Sparing effect of a low dose of intrathecal morphine on fentanyl requirements during spinal surgery: a preliminary clinical investigation in dogs

Objective— To evaluate the effect of preoperative intrathecal administration of a low dose of morphine on intraoperative fentanyl requirements in dogs undergoing cervical and thoracolumbar spinal surgery.
Study Design— Prospective randomized clinical study.
Animals— Dogs (n=18) matched by surgical procedure administered intrathecal morphine (MG) or no-treatment (control group, CG).
Methods— After premedication with romifidine (4 μg/kg, intravenously) and induction with propofol, anesthesia was maintained with sevoflurane in oxygen. Intrathecal morphine 0.03 (0.023–0.034) mg/kg was administered at lumbar level 41 (25–65) minutes before surgery in MG. Ketamine (0.5 mg/kg) was administered hourly, starting before incision. Fentanyl infusion (1.2 and 4.2 μg/kg/h in MG and CG, respectively) was administered after a loading dose (5 and 10 μg/kg in MG and CG, respectively), and boluses were given if an increase >20% in heart rate and arterial blood pressure was observed. Total amount of fentanyl administered was recorded, to calculate hourly requirements and predict plasma concentration using a computer simulation.
Results— Hourly fentanyl consumption and predicted plasma concentrations at the time of response to surgery were significantly lower in MG compared with CG.
Conclusions— Preoperative administration of a low dose of intrathecal morphine has a sparing effect on intraoperative fentanyl requirements.
Clinical Relevance— Preoperative intrathecal administration of a low dose of morphine at the lumbar level represented a safe and effective mean of providing intraoperative analgesia in dogs undergoing cervical and thoracolumbar spinal surgery.     

The relationship between graft incompatibility and phenols in Uapaca kirkiana Müell Arg.

The objective of the study was to determine the relationship between phenols and graft incompatibility in Uapaca kirkiana. Phenol quantification and identification were carried out using Folin-Ciocalteau reagent procedure, fluorescence microscopy and reverse phase high performance liquid chromatograph (RP-HPLC) above, below and at the graft union. Results showed no vascular cambium continuity above the scion/stock unions. Significant differences in total soluble phenols and cell wall bound phenols were obtained. Fluorescence microscope indicated the presence of flavonoids and other polymers above the union. The RP-HPLC identified ferulic acid as a major phenol component found in U. kirkiana plant cells and responsible for wood discolouration. High phenol concentrations were obtained in less compatible combinations than in compatible combinations. High peaks of ρ-coumaric acid were obtained above the union. It is concluded that phenols, especially ρ-coumaric acids and flavonoids caused poor callus formation at the union, and hence implicated in graft incompatibility.     

Hypertension and insulin resistance in a mixed-breed population of ponies predisposed to laminitis

OBJECTIVE: To determine the metabolic phenotype of a group of laminitis-prone ponies when at pasture in summer, compared with when at pasture in winter. ANIMALS: 40 ponies of various breeds predisposed to recurrent pasture-associated laminitis and 40 unaffected control ponies. PROCEDURES: Body condition score and size of the crest of the neck were assessed, blood samples obtained, and blood pressure measured by use of an indirect oscillometric technique, while ponies were kept on winter pasture (last week of November or beginning of December) and again on summer pasture (June). Serum insulin concentration and plasma glucose, triglyceride, uric acid, and ACTH concentrations were measured. Insulin sensitivity was calculated with proxies derived from basal serum insulin and plasma glucose concentrations. RESULTS: No significant differences were apparent between ponies predisposed to laminitis and control ponies during winter. However, in June, laminitis-prone ponies had increased serum insulin concentration and plasma triglyceride and uric acid concentrations, compared with control ponies. Also, laminitis-prone ponies were relatively insulin resistant, compared with control ponies. Mean blood pressure was significantly higher during summer in laminitis-prone ponies (median [interquartile range], 89.6 mm Hg [78.3 to 96.9 mm Hg]), compared with control ponies (76.8 mm Hg [69.4 to 85.2 mm Hg]). CONCLUSIONS AND CLINICAL RELEVANCE: Summer pastures appear to induce metabolic responses in some ponies, leading to expression of the prelaminitic phenotype, which includes hypertension as well as insulin resistance. Signs of this metabolic syndrome may not be apparent in affected ponies during periods of grazing winter pasture. Understanding this syndrome may enable improved countermeasures to be devised to prevent laminitis.     

Roles of thromboxane A2 and 5-hydroxytryptamine in endotoxin-induced digital vasoconstriction in horses

OBJECTIVE: To evaluate the roles of 5-hydroxytryptamine (5-HT), thromboxane A2 (TxA2), and platelet-activating factor (PAF) in endotoxin-induced digital hypoperfusion in horses. ANIMALS: 6 healthy adult Thoroughbreds. PROCEDURES: Horses were treated with IV administration of saline (0.9% NaCl) solution (control treatment) or the 5-HT 1B/D selective antagonist, GR55562 (0.3 mg/kg), prior to tryptamine infusion (1.6 microg/kg/min for 30 minutes) to establish an effective GR55562 dose. In a crossover study, horses were treated with IV administration of saline solution (control treatment), aspirin (4 mg/kg, 2 hours or 4 days before lipopolysaccharide [LPS] infusion), GR55562 (0.3 mg/kg), the PAF antagonist WEB2086 (3 mg/kg), or aspirin plus GR55562 prior to LPS infusion (30 ng/kg for 30 minutes). Digital blood flow was measured by use of Doppler ultrasonography. Concomitant measurements of hoof wall and coronary band surface temperatures were made. Serial blood samples were collected and plasma 5-HT and TxA2 concentrations determined. RESULTS: GR55562 abolished tryptamine-induced digital hypoperfusion. Neither WEB2086 nor GR55562 affected LPS-induced alterations in digital perfusion or plasma mediator concentrations. Aspirin given 2 hours before LPS administration abolished the increase in plasma TxA2 concentration and significantly attenuated LPS-induced digital hypoperfusion. Aspirin given 4 days before LPS significantly attenuated the increase in plasma TxA2 concentration and digital hypothermia. Aspirin plus GR55562 had a greater effect on LPS-induced digital hypothermia than aspirin alone. CONCLUSIONS AND CLINICAL RELEVANCE: Thromboxane A2 and 5-HT played a role in mediating LPS-induced digital hypoperfusion in horses. Platelet-activating factor appeared unimportant in mediating LPS-induced 5-HT or TxA2 release or digital hypoperfusion.     

Combination chemotherapy in feline lymphoma: treatment outcome, tolerability, and duration in 23 cats

BACKGROUND: Different chemotherapy regimes have been described for feline lymphoma with varying outcomes. HYPOTHESIS: In cats with lymphoma, a long-term, multiagent chemotherapy protocol will be effective and carry acceptable toxicity. ANIMALS: Twenty-three cats with histologically or cytologically confirmed diagnosis of lymphoma. METHODS: Prospective, single-arm clinical trial in which cats were treated with a chemotherapy protocol consisting of a cyclic combination of l-asparaginase, vincristine, cyclophosphamide, doxorubicin, methotrexate, and prednisolone with a planned total treatment time of 122 weeks. RESULTS: Complete remission (CR) rate was 74% (n = 17). Fourteen percent of cats attained partial remission (PR). Median duration of first CR was 264 days (range, 45-2,485 days). Six-month, 1-, and 2-5-year remission rates were 75, 50, and 34%, respectively. Duration of PR ranged between 23 and 63 days. Median survival in cats with CR was 296 days (range, 50-2,520 days). Six-month, 1-, 2-, and 3-5-year survival rates in cats with CR were 82, 47, 34, and 27%, respectively. Survival of cats achieving PR ranged between 38 and 120 days. Of the analyzed variables, only anatomical location had a significant influence on remission duration (P=.022). Actual median treatment time in cats with CR was 128 days (18 weeks). Hematologic and gastrointestinal toxicosis was infrequent and mostly low grade. CONCLUSIONS AND CLINICAL IMPORTANCE: In this population of cats with lymphoma, chemotherapy was effective. With infrequent and mostly low-grade toxicosis, tolerability of the protocol may be considered good.     

PATHOLOGIC BASIS FOR RIM ENHANCEMENT OBSERVED IN COMPUTED TOMOGRAPHIC IMAGES OF FELINE NASOPHARYNGEAL POLYPS

In postcontrast computed tomographic (CT) images, feline nasopharyngeal polyps typically demonstrate enhancement of the peripheral rim. Computed tomographic images and histologic specimens of a case series of 22 cats with surgically removed nasopharyngeal polyps were reviewed retrospectively in an attempt to elucidate the origin of rim enhancement. Polyps were present in the tympanic cavity in 15 (68%) cats (three with extension into the nasopharynx), only in the nasopharynx in four (18%) cats, and only in the external ear canal in the remaining three (14%) cats. All polyps had variable degrees of epithelial injury. Hemorrhage and inflammatory infiltration were significantly more marked in the superficial stroma whereas edema was significantly more marked in the core stroma. In noncontrast CT images (n = 22), the tympanic bulla was thickened in all 15 cats with a polyp in the tympanic cavity and enlarged in eight (53%) of these cats. In postcontrast CT images (n = 15), an outer zone of relatively increased attenuation compatible with a rim was observed in 11 (73%) polyps. The magnitude and extent of rim enhancement in CT images was positively correlated with the histologic grade of inflammation in the superficial stroma and negatively correlated with the grade of edema in the superficial stroma. It appears that inflammation is the major determinant of contrast medium accumulation in feline nasopharyngeal polyps, and the tendency for inflammation to affect predominantly the superficial layers explains the frequent observation of a rim in postcontrast CT images.