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We hypothesized that veterinarians and veterinary students may lack key knowledge about pulse oximetry, which may result in this type of patient monitor not being used on appropriate patient populations or to its full capabilities. A questionnaire was developed to assess an individual's knowledge and understanding of pulse oximetry. Residents and specialists in anesthesiology and critical care at several academic institutions were surveyed first to assess the questionnaire for clarity and to serve as a control group. General veterinary practitioners (GPs) attending continuing education courses at the University of Georgia were surveyed over a 24-month period. Students entering their senior year anesthesiology rotation at the University of Georgia were also surveyed. Residents and specialists (69% correct responses) scored significantly higher than senior students (46%), who scored significantly higher than GPs (34%). Only 15% of GPs and 21% of senior students reported that they had received training in pulse oximetry in school. Those who had received training scored significantly higher than those who did not. Many GPs did not report using a pulse oximeter on their critical patients under anesthesia, a group that would be expected to benefit from its use. Veterinarians have a poor understanding about how pulse oximetry works, the information provided by pulse oximetry, and how to best apply it to their patients. Furthermore, the respondents did not use pulse oximeters in a manner that would derive the most information and result in the greatest benefit to the patient relative to the cost of the instrument. Didactic training in veterinary curricula and during continuing education opportunities continues to be necessary in order to produce veterinarians, who have an understanding of the technologies available that can be used to improve patient care. [ABSTRACT FROM AUTHOR]

Caudal epidural anesthesia is useful when anesthesia of the lumbar and sacral dermatomes is needed. Its success relies on the proper placement of the needle in the epidural space. However, accurate positioning of the needle can be difficult in certain patients (i.e.obesity). The purpose of this preliminary study was to document the use of nerve stimulation as a means of confirming accurate needle positioning in the epidural space prior to drug administration. Twenty large breed dogs undergoing hindlimb or perineal surgery were enrolled. Following induction of general anesthesia, patients were prepared for routine epidural drug administration. A 17 ga, 3.5” shielded Tuohy needle was used and was connected to a peripheral nerve stimulator set to deliver a current at 1 Hz, with a pulse width of 0.2 m sec. Initial current was set at 1.2 mA as the needle was advanced into position. Confirmation of epidural needle placement was confirmed when twitches were observed in the hindlimbs and/or tail. Current setting was then decreased incrementally by 0.2 mA until no further twitches were observed. Success of epidural drug placement was confirmed subjectively by motor blockade to the blocked dermatomes and clinical signs of balanced anesthesia (lack of sympathetic response to surgical stimulation while maintained at light plane of anesthesia). Lowest mean (range) current to elicit hindlimb twitches was 0.72 mA (0.4–1.0 mA). Lowest mean (range) current to elicit tail twitches was 0.58 mA (0.4–1.0 mA). Tail twitches were reliably lost at mean current of 0.37 mA (0.2–0.8). Epidural anesthesia was considered to be successful in 19/20 dogs. In only 9/20 dogs, needle placement would have been correct based on using ‘classic’ indicators alone (‘pop’ as enter epidural space, loss of resistance to injection). The results of this study suggest that nerve stimulation may be useful in confirming correct epidural needle placement prior to drug administration. [ABSTRACT FROM AUTHOR]

Ketamine has been implicated as causing increases in intraocular pressure. The purpose of this study is to document the effects of ketamine, diazepam, and their combination on intraocular pressure (IOP) in normal, unpremedicated dogs. Random-source dogs were assigned to one of five groups of 10 dogs each: ketamine 5 mg kg–1 (KET5), ketamine 10 mg kg–1 (KET10), diazepam 0.5 mg kg–1 (VAL), ketamine 10 mg kg–1 with diazepam 0.5 mg kg–1 (KETVAL), saline 0.1 mL kg–1 (SAL), all given intravenously. A baseline IOP was measured before injection, immediately after injection, and at 5, 10, 15, and 20 minutes following injection. IOP was increased over baseline immediately after injection in the KET5, KET10, and KETVAL groups; at 5, 10, and 15 minutes in the KET5 group; and at 20 minutes in the KETVAL group. The mean IOP change compared to SAL increased immediately after injection and at 5 minutes in the KET5, KET10, and KETVAL groups; at 10 and 15 minutes in the KET5 group, and at 20 minutes in the KETVAL group. The mean IOP increased up to 5.7, 3.2, and 3.1 mm Hg over mean baseline in the KET5, KET10, and KETVAL groups, respectively. All dogs in the KET5 group and the majority in the KETVAL and KET10 groups had an increase in their IOP over baseline. Ketamine caused a clinically and statistically significant elevation in IOP over baseline and compared to SAL. The concurrent addition of diazepam did not blunt this increase. Ketamine should be avoided in dogs with corneal trauma, glaucoma, or in those undergoing intraocular surgery. [ABSTRACT FROM AUTHOR]