Transient postoperative glycosuria after isoflurane exposure in two dogs

The present report describes two surgical cases involving the development of sudden glycosuria after isoflurane anaesthesia, despite the dogs having normal blood glucose levels and renal glucose reabsorption. The glycosuria manifested 1 day after surgery and resolved spontaneously within 2 days in both cases. Considering that the surgeries (subcutaneous mandibular mass removal and fracture repair) were unrelated to the kidneys, and there were no remarkable events during anaesthesia, the glycosuria may have been associated with the isoflurane anaesthesia. There have been several previous reports of glycosuria in human patients following transient proximal tubule dysfunction due to volatile anaesthetics. This case report suggests the possibility of transient renal dysfunction following isoflurane anaesthesia in these two clinically healthy dogs. However, considering the observational nature of this report, it can not be excluded that any other procedure performed in these animals was responsible of the observed glycosuria.     

Matrix metalloproteinase activity in stifle synovial fluid of cranial cruciate ligament deficient dogs and effect of postoperative doxycycline treatment

This prospective clinical study investigated the activity of matrix metalloproteinases (MMPs) in stifle synovial fluid (SF) of 13 dogs with acute cranial cruciate ligament (CCL) rupture, and the effect of a postoperative doxycycline treatment. MMP-2, 3, 9 and 13 activities were compared with respect to the time of sampling (preoperatively or 1 month after surgical stabilisation) and the type of postoperative adjuvant treatment (doxycycline or not). No significant activity was detected for both MMP-3 and MMP-13. MMP-2 and MMP-9 activities were found to be significantly highly increased in SF of CCL ruptured stifles compared to control stifles of unaffected dogs. No significant effect from surgical stabilisation and postoperative doxycycline treatment on MMP-2 and MMP-9 activities was found, indicating that doxycycline may not be an appropriate postoperative medical treatment after CCL rupture.     

Autogenous osteochondral grafting for treatment of stifle osteochondrosis in dogs

Objective— To develop and assess clinical outcomes for osteochondral autografting for treatment of stifle osteochondrosis (OC) in dogs. Study Design— Retrospective case series. Animals— Dogs with stifle OC (n=10). Methods— Osteochondral autografting was developed and optimized in canine cadavers and purpose‐bred research dogs using the Osteochondral Autograft Transfer System (OATS). Dogs with stifle OC (n=10 dogs, 12 stifles) were then treated using the OATS system. Outcomes were assessed by radiography (n=12), magnetic resonance imaging (1), second‐look arthroscopy (9), lameness scoring (12), and telephone survey of owners (10 clients, 12 stifles) 6–15 months after surgery. Results— Complications were documented in 4 of the 12 stifles treated and included peri‐incisional seromas (3) and marked stifle effusion (1). Subjective assessment of follow‐up radiographs revealed evidence of integration of the grafts with maintenance of subchondral bone surface architecture. Subjective assessment of follow‐up MRI in 1 stifle revealed evidence for incorporation of grafts with restoration of articular surface contour. Second‐look arthroscopy 6–30 weeks after surgery revealed maintenance of articular cartilage at the graft site. Dogs were significantly (P<.001) less lame at follow‐up compared with preoperative scores. Based on follow‐up owner surveys, only 2 dogs had no pain or lameness; the other dogs were judged to have mild pain and/or lameness. All owners noticed improvement in the dogs' quality of life after surgery. Conclusion— Osteochondral autografting deserves consideration and further evaluation as a primary treatment option for stifle OC in dogs. Clinical Relevance— Osteochondral autografting for treatment of lateral femoral condylar OC lesions in dogs using OATS instrumentation is safe and results in improved function and quality of life based on owners' perception 6–15 months after treatment.     

Radiographic measurement of craniocaudal instability in stifle joints of clinically normal dogs and dogs with injury of a cranial cruciate ligament

OBJECTIVE: To determine craniocaudal laxity of the stifle joint of dogs when joints were positioned in tibial compression or neutral position. SAMPLE POPULATION: 19 normal stifle joints in 10 clinically normal dogs, 29 stifle joints with varying injury to the cranial cruciate ligament (10 complete ruptures alone, 10 complete ruptures with concomitant damage to the medial meniscus, 6 partial ruptures alone, and 3 partial ruptures with concomitant meniscal tearing), and 19 unaffected contralateral stifle joints in those 29 dogs. PROCEDURE: Relative displacement of bony landmarks was measured on paired lateral radiographs (neutral and tibial compression positions). Two measuring techniques were customized for use in dogs. RESULTS: The first technique failed to distinguish results in normal stifle joints from those in stifle joints with partial deficiency of cranial cruciate ligaments. Significant differences were found for joints with complete rupture, compared with stifle joints in clinically normal dogs. The second technique detected differences between normal stifle joints and injured joints with partial or complete rupture of the cranial cruciate ligament. Significant differences were not detected between joints with partial versus complete rupture. Adjusting data to account for size of dog did not improve results. CONCLUSIONS AND CLINICAL RELEVANCE: A wide range in measurements of laxity was found for stifle joints with intact cranial cruciate ligaments. Differences in degree of damage to the ligament and medial meniscus cannot be deduced from the amount of relative displacement measured on radiographs. Pathologic changes to the cranial cruciate ligament will not necessarily induce detectable changes in laxity of stifle joints in dogs.     

Epidural morphine and detomidine decreases postoperative hindlimb lameness in horses after bilateral stifle arthroscopy

OBJECTIVE: To determine whether preoperative epidural administration of morphine and detomidine would decrease postoperative lameness after bilateral stifle arthroscopy in horses. STUDY DESIGN: Prospective clinical controlled study. ANIMALS: Eight adult horses that had bilateral arthroscopic procedures, including drilling of cartilage and subchondral bone within the femoropatellar joints. METHODS: Horses were randomly separated into 2 groups. Preoperatively, 4 horses were administered a combination of epidural morphine (0.2 mg/kg) and detomidine (30 microg/kg), and 4 horses were administered an equivalent volume of epidural saline (0.9% NaCl) solution. Postoperative pain was assessed using 6 video recordings made at hourly intervals of each horse at a walk. Assessments began 1 hour after recovery from anesthesia. The recordings were scrambled out of sequence and evaluated by 3 observers, unaware of treatment groups, who scored lameness from 0 to 4. Lameness scores of the 2 groups of horses were compared using a Wilcoxon's rank sum test. Heart and respiratory rates were also measured at each hourly interval and compared between groups using a repeated-measures ANOVA; statistical significance was set at P <.05. RESULTS: Preoperative administration of epidural morphine and detomidine significantly decreased lameness and heart rates after bilateral stifle arthroscopy. The greatest decrease was detected at hours 1 and 2 after recovery from anesthesia. CONCLUSION: We conclude that horses undergoing a painful arthroscopic procedure of the stifle joint benefit from the administration of preoperative epidural morphine and detomidine. CLINICAL RELEVANCE: Preoperative epidural administration of detomidine and morphine may be useful in decreasing postoperative pain after stifle arthroscopy as well as pain associated with other painful disorders involving the stifle joint, such as septic arthritis and trauma.     

A comparison of epidural buprenorphine with epidural morphine for postoperative analgesia following stifle surgery in dogs

Objective To compare the efficacy of epidural buprenorphine with epidural morphine for post‐operative pain relief in dogs undergoing cranial cruciate ligament rupture repair. Study design A randomized, double blind clinical trial. Animals Twenty client‐owned dogs with cranial cruciate ligament rupture. Methods Dogs were randomly assigned to receive either epidural buprenorphine (4 µg kg^?1) or epidural morphine (0.1 mg kg^?1) in a total volume of 0.2 mL kg^?1. Epidural injections were performed immediately after induction of anesthesia. End‐tidal halothane and CO₂ were recorded every 15 minutes from the time of epidural administration of drug to extubation. A numerical rating pain score system was used by a blinded observer to evaluate analgesia beginning at extubation and continuing at specific intervals for 24 hours after surgery. Heart rate, respiratory rate, and blood pressure were recorded noninvasively at the same times. If pain score indicated moderate discomfort, rescue morphine at 1.0 mg kg^?1 was administered intramuscularly. Results There were no significant differences between groups with respect to pain score, heart rate, respiratory rate, indirect blood pressure, end‐tidal halothane or end‐tidal CO₂ at any time point. Fifty percent of dogs in the buprenorphine group and 50% of dogs in the morphine group required rescue analgesic medication. Time of systemic rescue morphine administration did not differ significantly between the two groups. There were no clinically observable side‐effects from epidural administration of either drug in any of the dogs of this study. Conclusions Epidural buprenorphine is as effective as epidural morphine for the relief of postoperative hindlimb orthopedic pain in dogs. Clinical relevance Buprenorphine appears to be an effective opioid for epidural use in healthy dogs. Buprenorphine may offer certain advantages over morphine for epidural use, such as lower abuse potential and, in some clinics, reduced cost and less wastage of drug.     

Comparison of two electroretinography systems used in dogs: the HMsERG and the RETIport

The purpose of the study was to compare two different electroretinography (ERG) instruments used on the same animal in a laboratory setting. Retinal function in both eyes of 12 healthy miniature schnauzers was evaluated under general anesthesia. Scotopic and photopic ERGs were recorded by the HMsERG and the RETIport using the Dog Standard Protocol recommended by the European College of Veterinary Ophthalmologists (ECVO). The waveforms of the ERGs obtained by the two ERG units were similar to those described in previous studies. The 90% reference ranges using the multiple of medians (MoM) showed that the changes in ERG parameters obtained by the HMsERG unit were very similar to those of the RETIport for most ERG responses, except for a few. The results demonstrate that the two ERG systems are comparable for evaluating retinal function in dogs. Further, the results also show that it is necessary to establish ERG system-specific limits of normality in each laboratory or clinic in order to obtain a correct diagnosis, for example by using a graphical representation of the 90% reference range.     

Relationship of physical examination test of shoulder instability to arthroscopic findings in dogs

Objective— To determine the diagnostic validity of commonly used physical examination maneuvers for shoulder instability.
Study Design— Retrospective study.
Animals— Dogs (n=24) referred for shoulder arthroscopy.
Methods— Results of physical maneuvers and arthroscopic findings were recorded and sensitivity, specificity, positive likelihood ratios (LR+), and negative likelihood ratios (LR−) were calculated for each of 4 physical examination test findings for arthroscopic changes in the medial, lateral, cranial, or caudal compartments of the shoulder joint viewed in dorsal recumbency by lateral and craniomedial portals.
Results— Distribution of compartment changes was: medial (17 dogs), caudal (15), cranial (12), and lateral (5). The biceps test had a moderate effect (LR+=9) on post-test probability of cranial compartment changes and a small effect on post-test probability of lateral and caudal compartment changes (LR+=3 and 2.4, respectively). Hyperabduction had a minimal effect and mediolateral instability test had a small effect (LR+=1.64 and 2.68, respectively) on post-test probability of medial compartment changes. Craniocaudal instability test had little to no effect on post-test probability of changes in any compartment.
Conclusions— Physical examination tests evaluated were limited in their ability to predict the type of arthroscopic pathology in this study population.
Clinical Relevance — Clinicians should understand that a diagnostic test performs inconsistently based on prevalence of a condition in a given patient population. The use of likelihood ratios can assist clinicians in determining the probability of intraarticular changes from a group with a differing prevalence than the patient population presented.     

Assessment of postoperative pain after unilateral mastectomy using two different surgical techniques in dogs

Background

There are few studies reporting pain and postoperative analgesia associated with mastectomy in dogs. The aim of this study was to evaluate postoperative pain after unilateral mastectomy using two different surgical techniques in the dog.

Findings

Twenty female dogs were assigned (n=10/group) to undergo unilateral mastectomy using either the combination of sharp and blunt dissection (SBD) or the modified SBD (mSBD) technique, in which the mammary chain is separated from the abdominal wall entirely by blunt (hand and finger) dissection except for a small area cranial to the first gland, in a prospective, randomized, clinical trial. All dogs were premedicated with intramuscular acepromazine (0.05 mg/kg) and morphine (0.3 mg/kg). Anesthesia was induced with intravenous ketamine (5 mg/kg) and diazepam (0.25 mg/kg), and maintained with isoflurane. Subcutaneous meloxicam (0.2 mg/kg) was administered before surgery. Postoperative pain was evaluated according to the University of Melbourne pain scale (UMPS) by an observer who was blinded to the surgical technique.. Rescue analgesia was provided by the administration of intramuscular morphine (0.5 mg/kg) if pain scores were >14 according to the UMPS. Data were analyzed using t-tests and ANOVA (P>0.05). There were no significant differences between the groups for age, weight, extubation time, and duration of surgery and anesthesia (P>0.05). There were no significant differences for postoperative pain scores between groups. Rescue analgesia was required in one dog in each group.

Conclusions

The two surgical techniques produced similar surgical times, incidence of perioperative complications and postoperative pain. Multimodal analgesia is recommended for treatment of postoperative pain in dogs undergoing unilateral mastectomy.     

Treatment of dogs diagnosed with medial shoulder instability using radiofrequency-induced thermal capsulorrhaphy

OBJECTIVE: To report clinical findings and outcome in dogs diagnosed with medial shoulder instability (MSI) treated with radiofrequency-induced thermal capsulorrhaphy (RITC). STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=43) with MSI. METHODS: Medical records from consecutive cases with MSI based on orthopedic examination, palpation of shoulder abduction angles, and arthroscopic findings were used to determine clinical findings and long-term (> or = 1 year) outcome of RITC. RESULTS: Forty-three dogs met the criteria for inclusion; 2 dogs had bilateral MSI. The most common clinical findings were chronic unilateral weight-bearing lameness, large (> 45 degrees) shoulder abduction angles, and spinatus muscle atrophy in the affected limb. Mean preoperative abduction angle (50.7 degrees +/- 4.8 degrees) in affected shoulders was significantly larger than in the unaffected shoulders (32.5 degrees +/- 2.1 degrees). Mean postoperative abduction angle in affected shoulders was not significantly different from unaffected shoulders when measured immediately, 8, 16-20 weeks, and approximately 1 year after surgery. Follow-up evaluation ranged from 1 to 6.2 years. RITC treatment resulted in improved clinical function in 40 cases (93%) with 34 cases (79%) considered excellent; 3 cases (7%) were considered failures. CONCLUSIONS: RITC was a safe and effective method of treatment of MSI in most dogs studied. CLINICAL RELEVANCE: RITC can be considered as a viable option for surgical treatment of selected cases of MSI in dogs.     

Effects of intraoperative positive end-expiratory pressure and fraction of inspired oxygen on postoperative oxygenation in dogs undergoing stifle surgery

ObjectiveTo compare the effects of fraction of inspired oxygen (FiO₂) with the addition of positive end-expiratory pressure (PEEP) during anesthesia on arterial oxygenation in the first 4 postoperative hours in dogs. We hypothesized that compared with dogs breathing FiO₂ ≥ 0.95 and no PEEP (ZEEP), the use of intraoperative PEEP would improve postoperative oxygenation, and that the use of PEEP combined with an FiO₂ of 0.4 would further improve it.Study designProspective, randomized study.AnimalsA total of 30 dogs undergoing unilateral stifle surgery.MethodsUsing a standardized anesthetic protocol, dogs were assigned to either FiO₂ ≥ 0.95 and ZEEP, FiO₂ ≥ 0.95 and 5 cmH₂O PEEP or FiO₂ 0.4 and 5 cmH₂O PEEP. All dogs were mechanically ventilated with a tidal volume of 12 mL kg^–1. Dogs breathed room air after recovery from anesthesia. Arterial blood gases were measured during surgical closure and 10, 120 and 240 minutes after extubation. Demographic characteristics were compared with Kruskal–Wallis tests. The effects of treatment and time on the PaO₂, PaCO₂, PaO₂:FiO₂ and shunt fraction (F-shunt) were assessed with mixed-effect models.ResultsThe PaO₂ and F-shunt were lower during anesthesia for dogs breathing FiO₂ 0.4. No differences among groups were measured after extubation for any variable.Conclusions and clinical relevanceCompared with dogs ventilated with FiO₂ ≥ 0.95 and ZEEP, application of 5 cmH₂O PEEP did not improve intraoperative gas exchange. The combination of 5 cmH₂O PEEP and FiO₂ 0.4 resulted in lower intraoperative F-shunt values. However, no benefits from those maneuvers on postoperative PaO₂ and F-shunt were recorded after extubation, suggesting that alterations in pulmonary function imposed by anesthesia were reversed soon after extubation.     

Deep learning-based diagnosis of stifle joint diseases in dogs

In this retrospective, analytical study, we developed a deep learning-based diagnostic model that can be applied to canine stifle joint diseases and compared its accuracy with that achieved by veterinarians to verify its potential as a reliable diagnostic method. A total of 2382 radiographs of the canine stifle joint from cooperative animal hospitals were included in a dataset. Stifle joint regions were extracted from the original images using the faster region-based convolutional neural network (R-CNN) model, and the object detection accuracy was evaluated. Four radiographic findings: patellar deviation, drawer sign, osteophyte formation, and joint effusion, were observed in the stifle joint and used to train a residual network (ResNet) classification model. Implant and growth plate groups were analyzed to compare the classification accuracy against the total dataset. All deep learning-based classification models achieved target accuracies exceeding 80%, which is comparable to or slightly less than those achieved by veterinarians. However, in the case of drawer signs, further research is necessary to improve the low sensitivity of the model. When the implant group was excluded, the classification accuracy significantly improved, indicating that the implant acted as a distraction. These results indicate that deep learning-based diagnoses can be expected to become useful diagnostic models in veterinary medicine.     

Comparison of bioavailability of two chloramphenicol preparations in dogs after intramuscular injection.

Aqueous chloramphenicol glycinate was compared with propylene glycol solution of chloramphenicol after equivalent intramuscular doses (22 mg/kg) were given to 10 normal, healthy dogs in a crossover study. Duration and magnitude of plasma concentrations of chloramphenicol were significantly longer and higher with the glycinate than with the propylene glycol solution.     

Comparison of bupivacaine femoral and sciatic nerve block versus bupivacaine and morphine epidural for stifle surgery in dogs

ObjectiveTo evaluate the efficacy of combined femoral and sciatic nerve blocks as an alternative to epidural anesthesia and analgesia in dogs undergoing stifle surgery under general anesthesia.Study designProspective, blinded, randomized, clinical comparison.AnimalsTwenty dogs weighing 37 ± 11 (mean ± SD) kg, aged 3 (1–8) [median (minimum–maximum)] years undergoing elective unilateral tibial-plateau leveling osteotomy.MethodsDogs were assigned randomly to receive either epidural anesthesia (bupivacaine 0.5%, 0.5 mg kg^?1 + morphine 0.1%, 0.1 mg kg^?1, in 0.2 mL kg^?1; EPID) or femoral and sciatic nerve blocks (Bupivacaine 0.5%, 0.1 mL kg^?1, was administered at each site; F + S) guided by electrolocation. All patients received a standard general anesthesia technique. Pain and sedation were scored (on scales of 0–10 and 0–3, respectively) pre-operatively, at extubation, and at 1, 4 and then every 4 hours thereafter up to 24 hours. Postoperatively, hydromorphone was administered to any patient with a pain score of >5 or whenever the blinded caregiver determined that more hydromorphone was necessary. Intraoperative heart rate (HR), mean arterial pressure (MAP), end tidal isoflurane (FE′ISO), body temperature, post-operative pain scores, time to first hydromorphone dose after surgery, time to first feeding, time to first drinking, time to first urination, time to first ambulation (walk on a lead) and cumulative dose of hydromorphone were recorded.ResultsIntra-operatively, FE′ISO and MAP were significantly lower in the EPID group (p = 0.05 and p = 0.04, respectively). Postoperatively, the cumulative hydromorphone consumption (p = 0.04) and the incidence of urinary retention (p = 0.03) were higher in the EPID group.Conclusion and clinical relevance F + S is a practical alternative to EPID that produces less urine retention and reduces opioid consumption in the 24 hours after surgery. EPID might be associated with a lower isoflurane requirement and lower systemic blood pressure.