Aspects of in vivo endotracheal tube intracuff pressure in cats

Objectives

To determine the endotracheal tube cuff pressure produced with two inflation techniques, in two brands of endotracheal tube in cats. To determine the inspiratory pressure which produces an audible leak when the intracuff pressure is 30 cmH₂O.

Successful balloon angioplasty of pulmonary artery stenosis in two cats and associated complications

Two cats (2.5 months and 8 months old) were each evaluated due to a loud systolic murmur, and each was diagnosed with severe pulmonary artery stenosis at the bifurcation of the main pulmonary artery. Echocardiograms confirmed significant right atrial dilation and right ventricular dilation and/or hypertrophy that was progressive in one cat. Atenolol was initiated and the cats were referred for interventional therapy. Balloon angioplasty was performed via the jugular vein. In case 1, the pressure gradient across the stenosis was reduced from 169.7 mmHg to 23.6 mmHg and 52.4 mmHg across the left and right branch pulmonary arteries, respectively. In case 2, the stenotic echocardiographic gradient was reduced from 64 mmHg to 38.0 mmHg and 35.3 mmHg across the left branch and right-branched pulmonary arteries respectively. Both patients developed moderate to severe dynamic right ventricular outflow tract obstruction post angioplasty. Case 2 developed hypotension, desaturation, and ventricular arrhythmias intra-operatively. Case 1 was discharged but appeared to develop acute lung perfusion injury approximately 36 h after procedure that was manifested by radiographic pulmonary congestion and pulmonary infiltrate of the left lung fields. The congestion was successfully managed medically. Serial echocardiograms over the following 4 years in case 1 showed near complete resolution of the stenosis and associated right heart enlargement.     

Prognostic value of mitral annular systolic plane excursion and tricuspid annular plane systolic excursion in cats with hypertrophic cardiomyopathy

Introduction

Hypertrophic cardiomyopathy (HCM) has a variable prognosis; left atrial size, presence of clinical signs and left ventricular systolic function have been shown to predict outcomes. Mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) assess longitudinal ventricular systolic function and are decreased in cats with HCM. The aim of the study was to ascertain whether MAPSE and TAPSE have prognostic value in HCM and if cats with pleural effusion have lower MAPSE and TAPSE than cats with pulmonary oedema.

Clinical and computed tomography tumour dimension assessments for planning wide excision of injection site sarcomas in cats: how strong is the agreement?

In injection site sarcoma (ISS) in cats lateral as well as deep margins should be correctly planned for a successful surgical outcome. The discrepancy between clinical and computed tomography (CT) measurements of dimension in resectable tumour has led to possible bias that affects the subsequent surgical dose. The aim of this study was to prospectively investigate the agreement between clinical and CT measurements of dimension in newly diagnosed ISS in cats. Fifty‐three client‐owned cats that underwent both clinical and CT measurements of the length and width of ISS were included. CT measurements showed a tendency towards being larger than clinical dimensions, and this difference increased with increasing tumour size. Based on our results, in further studies focusing on ISS in cats, the kind of assessment used to define tumour dimensions (CT versus clinic) should be declared and specified to properly consider surgical results and prognostic impact of this variable.     

Comparison of intraperitoneal ropivacaine and ropivacaine–dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy

ObjectiveTo investigate the intraperitoneal (IP) administration of ropivacaine or ropivacaine–dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy.Study designProspective, randomized, blinded, positively controlled clinical study.AnimalsA total of 45 client-owned cats were enrolled.MethodsThe cats were administered intramuscular (IM) meperidine (6 mg kg⁻¹) and acepromazine (0.05 mg kg⁻¹). Anesthesia was induced with propofol and maintained with isoflurane. Meloxicam (0.2 mg kg⁻¹) was administered subcutaneously in all cats after intubation. After the abdominal incision, the cats were administered one of three treatments (15 cats in each treatment): IP instillation of 0.9% saline solution (group Control), 0.25% ropivacaine (1 mg kg⁻¹, group ROP) or ropivacaine and dexmedetomidine (4 μg kg⁻¹, group ROP–DEX). During anesthesia, heart rate (HR), electrocardiography, noninvasive systolic arterial pressure (SAP) and respiratory variables were monitored. Sedation and pain were assessed preoperatively and at various time points up to 24 hours after extubation using sedation scoring, an interactive visual analog scale, the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT; von Frey anesthesiometer). Rescue analgesia (morphine, 0.1 mg kg⁻¹) IM was administered if the MCPS ≥6. Data were analyzed using the chi-square test, Tukey test, Kruskal–Wallis test and Friedman test (p < 0.05).ResultsHR was significantly lower in ROP–DEX compared with Control (p = 0.002). The pain scores, MNT, sedation scores and the postoperative rescue analgesia did not differ statistically among groups.Conclusions and clinical relevanceAs part of a multimodal pain therapy, IP ropivacaine–dexmedetomidine was associated with decreased HR intraoperatively; however, SAP remained within normal limits. Using the stated anesthetic protocol, neither IP ropivacaine nor ropivacaine–dexmedetomidine significantly improved analgesia compared with IP saline in cats undergoing ovariohysterectomy.     

Do cats need arachidonic acid in the diet for reproduction?

A brief review of the status of arachidonic acid as an essential dietary nutrient for cats is presented. The reproductive performance of male and female cats given a purified diet containing only partially hydrogenated vegetable oil as the fat source from weaning was investigated. Male kittens did not require a supplemental source of arachidonate for normal body weight gain and successful reproduction. Female kittens given the same diet also appeared to grow normally, came into oestrus and conceived, but produced only a limited number of viable litters. Subsequent supplementation of these queens with arachidonic acid did not result in the birth of viable kittens. It is suggested that completion of a normal pregnancy by queens given a diet based on partially hydrogenated oil for protracted periods may require fatty acids in addition to arachidonate.     

Chylothorax in cats: is there a role for surgery?

Chylothorax is a complex disease with many identified underlying causes including cardiac disease, mediastinal masses, heartworm disease and trauma. Management of this disease should be directed at identifying the cause, if possible, and treating the underlying disorder. In cats with idiopathic chylothorax, medical management is recommended initially because the condition may resolve spontaneously. Owners should be made aware of the potential development of fibrosing pleuritis in affected cats. When medical management is impractical or unsuccessful, surgical intervention should be considered. Surgical options include mesenteric lymphangiography and thoracic duct ligation, pericardiectomy, omentalisation, passive pleuroperitoneal shunting, active pleuroperitoneal or pleurovenous shunting, and pleurodesis. Of these, only thoracic duct ligation and pericardiectomy are preferred by the author because, if successful, the result is complete resolution of the chylothorax, thereby reducing the risk of developing fibrosing pleuritis. Omentalisation may be beneficial in some animals as adjuvant therapy, but this procedure may still allow fibrosing pleuritis to occur. Until the aetiology of the effusion in cats with idiopathic chylothorax is understood, the treatment success rate will be less than ideal. Future research needs to be directed at determining the pathophysiologic mechanisms underlying this disease in cats.     

Can owners assess outcome following treatment of canine cruciate ligament deficiency?

Forty-seven owners of 48 dogs surgically treated for cranial cruciate ligament deficiency were asked to assess the outcome of treatment at one year postsurgery. A standard visual analogue scale assessment tool was used in all cases and owners were asked to score a variety of generic and disease-specific features. The reliability and responsiveness of the assessment tool were estimated and found to be acceptable; generic features, such as 'level of disability', showed the greatest reliability and responsiveness. The results of assessments by owners were compared to assessments by a veterinary surgeon but few significant correlations were found. Assessments by owners appear to be a useful outcome measure in this disease but are unlikely to be directly comparable to assessments by a veterinary surgeon.     

Treatment of fibroadenomatous hyperplasia in cats with aglépristone

Fibroadenomatous hyperplasia (FAH) is characterized by a rapid proliferation of mammary stroma and duct epithelium of 1 or more glands and predominantly affects younger female cats. Endogenous progesterone and exogenous progestogens play an important role in the genesis of FAH. The presence of progesterone receptors in fibroadenomatous tissue allows for targeted endocrine therapy with progesterone receptor blockers. We report on 22 young cats with FAH, none of which had responded to the withdrawal of progestogens or ovariectomy. The common signs were tachycardia (11 cats); skin ulceration, painful mammary glands, or both (16 cats); lethargy (8 cats); and anorexia (4 cats). The cats were treated with subcutaneous injections of the progesterone receptor blocker aglépristone on 1 (7 cats, 20 mg/kg) or 2 consecutive days (15 cats, 10 mg/kg/d) once weekly. All but 1 cat responded with a complete and lasting remission of signs after 1-4 weeks of treatment. Two cats had a short-term skin irritation at the site of the aglépristone injection. Two pregnant cats with FAH aborted after treatment with aglépristone and subsequently developed endometritis. In conclusion, the results of this study demonstrate that FAH in cats can be treated successfully with the progesterone receptor blocker aglépristone.     

Trends in the management of horses referred for evaluation of colic: 2004–2017

The financial crisis of 2008 had effects on veterinary practice, with falling turnovers associated with reluctance of owners to spend money on veterinary care. There were anecdotal reports that fewer horses were undergoing colic surgery. The aims of this study were to document the numbers of horses with colic being referred to, and undergoing surgery and/or euthanasia, at two equine hospitals (a university based equine hospital in the United States [NC State] and a private equine hospital in the UK [Bell Equine]) over a 14-year period (2004–2017). There was a trend of declining total yearly equine accessions at NC State starting in 2009, followed by an increase starting in 2012. At Bell Equine, total accessions showed an increasing trend from 2004 to 2015, followed by a slight decline in 2016 and 2017. The proportion of equine accessions that were colics varied from around 15% to 20% at both hospitals and did not show any notable variations over the time period studied. Both practices showed a trend of decreasing colic admissions undergoing and recovering from surgery starting from 2007 to 2008. The numbers and percentages of colic admissions that were subjected to euthanasia increased from 2004/2005 to 2014/2015 in both hospitals; there was a greater increase in numbers being subjected to euthanasia at surgery at NC State, compared to a greater increase in numbers being subjected to euthanasia without surgery at Bell Equine. At both hospitals, there was a trend of increasing mean invoice totals over the study period. The results show that there has been a trend of decreasing numbers of horses undergoing surgical treatment for colic since 2004/2005. This is likely to be, at least partly, due to the financial crisis of 2008, although other factors, including the high costs of surgery and the ageing equine population may also be important.