Detomidine-Propofol Anesthesia for Abdominal Surgery in Horses

OBJECTIVE: To evaluate propofol for induction and maintenance of anesthesia, after detomidine premedication, in horses undergoing abdominal surgery for creation of an experimental intestinal adhesion model. STUDY DESIGN: Prospective study. ANIMALS: Twelve horses (424 +/- 81 kg) from 1 to 20 years of age (5 females, 7 males). METHODS: Horses were premedicated with detomidine (0.015 mg/kg i.v.) 20 to 25 minutes before induction, and a propofol bolus (2 mg/kg i.v.) was administered for induction. Propofol infusion (0.2 mg/kg/min i.v.) was used to maintain anesthesia. The infusion rate was adjusted to maintain an acceptable anesthetic plane as determined by muscle relaxation, occular signs, response to surgery, and cardiopulmonary responses. Oxygen (15 L/min) was insufflated through an endotracheal tube as necessary to maintain the SpO2 greater than 90%. Systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures, heart rate (HR), electrocardiogram (ECG), respiratory rate (RR), SpO2 (via pulse oximetry), and nasal temperature were recorded at 15 minute intervals, before premedication and after induction of anesthesia. Arterial blood gas samples were collected at the same times. Objective data are reported as mean (+/-SD); subjective data are reported as medians (range). RESULTS: Propofol (2.0 mg/kg i.v.) induced anesthesia (mean bolus time, 85 sec) within 24 sec (+/-22 sec) after the bolus was completed. Induction was good in 10 horses; 2 horses showed signs of excitement and these two inductions were not smooth. Propofol infusion (0.18 mg/kg/min +/- 0.04) was used to maintain anesthesia for 61 +/- 19 minutes with the horses in dorsal recumbency. Mean SAP, DAP, and MAP increased significantly over time from 131 to 148, 89 to 101, and 105 to 121 mm Hg, respectively. Mean HR varied over time from 43 to 45 beats/min, whereas mean RR increased significantly over anesthesia time from 4 to 6 breaths/min. Mean arterial pH decreased from a baseline of 7.41 +/- 0.07 to 7.30 +/- 0.05 at 15 minutes of anesthesia, then increased towards baseline values. Mean PaCO2 values increased during anesthesia, ranging from 47 to 61 mm Hg whereas PaO2 values decreased from baseline (97 +/- 20 mm Hg), ranging from 42 to 57 mm Hg. Muscle relaxation was good and no horses moved during surgery: Recovery was good in 9 horses and acceptable in 3; mean recovery time was 67 +/- 29 minutes with 2.4 +/- 2.4 attempts necessary for the horses to stand. CONCLUSIONS: Detomidine-propofol anesthesia in horses in dorsal recumbency was associated with little cardiovascular depression, but hypoxemia and respiratory depression occurred and some excitement was seen on induction. CLINICAL RELEVANCE: Detomidine-propofol anesthesia is not recommended for surgical procedures in horses if dorsal recumbency is necessary and supplemental oxygen is not available (eg, field anesthesia).     

Lactate Kinetics in veterinary Critical Care: A Review

Elevation in blood lactate concentration, with or without accompanying metabolic acidosis, is a hallmark finding in patients with circulatory compromise, and is also consistently noted in other conditions affecting critically ill or injured individuals. Little is reported in a veterinary literature regarding lactate measurement in the emergency and critical care setting, despite impressive reports of the clinical usefulness of lactate measurement in people. The purpose of this article is to review lactate kinetics and the clinical utility of lactate measurement. Limitations to lactate evaluation will also be discussed.     

SCINTIGRAPHIC CHARACTERIZATION OF THE EQUINE FOREDIGIT AND METACARPOPHALANGEAL REGION FROM BIRTH TO SIX MONTHS OF AGE

Both foredigits and metacarpophalangeal joints of six Quarter Horse foals were scanned serially to six months of age using ⁹⁹Tc-methylene diphosphonate. Dorsal scans were made on day 1 and at two, four, six, ten, 14, 18, 22 and 26 weeks of age. Scans were assessed visually for distal third metacarpal, proximal phalangeal, and middle phalangeal physeal appearance and closure. Scans were also evaluated by computer region-of-interest (ROI) and line-profile analysis to characterize the physes quantitatively. Physeal region radioactivity relative to a disphyseal reference region was greatest at four weeks for all physes. Scintigraphic physeal closure of all physes occurred at approximately six months of age with a range of four and one half to greater than six months. The study was conducted to allow better assessment of diffuse and focal physeal disease by determining developmental times at which normal physeal region radioactivity has decreased enough to not obscure abnormal radioactivity and by quantifying scintigraphic physeal appearance which enables computer analysis to detect visually indeterminate physeal abnormalities.     

THE EFFECTS OF INTRA-ARTICULAR ANESTHESIA ON SOFT TISSUE-AND BONE-PHASE SCINTIGRAPHY IN THE HORSE

Soft tissue- and bone-phase scintigrams were acquired from 4 normal horses before and over a 14-day period after metacarpophalangeal, antebrachiocarpal, tarsocrural and tarsometatarsal joint blocks. Images were evaluated subjectively and quantitatively for increased activity in these regions. The antebrachiocarpal block resulted in obvious focal accumulation of activity on soft tissue-phase scintigrams. This increased activity was greatest 2 to 4 days postanesthesia and persisted up to 14 days postanesthesia. On quantitative analysis of soft tissue-phase images, similar trends were noted after the metacarpophalangeal and tarsocrural blocks, but these increases were relatively mild and were not evident on subjective evaluation of the images. Abnormal soft tissue-phase activity was not associated with the tarsometatarsal block. On bone-phase scintigrams, increased activity was not present following any of these joint blocks.     

TECHNETIUM-99M AND IODINE-131 THYROID SCINTIGRAPHY IN NORMAL AND RADIOTHYROIDECTOMIZED COCKATIELS (NYMPHICUS HOLLANDICUS)

Thyroid scintigraphy using sodium ^99mTechnetium pertechnetate (⁹⁹TcO₄-) was performed in normal and radiothyroidectomized cockatiels ( Nymphicus hollandicus ). ¹³¹I scintigraphy was performed in the course of ablating the thyroid glands. The thyroid glands in normal birds were clearly visualized, but were not individually resolvable. Thyroid glands were not visualized in thyroid-ablated birds. With ^99mTcO₄ scans, thyroid (or other region of interest)/body count density ratios were used for comparisons of normal and thyroid-ablated birds. Normal ^99mTcO₄- thyroid/body ratios (mean +/− SD) for the dorsal and lateral views were 1.83 +/− 0.31 and 1.70 +/− 0.34 respectively. Pertechnetate thyroid/body count density ratios decreased (to 0.93 -/−0.14 and 0.88 +/− 0.12 for dorsal and lateral views respectively) after thyroid ablation, while crop/body ratios increased. ^99mTcO₄- thyroid scintigraphy, therefore, was capable of detecting hypofunctional thyroid abnormalities in ¹³¹I radiothyroidectomized cockatiels.