Results of Screw/Wire/Polymethylmethacrylate Composite Fixation for Acetabular Fracture Repair in 14 Dogs

Objective- To assess the clinical results in dogs with acetabular fractures stabilized using a screw-wire-polymethylmethacrylate (SWP) composite fixation.
Study Design- A retrospective study of client-owned dogs with acetabular fractures.
Animals- Fourteen dogs ranging in age from 4 to 95 months (mean, 34 ±25 months; median, 25 months) and body weight from 8 to 39 kg (mean, 25 ±6 kg; median, 27 kg).
Methods- Medical records and radiographs were retrospectively evaluated to determine location of the fracture, presence of preexisting degenerative joint disease, accuracy of fracture reduction and complications associated with surgery. Long-term results were evaluated by subjective assessment of lameness, elicitation of pain and/or crepitus on manipulation of the coxofemoral joint, measurements of pelvic limb circumference, coxofemoral joint goniometric measurements, and radiographic evaluation.
Results- Fracture reduction was considered anatomic in 13 dogs. At the time of the last follow-up evaluation (mean, 347 ±261 days; median, 380 days) 10 dogs were sound on the affected limb, three dogs had a subtle weight-bearing lameness of the affected limb, and the remaining dog had a consistent non-weight-bearing lameness of the affected limb. Mild (n = 10) or moderate (n = 1) degenerative changes of the affected coxofemoral joint attributed to the acetabular fracture and its repair were noted on the follow-up radiographs in 11 dogs. Limb circumference of the affected limb ranged from -8.2% to +10.8% (mean, -0.8 ±4.2%; median, -0.7%) of the contralateral limb.
Conclusions- The SWP composite fixation consistently maintained anatomic reduction, was associated with few complications, and yielded satisfactory clinical results.
Clinical Relevance- The SWP composite fixation technique would seem to be an acceptable means of stabilizing acetabular fractures in dogs.     

Effect of Ketorolac Tromethamine on Atracurium-Induced Neuromuscular Blockade in Anesthetized Dogs

Objective —The purpose of this study was to determine the effect of ketorolac tromethamine or placebo on the neuromuscular blockade induced by an infusion of atracurium in isoflurane-anesthetized dogs. Design —Randomized, controlled trial. Animals —Six healthy, adult mixed-breed dogs (five female, one male) weighing 24.8 ± 2.8 kg. Methods —Dogs were studied on two occasions with a minimum of 7 days between studies. Dogs were induced with 5% isoflurane in oxygen and maintained with 1.6 ± minimum alveolar concentration (MAC) end-tidal isoflurane. Neuromuscular blockade was assessed using the train of-four response. Once 50% depression of the first twitch (T₁) was achieved, the atracurium infusion rate was held constant for 30 minutes. Then ketorolac, 0.5 mg/kg, or the same volume of placebo (0.9% sodium chloride solution) was administered intravenously and the atracurium infusion maintained for an additional 60 minutes. Before and at 2, 5, 10, 15, 30, and 60 minutes after ketorolac or placebo, the percent depression of T₁ and the fourth twitch to the first twitch (T₄/T₁) ratio were recorded. The atracurium infusion was discontinued and the time for T₁ to recover from 50% to 75% of its original value was recorded. At 75% T₁, edrophonium, 0.5 mg/kg intravenously, was administered to antagonize the residual blockade. Results —There was no significant difference in T₁%, T₄/T₁ ratio, or recovery time after ketorolac administration compared with placebo. Conclusions —Ketorolac, 0.5 mg/kg intravenously, has no significant effect on either atracuriuminduced neuromuscular blockade or recovery time for T₁ in isoflurane-anesthetized dogs. Clinical Relevance —The concurrent use of atracurium should not be a contraindication for the administration of ketorolac for intraoperative or postoperative analgesia.     

The Effect of Trans-Stifle External Skeletal Fixation and Hyaluronic Acid Therapy on Articular Cartilage in the Dog

Transarticular external skeletal (TES) fixators were applied unilaterally to the stifle joints of 10 young adult dogs. After 4 weeks, the fixators were removed from all dogs. Two dogs were not allowed a remobilization period, whereas 8 dogs were provided with 4 additional weeks of weight-bearing activity in a kennel run. Four dogs were given high-molecular weight hyaluronic acid by intra-articular injection weekly during the remobilization period. Clinical gait evaluations and range of motion were determined during the remobilization period. Articular cartilage samples from both stifle joints of all dogs were evaluated histologically and histochemically. No significant differences in gait scores or range of motion were noted between treated and untreated dogs. Articular cartilage proteoglycan content was reduced after 4 weeks of trans-stifle external skeletal fixation as determined by loss of alcian blue (AB) histochemical staining. Improved homogeneity of histochemical staining was observed after remobilization. However, remobilization was associated with histological damage to the surface and tangential layers of articular cartilage. Remobilization combined with hyaluronic acid (HA) therapy improved histochemical staining and reduced structural damage to articular cartilage when compared with remobilization alone.     

Treatment of Forelimb Growth Plate Deformity in 11 Dogs by Radial Dome Osteotomy and External Coaptation

Radial dome osteotomy and external coaptation were used to correct forelimb growth deformities with carpal valgus angles of 15 to 43 degrees in 11 dogs (12 forelimbs). Osteotomy sites were clinically healed by week 4. Appearance and function in 10 limbs was good to excellent. The angular deformity recurred in one dog by week 4 due to partial closure of the distal radial growth plate. Carpal valgus recurred in one dog by week 2 because the ulnar osteotomy healed before radial growth ceased.     

The effects of maternal plasma dobutamine levels on fetal oxygenation in anaesthetized sheep

Objective To measure the effects of dobutamine infusion on fetal oxygenation during isoflurane anaesthesia in pregnant ewes. Study design Prospective randomized experimental study. Animals Seven clinically normal adult pregnant Rambouillet‐Dorset cross ewes with fetuses of 117–122 days gestational age. Methods The ewes were anaesthetized with ketamine (2 mg kg^?1) IM, and isoflurane (F_E′ISO 2.0%) in oxygen. After instrumentation and stabilization, dobutamine was infused at 4 µg kg^?1minute^?1 for 60 minutes and 10 µg kg^?1minute^?1 for 60 minutes in random order, separated by a 20‐minute washout period. Catheters were placed in the maternal and fetal carotid arteries; these were used for continuous blood pressure measurement and intermittent blood sampling. Results Maternal mean systemic carotid arterial pressure was 60 mm Hg prior to dobutamine infusion. After 5 minutes of dobutamine infusion, fetal oxygen saturation increased (p < 0.05) from 0.62 (0.17–0.71, minimum–maximum) to 0.72 (0.28–0.78) at a dose of 4 µg kg^?1minute^?1 and to 0.70 (0.20–0.73) at a dose of 10 µg kg^?1minute^?1. These increases were maintained during the infusion and were not significantly different between doses. Maternal oxygen saturation remained constant at 1.0 before and during all infusions. Although maternal heart rate and blood pressure increased (p < 0.05) by 90% and 25%, respectively, with dobutamine, this stimulant effect was not evident in the corresponding fetal variables. Maternal haemoglobin concentration increased 30% (p < 0.05) with each infusion. Conclusions Dobutamine at 4 µg kg^?1minute^?1 increases fetal oxygenation that is not improved by a dose of 10 µg kg^?1minute^?1. This increase is largely due to an increase in maternal haemoglobin concentration that, in turn, increases oxygen delivery to the placenta. Clinical relevance The use of dobutamine to treat hypotension in pregnant sheep during isoflurane anaesthesia improves fetal oxygenation. This may be true in other species.     

The use of the nondepolarizing neuromuscular blocking drug cis-atracurium in dogs

Objective This clinical trial attempted to evaluate the potency, onset and duration of action of cis‐atracurium in dogs. Animals Twenty dogs aged between 1 and 15 years and weighing between 15 and 85 kg admitted for a variety of elective, surgical procedures under general anaesthesia. Materials and methods Following induction of general anaesthesia, the effects of an intravenous loading dose of cis‐atracurium (0.1 mg kg^?1) were evaluated by counting visual responses to train of four (TOF) nerve stimulation. Incremental doses of 0.02 or 0.04 mg kg^?1 cis‐atracurium were administered when the first of four responses to TOF stimulation was present. Results An initial dose of 0.1 mg kg^?1 eliminated all four TOF responses in 18 out of 20 dogs. The same dose, repeated 10 minutes later in two animals in which blockade was incomplete, abolished all responses. In dogs receiving 0.1 mg kg^?1 cis‐atracurium neuromuscular blockade lasted 27.2 ± 9.3 minutes. Up to six incremental doses were given in individual animals; incremental doses appeared to be noncumulative. No untoward side‐effects were observed with the use of this drug. There was considerable variation between individuals in response to cis‐atracurium. Conclusions Cis‐atracurium is an effective neuromuscular blocking agent in the dog, although its potency varies. Clinical Relevance Further studies are required to determine whether observed differences in potency are related to age, breed or sex. Cis‐atracurium may prove useful in dogs with impaired renal and or hepatic function.     

Ischemic Postconditioning Does Not AttenuateIschemia–Reperfusion Injury of Rabbit Small Intestine

Objective— To determine whether ischemic postconditioning can attenuate intestinal ischemia–reperfusion (I–R) injury and has a beneficial effect on tissue blood flow during reperfusion. Study Design— In vivo experimental study. Animals— New Zealand White rabbits (n=6). Methods— Rabbits were anesthetized with pentobarbital, to avoid the preconditioning effects of volatile anesthetics, and ventilated with room air. Rectal temperature, hemodynamics, and normocapnia were maintained. After celiotomy, 3 jejunal segments were isolated in each rabbit for the following groups: (1) control, (2) I–R, and (3) I–R with postconditioning. I–R was induced by a 45‐minute occlusion of the segment jejunal artery followed by 2‐hour reperfusion. The postconditioning segment had 4 cycles of 30‐second reperfusion and 30‐second reocclusion during the initial 4 minutes of reperfusion. Stable isotope‐labeled microspheres were used to measure intestinal blood flow at baseline, end occlusion, and end reperfusion. At the end of reperfusion, intestine segments were harvested and the rabbits euthanatized. A semiquantitative histopathologic evaluation (0–5) was conducted by a single, blinded observer. Wet‐to‐dry weight ratios were calculated to assess intestinal edema. Results— There was no significant difference in grade of necrosis, tissue wet‐to‐dry weight ratios, or blood flow at any time point between ischemic and postconditioning groups. Conclusions— Ischemic postconditioning was ineffective in this model of intestinal I–R. Clinical Relevance— Further experimental studies will need to be performed before clinical application of postconditioning for intestinal ischemia.     

The Analgesic Effects of Administering Fentanyl or Medetomidine in the Lumbosacral Epidural Space of Cats

The analgesic effects of fentanyl (4 μg/kg) and medetomidine (10 μg/kg) in 1 mL saline injected epidurally were measured in 15 cats. The response to an electrical cutaneous stimulus from a constant current generator was used as the index of analgesia. The stimulus was applied to a forelimb before epidural injection, and at 15, 30, 60, 90, 120, 180, 240, and 300 minutes post-injection (PI). The hindlimb was tested 5 minutes later. One mL saline only was used to control for volume of injection and saline. Medetomidine significantly increased the pain threshold for the hindlimb at 20 to 245 minutes PI compared with the preinjection level. Fentanyl significantly increased the pain threshold at 20 minutes PI only compared with preinjection levels. Medetomidine significantly increased the pain threshold of the forelimb at 15 to 120 minutes PI compared with the preinjection levels. Fentanyl did not significantly increase the pain threshold of the forelimb. Administration of medetomidine produced emesis in 12 of 15 cats in an average of 6.4 minutes PI (range, 3 to 11 minutes) and mild sedation in all cats. Injection of fentanyl produced no visible side effects in any of the cats.     

Effect of Tamoxifen Citrate on Canine Immobilization (Disuse) Osteoporosis

The effect of tamoxifen citrate on bone mass in immobilization osteoporosis was studied in 11 growing dogs. Immobilization osteoporosis was induced by fiberglass cast immobilization of the right hindlimb for 28 days, while the left hindlimb served as a nonimmobilized control. Six dogs received tamoxifen citrate (1.5 mg/kg per os) once daily for 28 days; five dogs received no treatment. All dogs were euthanatized on day 28 and bone samples were collected. Bone mineral content of the distal tibial metaphysis of casted and uncasted limbs was measured by single photon absorptiometry. Immobilization resulted in a significant reduction in bone mass in the casted limb of untreated and tamoxifen-treated dogs. However, tamoxifen-treated dogs had less severe immobilization osteoporosis than untreated dogs. The calculated bone mass sparing effect of tamoxifen was 24.4%. Because of the complexity of pathologic bone remodeling, use of a single therapeutic agent may not be the optimal means of preventing bone loss associated with immobilization.     

Closed System Delivery of Halothane and Isoflurane with a Vaporizer in the Anesthetic Circle

Forty-four healthy dogs undergoing elective ovariohysterectomy were anesthetized with halothane or isoflurane delivered with an in-circuit vaporizer with closed system flow rates or an out-of-circuit vaporizer with semi-closed system flow rates. When dogs were anesthetized with halothane, there were no differences in heart rate, blood pressure, body temperature, respiratory rate, or lingual venous pH, PCO2, or PO2 during induction and maintenance. Lingual venous PO2 was significantly less but still within a clinically acceptable range when isoflurane was used in an in-circuit vaporizer. Recovery times tended to be longer with in-circuit vaporizers. The amount of anesthetic used was not affected by vaporizer location. In-circuit vaporizers were suitable for delivery of halothane or isoflurane to healthy dogs.