Potential risks,prognostic indicators,and diagnostic and treatment modalities affecting survival in dogs with presumptive aspiration pneumonia: 125 cases (2005–2008)

Objective – To evaluate a clinical population of dogs diagnosed with presumptive aspiration pneumonia (AP) and determine diagnostic and treatment modalities contributing to survival. Design – Retrospective study. Setting – A university veterinary teaching hospital in an urban setting. Animals – One hundred and twenty‐five dogs with presumed AP treated from 2005 to 2008. Interventions – None. Measurements and Main Results – Dogs with presumptive AP identified by a review of medical records had an overall survival of 81.6% (102/125). Male large‐breed dogs (mean 24.9 kg; 82/125) were overrepresented and were more likely to develop AP in this study population. Recent anesthesia had been performed in 16% (20/125), and vomiting was reported in 64% (80/125). The most common radiographic findings were a predominantly alveolar pattern (187/272, [68.8%] total lung lobes) in the right middle lung lobe (80/115, [69.6%]). A mean of 2 lung lobes were involved radiographically, and the relationship between survival and the number of lung lobes affected was statistically significant (P=0.04). Neutrophilia with a left shift was common with no significant change on consecutive daily evaluations. The mean PaO₂ was 77.7 mm Hg (SD, 17.5 mm Hg) (range, 40.7–100 mm Hg) with a median alveolar‐arterial gradient of 41.1 mm Hg (range, 8.1–81.8 mm Hg). In this study population, 37.6% (47/125) of dogs had microbial cultures performed and of these, 76.6% (36/47) were positive for growth; Escherichia coli (38.8%), Mycoplasma spp. (21.3%), Pasturella spp. (19.1%), and Staphylococcus spp. (17%) were the most common isolates in either single or multiagent infections. No treatment modality was statistically associated with increased survival. Colloid therapy was a negative prognostic indicator. Conclusions – In this study the overall prognosis for AP was good. Patients with only 1 affected lung lobe appeared more likely to survive. Supportive treatment modalities are warranted for the hospitalized patient, although no individual treatment method was found to be clearly superior to others.     

陆眠宁Ⅰ麻醉麋鹿不良反应观察及护理

介绍了昆明动物园2013年麋鹿麻醉锯茸出现不良反应后的观察及治疗期间的护理,使2只麋鹿完全康复的过程。锯茸使用的麻醉药物陆眠宁Ⅰ在对麋鹿麻醉时出现胃肠迟缓、酸中毒等不良反应,通过积极配合兽医治疗,加强观察、护理,缓解并发症状,使动物完全康复。     

A systematic review of the effects of injectable sedative and anesthetic drugs and inhalant anesthetics on intraocular pressure in the dog

ObjectiveThe purpose of this systematic review was to summarize the results of studies that have determined the effect of injectable and inhalant drugs used in anesthesia on intraocular pressure (IOP) in dogs.Databases usedA comprehensive search of research literature was performed without language restriction. The search utilized the PubMed, CAB Abstracts and the University of Georgia’s Galileo electronic databases using a combination of free text terms ‘Ophthalmology’, ‘Intraocular Pressure’, ‘Anesthetic’, ‘Anesthesia’, ‘Canine’ or ‘Dog’. The time frame searched was from 1970 to October 2018. Any published research paper that dealt with sedatives or anesthetics administered systemically and the canine eye was evaluated.ConclusionsThe effects of many anesthetic drugs in dogs with ocular pathology are largely unknown. Many anesthetic drugs do not induce clinically relevant changes in IOP in dogs with normal eyes, although some studies demonstrated results with statistically significant changes. The dose, route of administration, experimental conditions, drug combinations, timing of measurements, measurement technology and setting or individual animal characteristics may all produce some heterogeneity in results from multiple studies.     

Pharmacokinetics of midazolam in sevoflurane-anesthetized cats

ObjectiveTo estimate the pharmacokinetics of midazolam and 1-hydroxymidazolam after midazolam administration as an intravenous bolus in sevoflurane-anesthetized cats.Study designProspective pharmacokinetic study.AnimalsA group of six healthy adult, female domestic cats.MethodsAnesthesia was induced and maintained with sevoflurane. After 30 minutes of anesthetic equilibration, cats were administered midazolam (0.3 mg kg^–1) over 15 seconds. Venous blood was collected at 0, 1, 2, 4, 8, 15, 30, 45, 90, 180 and 360 minutes after administration. Plasma concentrations for midazolam and 1-hydroxymidazolam were measured using high-pressure liquid chromatography. The heart rate (HR), respiratory rate (f_R), rectal temperature, noninvasive mean arterial pressure (MAP) and end-tidal carbon dioxide (Pe′CO₂) were recorded at 5 minute intervals. Population compartment models were fitted to the time–plasma midazolam and 1-hydroxymidazolam concentrations using nonlinear mixed effect modeling.ResultsThe pharmacokinetic model was fitted to the data from five cats, as 1-hydroxymidazolam was not detected in one cat. A five-compartment model best fitted the data. Typical values (% interindividual variability where estimated) for the volumes of distribution for midazolam (three compartments) and hydroxymidazolam (two compartments) were 117 (14), 286 (10), 705 (14), 53 (36) and 334 mL kg^–1, respectively. Midazolam clearance to 1-hydroxymidazolam, midazolam fast and slow intercompartmental clearances, 1-hydroxymidazolam clearance and 1-hydroxymidazolam intercompartment clearance were 18.3, 63.5 (15), 22.1 (8), 1.7 (67) and 3.8 mL minute^–1 kg^–1, respectively. No significant changes in HR, MAP, f_R or Pe′CO₂ were observed following midazolam administration.Conclusion and clinical relevanceIn sevoflurane-anesthetized cats, a five-compartment model best fitted the midazolam pharamacokinetic profile. There was a high interindividual variability in the plasma 1-hydroxymidazolam concentrations, and this metabolite had a low clearance and persisted in the plasma for longer than the parent drug. Midazolam administration did not result in clinically significant changes in physiologic variables.     

Development of a lateral ultrasound-guided approach for the proximal radial,ulnar, median and musculocutaneous (RUMM) nerve block in cats

ObjectiveTo describe a lateral ultrasound (US)-guided approach to the radial, ulnar, median and musculocutaneous (RUMM) nerves through a single proximal in-plane insertion in cats and to determine whether one or two injection points are required to successfully stain all the target nerves.Study designProspective study.AnimalsA total of eight client-owned healthy cats and 12 cat cadavers.MethodsIn live cats, the US anatomy of the brachium, the landmarks and the site for needle accesses were determined. Then, 12 thawed feline cadavers were used to assess the spread of dye solution and nerve staining following the US-guided proximal-lateral-humeral RUMM injection using one and two injection points. Each cadaver was injected with 0.15 mL kg^–1 of a 0.25% new methylene blue solution in either a single injection aimed for the radial nerve of one limb (G1) or via two sites delivering 0.1 mL kg^–1 and 0.05 mL kg^–1 aimed for the radial and musculocutaneous nerves of the opposite limb, respectively (G2). Upon dissection, staining of the target nerves around their circumference for length of >1 cm was considered successful.ResultsSonoanatomy was consistent with anatomy upon dissection and target nerves were identified in all cadavers. Staining was 100% successful for the radial, median and ulnar nerves in both groups, and 41.7% and 100% for the musculocutaneous nerve in G1 and G2, respectively.Conclusions and clinical relevanceThis novel lateral US-guided approach for the proximal RUMM nerve block allowed a good identification of the nerves and related structures, and it provided a consistent muscular structure through which the needle could be easily guided. An injection performed in two aliquots (within the caudal and cranial compartments of the neurovascular sheath) appeared to be necessary to successfully stain all the target nerves.     

Validation of the oscillometric blood pressure monitor Vet20 SunTech in anesthetized healthy cats

ObjectiveTo evaluate a veterinary-specific oscillometric noninvasive blood pressure (NIBP) system according to the guidelines of the American College of Veterinary Internal Medicine (ACVIM) Consensus Statement.Study designProspective clinical study.AnimalsA total of 33 client-owned cats (20 females and 13 males).MethodsCats were premedicated with methadone (0.3 mg kg⁻¹) and alfaxalone (2 mg kg⁻¹) intramuscularly. After 15 minutes anesthesia was induced with isoflurane (3%) in 100% oxygen by facemask while breathing spontaneously. A 22 gauge catheter was placed in the median caudal artery and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures were measured. NIBP measurements were collected by placing the cuff (40% of limb circumference) on the right or left antebrachium. The agreement between the two methods was evaluated with the Bland–Altman methods, and the oscillometric NIBP device was evaluated using the ACVIM guidelines for validation of devices.ResultsData from 30 of the 33 cats were analyzed. Five paired measurements were taken from each cat, totaling 150 paired measurements. Mean bias (limits of agreements) for SAP, DAP and MAP were 2.7 (−22.7 to 28.1), 0.9 (−22.3 to 24.2) and 1.3 (−20.4 to 23.0). The oscillometric NIBP passed all validation criteria, except correlation which was <0.9 for SAP, DAP and MAP.Conclusions and clinical relevanceThe Vet20 did not meet all validation criteria by the ACVIM. However, all criteria except correlation were met.     

Duration of thermal support for preventing hypothermia induced by anesthesia with medetomidine-midazolam-butorphanol in mice

Hypothermia during anesthetic events is a common adverse effect of anesthesia in laboratory animals. In particular, small rodents such as mice is susceptible to hypothermia during anesthetic events. Therefore, the animals will need additional thermal support by external heating devices during and after anesthesia. In general, the time of recovery from anesthesia is typically longer in case of injectable anesthesia rather than inhalant anesthesia. However, the durations of thermal support have been almost limited to 1 hr from administration of anesthesia in general. Our study objectives are two-fold: 1) to compare the levels of hypothermia induced by injectable anesthesia with medetomidine-midazolam-butorphanol (MMB) and inhalant anesthesia with isoflurane (ISO); 2) to find the adequate durations of thermal support for preventing hypothermia induced by their anesthesia in mice. Adult male ICR mice were anesthetized during 40 min without and with the thermal support for 1 (both anesthetic groups), 2, 3, and 5 hr (in MMB group). Without thermal support, the decrease of body temperature in MMB group were more severe than that in ISO group. The durations of thermal support completely prevented hypothermia at 5 hr-support in MMB group and that at 1 hr-support in ISO group. However, the other short durations did not prevent hypothermia at 1, 2 and 3 hr-support in MMB group. These results suggest that the mice should be received thermal support over 5 hr after injection of MMB anesthesia to prevent hypothermia.     

MEASUREMENTS OF HINDLIMB BLOOD FLOW RECORDED USING DOPPLER ULTRASOUND DURING ADMINISTRATION OF VASOACTIVE AGENTS IN HALOTHANE-ANESTHETIZED HORSES

The purpose of the study was to determine the ability of Doppler ultrasound to detect changes in femoral blood flow during pharmacologic manipulation of arterial blood pressure. Doppler ultrasonography was performed in the femoral vessels of six halothane-anesthetized horses before and during administration of phenylephrine HCI and sodium nitroprusside. The time-averaged mean velocity and volumetric flow were calculated. The contour of the velocity waveform was assessed, and the early diastolic deceleration slope (EDDS) and pulsatility index (PI) were calculated. Administration of phenylephrine HCI resulted in increased mean aortic blood pressure (MABP) by 40% (29.3-53.0%). This caused significant decrease in cardiac output (26.8 to 13.5 l/min), femoral arterial velocity (left artery 7.20 to 4.00 cm/s; right artery 5.01 to 3.39 cm/s) and volumetric flow (left artery 556 to 221 ml/min; right artery 397 to 193 ml/min) in the femoral vessels and significant increase in systemic vascular resistance (163 to 433 dyn-s/cm5), EDDS (1a: 285 to 468: ra: 250 to 481) and PI (1a: 9.38 to 20.4; ra 17.1 to 29.1). Administration of sodium nitroprusside resulted in a decreased MABP of 27.2% (22.5-33%). This increased cardiac output (20.8 to 32.4 L/min), however, no significant changes were observed in femoral blood flow. Despite obvious changes in the waveform contour, no significant change occurred in EDDS or PI. These results suggest that Doppler ultrasound may be useful for measuring femoral blood flow in anesthetized horses. However, waveform analysis appears to be limited when multiple changes occur in central and peripheral haemodynamics.     

DUPLEX-ULTRASONOGRAPHIC EVALUATION OF THE COMMON CAROTID ARTERY IN THE RESTING, SEDATED AND ANESTHETIZED HORSE

The aim of this study was to determine the blood flow in the carotid artery during halothane anaesthesia by means of duplex-sonography. Seventeen warm blood horses were evaluated in dorsal and lateral recumbency and the results were compared with the values of the same horses resting and under sedation. The cross sectional area of the vessels, the time-averaged maximal blood velocity, time-averaged maximal blood flow and the resistance index were determined and the flow profile was evaluated. During halothane anesthesia the total blood flow shows a significant increase which is not dependent on the positioning of the horse. Mean blood velocity is decreased by sedation and significantly increased during anesthesia. Reduced peripheral resistance is expressed by a decline of the resistance index. After sedation and during recumbency there is an increase in diameter of the carotid artery.     

外源性H2S对氯胺酮全麻大鼠主要生理指标的影响

外源性H₂S在诸多方面对中枢神经系统具有保护性作用,本研究通过预试验确定了外源性H₂S的给药时间和剂量,将48只SD大鼠随机均分为4组,分别为对照组（CP组）、低剂量组（LP组,7 μmol/kg NaHS）、中剂量组（MP组,14 μmol/kg NaHS）、高剂量组（GP组,28 μmol/kg NaHS）。在盐酸氯胺酮麻醉前20 min,3个剂量组分别腹腔注射7、14、28 μmol/kg NaHS,观察外源性H₂S对大鼠体温、心率、呼吸频率、血氧饱和度及血压等生理指标的干预效果。试验结果表明,与对照组相比,3个剂量组体温和血氧饱和度浓度均显著升高（P<0.05）,心率和血压均显著降低（P<0.05）,但呼吸频率呈先减慢后加快趋势,且这些变化呈显著的剂量依赖性。