The sedative effects of low-dose medetomidine and butorphanol alone and in combination intravenously in dogs

ObjectiveTo evaluate the sedative effects of intravenous (IV) medetomidine (1 μg kg^?1) and butorphanol (0.1 mg kg^?1) alone and in combination in dogs.Study designProspective, blinded, randomized clinical trial.AnimalsSixty healthy (American Society of Anesthesiologists I) dogs, aged 6.2 ± 3.2 years and body mass 26 ± 12.5 kg.MethodsDogs were assigned to four groups: Group S (sodium chloride 0.9% IV), Group B (butorphanol IV), Group M (medetomidine IV) and Group MB (medetomidine and butorphanol IV). The same clinician assessed sedation before and 12 minutes after administration using a numerical scoring system in which 19 represented maximum sedation. Heart rate (HR), respiratory rate, pulse quality, capillary refill time and rectal temperature were recorded after each sedation score assessment. Sedation scores, sedation score difference (score after minus score before administration) and patient variables were compared using one-way anova for normally distributed variables and Kruskal–Wallis test for variables with skewed distributions and/or unequal variances. Where significance was found, further evaluation used Bonferroni multiple comparisons for pair-wise testing.ResultsBreed, sex, neuter status, age and body mass did not differ between groups. Sedation scores before substance administration were similar between groups (p = 0.2). Sedation scores after sedation were significantly higher in Group MB (mean 9.5 ± SD 5.5) than in group S (2.5 ± 1.8) (p < 0.001), group M (3.1 ± 2.5) (p < 0.001) and group B (3.7 ± 2.0) (p = 0.003). Sedation score difference was significantly higher in Group MB [7 (0–13)] than in Group S [0 (?1 to 4)] (p < 0.001) and Group M [0 (0–6)] (p < 0.001). HR decreased significantly in Groups M and MB compared with Group S (p < 0.05).Conclusion and clinical relevanceLow-dose medetomidine 1 μg kg^?1 IV combined with butorphanol 0.1 mg kg^?1 IV produced more sedation than medetomidine or butorphanol alone. HR was significantly decreased in both medetomidine groups.     

Effect of topical 1% tropicamide on Schirmer tear test results in clinically normal horses

Objective  To observe the effect of topical 1% tropicamide on equine tear production as measured by Schirmer I tear test.
Materials and methods  Fourteen adult horses received one drop of 1% tropicamide ophthalmic solution in one eye and the opposite eye served as the control. The tear production in both eyes was tested at 1, 2, 4, 6, and 24 h after 1% tropicamide administration.
Results  Measurements made 1 h after treatment revealed a significant reduction in Schirmer tear test values in tropicamide treated eyes ( P  = 0.002). The observed decrease in tear production was maintained up to 4 h after treatment ( P  = 0.002). Although tropicamide-induced decrease in STT values was observed in the treated eyes, the contralateral eyes did not show significant changes in Schirmer tear test results.
Conclusion  Single dose of topical 1% tropicamide resulted in statistically significant reduction in Schirmer tear test values in clinically normal horses.     

Analysis of tear uptake by the Schirmer tear test strip in the canine eye

OBJECTIVE: To analyze the uptake of tears in a Schirmer tear test (STT) in vitro and in vitro. MATERIALS AND METHODS: Uptake of fluid by Schirmer tear test strips was studied in vitro by examining fluid uptake over time from an unlimited fluid supply as well as with specific fluid volumes applied to the test strip. Uptake of fluid by Schirmer tear test strips was evaluated in a population of 100 ophthalmologically normal dogs together with a group of 40 dogs with tear film abnormalities such as keratoconjunctivitis sicca (KCS) or epiphora. Each animal was given a full ophthalmic examination followed by a standard Schirmer tear test extended over between 3 and 5 min with the STT reading recorded every 5 s and plotted over time. To determine the effect of ocular irritation by the test strip, uptake of tears by test strips was determined before and after topical anesthesia in 20 dogs. RESULTS: In vitro examination of fluid uptake by the STT strips showed an initial rapid uptake followed by a gradual reduction in rate of uptake. Temporal evaluation of STT in vivo showed a similar rapid initial uptake of tear fluid, followed in the majority of cases by a sudden change to a steady state uptake of fluid. The initial gradient was 29.3 +/- 16.9 mm/min followed by a steady state uptake of 5.2 +/- 2.3 mm/min in normal dogs and 1.9 +/- 1.3 mm/min in dogs with KCS. This corresponds to a steady state tear turnover of 7.8 +/- 3.4 microL/min in normal dogs and 2.8 +/- 1.9 microL/min in animals with KCS. Dogs with nasolacrimal blockage and resultant epiphora showed a high initial gradient but final gradients were not statistically different from those of normal dogs. Discussion and conclusions Temporal evaluation of tear uptake by the STT shows substantial differences in rate of tear uptake at different time-points during the period of the test. RESULTS: of this study suggest that the initial rapid rise in STT value represents uptake from the tear lake followed by a slower tear uptake of tears from steady state tear production. Temporal examination of the Schirmer tear test allows a more precise evaluation of tear production than the standard STT measuring tear uptake in 1 min, together with estimation of the contribution to the test strip tear uptake of tears from the residual tear lake volume and those from continual tear production.     

Effects of trimethoprim-sulfadiazine on tear production and the fluctuations of Schirmer tear test values in horses

The objectives of this study were to observe the effects of trimethoprim-sulfadiazine on equine tear production and to determine normal fluctuations in Schirmer tear test (STT) values in horses. A randomized, placebo-controlled, blinded clinical trial measuring STT values in 15 horses over an 8-week period was performed. The treatment group (eight horses) received 30 mg/kg trimethoprim-sulfadiazine orally once a day and the control group (seven horses) received placebo (flour) at the same time. All horses were housed outdoors throughout the study. Schirmer tear test values were measured at 0, 2, 4, 6 and 8 weeks, and 4 weeks after discontinuation of treatment. There were no significant differences in tear production between the treated and control groups. Fluctuations in STT were observed and may result from individual and environmental variations. Trimethoprim-sulfadiazine did not decrease tear production in the horses in this study. Horses normally experience periodic fluctuations in STT values.     

Effect of acepromazine or xylazine on tear production as measured by Schirmer tear test in normal cats

Objective  To evaluate the effect of acepromazine or xylazine on Schirmer tear test 1 results in clinically normal cats.
Animals  Sixteen healthy cross-breed cats.
Procedure  The animals were randomly divided into two groups of eight cats each. The first group was sedated with acepromazine alone (0.2 mg/kg) and the second group received only xylazine (2 mg/kg). All cats had Schirmer tear test (STT) readings taken prior to sedation and at 15 and 25 min postsedation.
Results  Sedation with acepromazine or xylazine in cats with normal pre-sedation STT 1 values caused a statistically significant decrease in mean values of tear production in both groups. In acepromazine group the mean ± SEM STT at T₁₅ and T₂₅ were 4.31 ± 0.98 ( P  < 0.001) and 5.18 ± 1.07 ( P  = 0.002). The post-treatment mean ± SEM values in xylazine group were 2.18 ± 0.97 ( P  < 0.001) and 2.62 ± 1.17 ( P  = 0.001) at 15 and 25 min respectively. Comparison between T₁₅ and T₂₅ in acepromazine group ( P  = 0.49) and xylazine group ( P  = 0.56) revealed no significant differences.
Conclusion  These observations indicate that both acepromazine or xylazine significantly reduced tear production in clinically normal cats. In cats, clinicians should measure STT values prior to utilizing acepromazine or xylazine as sedatives in order to accurately assess the results. Moreover, sterile ocular lubricant or tear replacement should be used as a corneal protectant during sedation with these drugs.     

Results of Schirmer tear test in clinically normal llamas (Lama glama)

Purpose To determine the normal reference range for Schirmer tear test (STT) values in clinically normal llamas (Lama glama) Animals Nine captive llamas (Lama glama) (seven females and two males) were used in this study. Procedure Complete ophthalmic examinations were performed without chemical restraint. STT I values were evaluated in both eyes of all llamas using a commercial STT strip of a single lot number (Schirmer‐Tränentest^®, Germany). STT II value was also measured in both eyes of seven female llamas. Results No statistically significant differences among ages or between right and left eyes were found for any of the results. The mean ± SD STT I of 18 eyes of nine llamas was 17.3 ± 1.1 mm/min (Range 15–19 mm/min). The mean ± SD STT II of 14 eyes of seven llamas was 15.4 ± 1.7 mm/min (Range 12.5–17.5 mm/min). A paired samples t‐test demonstrated that there was a significant difference between the STT I and II values (P = 0.001). Conclusion This study provides novel data for normal reference ranges of STT I and II values in healthy llamas. Results of this study may assist veterinarians in the diagnosis of ocular surface disease and syndromes affecting the tear film in these species.     

Effects of medetomidine,l‐methadone,and their combination on arterial blood gases in dogs

ObjectiveTo investigate the influence of l–methadone on medetomidine–induced changes in arterial blood gases and clinical sedation in dogs.Study designProspective experimental cross–over study (Latin square design).AnimalsFive 1–year–old purpose bred laboratory beagle dogs of both sexes.MethodsEach dog was treated three times: medetomidine (20 μg kg^?1 IV), l–methadone (0.1 mg kg^?1 IV) and their combination. Arterial blood was collected for blood gas analysis. Heart and respiratory rates were recorded, and clinical sedation and reaction to a painful stimulus were scored before drug administration and at various time points for 30 minutes thereafter.ResultsArterial partial pressure of oxygen decreased slightly after medetomidine administration and further after medetomidine/l–methadone administration (range 55.2–86.7 mmHg, 7.4–11.6 kPa, at 5 minutes). A slight increase was detected in arterial partial pressure of carbon dioxide after administration of l–methadone and medetomidine/l–methadone (42.6 ± 2.9 and 44.7 ± 2.4 mmHg, 5.7 ± 0.4 and 6.0 ± 0.3 kPa, 30 minutes after drug administration, respectively). Arterial pH decreased slightly after administration of l–methadone and medetomidine/l–methadone. Heart and respiratory rates decreased after administration of medetomidine and medetomidine/l–methadone, and no differences were detected between the two treatments. Most dogs panted after administration of l–methadone and there was slight sedation. Medetomidine induced moderate or deep sedation, and all dogs were deeply sedated after administration of medetomidine/l–methadone. Reaction to a noxious stimulus was strong or moderate after administration of methadone, moderate or absent after administration of medetomidine, and absent after administration of medetomidine/l–methadone.Conclusions and clinical relevanceAt the doses used in this study, l–methadone potentiated the sedative and analgesic effects and the decrease in arterial oxygenation induced by medetomidine in dogs, which limits the clinical use of this combination.     

Tear production in canine neonates – evaluation using a modified Schirmer tear test

Purpose The ability of human newborns to produce tears has been a subject of controversy in the literature since the mid‐20th century, and there has been considerable debate as to whether they are able to produce tears. Recently, it was established that total tear secretion (reflex + basal) in full‐term infants is similar to those of adults whereas both reflex and basal tear production is reduced in premature babies. The objectives of this study were to assess whether newborn dogs have measurable aqueous tear production at the fourth week of life and to evaluate a modified Schirmer tear test (mSTT) as a useful method for measuring neonatal tear production in dogs. Methods Thirty four‐week‐old healthy puppies from six litters were evaluated. A control group was composed of 10 normal adult dogs. The mSTT strips were obtained by cutting a 5 mm‐wide strip in half (making two 2.5 mm‐wide strips). The mSTT1 was performed in puppies and adult dogs. Values were compared using t‐tests. Results In neonates, the average value for the mSTT1 was 13.6 ± 3.07 (range = 7–19 mm/min), which was significantly lower in neonates than in adult dogs (23.25 ± 3.5, range = 17–30 mm/min, P < 0.0001). Conclusions Canine neonates do produce tears by the fourth week of life, which can be successfully measured with the mSTT. This report established for the first time that canine neonates have significantly reduced total (reflex + basal) tear secretion compared to adults.     

Effect of topical tropicamide on tear production as measured by Schirmer's tear test in normal dogs and cats

Objective To evaluate the effect of a single dose of topical 1% tropicamide on tear production as measured by the Schirmer tear test (STT) in the normal dog and cat. Material and methods Twenty‐eight dogs and 32 cats received 50 µl : l of 1% tropicamide in one eye and the opposite eye served as the control. STTs were performed immediately before instillation of tropicamide and then at 1, 4, 8 and 24 h post drug instillation. STT results were compared between the control and treated eyes at the different times. Results Aqueous tear production in dogs, measured by STT, was not significantly reduced. The mean ± SEM STTs for the baseline time for control and tropicamide‐treated eyes were 19.9 ± 0.8 and 20.3 ± 0.8 mm wetting/min, respectively. For the control eyes, the subsequent mean ± SEM STT levels were 20.3 ± 0.9 (1 h), 21.1 ± 0.8 (4 h), 20.1 ± 0.9 (8 h), and 18.7 ± 0.7 (24 h). For the tropicamide‐treated eyes, the subsequent mean ± SEM STT levels were 19.4 ± 0.9 (1 h), 19.3 ± 0.9 (4 h), 20.0 ± 0.9 (8 h), and 18.4 ± 0.8 (24 h). Aqueous tear production of both eyes was significantly reduced in cats at 1 h but returned to baseline by 4 h post tropicamide instillation. The mean ± SEM STT levels for the baseline time in cats for control and tropicamide‐treated eyes were 14.9 ± 0.8 and 14.7 ± 0.8 mm wetting/min, respectively. Subsequent mean ± SEM STT levels for the control eyes were 6.4 ± 1.1 (1 h), 11.9 ± 1.0 (4 h), 13.9 ± 0.8 (8 h), and 16.4 ± 1.0 (24 h). For the tropicamide‐treated eyes, the subsequent mean ± SEM STT levels were 5.3 ± 0.8 (1 h), 10.2 ± 0.8 (4 h), 14.7 ± 1.0 (8 h), and 16.6 ± 1.0 (24 h). Conclusion Single dose 1% tropicamide does not significantly lower tear production rates, as measured by the STT, in normal dogs. However, in normal cats single doses of 1% tropicamide in one eye cause significant reductions in tear production of both eyes at 1 h that recovered to baseline levels by 4 h.     

Intraocular pressure and Schirmer tear test results in clinically normal Long-Eared Hedgehogs (Hemiechinus auritus): reference values

Objective The present study was undertaken to establish reference values for Schirmer tear test (STT) and intraocular pressure (IOP) in the long‐eared hedgehog (Hemiechinus auritus). Animals Fourteen healthy long‐eared hedgehogs (H. auritus) of either sex were studied. Procedures The hedgehogs were individually immobilized with an intramuscular injection of combined Ketamine (20 mg/kg) and Diazepam (0.5 mg/kg), and each animal underwent ophthalmic examinations including: STT, tonometry, biomicroscopy, and indirect ophthalmoscopy. Results No significant effects of animal gender, weight, side (right vs. left eye) were found in this study. Mean (SD) STT values for all eyes (n = 28) were 1.7 ± 1.2 mm/1 min with a range of 0–4 mm/1 min. Mean STT in male animals was 2.2 ± 1.2. Mean STT in female Hedgehogs was 1.3 ± 1.1. Mean (SD) IOP values by applanation tonometry were 20.1 ± 4.0 mmHg (range 11.5–26.5 mmHg). Mean (SD) IOP values by applanation tonometry were 18.2 ± 4.0 and 22.0 ± 3.2 mmHg for males and females, respectively. Conclusions This study reports STT and IOP findings in long‐eared hedgehogs (H. auritus).     

Thermographic imaging of superficial temperature in dogs sedated with medetomidine and butorphanol with and without MK‐467 (L‐659’066)

ObjectiveTo record, with a thermal camera, peripheral temperature changes during different sedation protocols and to relate the results to changes in the rectal temperature.Study designRandomized crossover part-blinded experimental study.AnimalsEight healthy purpose-bred neutered Beagles (two females and six males) weight 14.5 ± 1.6 kg (mean ± SD) and aged 3–4 years.MethodsEach dog was sedated four times. Treatments were medetomidine 20 μg kg^?1 and butorphanol 0.1 mg kg^?1 (MB) with or without MK-467 500 μg kg^?1 (MK). Both drug combinations were administered IV and IM as separate treatments. A thermal camera (T425, FLIR) with a resolution of 320 by 240 was used for imaging.The dogs were placed in lateral recumbency on an insulated mattress. Digital (DFT) and metatarsal footpad temperatures (MFT) were measured with thermography. Thermograms and rectal temperature (RT) were taken before and at 3, 10, 20, 30, 45 and 60 minutes after treatment.ResultsAt 60 minutes after drug administration, MFT was higher (p < 0.001) after MB+MK (34.5 ± 1.1 IV, 34.8 ± 0.5 IM) than MB (31.1 ± 2.9 IV, 30.5 ± 3.6 IM), DFT was higher (p < 0.001) after MB+MK (33.6 ± 1.4 IV, 34.0 ± 0.6 IM) than MB (26.7 ± 1.4 IV, 26.7 ± 2.5 IM), and RT was lower (p < 0.001) after MB+MK (36.7 ± 0.8 IV, 36.9 ± 0.3 IM) than MB (37.5 ± 0.3 IV, 37.4 ± 0.4 IM), with both routes. The change from baseline was greater with MB+MK than MB in all variables.ConclusionsSuperficial temperature changes can be seen and detected with thermography. MK-467 used with MB resulted in increased superficial temperatures and a decline in rectal temperature compared to MB alone.Clinical relevanceThe sedation protocol may influence core temperature loss, and may also have an effect on thermographic images.