Cardiovascular effects of desflurane following acute hemorrhage in dogs

Objective: To determine the cardiovascular effects of desflurane in dogs following acute hemorrhage. Design: Experimental study. Animals: Eight mix breed dogs. Interventions: Hemorrhage was induced by withdrawal of blood until mean arterial pressure (MAP) dropped to 60 mmHg in conscious dogs. Blood pressure was maintained at 60 mmHg for 1 hour by further removal or replacement of blood. Desflurane was delivered by facemask until endotracheal intubation could be performed and a desflurane expiratory end‐tidal concentration of 10.5 V% was maintained. Measurements and main results: Systolic, diastolic, and mean arterial blood pressure (SAP, DAP and MAP), central venous pressure (CVP), cardiac output (CO), stroke volume (SV), cardiac index (CI), systemic vascular resistance (SVR), heart rate (HR), respiratory rate (RR), partial pressure of carbon dioxide in arterial blood (PaCO₂), and arterial pH were recorded before and 60 minutes after hemorrhage, and 5, 15, 30, 45 and 60 minutes after intubation. Sixty minutes after hemorrhage, SAP, DAP, MAP, CVP, CO, CI, SV, PaCO₂, and arterial pH decreased, and HR and RR increased when compared with baselines values. Immediately after intubation, MAP and arterial pH decreased, and PaCO₂ increased. Fifteen minutes after intubation SAP, DAP, MAP, arterial pH, and SVR decreased. At 30 and 45 minutes, MAP and DAP remained decreased and PaCO₂ increased, compared with values measured after hemorrhage. Arterial pH increased after 30 minutes of desflurane administration compared with values measured 5 minutes after intubation. Conclusions: Desflurane induced significant changes in blood pressure and arterial pH when administered to dogs following acute hemorrhage.     

Accuracy of an oscillometric blood pressure monitor during phenylephrine-induced hypertension in dogs

OBJECTIVE: To examine the agreement between direct arterial blood pressure measurements obtained from 2 arteries and indirect blood pressure measurements obtained with an oscillometric blood pressure monitor (OBPM) during normotension and phenylephrine-induced hypertension in dogs. ANIMALS: 16 male Beagles. PROCEDURES: In anesthetized dogs, arterial catheters were placed in the lingual and dorsal pedal arteries for measurement of arterial blood pressure. A blood pressure cuff was placed on either the dog's fore- or hind limb and connected to an OBPM. Systolic, diastolic, and mean arterial blood pressures (SAP, DAP, and MAP, respectively) were recorded from both arteries and the OBPM every 5 minutes for 30 minutes (baseline), during a 30-minute period in which dogs received a phenylephrine infusion IV to induce hypertension, and for 30 minutes after discontinuation of the infusion. Mean differences in blood pressure values and confidence intervals were calculated to compare the indirect and direct measurement techniques. RESULTS: In dogs, oscillometry underestimated SAP during normotension, and the difference between oscillometric and direct measurements increased during hypertension. Oscillometry underestimated DAP, but the difference between oscillometric and direct measurements decreased during hypertension. There was close agreement among techniques for MAP determinations. Biases between direct measurements and OPBM blood pressure values measured from dogs' forelimbs or hind limbs were not significantly different. CONCLUSIONS AND CLINICAL RELEVANCE: In normotensive dogs, oscillometric measurements of MAP and SAP agreed more closely with direct arterial pressure measurements than oscillometric estimates of DAP. Oscillometric measurement of MAP was accurate during both normotension and hypertension in dogs.     

White-coat effect on systemic blood pressure in retired racing Greyhounds

Background: Greyhounds are known to have a higher systemic arterial blood pressure (BP) than non‐Greyhound dogs. Objectives: The purpose of this study was to determine whether the high systemic BP was because of the white‐coat effect. Animals: Twenty‐two healthy retired racing Greyhounds (RRG) enrolled in a blood donation program. Materials/Methods: We prospectively measured systemic BP in 3 environments: in the hospital by the investigator (Hosp), in the home by the investigator (H/I), and in the home by the owner (H/O). Five serial measurements of systolic, diastolic, and mean arterial pressures (SAP, DAP, MAP) as well as heart rate (HR) were measured by an oscillometric method on the distal forelimb and distal hind limb in all 3 environments. Results: There was a significant difference for SAP, MAP, and HR between the Hosp and both H/I and H/O (P < .001); there were no significant differences for any of the parameters between the H/I and H/O environments. HR, but not SAP, MAP, or DAP (P < .05) decreased in RRG with multiple hospital visits for blood donation before this study. The hind limb SAP was significantly higher than the forelimb SAP (P < .05). Conclusions and Clinical Importance: We conclude that the high SAP, MAP, and HR seen in the hospital setting are likely because of a white‐coat effect. Furthermore, consideration should be given to defining the parameters of normal BP in RRG according to the environment in which they are obtained.     

Effects of Cyclosporin A on Blood Pressure, Baroreceptor Reflex and Renal Function in Dogs

The objective of this study is to investigate the effect of cyclosporin A (CsA) on baroreceptor reflex and renal function. Fifteen male mongrel dogs weighing 13-18 kg were divided into three groups and were treated orally as follows: group 1, enalapril 0.5 mg/kg per day for 10 days; group 2, CsA 20 mg/kg per day for 7 days; group 3, enalapril 0.5 mg/kg per day for 3 days combined with CsA 20 mg/kg per day for 7 more days. Measurements of blood pressure and of baroreflex response to sodium nitroprusside (SNP) and phenylephrine (PE) and renal function studies were performed on the days before and after receiving drugs. In group 1, both systolic arterial pressure (SAP) and mean arterial pressure (MAP) were unaltered, while diastolic arterial pressure (DAP) was reduced significantly. In group 2, all pressures (SAP, MAP and DAP) increased significantly. Group 3 showed no change in blood pressure. Studies of baroreceptor reflex showed that only dogs in group 2 had decreased sensitivity to PE without changing the setpoint. No change of the reflex was found in other groups. Renal function studies were unaltered in all groups. The data indicate that CsA increased blood pressure, which may be due to decreased baroreceptor reflex sensitivity mediated via activation of the renin-angiotensin-aldosterone system.     

Association of systemic hypertension with renal injury in dogs with induced renal failure

Systemic hypertension is hypothesized to cause renal injury to dogs. This study was performed on dogs with surgically induced renal failure to determine whether hypertension was associated with altered renal function or morphology. Mean arterial pressure (MAP), heart rate (HR), systolic arterial pressure (SAP), and diastolic arterial pressure (DAP) were measured before and after surgery. Glomerular filtration rate (GFR) and urine protein:creatinine ratios (UPC) were measured at 1, 12, 24, 36, and 56-69 weeks after surgery, and renal histology was evaluated terminally. The mean of weekly MAP, SAP, and DAP measurements for each dog over the 1st 26 weeks was used to rank dogs on the basis of MAP, SAP, or DAP values. A statistically significant association was found between systemic arterial pressure ranking and ranked measures of adverse renal responses. When dogs were divided into higher pressure and lower pressure groups on the basis of SAP, group 1 (higher pressure, n = 9) compared with group 2 (lower pressure, n = 10) had significantly lower GFR values at 36 and 56-69 weeks; higher UPC values at 12 and 56-69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, and fibrosis. When dogs were divided on MAP and DAP values, group 1 compared with group 2 had significantly lower GFR values at 12, 24, 36, and 56-69 weeks; higher UPC values at 12 and 56-69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, fibrosis, and cell infiltrate. These results demonstrate an association between increased systemic arterial pressure and renal injury. Results from this study might apply to dogs with some types of naturally occurring renal failure.     

Comparison of romifidine and medetomidine pre-medication in propofol-isoflurane anaesthetised dogs

The objective of this paper was to evaluate romifidine as a pre-medicant in dogs prior to propofol-isoflurane anaesthesia, and to compare it with medetomidine. For this, eight healthy dogs were anaesthetised. Each dog received three pre-anaesthetic protocols: R40 (romifidine, 40 microg/kg, IV), R80 (romifidine, 80 microg/kg, IV) or MED (medetomidine, 10 microg/kg, IV). Induction of anaesthesia was delivered with propofol and maintained with isoflurane. The following variables were studied before sedative administration and 10 min after sedative administration: heart rate (HR), mean arterial pressure (MAP), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) and respiratory rate (RR). During maintenance, the following variables were recorded at 5-min intervals: HR, MAP, SAD, DAP, arterial oxygen saturation (SpO(2)), end-tidal CO(2)(EtCO(2)), end-tidal concentration of isoflurane (EtISO) required for maintenance of anaesthesia and tidal volume (TV). Time to extubation, time to sternal recumbency and time to standing were also registered. HR and RR experimented a significantly decreased during sedation in all protocols respect to baseline values. Mean HR, MAP, SAP, DAP, SpO(2), EtCO(2), and TV during anaesthesia were similar for the three protocols. End tidal of isoflurane concentration was statistically similar for all protocols. Recovery time for R40 was significantly shorter than in R80 and MED. The studied combination of romifidine, propofol and isoflurane appears to be an effective drug combination for inducing and maintaining general anaesthesia in healthy dogs.     

Clinical evaluation of the Surgivet V60046, a non invasive blood pressure monitor in anaesthetized dogs

OBJECTIVE: To compare the performance of the Surgivet Non-Invasive Blood Pressure (NIBP) monitor V60046 with an invasive blood pressure (IBP) technique in anaesthetized dogs. STUDY DESIGN: A prospective study. ANIMALS: Thirty-four dogs, anaesthetized for a variety of procedures. METHODS: Various anaesthetic protocols were used. Invasive blood pressure measurement was made using a catheter in the femoral or the pedal artery. A cuff was placed on the contralateral limb to allow non invasive measurements. Recordings of arterial blood pressures (ABPs) were taken at simultaneous times for a range of pressures. For analysis, three pressure levels were determined: high [systolic blood pressure (SAP) > 121 mmHg], normal (91 mmHg < SAP < 120 mmHg) and low (SAP < 90 mmHg). Comparisons between invasive and non invasive measurements were made using Bland-Altmann analysis. RESULTS: The NIBP monitor consistently underestimated blood pressure at all levels. The lowest biases and greatest precision were obtained at low and normal pressure levels for SAP and mean arterial pressure (MAP). At low blood pressure levels, the biases +/- 95% confidence interval (CI) were 1.9 +/- 2.96 mmHg (SAP), 8.3 +/- 2.41 mmHg diastolic arterial pressure (DAP) and 3.5 +/- 2.09 mmHg (MAP). At normal blood pressure levels, biases and CI were: 1.2 +/- 2.13 mmHg (SAP), 5.2 +/- 2.32 mmHg (DAP) and 2.1 +/- 1.54 mmHg (MAP). At high blood pressure levels, the biases and CI were 22.7 +/- 5.85 mmHg (SAP), 5.5 +/- 3.13 mmHg (DAP) and 9.4 +/- 3.52 mmHg (MAP). In 90.6% of cases of hypotension (MAP < 70 mmHg), the low blood pressure was correctly diagnosed by the Surgivet. CONCLUSIONS: Measurement of blood pressure with the indirect monitor allowed detection of hypotension using either SAP or MAP. The most accurate readings were determined for MAP at hypotensive and normal levels. The monitor lacked accuracy at high pressures. CLINICAL RELEVANCE: When severe challenges to the cardiovascular system are anticipated, an invasive method of recording ABP is preferable. For routine usage, the Surgivet monitor provided a reliable and safe method of NIBP monitoring in dogs, thereby contributing to the safety of anaesthesia by providing accurate information about the circulation.     

Cardiovascular Effects of 1.0, 1.5, and 2.0 Minimum Alveolar Concentrations of Isoflurane in Experimentally Induced Hypothyroidism in Dogs

This study was performed to determine the cardiovascular responses to isoflurane in euthyroid and hypothyroid dogs. Four healthy mixed-breed dogs were studied prior to thyroidectomy (PRE), 6 months after thyroidectomy (HYP), and after 2 months of oral supplementation with 1-thyroxine (SUP). Heart rate (HR), cardiac output (), stroke volume (SV), systolic, diastolic, mean arterial blood pressure (SAP, DAP, MAP), and total peripheral resistance (TPR) were determined in awake dogs and in the same dogs when end-tidal isoflurane concentrations were 1.28%, 1.92%, and 2.56%. Ventilation was controlled in anesthetized dogs and Paco₂ maintained between 38 to 42 mm Hg. Isoflurane caused significant ( P <.05) dose-dependent reduction in , SV, SAP, DAP, and MAP in the PRE, HYP, and SUP dogs. Cardiac output was lower in the HYP dogs than in the PRE or SUP dogs during awake measurement. TPR was increased in the awake HYP dogs compared with the PRE or SUP dogs. During anesthesia, HYP dogs tended to have lower , SV, SAP, and MAP than the PRE or SUP groups, but the only significant reduction was SAP during 1.5 MAC. The cardiovascular responses to isoflurane in hypothyroid dogs are similar to euthyroid animals with a dose-dependent depression in , SV, and arterial pressure.     

Agreement between direct, oscillometric and Doppler ultrasound blood pressures using three different cuff positions in anesthetized dogs

ObjectiveTo evaluate the agreement between invasive blood pressure (IBP) and Doppler ultrasound blood pressure (DUBP) using three cuff positions and oscillometric blood pressure (OBP) in anesthetized dogs.Study designProspective study.AnimalsNine adult dogs weighing 14.5–29.5 kg.MethodsThe cuff was placed above and below the tarsus, and above the carpus with the DUBP and above the carpus with the OBP monitor. Based on IBP recorded via a dorsal pedal artery catheter, conditions of low, normal, and high systolic arterial pressures [SAP (mmHg) <90, between 90 and 140, and >140, respectively] were induced by changes in isoflurane concentrations and/or dopamine administration. Mean biases ± 2 SD (limits of agreement) were determined.ResultsAt high blood pressures, regardless of cuff position, SAP determinations with the DUBP underestimated invasive SAP values by more than 20 mmHg in most instances. With the DUBP, cuff placement above the tarsus yielded better agreement with invasive SAP during low blood pressures (0.2 ± 16 mmHg). The OBP underestimated SAP during high blood pressures (?42 ± 42 mmHg) and yielded better agreement with IBP for mean (MAP) and diastolic (DAP) arterial pressure measurements [overall bias: 2 ± 15 mmHg (MAP) and 0.2 ± 16 mmHg (DAP)].ConclusionsAgreement of SAP determinations with the DUBP is poor at SAP > 140 mmHg, regardless of cuff placement. Measurement error of the DUBP with the cuff placed above the tarsus is clinically acceptable during low blood pressures. Agreement of MAP and DAP measurements with this OBP monitor compared with IBP was clinically acceptable over a wide pressure range.Clinical relevanceWith the DUBP device, placing the cuff above the tarsus allows reasonable agreement with IBP obtained via dorsal pedal artery catheterization. Only MAP and DAP provide reasonable estimates of direct blood pressure with the OBP monitor evaluated.     

The effects of maxillary nerve block,ethmoidal nerve block and their combination on cardiopulmonary responses to nasal stimulation in anesthetized Beagle dogs

ObjectiveTo describe an approach for ethmoidal nerve block (E_BLOCK) and to compare the effects of a maxillary nerve block (M_BLOCK), E_BLOCK and their combination (M-E_BLOCK) on heart rate (HR), systolic (SAP), mean (MAP), diastolic (DAP) arterial pressures and respiratory rate (f_R) during nasal stimulation in dogs.Study designProspective, blinded, randomized, crossover placebo-controlled study.AnimalsBeagle dogs (five cadavers, nine live dogs), with a median (interquartile range) weight of 10.5 (10.3–11.0) kg.MethodsThe accuracy of iohexol injections (each 1 mL) at the maxillary and ethmoidal foramina in cadavers was evaluated using computed tomography. Then, anesthetized dogs were administered four bilateral treatments separated by 1 week, saline or 2% lidocaine 1 mL per injection: injections of saline at the maxillary and ethmoidal foramina (Control), injections of lidocaine at the maxillary foramina and saline at the ethmoidal foramina (M_BLOCK), injections of saline at the maxillary foramina and lidocaine at the ethmoidal foramina (E_BLOCK) and injections of lidocaine at all foramina (M-E_BLOCK). The ventral nasal meatus was bilaterally stimulated using cotton swabs, and HR, SAP, MAP, DAP and f_R were continuously recorded. Values for each variable were compared before and after stimulation using Wilcoxon signed-rank test. Changes in variables among treatments were analyzed using Mann–Whitney U and Kruskal–Wallis tests (p ≤ 0.05).ResultsComputed tomography revealed iohexol distribution around the openings of the target foramina in all cadavers. In living dogs, HR, SAP, MAP, DAP and f_R significantly increased after stimulation within each treatment (p < 0.03). Physiologic responses were significantly attenuated, but not absent, in the M-E_BLOCK [HR (p = 0.019), SAP, MAP, DAP and f_R (all p ≤ 0.001)] compared with those in the Control.Conclusions and clinical relevanceConcurrent injections of lidocaine at the maxillary and ethmoidal foramina attenuated HR, arterial pressure and f_R responses to nasal stimulation in Beagle dogs.     

Evaluation of noninvasive blood pressure in anesthetized horses: Bias,limits of agreement,and comparative detection of a predetermined mean blood pressure warranting treatment

Oscillometric blood pressure monitoring may be a practical tool for short procedures or those performed outside of the operating room. Oscillometric and direct blood pressure values in 30 juvenile and adult horses in a clinical setting using mixed effect models were compared. The limits of agreement and percentage errors were also calculated. We evaluated the sensitivity and false positive rate for the oscillometric method to trigger an intervention for treating blood pressure [direct mean arterial pressure (MAP) < 70 mmHg]. Oscillometric MAP and diastolic arterial pressure (DAP) differed from direct values (P < 0.001); systolic arterial pressure (SAP) did not (P = 0.08). Wide limits of agreement were observed. Percentage errors were smaller for SAP (39%) than for MAP and DAP (48% and 72%). The oscillometric monitor indicated there was a requirement for blood pressure treatment with a true positive rate of 82%, consequently, it failed 18% of the times. The false positive rate (unnecessary treatment) was 55%.     

Romifidine, medetomidine or xylazine before propofol-halothane-N2O anesthesia in dogs.

The objective of this paper was to evaluate romifidine as a premedicant in dogs prior to propofol-halothane-N2O anesthesia, and to compare it with the other alpha2-agonists (medetomidine and xylazine). For this, ten healthy dogs were anesthetized. Each dog received 3 preanesthetic protocols: atropine (10 microg/kg BW, IM), and as a sedative, romifidine (ROM; 40 microg/kg BW, IM), xylazine (XYL; 1 microg/kg, IM), or medetomidine (MED; 20 microg/kg BW, IM). Induction of anesthesia was delivered with propofol 15 min later and maintained with halothane and N2O for one hour in all cases. The following variables were registered before preanesthesia, 10 min after the administration of preanesthesia, and at 5-minute intervals during maintenance: PR, RR, rectal temperature (RT), MAP, SAP, and DAP. During maintenance, arterial oxygen saturation (SpO2), end-tidal CO2 (EtCO2) and percentage of halothane necessary for maintaining anesthesia (%HAL) were also recorded. Induction dose of propofol (DOSE), time to extubation (TE), time to sternal recumbency (TSR) and time to standing (TS) were also registered. The statistical analysis was carried out during the anesthetic period. ANOVA for repeat measures revealed no differences between the 3 groups for PR and RR; however, MAP, SAP and DAP were higher in the MED group; SpO2 was lower in MED and EtCO2 was lower in ROM; %HAL was higher in XYL. No statistical differences were observed in DOSE, TE, TSR or TS. Percentage of halothane was lower in romifidine and medetomidine than in xylazine premedicated dogs also anesthetized with propofol. All the cardiorespiratory variables measured were within normal limits. The studied combination of romifidine, atropine, propofol, halothane and N2O appears to be a safe and effective drug combination for inducing and maintaining general anesthesia in healthy dogs.     

Evaluation of analgesic,sympathetic and motor effects of 1% and 2% lidocaine administered epidurally in dogs undergoing ovariohysterectomy

ObjectiveTo compare, versus a control, the sensory, sympathetic and motor blockade of lidocaine 1% and 2% administered epidurally in bitches undergoing ovariohysterectomy.Study designRandomized, blinded, controlled clinical trial.AnimalsA total of 24 mixed-breed intact female dogs.MethodsAll dogs were administered dexmedetomidine, tramadol and meloxicam prior to general anesthesia with midazolam–propofol and isoflurane. Animals were randomly assigned for an epidural injection of lidocaine 1% (0.4 mL kg⁻¹; group L1), lidocaine 2% (0.4 mL kg⁻¹; group L2) or no injection (group CONTROL). Heart rate (HR), respiratory rate (f_R), end-tidal partial pressure of carbon dioxide (Pe′CO₂), and invasive systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were recorded every 5 minutes. Increases in physiological variables were treated with fentanyl (3 μg kg⁻¹) intravenously (IV). Phenylephrine (1 μg kg⁻¹) was administered IV when MAP was <60 mmHg. Postoperative pain [Glasgow Composite Pain Score – Short Form (GCPS–SF)] and return of normal ambulation were recorded at 1, 2, 3, 4 and 6 hours after extubation.ResultsThere were no differences over time or among groups for HR, f_R, Pe′CO₂ and SAP. MAP and DAP were lower in epidural groups than in CONTROL (p = 0.0146 and 0.0047, respectively). There was no difference in the use of phenylephrine boluses. More fentanyl was administered in CONTROL than in L1 and L2 (p = 0.011). GCPS–SF was lower for L2 than for CONTROL, and lower in L1 than in both other groups (p = 0.001). Time to ambulation was 2 (1–2) hours in L1 and 3 (2–4) hours in L2 (p = 0.004).Conclusions and clinical relevanceEpidural administration of lidocaine (0.4 mL kg⁻¹) reduced fentanyl requirements and lowered MAP and DAP. Time to ambulation decreased and postoperative pain scores were improved by use of 1% lidocaine compared with 2% lidocaine.     

Effects of 2.0% end-tidal isoflurane with and without atropine prior to dexmedetomidine administration on cardiovascular variables in dogs

The purpose of this study was to determine the cardiovascular effects of 2.0% end‐tidal isoflurane in dogs administered dexmedetomidine (DEX). Using a randomized crossover design and allowing at least 2 weeks between treatments 12 adult hound dogs of either sex weighing 22 ± 1.7 SD kg were anesthetized by face mask administration of either sevoflurane or isoflurane to facilitate instrumentation prior to administration of treatment drugs. Dogs were intubated and instrumented to enable measurement of heart rate (HR), systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, mean pulmonary arterial pressure (PAP), pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), pulmonary arterial temperature (TEMP), and cardiac output (CO) via thermodilution using 5 mL of 5% dextrose, and recording the average of three replicate measurements. Cardiac index (CI) and systemic (SVR) and pulmonary vascular resistances were calculated. Following completion of instrumentation, dogs were allowed to recover for 40 minutes. After collection of baseline data, dogs were administered one of four treatments at T‐10 minutes prior to injection of DEX (500? g M^–2 IM): 1) saline (SAL); 2) atropine [ATR, 0.02 (n = 6) or 0.04 (n = 6) mg kg^–1 IM]; 3) ISO (2.0% end tidal concentration); or 4) ISO + ATR. Cardiovascular data were collected at T‐20 and T‐5 minutes prior to administration of DEX, and at 5, 10 , 20, 30, 40, and 60 min following DEX. Data were analyzed using anova for repeated measures with post‐hoc differences between means identified using Bonferroni's method (p < 0.05). Differences in ATR dose were not found to be significant and thus results for ATR dose groups were pooled. Administration of SAL (dexmedetomidine alone) was associated with decreases in HR and CO and increases in SAP, MAP, DAP, CVP, and SVR. Administration of ATR was associated with an increase in HR and CO compared with SAL. Administration of ISO was associated with an increase in HR and a decrease in SVR, MAP and CVP compared with SAL. Administration of ISO + ATR was associated with effects similar to that of ISO or ATR alone. We conclude that administration of ISO reduces the increase in SVR associated with administration of DEX and does not adversely affect CO.     

A clinical comparison between a non‐invasive blood pressure monitor using high definition oscillometry (Memodiagnostic MD 15/90 Pro) and invasive arterial blood pressure measurement in anaesthetized dogs

ObjectiveTo compare high definition oscillometry (HDO) to invasive blood pressure measurement in anaesthetized dogs.Study designProspective, clinical trial.AnimalsFifty dogs weighing 1.95–79 kg (mean 23.5 kg).Materials and methodsAnaesthetic and peri–anaesthetic management was chosen according to each dog's physical status and anaesthetist's preference. Direct arterial blood pressure measurements were performed using a catheter placed in the dorsal pedal artery and an electronic pressure transducer connected to a multiparameter monitor. Non–invasive blood pressure measurements were performed using an appropriately sized cuff placed around the tail base. Comparisons between the two methods were made using Bland and Altman plots. The data are reported as mean bias (lower, upper limits of agreement). Further analysis was performed after separating the data into the following categories based on invasive mean arterial blood pressure (MAP): high (MAP > 100 mmHg), medium (70 mmHg < MAP < 100 mmHg) and low (MAP < 70 mmHg) blood pressure (BP). The two methods were compared as used clinically.ResultsEight hundred measurement pairs for invasive and HDO BP readings were compared. Overall, the HDO measured lower values for SAP and DAP but higher for MAP than the invasive method. The lowest bias (upper, lower limits of agreement) were obtained for MAP, ?1 (?22, 19) mmHg. The biggest discrepancy between the methods was reflected by a large bias (limits of agreement) 5 (?34, 45) mmHg, was for SAP. The results for DAP were between those for SAP and MAP with a bias (limits of agreement) of 3 (?20, 27) mmHg. When the values were separated into the pressure range categories the HDO measured higher in the high, medium and low BP groups, with the exception of SAP in the low BP group.ConclusionsWhen considering the mean bias, the accuracy of HDO compared well with direct arterial blood pressure, but the precision was poor, as determined by wide limits of agreement.Clinical relevanceUsing trends and serial measurements rather than a single measurement for clinical decision making is recommended with both methods, when used as reported here.     

The effect of an L-type calcium channel blocker on the hemodynamics of orbital arteries in dogs

Purpose (1) To determine the effect of the l ‐type calcium channel blocker amlodipine on color Doppler ultrasound‐determined vascular resistance and blood flow velocities in the distal retrobulbar arteries of dogs; (2) to determine any effect of blood pressure and PCO₂ rate on such color Doppler‐determined circulatory measurements. Methods Color Doppler imaging measurements of the short posterior ciliary artery, long posterior ciliary artery, and ophthalmic artery of normal eyes of 10 dogs were obtained under isofluorane anesthesia before and 1 week after oral amlodipine administration. Mean systemic arterial blood pressure and PCO₂ were monitored. Results The mean resistive index decreased significantly in the short posterior ciliary artery (P = 0.0347), in the long posterior ciliary artery (P = 0.0092), and ophthalmic artery (P = 0.0004) following systemic amlodipine administration. The end diastolic velocity increased significantly in the long posterior ciliary artery (P = 0.0368) and ophthalmic artery (P < 0.0001). The peak systolic velocity increased significantly in the ophthalmic artery (P = 0.0256). Mean systemic arterial blood pressure was significantly negatively associated with resistive index (P < 0.0001) and significantly associated with the log of the end diastolic velocity (P < 0.0001). Conclusions Systemically administered amlodipine increases color Doppler imaging‐determined blood flow velocity and decreases vascular resistive index in the ophthalmic artery, short posterior ciliary artery and long posterior ciliary artery of normal dogs. Changes in systemic arterial blood pressure can significantly affect the measurement of color Doppler imaging parameters.     

Effects of sodium nitroprusside after load reduction and/or atropine pre-treatment prior to dexmedetomidine administration on cardiovascular variables in dogs

The purpose of this study was to determine the cardiovascular effects of sodium nitroprusside (SNP)‐induced after load reduction in dogs administered dexmedetomidine (DEX). Using a randomized crossover design and allowing at least 2 weeks between treatments 12 adult hound dogs of either sex weighing 22 ± 1.7 SD kg were anesthetized by face mask administration of 2.9% ET sevoflurane to facilitate instrumentation prior to administration of treatment drugs. Dogs were intubated and instrumented to enable measurement of heart rate (HR), systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, mean pulmonary arterial pressure (PAP), pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), pulmonary arterial temperature (TEMP), and cardiac output (CO). Systemic (SVR) and pulmonary vascular resistances were calculated. Following completion of instrumentation dogs were allowed to recover for 40 minutes. After collection of baseline data, dogs were administered one of four treatments at T–10 minutes prior to injection of DEX (500? g M^–2 IM): 1) saline (SAL); 2) atropine (ATR, 0.02 [n = 6] or 0.04 [n = 6] mg kg^–1 IM); 3) SAL + SNP (infused at 1–10 ?g kg^–1 minute^–1, IV as needed to maintain MAP between 90–110 mm Hg; or 4) ATR + SNP. Cardiovascular data were collected at T‐20 minutes prior to administration of DEX, T‐5 and at 5, 10, 20, 30, 40, and 60 minutes following DEX. Data were analyzed using anova for repeated measures with post hoc differences between means identified using Bonferroni's method (p < 0.05). Differences in ATR dose were not found to be significant and thus results for ATR dose groups were pooled. Administration of SAL (dexmedetomidine alone) was associated with decreases in HR and CO and increases in SAP, MAP, DAP, CVP, and SVR. Administration of ATR was associated with an increase in HR and CO compared with SAL. Administration of SNP was associated with an increase in HR and CO and a decrease in SVR, MAP and CVP compared with SAL. Administration of SNP + ATR was associated with effects similar to that of SNP or ATR alone and resulted in an additive increase in CO. We conclude that SNP‐induced afterload reduction with or without atropine is effective in mitigating DEX‐induced impairment of cardiovascular function.     

Agreement of high definition oscillometry with direct arterial blood pressure measurement at different blood pressure ranges in horses under general anaesthesia

ObjectiveTo determine the agreement of high definition oscillometry (HDO) with direct arterial blood pressure measurements in normotensive, hypotensive and hypertensive horses during general anaesthesia.Study designExperimental study.AnimalsSeven healthy warmblood horses, aged 3–11 years, weighing 470–565 kg.MethodsMeasurements from a HDO device with the cuff placed around the base of the tail were compared with pressures measured invasively from the facial artery. High blood pressures were induced by intravenous (IV) administration of dobutamine (5 μg kg⁻¹ minute⁻¹) over ten minutes followed by norepinephrine (0.1 mg kg⁻¹ IV) and low pressures by increasing the inspired fraction of isoflurane and administration of nitroglycerine (0.05 mg kg⁻¹ IV). For analysis three pressure levels were determined: high (MAP>110 mmHg), normal (60 mmHgResultsA total of 245 paired measurements of systolic (SAP), mean (MAP) and diastolic (DAP) pressures were obtained. The HDO device underestimated blood pressure at hypertensive and normotensive levels and overestimated blood pressure at hypotensive levels. Best agreement was obtained for SAP and MAP within normotensive limits. At normotension, bias ± standard deviation for SAP, MAP and DAP were 0.1 ± 19.4 mmHg, 0.5 ± 14.0, 4.7 ± 15.6, respectively. At high pressure levels bias and SD were 26.1 ± 37.3 (SAP), 4.2 ± 19.4 (MAP), 1.5 ± 16.8 (DAP) and at low pressures -20.0 ± 20.9 (SAP), -11.4 ± 19.6 (MAP), -4.7 ± 20.1 (DAP), with HDO measurements at a MAP <50 mmHg often failing.Conclusion and clinical relevanceGood agreement with invasive arterial blood pressures was obtained with HDO at normotensive levels in horses. At high and low pressure ranges HDO was unreliable. Therefore, if haemodynamic instability is expected, invasive measurement remains preferable.     

Evaluation of an oscillometric blood pressure monitor for use in anesthetized sheep

ObjectiveTo determine the accuracy of an oscillometric blood pressure monitor in anesthetized sheep.Study designProspective study.AnimalsTwenty healthy adult sheep, 11 males and nine females, weighing 63.6 ± 8.6 kg.MethodsAfter premedication with buprenorphine or transdermal fentanyl, anesthesia was induced with ketamine‐midazolam and maintained with isoflurane and ketamine, 1.2 mg kg^?1 hour^?1, ± lidocaine, 3 mg kg^?1 hour^?1. Invasive blood pressure measurements were obtained from an auricular arterial catheter and noninvasive measurements were from a cuff on the metatarsus or antebrachium. Simultaneous invasive and noninvasive measurements were recorded over a range (55–111 mmHg) of mean arterial pressures (MAP). Isoflurane concentration was increased to decrease MAP and decreasing the isoflurane concentration and infusing dobutamine achieved higher pressures. Invasive and noninvasive measurements were compared.ResultsCorrelation (R²) was good between the two methods of measurement (average of three consecutive readings) for systolic (SAP) (0.87), diastolic (DAP) (0.86), and mean (0.90) arterial pressures (p < 0.001). Bias ± SD between noninvasive and invasive measurements for SAP was 3 ± 8 mmHg, for DAP was ?10 ± 7 mmHg, and MAP was ?7 ± 6 mmHg. There was no significant difference between the average of three measurements and use of the first measurement. Correlations using the first measurement were SAP (0.82), DAP (0.84), and MAP (0.89). Bias ± SD for SAP was 3 ±10 mmHg, for DAP was ?11 ± 7 mmHg, and MAP was ?7 ± 6 mmHg. The oscillometric monitor slightly overestimated SAP and underestimated DAP and MAP for both average values and the first reading.Conclusions and clinical relevanceThis oscillometric model provided MAP measurements that were acceptable by ACVIM standards. MAP measurements with this monitor were lower than those found with the invasive technique so a clinical diagnosis of hypotension may be made in sheep that are not hypotensive.