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Background: Strangulating small intestinal lesions in the horse have increased morbidity and mortality compared to nonstrangulating obstructions due to mucosal barrier disruption and subsequent endotoxaemia. Objectives: To investigate protective effects of dexmedetomidine on small intestinal ischaemia‐reperfusion injury in the horse. Study design: Randomised, controlled, experimental study. Methods: Eighteen systemically healthy horses were randomly assigned to three groups: control, preconditioning, and post‐conditioning. During isoflurane anaesthesia, complete ischaemia was induced in a 1‐m segment of jejunum for 90 minutes. Horses in the preconditioning and post‐conditioning groups received dexmedetomidine (3.5 µg/kg followed by 7 µg/kg/h) before (preconditioning) or after beginning ischaemia (post‐conditioning), and during reperfusion. Jejunal biopsies were collected before ischaemia (baseline‐1), at the end of the ischaemic period (ischaemia), and 30 minutes after reperfusion (reperfusion‐1). Additional biopsies were taken 24 hours after reperfusion from ischaemia‐reperfusion‐injured jejunum (reperfusion‐2). Epithelial injury was scored histologically, and morphometric analyses were used to calculate villus surface area (VSA) denuded of epithelium. Data were analysed using analysis of variance, Kruskal‐Wallis and Wilcoxon two‐sample tests. Results: In the control group, epithelial injury scores and percentage of VSA denudation for ischaemia‐reperfusion‐injured jejunum were higher compared to baseline‐1 at all time points. The ischaemia and both reperfusion samples from the pre‐ and post‐conditioning groups had lower epithelial injury scores and percentage of VSA epithelial denudation compared to the control group, with no difference from baseline‐1 at any time point for the preconditioning group. Main limitations: Preconditioning has limited application in the clinical setting with naturally occurring strangulating small intestinal lesions. Conclusions: Dexmedetomidine was protective for small intestinal ischaemia‐reperfusion injury in the horse when administered before or during ischaemia. [ABSTRACT FROM AUTHOR]

Background: Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on romifidine based sedation in horses during cheek tooth removal. Methods: Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of romifidine (0.01 mg/ kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. Results: Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if romifidine was administered in combination with ketamine compared to romifidine alone. Furthermore, horses of group RK needed less additional romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. Conclusion: Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/ kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of romifidine with either midazolam or ketamine improved sedation quality and surgical conditions. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study aimed to evaluate the applicability and repeatability of cold stimulation in dogs. ANIMALS: 10 healthy Beagle dogs were used in a blinded cross-over experiment. METHODS: Measurements were performed in triplicate at 4 skin locations. The probe was manually placed, and temperature decreased (32 to 10 °C) at different cooling rates (0.5, 1, and 5 °C second-1) and latency was measured (11 °C for 60 seconds). Stimulations were discontinued when avoidance reactions were detected. Thermal threshold or time-to-reaction were recorded. Experiments were performed 3 times per animal in weeks 1 (Exp1), 2 (Exp2), and 5 (Exp3). Feasibility of cold stimulation was scored (0-5). Data were analyzed with mixed logistic regression. RESULTS: No significant differences in number of avoidance reactions between cooling-rates were detected. Significantly more reactions (P < .001) were observed during Exp1 compared to Exp2 and Exp3. Thermal thresholds were 13 ± 2.6 °C, 17.7 ± 4 °C and 16.3 ± 4.6 °C for 5, 0.5 and 1 °C second-1, respectively. Latency to the reaction was determinable in 37% of measurements. The mean time-to-reaction was 13 ± 11 seconds. In 85% of measurements, a feasibility score of 0 (best feasibility) was assigned. CLINICAL RELEVANCE: The method is easily applicable and well tolerated, but habituation could not be excluded. Overall, the aversiveness of cold stimulation in healthy dogs is limited and it is not possible to recommend a specific protocol. In future studies, it needs to be determined if the aversiveness of cold stimulation is increased in diseased dogs. [ABSTRACT FROM AUTHOR]

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Background: Aim of the study was to compare the effect of neuroleptic sedation with acepromazine and neuroleptanalgesia with acepromazine and buprenorphine on thermal thresholds (TT) obtained at the nostrils and at the withers. The study was carried out as a randomized, blinded, controlled trial with cross-over design. Thermal thresholds were determined by incremental contact heat applied to the skin above the nostril (N) or the withers (W). Eleven horses were treated with saline (S), acepromazine (0.05 mg/kg) (ACE) or acepromazine and buprenorphine (0.0075 mg/kg) (AB) intravenously (IV). Single stimulations were performed 15 minutes prior and 15, 45, 75, 105, 165, 225, 285, 405 and 525 minutes after treatment. Sedation score, gastrointestinal auscultation score and occurrence of skin lesions were recorded. Data were analysed with analysis of variance for repeated measurements. Results: There were no significant differences in TT between N and W with all treatments. The TT remained constant after S and there was no difference in TT between S and ACE. After AB there was a significant increase above baseline in TT until 405 minutes after treatment. Restlessness occurred 30-90 minutes after AB in 7 horses. All horses had reduced to absent borborygmi after AB administration for 165 to 495 minutes. Conclusion: Thermal stimulation at both described body areas gives comparable results in the assessment of cutaneous anti-nociception in horses. There is no differential influence of neuroleptic sedation or neuroleptanalgesia on TTs obtained at N or W. Buprenorphine combined with acepromazine has a long lasting anti-nociceptive effect associated with the typical opioid induced side effects in horses. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate the performance of contact heat thermal stimulation in horses at different body sites and under different environmental conditions and different test situations. Five warm-blood horses were equipped with the thermal probe located on the skin of nostril (N), withers (W) or coronary band (C). Skin temperature and reaction temperature (thermal threshold) at each location were measured and percent thermal excursion (% TE = 100 " (threshold temperature - skin temperature)/(cut-out temperature - skin temperature) was calculated. Environmental conditions were changed in partial random order for all locations, so each horse was tested in its familiar box stall and stocks, in the morning and evening and at warm and cold ambient temperatures. Type of reaction to the stimulus and horse's general behaviour during stimulation were recorded. The stimulation sites were examined for the occurrence of possible skin lesions. Results: Skin temperatures were significantly different during warm and cold ambient temperatures at all three locations, but remained constant over repeated stimulation. An obvious response to stimulation before reaching cut-out temperature could be detected most frequently at N and W in boxes during warm ambient temperatures. The most frequent type of reaction to thermal stimulation at the nostril was headshaking (64.6%), skin twitching at the withers (82.9%) and hoof withdrawal at the coronary band (79.2%). Conclusion: The outcome of thermal threshold testing depended on ambient temperature, stimulation site and environment. Best results with the WTT2 in horses were obtained at the nostrils or withers in a familiar environment at warm ambient temperatures. [ABSTRACT FROM AUTHOR]

The diagnostic value of interictal short time electroencephalographic (EEG) recordings in epileptic dogs under general anaesthesia with propofol and the muscle relaxant rocuronium bromide was investigated. Two activation techniques, namely photic stimulation and hyperventilation, were evaluated for their potential to enhance the diagnostic validity of these recordings. Sixty-one dogs suffering from idiopathic epilepsy and 28 dogs suffering from symptomatic epilepsy were included. Electroencephalograms were recorded using five subdermal EEG electrodes (F3, F4, Cz, O1 and O2). All 89 EEGs were analysed visually and 61 were also evaluated quantitatively with fast Fourier transformation. Interictal paroxysmal epileptiform activity was found in 25% of idiopathic and in 29% of symptomatic epileptic dogs. Quantitative analysis of the EEGs (qEEGs) detected significant differences of frequency analysis in single reading points without any continuous changes of frequency bands. A comparison between healthy and affected brain hemispheres in seven dogs with focal lesions of one hemisphere did not show any significant differences in qEEG analysis, qEEG was not more sensitive than visual evaluation. Despite the use of activation techniques, the results showed that short time EEG recordings in epileptic dogs can detect interictal epileptic activity in less than one third of all seizuring dogs and is not a useful screening method. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the cardiopulmonary effects of dorsal recumbency and high-volume caudal epidural anaesthesia induced by xylazine or lidocaine in calves. Twenty-eight German Holstein-Friesian calves (57.7 ± 5.8 kg bodyweight) were randomly allocated to four equal (n = 7) groups for one of the following treatments, each injected into the caudal epidural space: (1) no treatment (control); (2) sterile saline (0.4 mL/kg); (3) lidocaine (2%), or (4) xylazine (0.1 mg/kg), with the latter two treatments diluted with sterile saline to a final volume of 0.4 mL/kg. Cardiac output was measured by thermodilution and cardiopulmonary function parameters were determined at preset time intervals over an observation period of 335 min. After baseline measurements in the standing animals, the calves received the epidural injection and were positioned in dorsal recumbency for 95 rain. In the control group, dorsal recumbency caused a significant (P < 0.05) decrease in cardiac index (el) (baseline 210 ± 12mL/kg/min, minimum value 174 ± 11 mL/kg/min), without significant change in blood-gas values. Calves treated with lidocaine or saline did not differ from the control group in any of the parameters measured. The epidural injection of xylazine caused a more pronounced decrease in Cl (baseline 209 ± 12 mL/kg/min, minimum value 127 ± 11 mL/kg/min), compared to the control group. At the same time, the heart rate was significantly (P < 0.05) decreased (baseline 113 ± 7 beats per min, minimum value 86 ± 4 beats per min). Furthermore, a significant (P < 0.05) increase in the oxygen extraction ratio was observed in the xylazine group (baseline 39 ± 7%, maximum value 47 ± 7%). In all groups, cardiorespiratory parameters remained within physiological limits. Changes in cardiopulmonary function induced by dorsal recumbency and high-volume caudal epidural anaesthesia with lidocaine or xylazine were well tolerated in healthy calves. [ABSTRACT FROM AUTHOR]

Objective To review the use and adverse effects of α2-agonists in sheep. Study design Literature review. Material and methods ‘Pubmed’ of the United States National Library of Medicine and ‘Veterinary Science’ of CAB International were searched for references relating sheep to α2-agonists. The bibliographies of retrieved articles were further scrutinized for pertinent references, and relevant articles were selected manually. Results Reports on the use of clonidine, xylazine, detomidine, romifidine, medetomidine and dexmedetomidine, MPV-2426 and ST-91 in sheep were found in the literature. Most of the studies described xylazine followed by medetomidine and clonidine. The literature on detomidine and romifidine in sheep was sparse. Reports included pharmacokinetic studies, evaluation of sedative, analgesic, and anaesthetic techniques with or without cardiovascular effects, and experimental investigations of adverse effects (mainly hypoxaemia) including the mechanisms of pulmonary oedema and impaired oxygenation after α2-agonist administration. Conclusions A2-agonists are potent and effective analgesics in sheep. In combination with ketamine, they are frequently used for the induction and maintenance of anaesthesia, in this case analgesia is satisfactory. The degree of hypoxaemia which occurs with all commercially available α2-agonists is highly variable and depends on individual or breed-related factors; the most severe reactions occur after intravenous (IV) injection and during general anaesthesia. Clinical relevance Subclinical respiratory disease is common in sheep. Rapid IV injection of α2-agonists without supplementary oxygen should be avoided whenever hypoxaemia may be critical. [ABSTRACT FROM AUTHOR]

Objective To compare the sedative, anaesthetic-sparing and arterial blood-gas effects of two medetomidine (MED) doses used as pre-anaesthetic medication in sheep undergoing experimental orthopaedic surgery. Study design Randomized, prospective, controlled experimental trial Animals Twenty-four adult, non-pregnant, female sheep of various breeds, weighing 53.9 ± 7.3 kg (mean ± SD). Methods All animals underwent experimental tibial osteotomy. Group 0 ( n = 8) received 0.9% NaCl, group L (low dose) ( n = 8) received 5 μg kg−1 MED and group H (high dose) ( n = 8) received 10 μg kg−1 MED by intramuscular (IM) injection 30 minutes before induction of anaesthesia with intravenous (IV) propofol 1% and maintenance with isoflurane delivered in oxygen. The propofol doses required for induction and endtidal isoflurane concentrations ( FE′ISO) required to maintain anaesthesia were recorded. Heart and respiratory rates and rectal temperature were determined before and 30 minutes after administration of the test substance. The degree of sedation before induction of anaesthesia was assessed using a numerical rating scale. Arterial blood pressure, heart rate, respiratory rate, FE′ISO, end-tidal CO2 (FE′CO2) and inspired O2 (FIO2) concentration were recorded every 10 minutes during anaesthesia. Arterial blood gas values were determined 10 minutes after induction of anaesthesia and every 30 minutes thereafter. Changes over time and differences between groups were examined by analysis of variance (anova) for repeated measures followed by Bonferroni-adjusted t-tests for effects over time. Results Both MED doses produced mild sedation. The dose of propofol for induction of anaesthesia decreased in a dose-dependent manner: mean (±SE) values for group 0 were 4.7 (±0.4) mg kg−1, for group L, 3.2 (±0.4) mg kg−1 and for group H, 2.3 (±0.3) mg kg−1). The mean (±SE) FE′ISO required to maintain anaesthesia was 30% lower in both MED groups [group L: 0.96 (±0.07) %; group H: 1.06 (±0.09) %] compared with control group values [(1.54 ± 0.17) %]. Heart rates were constantly higher in the control group with a tendency towards lower arterial blood pressures when compared with the MED groups. Respiratory rates and PaCO2 were similar in all groups while PaO2 increased during anaesthesia with no significant difference between groups. In group H, one animal developed a transient hypoxaemia: PaO2 was 7.4 kPa (55.7 mmHg) 40 minutes after induction of anaesthesia. Arterial pH values and bicarbonate concentrations were higher in the MED groups at all time points. Conclusion and clinical relevance Intramuscular MED doses of 5 and 10 μg kg−1 reduced the propofol and isoflurane requirements for induction and maintenance of anaesthesia respectively. Cardiovascular variables and blood gas measurements remained stable over the course of anaesthesia but hypoxaemia developed in one of 16 sheep receiving MED. [ABSTRACT FROM AUTHOR]

A peri-carinal tracheal laceration was produced in a 11-year-old cat during tracheal intubation. Before reconstructive surgery began, the leak was bypassed with an endobronchial tube positioned using endoscopy and direct vision. However, single-lung ventilation could not be sustained because the tube became dislodged and could not be repositioned. Consequently, surgery was completed with periods of intermittent apnoea interspersed with manually controlled hyperventilation. Cardiovascular variables were stable during anaesthesia and no signs of hypoxia were detected. The difficulties in maintaining endobronchial tube position resulted from the animal's small size relative to the dimensions of the endotracheal tube. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate the use of laser Doppler flowmetry and spectrophotometry (LDFS) for large intestinal viability assessment in horses with naturally occurring large intestinal strangulations. METHODS By use of LDFS, intestinal microperfusion was quantified as tissue oxygen saturation (tSo2), hemoglobin (tHB), and blood flow (tBF) in cases with large colon volvulus and small colon strangulations undergoing colic surgery (n = 17). Intestinal biopsies were taken from the pelvic flexure in all large colon cases and in small colon cases that underwent intraoperative euthanasia. Measurements were compared between survivors and nonsurvivors, and the correlation between LDFS and (immuno)histology was tested (P < .05). RESULTS The tSo2 and tBF were clearly lower and tHB was higher than previously reported in healthy horses. Following correction of the lesion, pelvic flexure tBF was significantly lower than that of the left ventral colon. Prior to correction of the lesion, microperfusion did not differ between survivors and nonsurvivors, but following release of the strangulation the survivors had a significantly higher tSo2 and tBF compared to the nonsurvivors. There was a negative correlation between tBF and interstitium-to-crypt ratio and a positive correlation between tHB and the histological hemorrhage score. There were no significant correlations between LDFS measurements and inflammatory cell counts or hypoxia-inducible factor-1α immunoreactivity. CONCLUSIONS Large intestinal microperfusion was decreased in nonsurvivors compared to survivors and was correlated with histological injury, suggesting that LDFS has the potential to predict tissue injury and postoperative survival. CLINICAL RELEVANCE The use of LDFS as an ancillary diagnostic aid may improve intraoperative viability assessment during colic surgery. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the histological injury and intestinal microperfusion measured by laser Doppler flowmetry and spectrophotometry (LDFS) of the small intestine orad to a strangulation during colic surgery. ANIMALS: Horses with naturally occurring small intestinal strangulations undergoing colic surgery were included. METHODS: In this prospective clinical trial, intestinal tissue oxygen saturation (tSO2) and tissue blood flow (tBF) were measured by LDFS orad to the strangulation following release of the strangulation (n = 18). The number of horses with postoperative reflux (POR) and the cases that survived until discharge were compared between groups using Fisher's exact test (P < .05). Intestinal biopsies were taken in cases that underwent intestinal resection or intraoperative euthanasia (n = 28). Measurements were compared between injured and noninjured segments with a Mann-Whitney U or t test. RESULTS: The tSO2 and tBF of the orad intestine were lower than previously reported in healthy horses. Horses with low tSO2 of < 35% were significantly more likely to suffer from POR (6/6 cases) compared to cases with tSO2 > 69% (1/6). The number of horses that survived were not statistically different between these groups (2/6 and 6/6). All horses with mucosal injury developed POR (6/6), which was significantly more likely compared to horses without mucosal injury (3/13). No significant difference in tSO2 or tBF could be found between the segments with and without histological injury. CLINICAL RELEVANCE: The results suggest that measuring tSO2 in the orad segment during colic surgery may aid in predicting postoperative issues. [ABSTRACT FROM AUTHOR]

Objective The aim of the study was to evaluate the influence of tramadol on acute nociception in dogs. Study design Experimental, blinded, randomized, crossover study. Animals Six healthy laboratory Beagle dogs. Methods Dogs received three treatments intravenously (IV): isotonic saline placebo (P), tramadol 1 mg kg-1 (T1) and tramadol 4 mg kg-1 (T4). Thermal thresholds were determined by ramped contact heat stimulation (0.6 °C second-1) at the lateral thoracic wall. Mechanical thresholds (MT) were measured using a probe containing three blunted pins which were constantly advanced over the radial bone, using a rate of force increase of 0.8 N second-1. Stimulation end points were defined responses (e.g. skin twitch, head turn, repositioning, vocalization) or pre-set cut-out values (55 °C, 20 N). Thresholds were determined before treatment and at predetermined time points up to 24 hours after treatment. At each measurement point, blood was collected for determination of O-desmethyltramadol concentrations. The degree of sedation and behavioural side effects were recorded. Data were analysed by one-way ANOVA and two-way ANOVA for repeated measurements. Results Thermal nociception was not influenced by drug treatment. Mechanical nociception was significantly increased between P and T1 at 120 and 240 minutes, and between P and T4 at 30, 60, 240 and 420 minutes. T1 and T4 did not differ. O-desmethyltramadol (M1) maximum plasma concentrations (Cmax) were 4.2 ± 0.8 ng mL-1 and 14.3 ± 2.8 ng mL-1 for T1 and T4, respectively. Times to reach maximum plasma concentrations (Tmax) were 27.6 ± 6.3 minutes for T1 and 32.1 ± 7.8 minutes for T4. No sedation occurred. There were signs of nausea and mild to moderate salivation in both groups. Conclusion and clinical relevance Tramadol was metabolized marginally to O-desmethyltramadol and failed to produce clinically relevant acute antinociception. Therefore, the use of tramadol for acute nociceptive pain is questionable in dogs. [ABSTRACT FROM AUTHOR]

Objective To compare alteration in intestinal blood flow in anaesthetized horses with changes in oral mucosa blood flow. Study design Prospective, randomized clinical study. Animals Eight warmblood horses. Methods After induction with guaifenesin and ketamine, anaesthesia was maintained with isoflurane at 1.5 vol% in oxygen. The tissue blood flow was measured using laser Doppler flowmetry at the jejunum, colon, rectal mucosa, oesophageal mucosa and the oral mucosa. After three baseline measurements, blood flow was first increased by dobutamine infusion and thereafter decreased by increasing isoflurane concentration and all measurements repeated twice. ANOVA was used for comparing the measured parameters to baseline and correlation between the different measurement localizations was examined using Pearson correlation (p < 0.05). Results Microperfusion at all measurement sites increased significantly during dobutamine infusion and decreased significantly during high isoflurane concentration. There was a significant correlation between flow at the oral mucosa and flow at the jejunum (r2 = 0.77, p = 0.002), colon (r2 = 0.76, p < 0.001), rectal mucosa (r2 = 0.88, p < 0.001) and oesophageal mucosa (r2 = 0.83, p <0.001). Conclusions and clinical relevance Oral mucosa blood flow can be used in isoflurane anaesthetized horses to reflect changes of intestinal microcirculation. [ABSTRACT FROM AUTHOR]

Objective To characterize a propofolemedetomidine- ketamine total intravenous anaesthetic in impala (Aepyceros melampus). Study design Prospective clinical study. Animals Ten adult female impala. Materials and methods Impala were immobilized at 1253 m above sea level with 2.0 mg thiafentanil and 2.2 mg medetomidine via projectile darts. Propofol was given to effect (0.5 mg kg-1 boluses) to allow endotracheal intubation, following which oxygen was supplemented at 2 L minute-1. Anaesthesia was maintained with a constant-rate infusion of medetomidine and ketamine at 5 mg kg-1 hour-1 and 1.5 mg kg-1 hour-1, respectively, and propofol to effect (initially 0.2 mg kg-1 minute-1) for 120 minutes. The propofol infusion was titrated according to reaction to nociceptive stimuli every 15 minutes. Cardiopulmonary parameters were monitored continuously and arterial blood gas samples were analysed intermittently. After 120 minutes' maintenance, the thiafentanil and medetomidine were antagonized using naltrexone (10:1 thiafentanil) and atipamezole (5:1 medetomidine), respectively. Results All impala were successfully immobilized. The median dose [interquartile range (IQR)] of propofol required for intubation was 2.7 (1.9-3.3) mg kg-1. The propofolemedetomidineeketamine combination abolished voluntary movement and ensured anaesthesia for the 120 minute period. Propofol titration showed a generally downward trend. Median (IQR) heart rate [57 (53-61) beats minute-1], respiratory rate [10 (9-12) breaths minute-1] and mean arterial blood pressure [101 (98e106) mmHg] were well maintained. Arterial blood gas analysis indicated hypoxaemia, hypercapnia and acidaemia. Butorphanol (0.12 mg kg-1) was an essential rescue drug to counteract thiafentanil-induced respiratory depression. All impala regurgitated frequently during the maintenance period. Recovery was calm and rapid in all animals. Median (IQR) time to standing from antagonist administration was 4.4 (3.2-5.6) minutes. Conclusions and clinical relevance A propofolemedetomidineeketamine combination could provide adequate anaesthesia for invasive procedures in impala. The propofol infusion should begin at 0.2 mg kg-1 minute-1 and be titrated to clinical effect. Oxygen supplementation and airway protection with a cuffed endotracheal tube are essential. [ABSTRACT FROM AUTHOR]

Objective To compare the effects of controlled mechanical ventilation (CMV) and constant positive end-expiratory pressure (PEEP) and interposed recruitment manoeuvres (RMs) with those of CMV without PEEP on gas exchange during general anaesthesia and the early recovery period. Study design Prospective, randomized clinical trial. Animals A total of 48 Warmblood horses undergoing elective surgery in lateral (Lat) (n = 24) or dorsal (Dors) (n = 24) recumbency. Methods Premedication (romifidine), induction (diazepam and ketamine) and maintenance (isoflurane in oxygen) were identical in all horses. Groups Lat- CMV and Dors-CMV (each n = 12) were ventilated using CMV. Groups Lat-RM and Dors-RM(each n = 12) were ventilated using CMV with constant PEEP (10 cmH2O) and intermittent RMs (three consecutive breathswith peak inspiratory pressure of 60 cmH2O, 80 cmH2O and 60 cmH2O, respectively). RMs were applied as required to maintain PaO2 at > 400 mmHg (> 53.3 kPa). Dobutamine was given to maintain mean arterial blood pressure at > 60 mmHg. Physiological parameters were recorded every 10 minutes. Arterial blood gases were measured intra- and postoperatively. Statistical analyses were conducted using analyses of variance (ANOVA), t tests and the ManneWhitney U-test. Results Horses in Dors-RM had higher PaO2 values [478 ± 35 mmHg (63.7 ± 4.6 kPa)] than horses in Dors-CMV [324 ± 45 mmHg (43.2 ± 6 kPa)] during anaesthesia and the early recovery period. There were no differences between horses in groups Lat-CMV and Lat-RM. Other measured parameters did not differ between groups. Conclusions and clinical relevance Ventilation with CMV, constant PEEP and interposed RM provided improved arterial oxygenation in horses in dorsal recumbency that lasted into the early recovery period, but had no benefit in horses in lateral recumbency. This mode of ventilation may provide a clinically practicable method of improving oxygenation in anaesthetized horses, especially in dorsal recumbency. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of levomethadone/fenpipramide and metamizole alone and in combination on acute nociception., Methods: 8 healthy, adult Beagles were used in 2 separate randomized, complete crossover, experimental trials (threshold testing and determination of minimal alveolar concentration [MAC]) with masked observers. In both trials, treatments were 0.2 mg·kg-1 levomethadone/fenpipramide (L), 75 mg·kg-1 metamizole (M), or their combination (LM). In conscious dogs, mechanical thresholds were determined using constantly rising force. Thermal thresholds were measured via ramped contact heat. The MAC of sevoflurane was determined using the bracketing method with electrical stimulus (50 V, 50 Hz, 10 ms) before and 1 and 4 hours after treatment., Results: Mechanical thresholds in L and LM were significantly increased above baseline (BL) for 165 minutes and above M for 135 minutes. Percent thermal threshold excursion significantly increased above BL in L for 75 minutes and in LM for 135 minutes. In L and LM, the percent thermal threshold excursion was significantly higher than in M from 15 to 75 or 135 minutes, respectively. In L and LM, the MAC of sevoflurane was significantly reduced at 1 hour compared to BL and M., Conclusion: Duration but not the magnitude of thermal antinociception of levomethadone/fenpipramide was increased by metamizole. Mechanical antinociception in awake dogs and anesthetic-sparing effects of levomethadone/fenpipramide were not altered., Clinical Relevance: Coadministration of levomethadone/fenpipramide and metamizole to increase antinociception is not justified.

Objective: Comparison of ultrasound-guided femoral and sciatic nerve block versus epidural anaesthesia with bupivacaine and morphine for orthopaedic surgery of the pelvic limb in dogs with respect to analgesic effectiveness, clinical utility and side effects., Material and Methods: The study included 22 dogs (American Society of Anesthesiologists, ASA grades I and II) undergoing orthopaedic surgery distal to the mid-femoral bone. The study was designed as a randomized, prospective, blinded clinical trial. All dogs were randomly assigned to receive 0.5 mg/kg bupivacaine (0.5%) and 0.1 mg/kg morphine sulphate (1%) either as epidural anaesthesia (group EPI) or by ultrasound-guided femoral and sciatic nerve block (group LA). During surgery, the heart rate, respiratory rate, mean arterial pressure (MAP), end-tidal isoflurane concentrations and dose of rescue analgesia (fentanyl boluses of 5 µg/kg i. v.) were measured. Pain severity was scored (short form of the Glasgow Composite Measure Pain Scale, GCMPS) before surgery and postoperatively at 2, 4, 6, 12 and 24 hours after extubation. Post-operative rescue analgesia consisted of methadone (0.2 mg/kg i. v.), and was applied when the GCMPS > 6. For statistical analysis, the Chi-square, Fisher, and Wilcoxon tests and one- and two-way ANOVA were applied. Differences were considered statistically significant at p < 0.05., Results: Only the MAP was significantly different between the two treatment groups. Intra- and postoperative MAP of group LA (111.2 ± 11.2 mmHg and 119.3 ± 18.2 mmHg, respectively) was higher than in group EPI (86.6 ± 8.7 mmHg and 95.2 ± 13.1 mmHg, respectively). None of the dogs developed urinary retention or ambulatory deficits when completely recovered from anaesthesia. No other side effects were noted., Clinical Relevance: In conclusion, femoral and sciatic nerve blocks and epidural anaesthesia ensure comparable analgesic effects in canine patients undergoing orthopaedic surgery of the pelvic limb. The lower mean arterial blood pressure of group EPI was not of clinical relevance.

Objective: To determine the acute anti-nociceptive and the minimal alveolar concentration (MAC) sparing effects of metamizole sodiummonohydrate (dipyrone) in dogs for possible perioperative analgesia., Study Design: Two groups of seven adult dogs were used in two separate randomised, blinded, controlled, cross-over studies. In each study, each dog received metamizole 50 mg kg(-1) intravenously (IV) and placebo (saline 0.9%) IV., Methods: Sevoflurane MAC was determined using the bracketing technique and electrical stimulation (50 V, 50 Hz, 10 milliseconds) at a thoracic limb, before treatment and 1 and 4 hours post treatment. In conscious dogs, thermal thresholds were determined by ramped contact heat at the thoracic wall. Mechanical thresholds (MTs) were measured by constantly rising force pressing against the radial bone. Thresholds were determined pre and 45, 75, 105, 135, 165, 195, 225, 255, 285, 315, 345, 375, 435, 495, 555, 615, 675, 735 minutes and 24 hours post treatment. Parametric data were analyzed by analysis of variance for repeated measurements and paired t-tests. Friedman test was used for nonparametric data. Level of significance was set to <5%., Results: Metamizole did not change MAC of sevoflurane significantly compared to baseline values [mean ± SD Vol%; 2.7 ± 0.5 (BL); 2.8 ± 0.6 (1 hour); 2.8 ± 0.4 (4 hours)] and placebo [2.8 ± 0.5 (BL); 2.9 ± 0.5 (1 hour); 2.9 ± 0.4 (4 hour)]. Metamizole caused a significant rise in % TE up to 105 minutes (66.5 ± 12.1%) and in MT up to 75 minutes (12.7 ± 5.0 N) compared to baseline (55 ± 10%; 7.9 ± 1.8 N). There were no significant differences between treatments., Conclusion and Clinical Relevance: Metamizole did not induce an anaesthetic sparing effect. In awake dogs metamizole induced only mild and short cutaneous anti-nociception. Metamizole as the sole analgesic drug in the perioperative periode is not recommended., (© 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.)

Objective: Previous studies showed an influence of xylazine on the LiDCO sensor in vitro and in standing horses, but did not prove that this interaction caused error in LiDCO measurements. Therefore, agreement of cardiac output (CO) measurements by LiDCO and bolus-thermodilution (BTD) was determined in horses receiving xylazine infusions., Study Design: Prospective, experimental study., Animals: Eight Warmblood horses., Methods: All horses were premedicated with xylazine. Anaesthesia was induced with midazolam and ketamine and was maintained with isoflurane in oxygen. During six hours of anaesthesia CO measurements and blood samples were taken before, during and after a 60 minute period of xylazine infusion. Pairs of LiDCO and bolus thermo-dilution (BTD) measurements of CO were performed. Sensor voltages exposed to blood and saline were measured before, during and after xylazine infusion and compared using Bland-Altman method of agreement with corrections for repeated measures., Results: The CO values (mean ± SD) before xylazine were 34.8 ± 7.3 and 36.4 ± 8.1 L minute(-1) for BTD and LiDCO, respectively. After starting the xylazine infusion, the CO values for BTD decreased to 27.5 ± 6.1 L minute(-1) whereas CO values measured by LiDCO increased to 54.7 ± 18.4 L minute(-1) . One hour after discontinuing xylazine infusion, CO values were 33 ± 6.7 and 36.5 ±11.9 L minute(-1) for BTD and LiDCO, respectively. The difference between saline and blood exposed sensor voltages decreased during xylazine infusion and these differences were positive numbers before but negative during the infusion. There were correlations between xylazine plasma concentrations, CO differences and sensor voltage differences (saline - blood)., Conclusions and Clinical Relevance: This study proved that xylazine infusion caused concentration dependent bias in LiDCO measurements leading to an overestimation of readings. Sensor voltage differences (saline - blood) may become valuable clinical tool to predict drug-sensor interactions., (© 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.)

Objective: To assess the effect of adjunctive gabapentin (GBP) on pain after thoracolumbar intervertebral disc surgery in dogs., Study Design: Prospective, randomized, controlled, clinical, 'blinded' trial., Animals: Sixty-three client owned dogs undergoing hemilaminectomy, Methods: Dogs were assigned to two treatment groups. The GBP group received gabapentin 10 mg kg(-1) orally every 12 hours starting before anaesthesia; the placebo (P) group received empty gelatin capsules. Background analgesia was initiated with intravenous levomethadone 0.6 mg kg(-1) (as the combination 'L-Polamivet) at anaesthesia induction, followed by a fentanyl patch and levomethadone 0.2 mg kg(-1) subcutaneously every 8 hours for 24 hours. Pain was assessed by the short form of the Glasgow Composite Measure Pain Score (CMPS-SF) without the gait category, and by a Visual Analogue Scale (VAS). Serum GBP concentrations and cortisol concentrations were measured. Statistical analyses utilized chi square test, Kolmogorov-Smirnov test, two-way analysis of variances for repeated measurements, Wilcoxon test and Friedmann test as relevant. Correlations were tested by Spearman's and Pearson's correlation coefficient. p < 0.05 was considered significant., Results: Median CMPS-SF was lower in group GBP than in group P on days 0.5, 1, 4 and 5. However, CMPS-SF and VAS were not significantly different between groups. Both pain scores decreased significantly over time. Cortisol concentrations were not significantly different between groups. Minimum serum concentrations of GBP fell below the detection limit of 1 μg mL(-1) in 6 of 29 and 7 of 28 dogs at 24 and 72 hours, respectively., Conclusions and Clinical Relevance: 10 mg kg(-1) GBP orally twice a day did not result in a detectable reduction in pain behaviour compared to background opioid analgesia alone, although a trend to lower pain levels (p < 0.1) was present. Further studies are needed to determine if this is related to effective background analgesia or an ineffective dose of GBP., (© 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)

Objective: To determine the cardiovascular effects of a proprietary l-methadone/fenpipramide combination (Polamivet) alone and in addition to acepromazine in dogs., Study Design: Prospective, randomized, experimental crossover study., Animals: Five adult healthy Beagle dogs (one male and four females, weighing 12.8-16.4 kg)., Methods: Dogs were instrumented for haemodynamic measurements whilst anaesthetized with isoflurane. Three hours after recovery dogs received 0.025 mg kg(-1) acepromazine (AP) or saline (SP) IM followed by 0.5 mg kg(-1) L-methadone/ 0.025 mg kg(-1) fenpipramide IV after 30 minutes. Cardiac output using thermodilution, heart rate, mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary artery occlusion pressure (PAOP), haemoglobin concentration, arterial and mixed-venous blood gas analysis were measured and sedation evaluated at baseline (BL), 30 minutes after acepromazine or saline IM (A/S), 5 minutes after L-methadone/fenpipramide IV application (35), every 15 minutes for 1 hour (50, 65, 80, 95 minutes) and every hour until baseline cardiac output was regained. Standard cardiovascular parameters were calculated. Data were analyzed by repeated measures anova and paired t-tests with p < 0.05 considered significant., Results: Baseline measurements did not differ. Cardiac index decreased after acepromazine administration in treatment AP (p = 0.027), but was not significantly influenced after l-methadone/fenpipramide injection in either treatment. In both treatments heart rate did not change significantly over time. Stroke volume index increased after A/S in both treatments (p = 0.049). Systemic vascular resistance index, MAP, CVP, MPAP, and pulmonary vascular resistance index did not change significantly after either treatment and did not differ between treatments. Dogs were deeply sedated in both treatments with a longer duration in treatment AP., Conclusions and Clinical Relevance: In healthy dogs the dose of l-methadone/fenpipramide used in this study alone and in combination with acepromazine induced deep sedation without significant cardiovascular changes., (© 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)

Objective: To compare three anaesthetic protocols for umbilical surgery in calves regarding adequacy of analgesia, and cardiopulmonary and hormonal responses., Study Design: Prospective, randomised experimental study., Animals: Thirty healthy German Holstein calves (7 female, 23 male) aged 45.9 ± 6.4 days., Methods: All calves underwent umbilical surgery in dorsal recumbency. The anaesthetic protocols were as follows: group INH (n = 10), induction 0.1 mg kg(-1) xylazine IM and 2.0 mg kg(-1) ketamine IV, maintenance isoflurane in oxygen; Group INJ (n = 10), induction 0.2 mg kg(-1) xylazine IM and 5.0 mg kg(-1) ketamine IV, maintenance 2.5 mg kg(-1) ketamine IV every 15 minutes or as required; group EPI (n = 10), high volume caudal epidural anaesthesia with 0.2 mg kg(-1) xylazine diluted to 0.6 mL kg(-1) with procaine 2%. All calves received peri-umbilical infiltration of procaine and pre-operative IV flunixin (2.2 mg kg(-1) ). Cardiopulmonary variables were measured at preset intervals for up to 2 hours after surgery. The endocrine stress response was determined. Intra-operative nociception was assessed using a VAS scale. Data were compared between groups using appropriate statistical tests. A value of p < 0.05 was considered significant., Results: All three protocols provided adequate anaesthesia for surgery although, as judged by the VAS scale, intra-operative response was greatest with INJ. Lowest mean cortisol levels during surgery occurred in EPI. Heart rate and cardiac output did not differ between groups, but mean arterial blood pressure, systemic vascular resistance, and partial pressure of carbon dioxide were higher and arterial pH lower in groups INH and INJ than in Group EPI. Group INJ became hypoxaemic and had a significantly greater vascular shunt than did the other groups., Conclusion and Clinical Relevance: Groups INH and EPI both proved acceptable protocols for calves undergoing umbilical surgery, whilst INJ resulted in variable anti-nociception and in hypoxaemia. High volume caudal epidural anaesthesia provides a practical inexpensive method of anaesthesia for umbilical surgery., (© 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)