MAGNETIC RESONANCE IMAGING OF THE EQUINE DIGIT WITH CHRONIC LAMINITIS

Chronic laminitis is a severe disease affecting the equine digit. It was hypothesized that magnetic resonance (MR) imaging would improve visualization of structures within the foot and pathology associated with chronic laminitis. This study aimed to describe the MR imaging findings in chronic laminitis, compare different pulse sequences for visualization of pathology, and to compare MR imaging with standard radiography. Twenty (10 forelimb, 10 hindlimb) cadaver limbs from 10 horses clinically diagnosed with chronic laminitis (group L) and 10 limbs without laminitis (group N) were used. Lateromedial radiographs and sagittal and transverse MR images of the foot were obtained. Radiographs and MR images were evaluated for anatomic definition and evidence of pathology. Dorsal hoof wall thickness and angle of rotation and displacement distance of the distal phalanx were measured. Comparisons were made between group L and N, forelimb and hindlimb within each horse, and MR imaging and radiography. Features consistently noted with MR images in group L, but not detected using radiography, included laminar disruption, circumscribed areas of laminar gas, laminar fluid, and bone medullary fluid. Other findings seen only on MR images included increased size and number of vascular channels, alterations in the corium coronae, and distal interphalangeal joint distension. Magnetic resonance imaging allowed better definition of laminar gas lines and P3 surface irregularity observed on radiographs. Based on measurements, group L had a greater angle of rotation, distal displacement, and dorsal hoof wall thickness than group N; forelimb hoof wall thickness was greater than hindlimb; and distal displacement and hoof wall thickness measurements were smaller using MR imaging than radiography, but had a similar pattern. It is concluded that there are features of chronic laminitis consistently observed using MR imaging and that these may be additional to features observed radiographically.     

Agreement of SpO2, SaO2 and ScO2 in anesthetized cynomolgus monkeys (Macaca fascicularis)

Objective To assess the agreement between three measurements of arterial oxygen saturation (SpO₂, SaO₂ and ScO₂) in anesthetized cynomolgus monkeys. Study Design Prospective study. Animals Eleven mature, male cynomolgus monkeys (Macaca fasicularis). Methods Monkeys were anesthetized with intramuscular ketamine followed by intravenous propofol. The trachea of each was intubated and the lungs ventilated. Arterial oxygen saturation was measured with a Nonin 8500 V pulse oximeter, using a lingual clip on the cheek. Arterial blood samples were taken from an indwelling catheter. Inspired oxygen concentration was varied from 12 to 20%, and 88 paired arterial blood samples and saturation measurements were taken. Arterial oxygen saturation in the blood samples was measured using a cooximeter. The saturation was also calculated from the arterial oxygen tension using the Adair equation. The results were compared using Bland and Altman's method. Results The pulse oximeter readings were 2.7% higher than that of the cooximeter, with a limit of agreement of ?3.9 to 9.3%. The pulse oximeter readings were 1.8% higher than the calculated saturation, with a limit of agreement of ?6.5% to 10.1%. The cooximeter readings were 0.9% lower than the calculated saturation, with a limit of agreement of ?5.6% to 3.8%. Conclusions The agreement between SpO₂ and other measurements of arterial oxygen saturation in this study is typical for this technique. The bias and limits of agreement are consistent with reports in other species. Clinical relevance The Nonin 8500 V is a useful pulse oximeter for clinical use in primates.     

Inguinal Herniation of the Ascending Colon in a 6‐month‐old Standardbred Colt

Objective— To report inguinal herniation of the ascending colon in a Standardbred colt. Study Design— Case report. Animals— A 6‐month‐old Standardbred colt. Methods— The colt underwent surgical exploration of the hernia with large colon resection and anastomosis. Results— A successful large colon resection and anastomosis was completed, however, the colt was euthanatized at the end of surgery upon owner request. Conclusions and Clinical Relevance— Although uncommon, indirect inguinal herniation of the ascending colon can occur in young horses.     

A comparison of total calcium,corrected calcium,and ionized calcium concentrations as indicators of calcium homeostasis among hypoalbuminemic dogs requiring intensive care

Objective – (1) To evaluate whether total calcium (tCa) correlates with ionized calcium (iCa) in hypoalbuminemic dogs; (2) to evaluate whether calcium adjusted for albumin (Alb), or total protein (TP), or both accurately predict iCa concentrations and hence can be used to monitor calcium homeostasis in critically ill hypoalbuminemic dogs; and (3) to evaluate factors associated with any potential discrepancy in calcium classification between corrected total and ionized values. Design – Prospective observational clinical study. Setting – Small animal intensive care unit in a veterinary medical teaching hospital. Animals – Twenty‐eight client‐owned dogs with hypoalbuminemia. Interventions – None. Measurements and Main Results – iCa was determined using ion‐specific electrode methodology, on heparinized plasma. The tCa concentration was adjusted for Alb and TP using published equations. In total 29% (8/28) of the hypoalbuminemic, critically ill dogs in this study were hypocalcemic at intensive care unit admission, as determined by iCa measurement. Corrected calcium values failed to accurately classify calcium status in 67.9% and 64.3% of cases, according to whether the Alb‐adjusted or TP‐adjusted values, respectively, were used. The sensitivity and specificity of the tCa to evaluate hypocalcemia was 100% and 47%, respectively. The sensitivity and specificity of the correction formulae were 37.5% and 79% for the Alb‐adjusted values and 37.5% and 74% for TP‐adjusted values. tCa overestimated the presence of hypocalcemia and underestimated the presence of normocalcemia, while corrected calcium values overestimated the presence of normocalcemia and underestimated the presence of hypocalcemia. Conclusions – Calcium homeostasis in hypoalbuminemic critically ill dogs should be evaluated by iCa concentrations rather than tCa or calcium adjusted for Alb or TP. Given that tCa has 100% sensitivity for detecting hypocalcemia in this population it is recommended that all hypoalbuminemic and critically ill patients with low tCa should be evaluated with an iCa measurement.     

Comparison of sevoflurane and isoflurane anesthetic index in unpremedicated dogs

Anesthetic respiratory effects of sevoflurane (SEVO) were compared with isoflurane (ISO) in unpremedicated dogs. Minimum alveolar concentration (MAC), apneic concentration (AC), and anesthetic index (AI) of SEVO and ISO were determined in eight 1‐year‐old healthy dogs, weighing 19 ± 3 kg (mean ± SEM) in a randomized complete block multiple cross‐over design. Dogs were mask‐induced with either SEVO or ISO in 100% oxygen. Following endotracheal intubation, dogs were instrumented, mechanically ventilated, and MAC was determined using a tail‐clamp method. Next, spontaneous ventilation was re‐established, and anesthetic concentration was increased to determine the AC. Throughout the anesthetic event, heart rate (HR), systolic blood pressure (SAP), mean blood pressure (MAP), diastolic blood pressure (DAP), respiratory rate (RR), end‐tidal carbon dioxide (Pe ′CO₂), and oxyhemoglobin saturation (SpO₂) were recorded at 3‐minute intervals. Following AC determination, AI was calculated as AC/MAC, and dogs were allowed to recover. Each dog was anesthetized four times (twice with ISO and SEVO each) at 1‐week intervals. All data were analyzed using the two‐way anova . Multiple comparisons were performed between ISO and SEVO treatments. Statistical significance was set at p < 0.05. Significant differences were noted between agents for MAC (SEVO, 2.13 ± 0.10%; ISO, 1.38 ± 0.14%; p < 0.0001), AC (SEVO, 7.34 ± 0.13%; ISO, 3.60 ± 0.13%; p < 0.0001), and AI (SEVO, 3.46 ± 0.22; ISO, 2.63 ± 0.14; p = 0.0002). Physiologic parameters were compared between SEVO and ISO at 1MAC, 2MAC, 3MAC, and AC. No differences were noted between SEVO and ISO treatments for cardiovascular parameters (HR, SAP, MAP, DAP). Significant differences were noted, favoring SEVO, for all respiratory parameters (RR, Pe ′CO₂, SpO₂) at increasing MAC multiples. Additionally, regression analysis was conducted for physiologic variable data points. Analysis of Pe ′CO₂ data points demonstrated a significant slope difference of ?6.47 ± 1.02 (B_SEVO ? B_ISO; p < 0.0001; r² = 0.6042) favoring SEVO. While expected dose‐related ventilatory depression was noted for both agents, all the respiratory parameters for SEVO demonstrated less respiratory depression than ISO at equipotent doses. These results indicated that SEVO caused less dose‐dependent ventilatory depression than ISO, having a significantly higher AI and causing less detrimental change in pulmonary parameters at increasing levels of MAC.