Postoperative Analgesia for Stifle Surgery: A Comparison of Intra-articular Bupivacaine, Morphine, or Saline

A prospective study was undertaken to compare the analgesic effect of intra-articular bupivacaine, morphine, or saline in the 24-hour period following cranial cruciate ligament repair in dogs. Thirty-six clinical patients with ruptured cranial cruciate ligaments were randomly assigned to one of three groups. After surgical stabilization, and before skin closure, an intra-articular injection was given; group one (n = 12) received 0.5% bupivacaine HCl at 0.5 mL/kg, group two (n = 12) received morphine at 0.1 mg/kg diluted with saline to a volume of 0.5 mL/kg, and group three (n = 12) received saline at 0.5 mL/kg. Heart rate, respiratory rate, mean arterial blood pressure, cumulative pain score, visual analog pain score, and pain threshold test on both stifles were recorded preoperatively and at 0 to 6 and 24 hours postoperatively. Surgeons and pain scoring investigators were unaware of the intra-articular medication given. Supplemental analgesia, if needed, was provided in the postoperative period according to subjective assessment of patient discomfort. Postoperative pain scores were lowest in the bupivacaine group and highest in the saline group. Pain threshold, measured by applying calibrated loads to the knee, was higher postoperatively in the bupivacaine group than in the saline group. Dogs in the morphine and bupivacaine groups required less supplemental analgesia than dogs in the saline group. The local provision of analgesia reduces the need for systemic drugs with potential side effects. Both intra-articular morphine and intra-articular bupivacaine provided better postoperative analgesia than intra-articular saline, with intra-articular bupivacaine showing the greatest effect.     

Biomechanical Stability of Four Cranial Cruciate Ligament Repair Techniques in the Dog

Four commonly used cranial cruciate ligament (CCL) repair techniques were compared biomechanically in canine cadaver stifles by assessment of immediate postoperative laxity (cranial drawer) and stiffness. Each joint was tested nondestructively before repair, with the CCL intact and with the CCL excised. The cranio-caudal laxity after each repair was expressed as a percentage of the laxity in the same stifle after CCL excision. The stiffness of a repair was expressed as a percentage of the same intact joint's stiffness at an equivalent displacement. Repaired stifles were tested three consecutive times to the same maximum load (180 N) and the comparative laxity and stiffness in each test were determined. Fibular head transposition resulted in significantly increased stiffness, less laxity, and less decay per test than the other repairs. Lateral imbrication resulted in significantly less laxity on all tests, and significantly greater stiffness than the fascial strip or patellar tendon on the second and third tests to maximum load. The fascial strip resulted in significantly less laxity on all tests than the patellar tendon, but it was not significantly greater in stiffness. These data suggest that, of the reconstructive methods tested, fibular head transposition has biomechanically superior properties in the immediate postoperative period.     

COMPARATIVE STRUCTURAL ANALYSIS OF THE CANINE FEMORAL HEAD IN LEGG-CALVÉ-PERTHES DISEASE

The goal of this study was to examine the microarchitecture of the trabecular bone of the canine femoral head using microcomputed tomography (micro-CT) technology. Specifically, we assessed changes seen in the femoral head in dogs with Legg-Calvé-Perthes disease and compared this with changes seen in dogs with hip dysplasia and coxofemoral luxation. Femoral heads from healthy animals were examined as a control. In total, 38 femoral heads were studied. Rules for defining spherical volumes (region of interest) for determination of the structural parameters within the trabecular structure were established using micro-CT images. The following parameters were determined directly in three dimensions: bone volume fraction, surface volume fraction, trabecula thickness, trabecular count, trabecular spacing, and connectivity. Characteristic femoral head changes were found for each condition. An unexpected result was found that contradicts the prevailing understanding of Legg-Calvé-Perthes disease. Instead of observing a thickening of the bone trabeculae caused by layering of new bone matrix on top of necrotic trabeculae, we observed an increase in trabecular count and a smaller trabecular thickness. From this it may be concluded that trabecular regeneration is more prominent or prevails over the characteristically described layering processes in the revascularization and repair processes occurring in this illness.     

Evidence for aliphatic mixed mode coordination in copper(II)–fulvic acid complexes

A comparative approach based on ion–selective electrode measurements is presented for studying Cu(II) complexing by fulvic acids. Metal binding curves (% free metal vs pH) and complexation capacity curves (% free metal vs total metal at fixed pH) for copper(II) fulvic acid systems are compared with those for appropriate model ligands.
It is inferred that citrate, malonate and amino acid moieties could dominate complexing to Cu(II) at pH 3 to 7. The involvement of amino acid moieties is supported by fluorescence quenching and by anodic stripping voltammetry (ASV) studies. The proportion of ASV–non labile complexes is reported for Cu(II) and Pb(II) fulvic acid systems at pH 4.8.
A mixed mode of coordination is proposed, with the dominant binding sites varying with pH and metal:ligand ratio.     

Protonation reactions of fulvic acids

The protonation reactions of fulvic acids are described in terms of a model involving a mixture of n monoprotic acids HA, HB, HC … pH titration data were analysed by nonlinear least squares methods, using a model having n independent 'titration' (protonation) constants, K_i i= 1 to n , and n– 1 independent acid concentrations. The best fit was obtained with n =4. The results for three fulvic acid samples were in the range log K₁ 6.5–6.7 (∼8% of total carboxyl acidity), log K₂ 5.3–5.6 (∼15%), log K₃ 3.9–4.8 (∼20–30%) and log K₄ 2.6–2.7 (∼50–70%).
The results indicate a comparatively small proportion (∼ 10–20%) of polyprotic carboxyl moieties in the diverse fulvic acid structures. They give some support to the Wershaw model of fulvic acids as strongly associated aggregates of acids, each of comparatively low molecular weight.     

The Effects of Active Peripheral Skin Warming on Perioperative Hypothermia in Dogs

Objective — This study evaluates the efficacy of three perioperative warming protocols to improve control of body temperature in anesthetized dogs.
Study Design — A randomized controlled clinical trial.
Animals or Sample Population — Thirty-two client-owned dogs.
Methods — We prospectively studied dogs entering the University of Pennsylvania Veterinary Teaching Hospital for orthopedic or dental procedures and assigned them to one of three perianes-thetic warming protocols. Group 1 (n = 10) had a single circulating warm water mattress applied over the trunk (single-trunk warming). Group 2 (n = 12) had two circulating warm water mattresses, one placed over and one under the trunk (double-trunk warming). Group 3 (n = 10) had warm circulating mattresses applied only around the feet and legs of all available limbs (peripheral warming). The warm water mattresses were prewarmed and maintained at 40°C (104°F) and applied immediately after induction of general anesthesia. All dogs had a layer of thick terry cloth toweling beneath and above the trunk. Body temperature measurements were recorded every 15 minutes for the first 2.5 hours of anesthesia.
Results — The lowest mean temperature for dogs in group 3 was 37.4 ± 0.2°C (99.5°F), compared with 36.4 ± 0.2°C (97.4°F) and 36.7 ± 0.2°C (98.0°F) in groups 1 and 2, respectively.
Conclusions — Dogs in the peripheral warming group maintained significantly higher core body temperatures than dogs in either trunk warming groups throughout the 2.5-hour study period.
Clinical Relevance — To maintain body heat in dogs during anesthesia, it is more effective to warm the feet and legs than to warm the trunk.     

Acid pyrophosphate extraction of soil fulvic acids

A simple three step method is described for isolation of soil fulvic acids in high yield. The complexing agent H₂P₂O₇^2? (at pH 2) is used to release soil-bound fulvic acids. Extraction of humic acids is minimal. Selective separation of the protonated fulvic acids from the ionic extractant is achieved on a non-ionic polyacrylate resin (Amberlite XAD-7); after washing the resin, fulvic acids were retrieved in >98% yield by adjusting the pH to 6.5. Two problems associated with the classical alkali extraction method are avoided: possible alkaline oxidation of phenolic components, and their oxidation by Fe³⁺ under the acidic conditions employed to precipitate humic acids. The product typically has an ash weight of <0.6% after one XAD treatment. The method has been applied to three soils and one IHSS peat sample.