Peri-anaesthetic and anaesthetic-related mortality risks in great apes (Hominidae) in zoological collections in the UK and Ireland

OBJECTIVE: To estimate the risk of death and identify the major risk factors for peri-anaesthetic mortality in great apes (Hominidae) that underwent anaesthesia in zoological collections in the UK and Ireland between 1 January 1990 and 30 June 2005. STUDY DESIGN: confidential, retrospective cohort study. ANIMAL POPULATION: The study population comprised all great apes from 16 zoological collections in the UK and Ireland that were anaesthetised during that period. METHODS: All available anaesthetic records were collected. Outcome at 7 days post-anaesthesia was recorded as alive, dead or euthanased. The risk of peri-anaesthetic mortality was calculated. Multivariable analysis of potential risk factors was performed. RESULTS: A total of 1182 anaesthetic records were collected and analysed. Sixteen peri-anaesthetic deaths occurred, resulting in a peri-anaesthetic mortality risk of 1.35%. Twenty percent of deaths (3/15) occurred during maintenance and 80% (12/15) occurred post-anaesthetic but within 7 days. A subjective assessment suggests at least five anaesthetic-related deaths occurred; in other words an anaesthetic-related mortality risk of 0.42% (5/1182) or above. In the multivariable analysis, health status and age were significantly associated with peri-anaesthetic mortality. Animals assessed as 'sick' pre-anaesthetic were associated with a 26-fold (95% CI 5.55-122.32) increased risk of death compared with animals with a good health status. Animals aged over 30 years were associated with a 30-fold (95% CI 3.44-261.85) increased risk of death, compared with adults aged between 10 and 30 years. CONCLUSIONS AND CLINICAL RELEVANCE: This study has shown that great ape anaesthesia appears to carry a high risk of mortality. Sick and aged patients are at an increased risk of death and particular care should be exercised during their anaesthesia. Standardisation and completeness of anaesthetic records across zoological collections would assist greatly in further studies.     

Mortality related to general anaesthesia and sedation in dogs under UK primary veterinary care

ObjectivesTo quantify and explore risk factors in dogs seen at primary care UK veterinary clinics for general anaesthetic (GA)/sedative-related death overall, in addition to neuter-specific procedures.Study designA nested case-control study within UK primary care veterinary electronic patient record surveillance programme, VetCompass, including over 300 UK veterinary practices.AnimalsA total of 157,318 dogs undergoing GA/sedative events.MethodsCases included dogs undergoing GA/sedative events between January 2010 and December 2013 with GA/sedative-related death recorded within 48 hours or 2 weeks of the event. Controls were randomly selected from dogs undergoing GA/sedation that did not die within these time periods. Risks of GA/sedative-related death for all surgeries and neuter-specific surgeries were estimated. Demographic and clinical associations with GA/sedative-related death were reported as odds ratios following multivariable logistic regression modelling. Statistical significance was set at 5%.ResultsFrom 157,318 dogs with a GA/sedative event, there were 159 (0.10%) within 48 hours and 219 (0.14%) GA/sedative-related deaths within 2 weeks. Within 89,852 dogs that underwent a neuter surgery, there were eight GA/sedative related (0.009%). Greater age, poorer American Society of Anaesthesiologists health status scores and more urgent procedures were associated with greater odds of death. Compared with mixed breeds, Rottweilers and West Highland White Terriers had greater odds and Cocker Spaniels had lower odds of GA/sedative-related death.Conclusions and clinical relevanceThe overall risk for GA/sedative related death was relatively low, particularly among the subset of dogs undergoing castration or ovariohysterectomy surgery. Associations and risk estimates may assist shared decision-making in clinical practice and provide benchmarks for audit.     

The risk of passive regurgitation during general anaesthesia in a population of referred dogs in the UK

Objective To evaluate the risk of passive regurgitation during anaesthesia, and to identify major factors associated with this in dogs attending the Queen Mother Hospital for Animals (QMHA), the Royal Veterinary College. Study design A case‐control study nested within the cohort of dogs undergoing anaesthesia with inhalation agents. Animal population All dogs undergoing general anaesthesia at the referral hospital between October 2006 and September 2008 (4271 cases). Methods All dogs anaesthetized at the QMHA during the study period were included. Regurgitating cases were defined as dogs for which reflux material was observed at the external nares or in the mouth, either during anaesthesia or before return to normal consciousness immediately after general anaesthesia. The risk of regurgitation was estimated and risk factors for regurgitation were evaluated with multivariable logistic regression (p < 0.05). Results The overall risk of regurgitation was 0.96% (41 cases out of 4271 anaesthetics, 95% confidence interval [95% CI] 0.67–1.25%). Exclusion of animals where pre‐existing disease was considered a contributing factor to regurgitation (n = 14) resulted in a risk of passive regurgitation of 0.63% (27 cases of 4257 anaesthetics, 95% CI 0.40–0.87%). In the multivariable logistic regression model, procedure and patient weight were significantly associated with regurgitation. Dogs undergoing orthopaedic surgery were 26.7 times more likely to regurgitate compared to dogs undergoing only diagnostic procedures. Dogs weighing more than 40 kg were approximately five times more likely to regurgitate than those weighing <20 kg. Conclusions and clinical relevance This study highlights the rare but important occurrence of perioperative regurgitation and identifies that dogs undergoing orthopaedic procedures, and those weighing more than 40 kg, are particularly at risk. Further work is required to evaluate the reasons for these observations.     

Risk factors for mortality associated with respiratory disease among Menz and Horro sheep in Ethiopia

A retrospective case-control study was conducted on 6718 sheep of two breeds (2772 Horro and 3946 Menz) on risk factors for mortality associated with respiratory disease (MARD) in Ethiopia, based on data collected between October 1993 and December 1997. Potential risk factors examined were breed, gender, age, month, and air temperatures.Fifty-four per cent of total deaths in the flock could be attributed to respiratory disease and the annual MARD rate ranged between 6.3 and 19.0%. There was significant breed (P<0.0001) and gender (P<0.0001) difference in MARD. The Horro breed had a higher (P<0.0001) annual MARD than the Menz breed (16.5+/-0.18 vs. 12.4+/-0.15%). A higher (P<0.0001) proportion of males suffered than females (15.1+/-0.23% vs. 13.8+/-0.13%). Age was also an important risk factor for MARD: there was a strong polynomial relationship (R(2)=0.91, P<0.0001) between MARD and age; the risk of being young if a sheep was a MARD case was high. MARD was high between October and March but relatively low between the months of April and September. There was a significant (P<0.05) negative cubic relationship (R(2)=0.49) between monthly MARD and monthly average minimum air temperatures. There was also a significant (P<0.01) positive exponential relationship (R(2)=0.61) between monthly MARD and average monthly daily deviation between maximum and minimum air temperatures.Timely health and management interventions focusing on these factors are necessary to alleviate losses from MARD. Understanding variations in MARD risk within a population can enhance early response to potential outbreaks, reducing losses.     

Asystole associated with cerebrospinal fluid collection in a 3-month-old foal under general anaesthesia

A 3-month-old colt foal presented to the Philip Leverhulme Equine Hospital for investigation of progressive neurological signs. Diagnostic investigation included cerebrospinal fluid collection, which was performed under general anaesthesia. During this procedure, severe bradycardia which progressed to asystole occurred. Initial resuscitation was successful; however, the foal had clinical signs consistent with cerebral hypoxia post-resuscitation and was euthanased the following day due to deterioration of neurological function. Asystole was presumed due to a Cushing-type reflex as a result of changes in intracranial pressure during the sampling procedure.     

Seroprevalence of low pathogenic avian influenza (H9N2) and associated risk factors in the Gyeonggi-do of Korea during 2005-2006

Between November 2005 and March 2006, a total of 253 poultry flocks in the Gyeonggi-do of Korea were examined for seroprevalence against avian influenza (AI) using a hemagglutination inhibition (HI) test and an agar gel precipitation test. No low pathogenic avian influenza (LPAI) virus was isolated from 47 seropositive flocks that lacked clinical signs during sampling. The unadjusted percentage of seroprevalence rates of layer and broiler flocks were not significantly different, i.e., 26% (25/96) and 23% (22/97), respectively. The HI titer of the layers (mean = 89) was higher than the broilers (mean = 36; p < 0.001). A cross-sectional study was conducted for the seroprevalence of LPAI in the layers. Of 7 risk factors, farms employing one or more workers had a higher seropositive prevalence as compared to farms without hired employees (adjusted prevalence OR = 11.5, p = 0.031). Layer flocks older than 400 d had higher seropositivity than flocks younger than 300 d (OR = 4.9, p = 0.017). The farmers recognized at least one of the clinical signs in seropositive flocks, such as decreased egg production, respiratory syndromes, and increased mortality (OR = 2.3, p = 0.082). In a matched case-control study, 20 pairs of case and control flocks matched for type of flock, hired employees, age, and flock size were compared. Frequent cleansing with disinfectants was associated with a decreased risk of seropositivity (OR = 0.2, p = 0.022). Although there was a low statistical association, using a foot disinfectant when entering the building led to a decreased rate of seropositivity (OR = 0.3, p = 0.105).     

A single-cohort retrospective analysis of factors associated with morbidity and mortality in 193 anesthetized domestic goats

ObjectiveTo define the morbidity and mortality rates in goats undergoing general anesthesia at a large animal teaching hospital.Study designRetrospective, single-cohort, observational study.AnimalsRecords of 193 client-owned goats.MethodsData were collected from 218 medical records on 193 goats undergoing general anesthesia between January 2017 and December 2021. Demographic data, anesthetic management, recovery period and perianesthetic complications were recorded. Perianesthetic death was defined as anesthesia-related or anesthesia-contributory death occurring within 72 hours after recovery. Records of goats that were euthanized were reviewed to ascertain the cause of euthanasia. Each explanatory variable was individually investigated by univariable penalized maximum likelihood logistic regression, followed by multivariable analysis. Statistical significance was set at p < 0.05.ResultsPerianesthetic mortality was 7.3%, but was 3.4% when considering only goats undergoing elective procedures. Multivariable analysis showed that gastrointestinal surgeries [odds ratio (OR) 19.17, standard error (SE) 12.99, 95% confidence interval (CI) 5.08–72.33; p < 0.01] and requirement for perianesthetic norepinephrine infusion (OR 10.85, SE 8.82, 95% CI 2.21–53.33; p < 0.01) were associated with increased mortality. Maintaining other variables equal, the use of perianesthetic ketamine infusion was associated with decreased mortality (OR 0.09, SE 0.09, 95% CI 0.01–0.73; p = 0.02). Anesthesia-related or anesthesia-contributory complications included hypothermia (52.4%), bradycardia (38.1%), hypotension (35.3%), hypoxemia (14.8%), regurgitation/aspiration (7.3%), azotemia/acute renal failure (4.6%), myopathies/neuropathies (4.1%) and fever of unknown origin (2.7%).Conclusions and clinical relevanceIn this population, gastrointestinal surgeries and the requirement for perianesthetic norepinephrine infusion were associated with increased mortality in goats undergoing general anesthesia, while ketamine infusion may have a protective effect.     

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.     

In vitro validation of a Pitot-based flow meter for the measurement of respiratory volume and flow in large animal anaesthesia

Objective  To remodel and validate commercially available monitors and their Pitot tube-based flow sensors for use in large animals, using in vitro techniques.
Study design  Prospective, in vitro experiment.
Methods  Both the original and the remodelled sensor were studied with a reference flow generator. Measurements were taken of the static flow-pressure relationship and linearity of the flow signal. Sensor airway resistance was calculated. Following recalibration of the host monitor, volumes ranging from 1 to 7 L were generated by a calibration syringe, and bias and precision of spirometric volume was determined. Where manual recalibration was not available, a conversion factor for volume measurement was determined. The influence of gas composition mixture and peak flow on the conversion factor was studied.
Results  Both the original and the remodelled sensor showed similar static flow–pressure relationships and linearity of the flow signal. Mean bias (%) of displayed values compared with the reference volume of 3, 5 and 7 L varied between −0.4% and +2.4%, and this was significantly smaller than that for 1 L (4.8% to +5.0%). Conversion factors for 3, 5 and 7 L were very similar (mean 6.00 ± 0.2, range 5.91–6.06) and were not significantly influenced by the gas mixture used. Increasing peak flow caused a small decrease in the conversion factor. Volume measurement error and conversion factors for inspiration and expiration were close to identity.
Conclusion  The combination of the host monitor with the remodelled flow sensor allowed accurate in vitro measurement of flows and volumes in a range expected during large animal anaesthesia.
Clinical relevance  This combination has potential as a reliable spirometric monitor for use during large animal anaesthesia.     

Herd and sow-related risk factors for mortality in sows in group-housed systems

Mortality of sows is a major problem for pig production worldwide. In this study, we used hierarchical multivariable logistic analyses to investigate different risk factors for mortality at the sow and herd level in herds with group-housed pregnant sows. Data included 3652 pregnant and 1266 lactating sows from 34 sow herds. A clinical examination for 16 clinical signs was carried out for each sow, and information about 16 herd related factors was obtained by interviews. Farm records were used to obtain information about whether or not sows died suddenly or were euthanized within 3 months after the clinical examination. Factors increasing the risk of sow mortality in the gestation unit were solid pen floors (OR = 1.87), presence of vulva bites (OR = 1.73) and unwillingness to stand when approached (OR = 1.62). Factors increasing the risk of sow mortality in the lactation unit were pale vulva color (OR = 12.69), body leanness (OR = 4.11), and presence of shoulder ulcers (OR = 2.89). The estimated between herd variation was small. Thus, the findings for the sow level variables may be generally applicable for sows in herds with group housed systems.     

Influence of modifiable risk factors on the incidence of stillbirth/perinatal mortality in dairy cattle

Bovine perinatal mortality is defined as the death of a full-term calf before, during or up to 48 h after calving. Recent studies indicate that the prevalence of bovine perinatal mortality is increasing, particularly in Holstein primiparae. Factors leading to a greater incidence of dystocia are the most important modifiable variables influencing the risk of perinatal mortality. Modifiable predictors are largely (age at first calving, breeding method, sire, calving management, feto-maternal health status and gestational nutrition) or moderately (calf breed, sex, gestation length) under the control of the dairy farm manager. Unlike non-modifiable risk factors, such as primiparity and fetal plurality, these factors can be manipulated to reduce the incidence of perinatal mortality.     

Ultrasound-guided dorsal approach for the brachial plexus block in common kestrels (Falco tinnunculus): a cadaver study

ObjectiveTo develop an ultrasound-guided dorsal approach to the brachial plexus and to investigate the nerve distribution and staining of a dyed injectate in common kestrel (Falco tinnunculus) cadavers.Study designProspective, cadaver study.AnimalsA group of three common kestrel cadavers (six wings).MethodsAll cadavers were fresh-frozen at –20 °C and thawed for 10 hours at room temperature before the study. The cadavers were placed in sternal recumbency and their wings were abducted. A 8–13 MHz linear-array transducer was placed over the scapulohumeral joint, at the centre of a triangle formed by the scapula and the humerus. The brachial plexus was identified between the scapulohumeralis muscle and the pectoralis major muscle, as hypoechoic structures lying just cranially to the axillary vessels. After ultrasound-guided brachial plexus identification, a 22 gauge, 50 mm insulated needle was advanced in-plane using ultrasound visualization. A volume of 0.5 mL kg^–1 of a 3:1 (2% lidocaine:methylene blue) solution was injected. Following cadaver dissection, the pattern of the spread was assessed, and the extent of nerve staining was measured with a calliper and deemed adequate if more than 0.6 cm of the nerve staining was achieved.ResultsThe brachial plexus was clearly identified in all wings with the dorsal approach. After dye injection, all the branches of the brachial plexus defined as nerves 1–5 (N1, N2, N3, N4 and N5) were completely stained in five (83%) and partially stained in one (17%) of the six wings.Conclusions and clinical relevanceThe ultrasound-guided dorsal approach allows a clear visualization of the brachial plexus structure. The injection of 0.5 mL kg^–1of a lidocaine/dye solution produced complete nerve staining in most cases. Further in vivo studies are mandatory to confirm the clinical efficacy of this locoregional anaesthesia technique in common kestrels (Falco tinnunculus).     

浙江省引起高致病性禽流感暴发流行的风险因子调查与分析

为明确浙江省高致病性禽流感(HPAI)发生的风险水平,我们开展了相关风险因子调查和分析工作.本研究将风险因子等级分为高、较高、中和低4个风险等级,对母源抗体、免疫抗体、家禽密度、饲养设施、禽类混养、饲养场地理位置、水禽和迁徙鸟、活禽市场等风险因子进行了定量评估.通过权重赋值评估浙江省发生的HPAI的风险水平为0.66875,判定为中等,提示浙江省发生禽流感疫情的可能性时刻存在.通过风险因子分析,发现了高致病禽流感防控工作中存在的薄弱环节,明确今后工作的重点,为浙江省HPAI管理和决策提供了依据.     

Human brucellosis: seroprevalence and risk factors related to high risk occupational groups in Tanga Municipality, Tanzania

The objective of this study was to describe the prevalence of brucellosis in various occupations in Tanga, Tanzania. During the year 2004, serum samples were collected from volunteers in various occupations and screened for brucella antibodies using Rose Bengal Plate Agglutination Test. Information on occupation, kind of work and contacts with livestock was collected and age and sex were recorded. The overall sero prevalence of antibodies to Brucella abortus was 5.52%. One variable in a multivariate regression model was significantly associated with seropositivity to B. abortus: abattoir workers. The prevalence of antibody was significantly higher (P < 0.05) among personnel employed in high-risk jobs such as cutting animal throats and cleaning slaughtered animals parts. None of the other factors investigated was associated with seropositivity to B. abortus. This study documents the serological evidence of B. abortus infection for the first time in abattoir workers in Tanzania.     

Peri-anaesthetic mortality and nonfatal gastrointestinal complications in pet rabbits: a retrospective study on 210 cases

Objective

The aim of this study was to determine the incidence and the associated risk factors of peri-anaesthetic mortality and gastrointestinal complications in pet rabbits.

Clinical efficacy and cardiorespiratory effects of alfaxalone, or diazepam/fentanyl for induction of anaesthesia in dogs that are a poor anaesthetic risk

ObjectiveTo evaluate the clinical efficacy and cardiorespiratory effects of alfaxalone as an anaesthetic induction agent in dogs with moderate to severe systemic disease.Study designRandomized prospective clinical study.AnimalsForty dogs of physical status ASA III-V referred for various surgical procedures.MethodsDogs were pre-medicated with intramuscular methadone (0.2 mg kg^?1) and allocated randomly to one of two treatment groups for induction of anaesthesia: alfaxalone (ALF) 1–2 mg kg^?1 administered intravenously (IV) over 60 seconds or fentanyl 5 μg kg^?1 with diazepam 0.2 mg kg^?1± propofol 1–2 mg kg^?1 (FDP) IV to allow endotracheal intubation. Anaesthesia was maintained with isoflurane in oxygen and fentanyl infusion following both treatments. All dogs were mechanically ventilated to maintain normocapnia. Systolic blood pressure (SAP) was measured by Doppler ultrasound before and immediately after anaesthetic induction, but before isoflurane administration. Parameters recorded every 5 minutes throughout subsequent anaesthesia were heart and respiratory rates, end-tidal partial pressure of carbon dioxide and isoflurane, oxygen saturation of haemoglobin and invasive systolic, diastolic and mean arterial blood pressure. Quality of anaesthetic induction and recovery were recorded. Continuous variables were assessed for normality and analyzed with the Mann Whitney U test. Repeated measures were log transformed and analyzed with repeated measures anova (p < 0.05).ResultsTreatment groups were similar for continuous and categorical data. Anaesthetic induction quality was good following both treatments. Pre-induction and post-induction systolic blood pressure did not differ between treatments and there was no significant change after induction. The parameters measured throughout the subsequent anaesthetic procedures did not differ between treatments. Quality of recovery was very, quite or moderately smooth.Conclusions and clinical relevanceInduction of anaesthesia with alfaxalone resulted in similar cardiorespiratory effects when compared to the fentanyl-diazepam-propofol combination and is a clinically acceptable induction agent in sick dogs.