Evaluation of a Midhumeral Block of the Radial,Ulnar, Musculocutaneous and Median (RUMM Block) Nerves for Analgesia of the Distal Aspect of the Thoracic Limb in Dogs

Objective: To evaluate a technique for midhumeral peripheral nerve blockade in the dog. Study Design: Cadaveric technique development; in vivo placebo‐controlled, prospective crossover study. Animals: Canine cadavers (n=38) and 8 clinically healthy, adult hound dogs. Methods: A technique for peripheral block of the radial, ulnar, musculocutaneous, and median nerves (RUMM block) was evaluated using cadaver limbs. Eight purpose‐bred, research dogs were anesthetized; a RUMM block was performed on each thoracic limb. One limb from each dog randomly received 0.5% bupivacaine and the opposite limb was assigned to receive sterile saline solution as a control. After recovery from anesthesia, skin sensation at selected dermatomes was evaluated for 24 hours using a mechanical stimulus. Weight‐bearing, conscious proprioception, and withdrawal reflex were also evaluated. One month after initial testing, each dog was reanesthetized and each limb received the opposite treatment. Results: Sensory thresholds were significantly increased over baseline measurements when compared with control limbs for all nerves. Complete sensory block was achieved in radial (15/16), ulnar (3/16), musculocutaneous (8/16), and median (11/16) nerves, using a mechanical stimulus of analgesia. Complete simultaneous block of all nerves was only obtained in 1 of 16 limbs. Conclusion: RUMM block resulted in desensitization of the skin in the associated dermatomes for 4–10 hours. Complete sensory block of the dermatomes supplied by the radial nerve was most consistent. Clinical Relevance: RUMM block may be an effective technique to provide adjunctive analgesia for dogs undergoing surgery of the distal aspect of the thoracic limb.     

Carbon monoxide toxicity: a case series

Objective: To describe diagnostics, therapy, and sequelae of acute carbon monoxide (CO) toxicity because of a motor vehicle generator in 4 dogs and 2 cats. Series summary: Four dogs and 2 cats presented for recumbency, disorientation, dyspnea, and stiffness after an estimated 6–8 hour exposure to exhaust from a generator. Diagnostics included a serum carboxyhemoglobin levels evaluation, arterial blood gas analysis, pulse oximetry readings, and blood pressure measurements. Initial therapy included oxygen (O₂) administration, intravenous bronchodilators, fluids, and a hemoglobin‐based O₂ carrying (HBOC) molecule. Following administration of the HBOC, 4 of the 6 animals showed dramatic clinical improvement. Two weeks after hospital discharge, the owner reported potential hearing deficits in all animals. Brain auditory evoked response (BAER) tests were conducted in all surviving animals and some degree of hearing impairment was documented in all cases, with complete clinical resolution noted 6 weeks later. Unique information provided: This report describes the therapeutic use of an HBOC in acute isolated CO toxicity (i.e. without the complications of smoke inhalation). In addition, delayed nervous system dysfunction was documented in all surviving animals.     

Hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats

OBJECTIVE: To determine the hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats. ANIMALS: 12 healthy adult domestic shorthair cats. PROCEDURE: Cats were anesthetized by administration of isoflurane in oxygen. After instruments were inserted, end-tidal isoflurane concentration was set at 1.25 times the individual minimum alveolar concentration, and nitrous oxide was administered in a Latin-square design at 0, 30, 50, and 70%. Each concentration was administered for 25 minutes before measurements were obtained to allow for stabilization. Heart rate; systemic and pulmonary arterial pressures; central venous pressure; pulmonary artery occlusion pressure; cardiac output; body temperature; arterial and mixed-venous pH, PCO2, PO2, and hemoglobin concentrations; PCV; and total protein and lactate concentrations were measured before and during noxious stimulation for each nitrous oxide concentration. Arterial and mixed-venous bicarbonate concentrations and oxygen saturation, cardiac index, stroke index, rate-pressure product, systemic and pulmonary vascular resistance indices, left and right ventricular stroke work indices, arterial and mixed-venous oxygen contents, oxygen delivery, oxygen consumption, oxygen extraction ratio, alveolar-to-arterial oxygen difference, and venous admixture were calculated. RESULTS: Arterial pressure, central venous pressure, pulmonary arterial pressure, rate-pressure product, systemic and pulmonary vascular resistance indices, arterial PCO2, and PCV increased during administration of 70% nitrous oxide. Arterial and mixed-venous pH, mixed-venous PO2, and alveolar-to-arterial oxygen difference decreased during administration of 70% nitrous oxide. Results before and during noxious stimulation were similar. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of 70% nitrous oxide to isoflurane-anesthetized cats resulted in improved arterial pressure, which was related to a vasoconstrictive effect.     

Myasthenia gravis and masticatory muscle myositis in a dog

A 21-month-old, castrated male Vizsla was presented for pelvic limb weakness, difficulty opening his mouth, ptyalism, voice change, and urinary incontinence. Myasthenia gravis and masticatory myositis were diagnosed. The unusual clinical findings, diagnosis, treatment, and case outcome are described, followed by a brief discussion of myasthenia gravis and masticatory myositis.     

Risk factors and prevalence of injuries in horses during various types of steeplechase races

OBJECTIVE: To identify the types of injuries sustained by horses that competed in steeplechase races and determine the prevalence of and risk factors for those injuries. DESIGN: Prospective study. ANIMALS: 2,680 horses that competed in various types of steeplechase races from 1996 through 2000. PROCEDURE: Data regarding races; environment; equipment problems; the number of horses that entered, started, and finished races; the number of riders that fell; and the number of horses that were slowed or stopped by the rider, ran off the course, fell, and sustained injuries or physical abnormalities during races were collected on a standard form by the official veterinarian who attended each meet. Data from all meets were not recorded; however, in recorded meets, data from every race were reported. RESULTS: Data for 197 hurdle, 65 timber, 76 flat, and 8 mixed races were recorded. Nine (3.4/1,000 horses that started in races) horses died or were euthanatized, and 7 of those were associated with catastrophic musculoskeletal injury. Seven fractures were recorded. Four fractures involved forelimbs, 1 involved a hind limb, and 2 involved the cervical portion of the vertebral column. All horses with fractures were euthanatized. Deep or hard course conditions were associated with an increased risk of breakdown injuries. CONCLUSIONS AND CLINICAL RELEVANCE: Successful development and implementation of strategies to prevent injuries and death in horses in steeplechase races depend on a clear understanding of the types and prevalence of injuries involved and risk factors associated with those injuries.     

Genomic hypomethylation in neoplastic cells from dogs with malignant lymphoproliferative disorders

DNA methylation is an epigenetic modification in which a methyl group is added usually to the fifth carbon position of a cytosine residue. Dysregulation of this process is an important molecular event which has been shown to be associated with neoplastic transformation and tumour progression in humans and mice. Features of methylation dysregulation in many different types of neoplasms include general genomic hypomethylation, focal hypermethylation, and altered expression of genes which encode a series of DNA (cytosine-5) methyltransferases. Interestingly, many types of neoplasia that are recognised in humans also develop spontaneously in the dog. By comparing the restriction patterns of MspI and HpaII, this study demonstrates that as in human, genomic hypomethylation is a feature of neoplastic cells in the majority of canine lymphoma cases and approximately one-third of canine leukemia cases confirming that dysregulation of the DNA methylating machinery is implicated in malignant transformation of lymphoid cells in some dogs.     

Packed red blood cell transfusions in dogs with gastrointestinal hemorrhage: 55 cases (1999-2001)

Fifty-five dogs received packed red blood cell (PRBC) transfusions for gastrointestinal (GI) hemorrhage during a 26-month period (1999 to 2001), accounting for 11.7% of the PRBC transfusions in that time. Thirty-nine (61%) dogs had an intestinal pathology (primary or secondary) as the cause of GI hemorrhage, including intestinal masses, gastroenteritis, hepatic disease, and renal disease. Nonsteroidal and steroidal anti-inflammatory drug use was found frequently in dogs with GI hemorrhage. Sixteen (39%) dogs were identified as having immune-mediated thrombocytopenia (IMT) and associated GI hemorrhage. Dogs with IMT received more transfusions of PRBC than nonIMT dogs (P<0.03) and received a significantly larger total volume of PRBC (P<0.01) during hospitalization.