Anesthesia for patients with severe systemic debilitation.

Any patient presenting for anesthesia and surgery who has a severe debilitating problem is at great risk for a prolonged recovery, renal failure, or hypotension. A stable hemodynamic state should be maintained. Fluid homeostasis should be ensured. Anesthetic induction techniques using narcotics and benzodiazepines are my preferred approach, with maintenance of anesthesia incorporating isoflurane, narcotics, or both or the use of regional anesthesia.     

Diet-induced alterations in progesterone clearance appear to be mediated by insulin signaling in hepatocytes

Factors that affect progesterone clearance from plasma and by hepatocytes in culture were examined in a series of experiments. In Exp. 1, the objective was to determine whether an increase in hepatic portal blood acetate or propionate could alter progesterone metabolism by the liver. For ewe lambs gavaged orally with sodium propionate compared with those gavaged orally with sodium acetate, serum progesterone concentrations began to diverge as early as 0.5 h after administration and were greater (P < 0.05) at 3 and 4 h after administration. The objective of Exp. 2 was to determine the effect of a single oral gavage of either sodium acetate or sodium propionate on peripheral insulin and glucagon concentrations. Ewes gavaged orally with sodium propionate had greater (P < 0.05) insulin concentrations at 0.5 and 1 h after gavage than ewes gavaged with sodium acetate. Furthermore, glucagon concentrations were greater (P < 0.05) at 0.5, 1, and 2 h for ewe lambs gavaged orally with sodium propionate compared with those receiving sodium acetate. The third experiment investigated the rate of in vitro progesterone clearance by cultured hepatocytes in response to treatment with different concentrations of insulin and glucagon. Progesterone clearance was reduced (P < 0.05) with the addition of 0.1 nM insulin compared with the control. Furthermore, there was a greater reduction (P < 0.05) in progesterone clearance in response to 1.0 and 10 nM insulin compared with the control and 0.1 nM insulin. No change was observed in progesterone clearance in hepatocytes treated with either physiological (0.01 and 0.1 nM) or supraphysiological (1.0 nM) glucagon. Supraphysiological concentrations of glucagon (1.0 nM) negated the effects of either 0.1 or 1.0 nM insulin on progesterone clearance by hepatocytes. However, with physiological concentrations of glucagon (0.1 nM) and 1.0 nM insulin, glucagon was not able to negate the reduction in progesterone clearance caused by insulin. These data are consistent with a paradigm in which elevated hepatic portal vein propionate increases plasma insulin in ruminants, which decreases progesterone clearance, thereby increasing serum progesterone concentrations.     

Disease and mortality on red deer farms in New Zealand

A longitudinal observational study of 15 red deer farms was carried out in New Zealand for two years from March 1992. The deer were monitored for performance and health problems, and farm management practices were recorded. Numbers at risk were 4,683 hind-years, 2,459 stag-years and 3,202 weaner-years. The numbers of primiparous and adult hinds at risk of losing their progeny by weaning were 653 and 3,364, respectively. Where possible, postmortem examinations were carried out, and organs were sampled for histological and microbiological investigation. Rates of mortality varied with season with most stag and hind deaths in winter and weaner deaths in autumn and winter. Overall mortality rates were 1.77, 2.60 and 5.87 per 100 deer-years for hinds, stags and weaners, respectively. Malignant catarrhal fever accounted for 0.53 stag and 0.17 hind deaths per 100 deer-years at risk Misadventure, including broken bones, accounted for 15.4 per cent of weaner mortalities, or 0.53 weaner mortalities per 100 weaner-three months in autumn. Yersiniosis was confirmed in 18.6 per cent of weaner deaths, or 1.09 weaners per 100 weaner-years during the first six months after weaning, but was also suspected but unconfirmed in a further 41 per cent of weaner mortalities. Overall, 17 per cent of yearling hinds, and 9.2 per cent of adult hinds lost their progeny between pregnancy diagnosis in June and weaning in March. One outbreak of osteochondrosis was recorded. Mortality rates varied between farms and many mortalities were preventable.     

Assessment of mild hindlimb lameness during over ground locomotion using linear discriminant analysis of inertial sensor data

REASONS FOR PERFORMING STUDY: Hindlimb lameness is common and can be difficult to diagnose or quantify in evaluating response to nerve blocks. An objective measure of lameness can also be used to evaluate the effectiveness of the treatment's contribution to evidence-based medicine. The inertial sensor system can be used to capture 6 degree of freedom movement during over ground locomotion and here was used to quantify tuber coxae movement in nonlame and lame horses. HYPOTHESIS: Tuber coxae movement is useful for discriminating between nonlame and lame horses. OBJECTIVES: To measure left and right tuber coxae movement in lame and nonlame horses during over ground locomotion and to implement a linear discriminant analysis to discriminate between lame and nonlame horses. METHODS: Two inertial sensors were attached to the skin over left and right tuber coxae of 21 horses (9 mildly and 12 not lame). Horses were trotted on a hard surface. A total of 1021 strides were collected. For each stride 34 features were extracted from the dorsoventral and craniocaudal movement and used in 2 different classification scenarios (lame vs. nonlame or left lame, right lame and nonlame) using linear discriminant analysis. RESULTS: Six degree of freedom inertial sensors were successfully used to collect kinematic data continuously from left and right tuber coxae in horses during over ground locomotion. These data were used for an automated classification of lameness. In the first scenario, a sensitivity of 89% was achieved with a specificity of 75%. In the second scenario, all horses could be correctly assigned to the correct class in a simple 3 class reclassification test. POTENTIAL RELEVANCE: A mobile system that reliably detects and quantifies hindlimb lameness in horses during unconstrained locomotion could be a valuable tool to perform an evidence-based assessment of lameness in horses in a clinical setting, e.g. before and after nerve blocks or before and after surgery.     

Surgical repair of femoral fractures in New World camelids: five cases (1996-2003)

Five New World camelids were admitted to the Western College of Veterinary Medicine between 1996 and 2003 for evaluation of femoral fractures. There were three alpacas and two llamas. Four of the animals were female and three were less than 3 months of age. Fracture configurations consisted of distal physeal fractures (three), a comminuted diaphyseal/metaphyseal fracture, and a transverse diaphyseal fracture. Fractures were diagnosed with a combination of physical examination and radiographs in all cases. All five fractures were repaired with internal fixation and three animals were discharged from the hospital with fractures that healed. One cria underwent successful internal fixation but died from pulmonary oedema during recovery from anaesthesia. Postoperative complications were rare and limited to inadequate fracture stability in one alpaca and prolonged recovery to weight bearing in another. One llama with a comminuted metaphyseal fracture, repaired with a 4.5 mm dynamic compression plate, subsequently had catastrophic failure of the bone 17 days after surgery. Overall the clients were pleased with the outcome of discharged animals. Although femoral fractures are considered rare, they pose a unique opportunity for the large animal veterinarian to successfully achieve fracture union with the aid of internal fixation.     

Phacofragmentation and aspiration for cataract extraction in dogs: 56 cases (1980-1984)

Fifty-six cases of cataract removal in dogs by phacofragmentation and aspiration were reviewed. Improvement of vision was detected in the immediate postoperative period in 53 (94.6%) of 56 dogs. Vision was present in 25 (85.2%) of 29 dogs evaluated at 2 years after surgery, and in 5 (71.4%) of 7 dogs evaluated 4 years after surgery. Reasons for failure of visual improvement and complications in visual eyes were related primarily to development of postoperative anterior uveitis. Age of the dog at surgery was not a significant factor in the restoration of vision.     

Use of ultrasound to predict body composition changes in steers at 100 and 65 days before slaughter

Steers from research crossbreeding projects (n = 406) were serially scanned using real-time ultrasound at 35-d intervals from reimplant time until slaughter. Cattle were evaluated for rump fat depth, longissimus muscle area (ULMA), 12th-rib fat thickness (UFAT), and percentage of intramuscular fat (IMF) to determine the ability of ultrasound to predict carcass composition at extended periods before slaughter. Additional background information on the cattle, such as live weight, ADG, breed of sire, breed of dam, implant, and frame score was also used. Carcass data were collected by trained personnel at "chain speed," and samples of the 12th-rib LM were taken for ether extract analysis. Simple correlation coefficients showed positive relationships (P < 0.01) between ultrasound measures taken less than 7 d before slaughter and carcass measures: ULMA and carcass LM area (CLMA, r = 0.66); UFAT and carcass 12th-rib fat thickness (CFAT, r = 0.74); and IMF and carcass numeric marbling score (r = 0.61). The same correlation coefficients for ultrasound measures taken 96 to 105 d before slaughter and carcass values (P < 0.01) were 0.52, 0.58, and 0.63, respectively. Steers were divided into source-verified and nonsource-verified groups based on the level of background information for each individual. Regression equations were developed for the carcass measurements; 46% of the variation could be explained for CLMA and 44% of CFAT at reimplant time, 46% of the variation in quality grade and 42% of the variation in yield grade could be explained. Significant predictors of quality grade were IMF (P < 0.001), natural log of 12th-rib fat thickness (LUFAT, P < 0.001), and ADG (P < 0.01), whereas LUFAT (P < 0.001), ULMA (P < 0.01), live weight (P < 0.001), hip height (P < 0.001), and frame score (P < 0.001) were significant predictors of yield grade. Regressions using ultrasound data taken 61 to 69 d before slaughter showed increasing R2. Live ultrasound measures at reimplant time are a viable tool for making decisions regarding future carcass composition.     

Vascularization of cancellous chip bone grafts

Fresh autogenous, frozen allogeneic, and commercially prepared xenogeneic cancellous chip bone grafts were placed into plug holes in the tibia and into surgically simulated nonunion defects in the ulna of dogs. The microvascular and correlated histologic reactions were studied at given times up to 12 weeks after the graft implantation. Marked and characteristic differences were noted among the 3 graft materials. Fresh autogenous chips were extensively vascularized by 1 week, and subsequent microscopic healing was rapid. Allogeneic chips were incorporated into all defects, but vascularization and histologic healing rates were slower than those with the fresh autogenous graft material. The xenogeneic graft was poorly incorporated. A foreign body reaction was seen histologically, and corresponding vascularization of the graft was slow and incomplete.