and 7·8 with a mean and standard deviation of 6·1 ± 0·8. The length of the liver tip protruding behind the curve of the 12th rib varied between -0·5 and 1·7 with a mean and standard deviation of 0·6 ± 0.7. This great variability in radiographic liver size between normal dogs of the same thoracic conformnation makes it rather difficult to diagnose hepatomegaly in individual cases. No difference in radiographic liver size of statistical significance could be found between right and left lateral recumbency. The respiratory phase during which the radiograph was made was the only factor causing a difference of statistical significance in radiographic liver size. In all dogs the length of the liver tip protruding behind the costal arch was longer on the view made during inspiration.     

Effects of animal position and number of repeated measurements on selected two-dimensional and M-mode echocardiographic variables in healthy dogs

OBJECTIVE: To evaluate the effects of positioning and number of repeated measurements on intra- and interobserver variability of echocardiographic measurements in dogs. DESIGN: Prospective study. ANIMALS: 4 healthy dogs. PROCEDURE: Each observer performed 24 examinations, separately assessing each dog 6 nonconsecutive times (3 times with the dog in lateral recumbency and 3 with the dog in a standing position). Variables evaluated included M-mode measurements of left ventricular end-diastolic and left ventricular end-systolic diameters, left ventricular free-wall thickness in diastole and systole, interventricular septal thickness in diastole and systole, left ventricular shortening fraction, and 2-dimensional measurements of the left atrial diameter-to-aortic diameter ratio. RESULTS: All coefficients of variation (range, 3.4% to 26.6%) were similar between operators and positions and were < 15% for 27 of 32 values. For both operators, repeatability of the measurements was better for left ventricular end-systolic diameter, left ventricular free-wall thickness in diastole, left ventricular free-wall thickness in systole, and the left atrial diameter-to-aortic diameter in the standing position, and similar for both positions for shortening fraction and left ventricular end-diastolic diameter. No effect of cardiac cycle was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Within-day variability of conventional echocardiography performed with the dog in the standing position was at least as good as that obtained with the dog in lateral recumbency for most measured variables. Single measurements of each variable may be sufficient for trained observers examining dogs that do not have an arrhythmia. The standing position should be used, particularly for stressed or dyspneic dogs.     

THE EFFECT OF POSITIONING ON THE RADIOGRAPHIC APPEARANCE OF CAUDODORSAL MEDIASTINAL MASSES IN THE DOG

In this prospective study, the effect of thoracic positioning on the visibility and size of caudal esophageal masses caused by spirocercosis was investigated. Dorsoventral (DV), ventrodorsal (VD) as well as left lateral recumbent (LLR) and right lateral recumbent (RLR) thoracic radiographs of 28 dogs, diagnosed endoscopically with spirocercosis, were evaluated. The radiographic findings were compared with those of esophageal endoscopy. Masses were seen equally well in left vs. right recumbency as well as in DV vs. VD positions but in DV/VD views 86% of masses were detected whereas in lateral views only 50% of masses were identified. In spirocercosis-endemic areas DV and RLR views are advised as they also allow for better visualization of descending aorta aneurysms and to avoid interpreting the potentially normally visible esophagus in LLR in large dogs as a mass.     

Postural Influence on Systemic Blood Pressure in Large Full-term Pregnant Bitches during General Anesthesia

Effects of positioning on systemic blood pressure were evaluated in six full-term pregnant golden retriever bitches during general anesthesia. Two positions (dorsal and left lateral recumbency) were examined. Anesthesia was induced with thiamylal sodium and maintained with halothane in oxygen. Direct arterial blood pressures were recorded from the bitches in each position. Effects of positioning for each bitch during general anesthesia were reexamined after the bitch weaned its pups; thus, each bitch served as its own control. Maternal posture had no significant effect (p greater than 0.05) on systemic blood pressure. Pregnancy had no significant effect (p greater than 0.05) on systemic blood pressure. Supine hypotension did not occur in anesthetized large, full-term pregnant bitches. Dorsal recumbency was an acceptable position for cesarean sections performed with the patient under general anesthesia.     

Radiographic and computed tomographic evaluation of experimentally induced lung aspiration sites in dogs

This study was performed to radiographically examine the prevalence of aspiration sites and to evaluate their atomical correlation with the bronchial pattens. Ten healthy beagle dogs were repeatedly radiographed, at weekly intervals, in the left and right lateral, ventrodorsal (VD) and dorsoventral (DV) positions. Three mililiters of iohexol distilled with same volume of saline was infused into the tracheal inlet. Which lung lobe was aspirated was decided upon by the presence of a significant alveolar pattern due to the contrast medium. Alveolar patterns were identified at the left (100%) and right cranial lung lobes (77%) with the dogs in dependant lateral recumbency, at the right caudal lung lobe (71%) with the dogs in VD recumbency and at the right middle lung lobe (59%) with the dogs in DV recumbency, respectively. The anatomical correlation was evaluated by performing computed tomography. The right principal bronchus (165.8 ± 1.6°) was more straightly bifurcated than was the left principal bronchus (142.7 ± 1.8°, p < 0.01). In VD position, the right side lung had a greater opertunity to become aspirated. The ventrally positioned right middle lobar bronchial origin was more easily to be aspirated the other laterally positioned ones. We think that these anatomical characteristics can be one of the causes for aspiration pneumonia to occur more frequently in the right side lung.     

Evaluation of six-lead electrocardiograms obtained from dogs in a sitting position or sternal recumbency

OBJECTIVE: To compare 6-lead ECG traces in clinically normal conscious dogs in a sitting position and sternal recumbency to that of right lateral recumbency. ANIMALS: 31 healthy dogs with no history of cardiac disease. PROCEDURE: Six-lead ECGs were recorded for dogs in right lateral recumbency, a sitting position, and sternal recumbency. Q-, R-, and S-wave amplitudes as well as QRS-complex duration were measured in all leads. Additionally, P-wave amplitude and duration, PR interval, ST-segment elevation or depression, and OT interval were measured in lead II. RESULTS: Compared with measurements in right lateral recumbency, the sitting position resulted in increased Q-wave amplitude (lead III), increased R-wave amplitude (leads I and aVL), decreased R-wave amplitude (leads III and aVF), increased S-wave amplitude (lead aVR), decreased S-wave amplitude (lead aVL), increased P-wave amplitude (lead II), and a leftward shift in the mean electrical axis. Compared with measurements in right lateral recumbency, sternal recumbency resulted in decreased Q-wave amplitude (leads I, II, and aVF), increased R-wave amplitude (leads 11, III, and aVF), decreased R-wave amplitude (lead aVR), increased S-wave amplitude (lead aVR), increased P-wave amplitude (lead II), and decreased ST-segment depression (lead II). Compared with right lateral recumbency, the sitting position or sternal recumbency did not result in significant differences in PR interval, QT interval, or QRS-complex duration. CONCLUSIONS AND CLINICAL RELEVANCE: Significant changes are found in ECG measurements in the sitting position and sternal recumbency, compared with right lateral recumbency. In dogs, many ECG reference range values for right lateral recumbency are not valid for ECGs obtained in the sitting position or sternal recumbency.     

Effect of body position on oesophageal and gastric pressures in the anaesthetised dog

The effect of body position on lower oesophageal sphincter pressure (LOSP), gastric pressure and barrier pressure (BrP) was investigated in 40 dogs anaesthetised for neutering procedures. The dogs were placed in lateral recumbency followed by dorsal recumbency (group 1) or vice versa (group 2). LOSP decreased significantly in the animals which were positioned initially in lateral recumbency, when they were then placed in dorsal recumbency, while those initially positioned in dorsal recumbency showed no significant change in their LOSP or BrP when their position was altered to lateral recumbency. When the data from both groups were pooled, LOSP and BrP were significantly lower when the dogs were in dorsal compared to lateral recumbency (P<0–05).