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Objective: To evaluate the clinical benefit and adverse events following outpatient intravenous (IV) ketamine-lidocaine (KL) infusions for palliation of cancer pain in dogs and cats., Methods: Medical records from 15 years (2008 to 2023) were searched and data reviewed retrospectively. Animals were prescribed ketamine (0.15 mg/kg/h) and lidocaine (3 mg/kg/h in dogs and 1.5 mg/kg/h in cats) diluted in 250 mL (cats or dogs < 15 kg) or 500 mL (dogs ≥ 15 kg) of 0.9% saline administered IV at 2.5 mL/kg/h for 4 to 6 hours., Results: A total of 105 dogs and 9 cats (114 animals) were included. The most common tumor types treated were appendicular osteosarcoma in dogs (n = 45 [43%]) and oral squamous cell carcinoma in cats (4 [44%]). All animals received concomitant oral analgesic medications. Animals received a median of 2 KL infusions (range, 2 to 49 KL infusions). The overall clinical benefit rate was 76% following the first KL infusion, as defined by an improvement in at least 1 evaluated clinical sign. The likelihood of clinical response was improved with a ketamine infusion rate ≥ 2 µg/kg/min, total ketamine dose of ≥ 0.5 mg/kg, and lidocaine infusion rate ≥ 25 µg/kg/min., Conclusions: Outpatient IV KL infusions were well-tolerated in dogs and cats with cancer and provided a high rate of clinical benefit when combined with standard anti-cancer and analgesic therapies., Clinical Relevance: Management of cancer pain often requires multimodal analgesia. Given the clinical benefit and minimal toxicity observed with outpatient KL infusions, KL infusions should be considered as an adjunctive treatment to use in combination with anticancer therapy, oral and topical analgesics, and interventional therapies in dogs and cats for palliation of refractory cancer pain from advanced disease.

Objective: To test whether the use of low-dose epidural anesthesia (EA) in goats undergoing lower urinary tract surgery reduces the requirements of perioperative analgesics, contributes to intraoperative hypotension, and improves postoperative comfort during the first 24 hours after surgery., Animals: Retrospective analysis of 38 goats between January 2019 and July 2022., Procedures: Goats were divided into 2 groups (EA or no EA). Demographic characteristics, surgical procedure, time of anesthesia, and anesthetic agents used were compared between treatment groups. Outcome variables potentially related to the use of EA included dose of inhalational anesthetics, incidence of hypotension (mean arterial pressure < 60 mm Hg), intraoperative and postoperative administration of morphine, and time to first meal after surgery., Results: EA (n = 21) consisted of bupivacaine or ropivacaine 0.1% to 0.2% with an opioid. There were no differences between groups except for age (EA group was younger). Less inhalational anesthetic (P = .03) and less intraoperative morphine (P = .008) were used in the EA group. The incidence of hypotension was 52% for EA and 58% for no EA (P = .691). Administration of postoperative morphine was not different between groups (EA, 67%, and no EA, 53%; P = .686). Time to first meal was 7.5 hours (3 to 18 hours) for EA and 11 hours (2 to 24 hours) for no EA (P = .057)., Clinical Relevance: Low-dose EA reduced the use of intraoperative anesthetics/analgesics in goats undergoing lower urinary tract surgery without an increased incidence of hypotension. Postoperative morphine administration was not reduced.

Objective: To evaluate the duration and analgesic quality of bupivacaine mixed with dexmedetomidine (BUP-DEX) or bupivacaine liposome suspension (BLS) administered as a transverse abdominis plane (TAP) block, compared with a negative control (no TAP block; CTRL) in dogs., Animals: 26 mixed-breed shelter dogs undergoing elective ovariohysterectomy between January 28 and December 8, 2020., Procedures: Each dog was randomly assigned to receive either an ultrasound-guided TAP block with either BUP-DEX or BLS or to receive no TAP block at time 0 after induction of general anesthesia. Superficial and abdominal wall pain scores were evaluated before time 0 and at 4, 6, 12, 24, 48, 72, and 96 hours later. Additionally, sedation scores and time to return of various behaviors, such as eating or drinking, were compared., Results: The CTRL group had significantly greater pain scores than the BUP-DEX and BLS groups, but no differences were found between the BUP-DEX and BLS groups. Postoperatively, significantly more dogs needed rescue analgesia and the time to need it was shorter for the CTRL group, compared with the BUP-DEX or BLS groups. Additionally, the CTRL group had greater sedation scores than the other 2 groups. No significant differences were observed in any of the evaluated outcome variables such as eating or drinking., Clinical Relevance: A TAP block appeared to provide adequate postoperative analgesia for abdominal surgery in the dogs of the present study undergoing elective ovariohysterectomy. The BLS TAP block did not appear to provide any extra benefit beyond what BUP-DEX TAP block added under these specific conditions.

Objective: To compare the thermoregulatory and analgesic effects of high-dose buprenorphine versus morphine in cats undergoing ovariohysterectomy., Animals: 94 client-owned cats., Procedures: Cats were randomized to receive either buprenorphine 0.24 mg/kg or morphine 0.1 mg/kg subcutaneously (SC) during recovery from ovariohysterectomy. Body temperature measurements were obtained before anesthesia, during anesthesia (averaged), at extubation, and 2, 4, and 16 to 20 hours postoperatively. Signs of pain were assessed, and demographic characteristics were compared between groups. The effects of treatment and time on body temperature, point prevalence of hyperthermia (> 39.2 °C), and pain scores were compared with linear or generalized mixed-effect models., Results: Cats receiving morphine (vs. buprenorphine) were older and heavier (both, P ≤ 0.005). Other group characteristics did not differ between treatments. Cats receiving buprenorphine (vs. morphine) had higher postoperative temperatures (P = 0.03). At 2, 4, and 16 to 20 hours after extubation, the point prevalence of hyperthermia was greater (P = 0.001) for cats receiving buprenorphine (55% [26/47], 44% [21/47], and 62% [27/43], respectively) versus morphine (28% [13/46], 13% [6/46], and 47% [21/44], respectively). There were no differences in pain scores between groups or over time. Five cats receiving buprenorphine and 6 receiving morphine required rescue analgesia within the 24-hour period., Clinical Relevance: Administration of buprenorphine (0.24 mg/kg SC), compared with morphine (0.1 mg/kg SC), resulted in higher body temperatures without an apparent advantage with regard to analgesia during the first 20 postoperative hours than morphine. Opioid-induced postoperative hyperthermia could confound the diagnosis of fever from different sources.

OBJECTIVE To evaluate the effects of maropitant in cats receiving dexmedetomidine and morphine. DESIGN Randomized controlled trial. ANIMALS 66 healthy female domestic shorthair cats. PROCEDURES Cats were randomly assigned to receive maropitant (1 mg/kg [0.45 mg/lb], SC; maropitant group; n = 32) or saline (0.9% NaCl) solution (0.1 mL/kg [0.045 mL/lb], SC; control group; 34) 20 hours before IM administration of dexmedetomidine (20 μg/kg [9.1 μg/lb]) and morphine (0.1 mg/kg). Following administration of dexmedetomidine and morphine, the incidences of emesis, retching, and signs of nausea (sialorrhea and lip licking) were compared between the 2 groups. The aversive behavioral response of each cat to injection of maropitant or saline solution was scored on a visual analogue scale by each of 4 observers who were unaware of the treatment administered. RESULTS Only 1 of 32 cats in the maropitant group vomited, whereas 20 of 34 control cats vomited. The incidences of emesis and retching for the maropitant group were significantly lower than those for the control group. The incidence of signs of nausea did not differ between the 2 groups. Visual analogue scale scores for the maropitant group were significantly higher than those for the control group. CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study indicated that administration of maropitant to healthy cats approximately 20 hours prior to administration of dexmedetomidine and morphine significantly decreased the incidence of emesis but did not decrease the incidence of signs of nausea. However, maropitant appeared to cause substantial discomfort when injected SC.

Objective: To evaluate the righting reflex after topical application of a sevoflurane jelly in cane toads (Bufo marinus)., Animals: 8 cane toads., Procedures: Toads were 6 to 8 months of age and weighed (mean ± SD) 142.0 ± 25.2 g. Sevoflurane jelly was applied to the dorsum of each toad at a dose of 25 μL/g in trial 1 and 37.5 μL/g in trial 2. Toads were placed in dorsal recumbency every 30 seconds until loss of the righting reflex. Jelly was then removed by rinsing the toads with tap water. Toads were then left undisturbed in dorsal recumbency until return of the righting reflex. Chamber sevoflurane concentration was measured to determine vaporization., Results: 6 of 8 toads in trial 1 and 8 of 8 toads in trial 2 lost the righting reflex. Mean ± SD time to loss of the reflex was 8.2 ± 1.3 minutes for trial 1 and 8.3 ± 0.9 minutes for trial 2; this difference was not significant. Mean ± SD time to return of the reflex was 25.6 ± 26.2 minutes for trial 1 and 84.4 ± 47.2 minutes for trial 2; this difference was significant. Chamber sevoflurane concentration did not change significantly, compared with baseline (time 0) concentration, at any time in trial 1; however, there was a significant change in chamber sevoflurane concentration from baseline (time 0) concentration in trial 2. Chamber sevoflurane concentrations were not significantly different between trial 1 and trial 2 at any time. Mean ± SD chamber sevoflurane concentration was 0.46 ± 0.2% for trial 1 and 0.57 ± 0.28% for trial 2., Conclusions and Clinical Relevance: Sevoflurane jelly applied topically at a dose of 37.5 μL/g induced a more reliable loss of righting reflex and longer recovery time than when applied at a dose of 25 μL/g in cane toads.