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Rodríguez-Trujillo R, Batista-Arteaga M, Iusupova K, Rosario-Medina I, Alamo-Santana D. Comparison of Propofol and Alfaxalone as Anesthesic Drugs in Bitches Undergoing Ovariohysterectomies (Healthy Bitches and with Pyometra) and Cesarean Sections. Animals (Basel) 2024; 14:1343. [PMID: 38731346 PMCID: PMC11083245 DOI: 10.3390/ani14091343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
This study evaluated the efficacy and safety of two anesthetic agents, alfaxalone and propofol, on maternal physiological parameters (heart and respiratory rates, blood pressure, and temperature) on either ovariohysterectomies or cesarean sections in bitches. A total of 34 healthy and pyometra-affected females (classified as ASA II), were induced with IV propofol (4 mg/kg), while 35 females, both healthy and pyometra affected, were induced with IV alfaxalone (1 mg/kg). For cesarean sections, females (ASA II) were induced with propofol (n = 14) or alfaxalone (n = 14). Additionally, the neonatal viability and modified Apgar score were recorded at 5, 60, and 120 min post-delivery. There were no significant differences in the physiological parameters when comparing the use of propofol and alfaxalone in bitches undergoing ovariohysterectomies, regardless of their health status, nor when comparing cesarean sections. It was observed that bitches induced with propofol occasionally required an additional dose for maintenance of the anesthesia. Neonatal mortality rates were similar for both groups; however, alfaxalone was associated with higher neonatal viability as indicated by the Apgar scores. The findings suggest that both anesthetic protocols are effective and safe for use in canine reproductive surgeries, with no major differences in basic physiological parameters' alteration or neonatal outcomes between the two agents.
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Affiliation(s)
| | - Miguel Batista-Arteaga
- Unit of Reproduction, Universitary Institute of Biomedical Research and Health, University of Las Palmas de Gran Canaria, Transmontaña s/n, 35413 Arucas, Las Palmas, Spain; (R.R.-T.); (K.I.); (I.R.-M.); (D.A.-S.)
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Srithunyarat T, Jitpean S, Wipoosak P, Nonthakotr C, Boonbal N, Kunkitti P, Seesupa S. Apgar scores in puppies following the induction of etomidate compared with alfaxalone or propofol for cesarean section. Vet World 2024; 17:527-534. [PMID: 38680154 PMCID: PMC11045537 DOI: 10.14202/vetworld.2024.527-534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/07/2024] [Indexed: 05/01/2024] Open
Abstract
Background and Aim The Apgar score is a useful assessment of neonatal viability in dogs. The Apgar score in puppies born by cesarean section can be lower than vaginal delivery because all anesthetic drugs can cross the placenta. Therefore, anesthetic drugs with minimal cardiorespiratory effect and rapid elimination are recommended for cesarean section. The present study aimed to compare Apgar scores in puppies born after the induction of etomidate, alfaxalone or propofol, and those maintained with isoflurane inhalation during cesarean section. Materials and Methods Thirty-six bitches were equally divided in the three anesthetic drug groups. Modified Apgar scores were assessed at 5, 15, and 60 min after delivery. Intraoperative vital signs and Apgar scores were compared using a linear mixed model and adjusted pairwise comparisons using Bonferroni analysis. Results A total of 125 puppies were included in this study. Age, body weight, litter size, type of surgery, delivery time, anesthetic and surgical duration, and intraoperative vital signs did not significantly differ between the groups. Puppies in the alfaxalone and propofol groups had significantly higher Apgar scores than the etomidate group in both elective and emergency surgery. In elective surgery, Apgar scores at 5 min after delivery did not differ significantly between groups. At 15 and 60 min after delivery, Apgar scores in the etomidate group were significantly lower than those in the other groups. In emergency surgery, Apgar scores were significantly lower in the etomidate group than in the alfaxalone group at all time points. Conclusion Induction with alfaxalone and propofol resulted in better outcomes with higher Apgar scores and neonatal viability than etomidate. Therefore, alfaxalone and propofol should be used as anesthetic induction drugs in both elective and emergency cesarean sections.
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Affiliation(s)
- Thanikul Srithunyarat
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
| | - Supranee Jitpean
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
| | - Piyasak Wipoosak
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
| | - Chalermkwan Nonthakotr
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
| | - Nitaya Boonbal
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
| | - Panisara Kunkitti
- Division of Theriogenology, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
| | - Suvaluk Seesupa
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand
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Gloria A, Veronesi MC, Contri A. Does Placental Efficiency and Vascularization Affect Puppy Health? A Study in Boxer and Dobermann Dogs. Animals (Basel) 2024; 14:423. [PMID: 38338066 PMCID: PMC10854954 DOI: 10.3390/ani14030423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The anatomical and functional characteristics of the placenta influence the adaptive ability of the fetus to the extrauterine environment. Placental efficiency, measured as the gram of neonate produced by each gram of placenta, summarizes these characteristics. In the present study, placental efficiency and its impact on the 7-day postpartum life of the puppies were studied in canine large breeds. METHODS Placental efficiency (PE) was computed using chorioallantois weight (WPE) and surface (SPE) efficiency for puppies born from natural delivery or elective cesarean section. Capillary density was also histologically determined. Neonate viability was estimated by the APGAR score and the daily weight gain (DWG) was recorded on day 7 after delivery. RESULTS from 15 large-breed bitches, 69 live puppies were born by natural delivery (24 puppies) and elective cesarean section (45 puppies). Cluster analysis detected a group of neonates for which reduced placental efficiency (8 for the WPE, 9 for the SPE) was identified, despite a placental weight and surface within the mean and no difference in capillary density. In this group, the DWG was lower and the mortality within 7 days was higher. CONCLUSIONS the results suggest that placental efficiency could be an additional tool for the evaluation of a puppy in the first 7 days after delivery.
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Affiliation(s)
- Alessia Gloria
- Department of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy;
| | - Maria Cristina Veronesi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell’Università, 26900 Lodi, Italy;
| | - Alberto Contri
- Department of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy;
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Hyndman TH, Fretwell S, Bowden RS, Coaicetto F, Irons PC, Aleri JW, Kordzakhia N, Page SW, Musk GC, Tuke SJ, Mosing M, Metcalfe SS. The effect of doxapram on survival and APGAR score in newborn puppies delivered by elective caesarean: A randomized controlled trial. J Vet Pharmacol Ther 2023; 46:353-364. [PMID: 37211671 DOI: 10.1111/jvp.13388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/12/2023] [Accepted: 04/30/2023] [Indexed: 05/23/2023]
Abstract
Doxapram is marketed as a respiratory stimulant and is used by some veterinarians to help with neonatal apnoea, especially in puppies delivered by caesarean. There is a lack of consensus as to whether the drug is effective and data on its safety are limited. Doxapram was compared to placebo (saline) in newborn puppies in a randomized, double-blinded clinical trial using two outcome measures: 7-day mortality rate and repeated APGAR score measurements. Higher APGAR scores have been positively correlated with survival and other health outcomes in newborns. Puppies were delivered by caesarean and a baseline APGAR score was measured. This was immediately followed by a randomly allocated intralingual injection of either doxapram or isotonic saline (of the same volume). Injection volumes were determined by the weight of the puppy and each injection was administered within a minute of birth. The mean dose of doxapram administered was 10.65 mg/kg. APGAR scores were measured again at 2, 5, 10 and 20 min. One hundred and seventy-one puppies from 45 elective caesareans were recruited into this study. Five out of 85 puppies died after receiving saline and 7 out of 86 died after receiving doxapram. Adjusting for the baseline APGAR score, the age of the mother and whether the puppy was a brachycephalic breed, there was insufficient evidence to conclude a difference in the odds of 7-day survival for puppies that received doxapram compared to those that received saline (p = .634). Adjusting for the baseline APGAR score, the weight of the mother, the litter size, the mother's parity number, the weight of the puppy and whether the puppy was a brachycephalic breed, there was insufficient evidence to conclude a difference in the probability of a puppy having an APGAR score of ten (the maximum APGAR score) between those that received doxapram compared to those that received saline (p = .631). Being a brachycephalic breed was not associated with an increased odds of 7-day mortality (p = .156) but the effect of the baseline APGAR score on the probability of having an APGAR score of ten was higher for brachycephalic than non-brachycephalic breeds (p = .01). There was insufficient evidence that intralingual doxapram provided an advantage (or disadvantage) compared to intralingual saline when used routinely in puppies delivered by elective caesarean and that were not apnoeic.
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Affiliation(s)
- Timothy H Hyndman
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
- Harry Butler Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Shelby Fretwell
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
- Applecross Veterinary Hospital, Applecross, Western Australia, Australia
| | - Ross S Bowden
- Mathematics and Statistics, Murdoch University, Murdoch, Western Australia, Australia
| | - Flaminia Coaicetto
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Peter C Irons
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Joshua W Aleri
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
- Harry Butler Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Nino Kordzakhia
- School of Mathematical and Physical Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Stephen W Page
- Advanced Veterinary Therapeutics, Newtown, New South Wales, Australia
| | - Gabrielle C Musk
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - S Jonathan Tuke
- Mathematics and Statistics, The University of Adelaide, Adelaide, South Australia, Australia
| | - Martina Mosing
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Steven S Metcalfe
- Applecross Veterinary Hospital, Applecross, Western Australia, Australia
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Greghi JR, Favaron PO, Trautwein LGC, Silva CGBD, Lemos GAAD, Martins MIM. Emergency cesarean section in dogs: Usefulness of amniotic fluid biochemical parameters and placental morphology as indicators of neonatal viability. Theriogenology 2023; 211:115-124. [PMID: 37607467 DOI: 10.1016/j.theriogenology.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/24/2023]
Abstract
In recent years, special attention has been paid to the analysis of fetal fluids and placental histopathology to identify parameters that can be used as indicators of maternal reproductive quality, embryonic viability, and fetal and neonatal health. Newborn health reflects the functioning of the fetal adnexa and its relationship with maternal tissues. Therefore, evaluating these components is promising for the early detection of newborns at risk. This study aimed to detect the biochemical characteristics of the amniotic fluid (AF) and histopathological characteristics of the placenta for comparison between canine neonates born by elective (EL) and emergency (EM) cesarean sections (CSs) and associate the results with neonatal viability in the first 24 h. A total of 38 neonates born by ELCS (n = 19) and EMCS (n = 19) were selected. AF was collected to analyze the concentration of its biochemical components [alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatinine, urea, total protein, albumin, total and direct bilirubin, lactate, glucose, potassium, chloride, calcium, and sodium]. Histopathological processing of the placenta was used to describe the lesions and identify the arrangement of collagen fibers using hematoxylin-eosin and picrosirius staining. There was an increase in ALP activity (P = 0.035) and the concentrations of lactate (P < 0.001) and potassium (P = 0.031), and a decrease in chlorides (P < 0.001) in the AF of neonates in the EMCS group. The comparisons between the groups did not show differences between the presence and extent of lesions in the placenta; however, a difference was observed in the arrangement of collagen fibers in the placental structure. A comparison between AF and histopathological findings showed a negative correlation (r = -0.609, P = 0.003) between glucose concentration and the presence of necrosis in the placental labyrinth. It was observed that the composition of the AF changed owing to the influence of the type of cesarean, possibly caused by prolonged hypoxia in cases of dystocia. ALP activity and lactate, potassium, and chloride concentrations in the AF might be explored as markers of neonatal health in EMCS. Under the conditions of this study, no correlations were found between the placenta's histopathological characteristics and the neonates' viability.
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Affiliation(s)
- Julia Rodrigues Greghi
- Department of Veterinary Clinics, State University of Londrina (UEL), Rod Celso Garcia Cid, PR 445 Km 380, CEP 86057-970, Londrina, PR, Brazil.
| | - Phelipe Oliveira Favaron
- Department of General Biology, State University of Londrina (UEL), Rod Celso Garcia Cid, PR 445 Km 380, CEP 86057-970, Londrina, PR, Brazil.
| | - Luiz Guilherme Corsi Trautwein
- Department of Veterinary Clinics, State University of Londrina (UEL), Rod Celso Garcia Cid, PR 445 Km 380, CEP 86057-970, Londrina, PR, Brazil.
| | - Caio Garcia Barbosa da Silva
- Department of Veterinary Clinics, State University of Londrina (UEL), Rod Celso Garcia Cid, PR 445 Km 380, CEP 86057-970, Londrina, PR, Brazil.
| | - Gisele Augusta Amorim de Lemos
- Department of Preventive Veterinary Medicine, State University of Londrina (UEL), Rod Celso Garcia Cid, PR 445 Km 380, CEP 86057-970, Londrina, PR, Brazil.
| | - Maria Isabel Mello Martins
- Department of Veterinary Clinics, State University of Londrina (UEL), Rod Celso Garcia Cid, PR 445 Km 380, CEP 86057-970, Londrina, PR, Brazil.
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Grundy SA. Canine Neonatal Health. Vet Clin North Am Small Anim Pract 2023:S0195-5616(23)00081-5. [PMID: 37423840 DOI: 10.1016/j.cvsm.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
This article provides a high-level overview of canine neonatal health for clinicians to use as a mental framework so that when presented with a canine neonate it is easier to construct a logical and systematic clinical approach that is less overwhelming. As early detection of the at-risk neonate results in earlier intervention, and improved health outcomes, there will be a focus on pro-active care. Where appropriate, other articles in this issue will be mentioned for a more in-depth discussion of specific areas. Key points will be highlighted throughout the text.
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Affiliation(s)
- Sophie A Grundy
- Banfield Pet Hospital, 6081 Florin Road, Sacramento, CA 95823, USA.
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Cain J, Davidson A. Canine Cesarean Section: Emergency and Elective. Vet Clin North Am Small Anim Pract 2023:S0195-5616(23)00069-4. [PMID: 37246012 DOI: 10.1016/j.cvsm.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Canine Cesarean Section (CS) is primarily performed to increase survival of newborns and less commonly to save the life or reproductive future of the dam. Conducting proper ovulation timing to accurately predict the due date will allow a planned, elective CS as an excellent alternative to a high-risk natural whelping, and possible dystocia, for certain breeds and situations. Techniques for ovulation timing, anesthesia, and surgery tips are provided.
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Affiliation(s)
- Janice Cain
- Canine Reproduction Center at Ironhorse Vet Care, 7660 Amador Valley Boulevard, Suite E, Dublin, CA 94568, USA.
| | - Autumn Davidson
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Dr, Davis, CA 95616, USA
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Veronesi MC, Fusi J. Biochemical factors affecting newborn survival in dogs and cats. Theriogenology 2023; 197:150-158. [PMID: 36516700 DOI: 10.1016/j.theriogenology.2022.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
The importance and implications of small animal neonatology were underestimated until recent times. Despite the recent increasing interest for this branch of veterinary medicine, however, perinatal mortality rates in canine and feline species remain high, representing an important challenge for the clinician. In this perspective, the prompt identification of newborns requiring additional and tailored assistance becomes a key to reduce the perinatal losses in small animals. To achieve this goal, clinical and laboratory findings must be carefully evaluated. This paper focuses on biochemical parameters and their reported influence on neonatal survival, guiding through the evaluation of canine and feline newborn laboratory analyses, with a thorough discussion about the use of different biological material in these subjects. Beside blood, other biological material, such as urines and fetal fluids proved to be interesting for the identification of possible prognostic markers, thanks also to their easy and safe collection. However, the correct reading-through the results must consider many variables such as type of delivery, anesthesia protocol in case of Caesarean section, age of the newborn at samples collection, and for blood analysis, also the type of blood, site of collection, modality of collection and storage must be considered. Notwithstanding the recent progress in literature, for most of the parameters more research is needed to define cut-off values with certainty.
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Affiliation(s)
- Maria Cristina Veronesi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Jasmine Fusi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
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Refining the APGAR Score Cutoff Values and Viability Classes According to Breed Body Size in Newborn Dogs. Animals (Basel) 2022; 12:ani12131664. [PMID: 35804563 PMCID: PMC9264973 DOI: 10.3390/ani12131664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
The Apgar score (AS) represents a key tool for neonate assessment, but the possible breed effect on AS in newborn puppies has never been investigated. Therefore, data from 234 dog litters born by caesarean section, grouped according to breed body size (BBS) (small, medium, large), were evaluated. Live-birth puppies were assessed through AS within 5 min of delivery, and classified in viability classes: 0−3 severely distressed, 4−6 moderately distressed, 7−10 not distressed. Statistical analysis evaluated possible differences of AS and viability class according to BBS, and between BBS and puppies’ mortality. Results showed no differences in the distribution of mortalities among BBSs. However, an effect of BBS on the AS was found, with small-sized puppies being the most represented in the severely distressed class, but having the best survival chance compared to large-sized newborns. Through receiver-operating-characteristics analysis, the AS new cutoff values for survival and for death <24 h and 24 h−7 days of age were identified, and the viability classes were redefined, with a narrower class of moderately distressed puppy specific for each BBS. In conclusion, the refining of the AS in dog species is imperative, with cutoff values and viability classifications that must be adapted to the BBS.
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Hibaru VY, Pereira KHNP, Fuchs KDM, Lopes MD, Alfonso A, de Souza FF, Chiacchio SB, Tsunemi MH, Machado LHDA, Lourenço MLG. Topics in the routine assessment of newborn kitten vitality: Apgar score, reflexes and complementary assessments. J Feline Med Surg 2022; 24:e34-e42. [PMID: 35352984 PMCID: PMC11104224 DOI: 10.1177/1098612x221081404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to perform neonatal clinical assessments at birth to identify newborn kittens at risk according to type of delivery, thus allowing immediate intervention and increasing their chances of survival. METHODS This study compared Apgar scores, reflexes and clinical parameters (temperature, weight, blood glucose and peripheral oxygen saturation [SpO2]) between eutocic neonates and those delivered by emergency cesarean section. The animals were evaluated at birth and after 10 and 60 mins. RESULTS Thirty-two neonates were evaluated, with 19 animals in the eutocic group (EG) and 13 animals in the cesarean group (CG). When comparing groups, CG neonates had significantly lower Apgar scores (P <0.0001), lower SpO2 (P = 0.0535), higher blood glucose (P = 0.0009), reduced reflexes (P <0.0001) and lower respiratory rates (P <0.0001) at birth and after 10 and 60 mins than EG neonates. Apgar scores positively correlated with parameters such as heart rate, reflex score, SpO2 and weight. The mortality rate in evaluated newborns was 15.6% (5/32). The early mortality rate (0-2 days old) was 80% (4/5) and the late mortality rate (3-30 days old) was 20% (1/5). CONCLUSIONS AND RELEVANCE This study showed lower vitality in cats delivered by emergency cesarean section than in those delivered through eutocic birth. In general, neonates delivered by cesarean section have greater depression and low vitality at birth and may require advanced resuscitation procedures. The evaluations carried out in this study identified newborns with low vitality and those requiring advanced resuscitation, thus allowing immediate intervention. Apgar and reflex scores for feline neonates were suggested. Newborn-specific clinical assessment with these feline vitality scores allows the identification of at-risk neonates. Care immediately after birth increases the chance of survival among these patients.
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Affiliation(s)
- Viviane Yukari Hibaru
- Veterinary Neonatology Research Group, Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Keylla Helena Nobre Pacífico Pereira
- Veterinary Neonatology Research Group, Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Kárita da Mata Fuchs
- Veterinary Neonatology Research Group, Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Maria Denise Lopes
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Angélica Alfonso
- Veterinary Neonatology Research Group, Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Fabiana Ferreira de Souza
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Simone Biagio Chiacchio
- Veterinary Neonatology Research Group, Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | | | - Luiz Henrique de Araújo Machado
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
| | - Maria Lucia Gomes Lourenço
- Veterinary Neonatology Research Group, Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, Brazil
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Plavec T, Knific T, Slapšak A, Raspor S, Lukanc B, Pipan MZ. Canine Neonatal Assessment by Vitality Score, Amniotic Fluid, Urine, and Umbilical Cord Blood Analysis of Glucose, Lactate, and Cortisol: Possible Influence of Parturition Type? Animals (Basel) 2022; 12:ani12101247. [PMID: 35625093 PMCID: PMC9137714 DOI: 10.3390/ani12101247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Parturition as a stressful event may influence puppies’ neonatal morbidity and mortality. The purpose of this study was to investigate the impact of parturition type on stress in newborn puppies, their weight gains, and survival in the first week postpartum. One hundred and twenty-three puppies were divided into three groups: vaginal parturition, emergency, and elective cesarean section. The Apgar score was assessed 5, 15, and 60 min postpartum, and samples of amniotic fluid, umbilical blood, and urine were collected for lactate, glucose, and cortisol concentration measurements. Although emergency cesarean section puppies had the highest cortisol concentration of all groups, their Apgar score at 5 min postpartum was comparable to the vaginal parturition group, which had the highest lactate levels. There were no significant differences between groups regarding relative growth rate. The type of parturition had no impact on puppies’ survival in our study, but supportive treatment was provided for non-vital puppies in stress. Non-invasive analysis of amniotic fluid and/or urine could help in the assessment of the neonatal vitality. Abstract The objective of this study was to investigate the impact of parturition type on vitality in newborn puppies, their weight gains, and survival in the first week postpartum. One hundred and twenty-three puppies were divided in three groups: vaginal parturition (VP), emergency (EM-CS), and elective cesarean section (EL-CS). Apgar scores were assessed 5, 15, and 60 min postpartum. Lactate and glucose concentrations were measured in amniotic fluid and umbilical blood; cortisol concentrations were measured in amniotic fluid and puppy urine. Puppies’ weight gain was tracked daily for 7 days postpartum. Apgar score at 5 and 15 min was significantly better in the VP group. EL-CS puppies had significantly lower umbilical blood and amniotic fluid lactate concentrations compared to the VP group, which also had higher umbilical blood lactate concentration than EM-CS puppies. The cortisol concentration in the amniotic fluid and in urine differed significantly between the groups, with the highest concentration in the EM-CS, followed by the VP group. Glucose concentration in amniotic fluid was higher in the VP group than EM-CS group. The type of parturition had no impact on puppies’ weight gain or their survival at birth; however, supportive treatment was provided for non-vital puppies. Non-invasive analysis of puppies’ fluids could help in the assessment of the neonatal vitality.
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Affiliation(s)
- Tanja Plavec
- Veterinary Faculty, University of Ljubljana, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia; (T.P.); (A.S.); (S.R.); (B.L.)
| | - Tanja Knific
- Veterinary Faculty, Institute of Food Safety, Feed and Environment, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Aleksandra Slapšak
- Veterinary Faculty, University of Ljubljana, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia; (T.P.); (A.S.); (S.R.); (B.L.)
| | - Sara Raspor
- Veterinary Faculty, University of Ljubljana, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia; (T.P.); (A.S.); (S.R.); (B.L.)
| | - Barbara Lukanc
- Veterinary Faculty, University of Ljubljana, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia; (T.P.); (A.S.); (S.R.); (B.L.)
| | - Maja Zakošek Pipan
- Veterinary Faculty, University of Ljubljana, Clinic for Reproduction and Large Animals, Gerbičeva 60, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-4779-396
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Abstract
Practical relevance: Cats are common pets worldwide. Successful breeding of cats starts
with the selection of suitable breeding animals, and care should
be taken to avoid inbreeding. Keeping cats in smaller groups
reduces stress and facilitates management. Clinical challenges: Breeding cats is challenging in many ways. Group housing is a
common scenario, and care should be taken not to have groups
that are too large, because of the risk of stress and infectious
diseases. Feline pregnancy and parturition both vary in length,
which is one reason why it may be challenging to diagnose
dystocia. In queens with pyometra, a vaginal discharge may not
be evident due to their meticulous cleaning habits. Audience: This review is aimed at clinicians in small animal practice,
especially those in contact with cat breeders. Patient group: Reproductive emergencies occur in both intentionally and
unintentionally bred cats, and more often in young or
middle-aged queens. Pyometra tends to be a disease of older
queens. Evidence base: Evidence is poor for many conditions in the breeding queen, and
information is extrapolated from the dog or based on case
reports and case series.
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Affiliation(s)
- Bodil Ström Holst
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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13
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Martín Bellido V, Vettorato E. Clinical review of the pharmacological and anaesthetic effects of alfaxalone in dogs. J Small Anim Pract 2021; 63:341-361. [PMID: 34893985 DOI: 10.1111/jsap.13454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/11/2021] [Accepted: 11/16/2021] [Indexed: 01/02/2023]
Abstract
This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic-pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio-respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered.
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Affiliation(s)
- V Martín Bellido
- Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - E Vettorato
- Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
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14
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Antończyk A, Ochota M, Niżański W. Umbilical Cord Blood Gas Parameters and Apgar Scoring in Assessment of New-Born Dogs Delivered by Cesarean Section. Animals (Basel) 2021; 11:ani11030685. [PMID: 33806500 PMCID: PMC8000146 DOI: 10.3390/ani11030685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The article presents the results of the clinical evaluation and umbilical cord blood analysis obtained from newborn pups delivered by the elective Caesarean section. In human medicine both the umbilical cord blood and Apgar score were proved to provide valuable information on neonatal status. In veterinary medicine very few reports concerning the relation between the clinical neonatal assessment (Apgar score) and umbilical cord blood parameters exist. All puppies show mild respiratory acidemia regardless the Apgar scores result. The lactates were not elevated whereas all the puppies with low Apgar sores had higher glucose and mortality rates. Only pups with low initial Apgar scores were at risk of death within first 24 h. Adaptation to the extra-uterine life is crucial and any practical improvement in neonatal diagnostics and care would be beneficial for newborn puppy survival. Abstract The article presents the results of the clinical evaluation (Apgar scores, AS) and umbilical cord blood gas analysis (UCBGA) obtained from clamped umbilical cords of newborn pups delivered by the elective Caesarean section. The study was planned as a controlled clinical study, the newborns were allocated into one of the groups, I—critical neonates (severe distress, AS ≤ 3), II—weak neonates (moderate distress, AS 4–6) and III—healthy neonates (no distress, AS ≥ 7). The following parameters were evaluated: pH (pH units), carbon dioxide partial pressure (pCO2; mmHg), oxygen partial pressure (pO2; mmHg), actual bicarbonate (cHCO3−; mmol/L), total carbon dioxide (cTCO2; mmol/L), base excess of extracellular fluid (BE(ecf); mmol/L), base excess of blood (BE(b); mmol/L), oxygen saturation (csO2; %), lactate (Lac; mg/dL), hematocrit (Hct; %PCV), hemoglobin (cHgb; g/dL), glucose (Glu; mg/dL), ions (Na, K, Ca, Cl). The majority of puppies had low AS at birth (AS 4–6 in 38.1% and AS ≤ 3 in 57.1% of the neonates), but most of them (85.7%) improved by the 20th min. reaching AS of 7 and more. Moreover, puppies with lower AS (≤ 3) were at higher risk of death within the first 24h (20.8% did not survive). The positive correlation was found between Apgar score measured at 0 min and pH (r = 0.46, p = 0.01), and between Apgar score (at 0 min) and base excess in whole blood measured [BE(b)] r = 0.36, p = 0.03). Whereas, a negative correlation was detected between Apgar score at 0 and 5th min and glycemia (r = −0.42, p = 0.05, r = −0.34, p = 0.02 respectively. Overall, the puppies with higher glucose levels had lower Apgar scores and were at higher risk of death. Furthermore, in our study, the newborn puppies had mild acidemia with elevated pCO2 levels and the HCO3 at the lower range of normal limits, suggesting the mixed component in the acidemic state. Adaptation to extra-uterine life is crucial and any practical improvement in neonatal diagnostics and care would be beneficial for newborn puppy survival.
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Affiliation(s)
- Agnieszka Antończyk
- Wrocław University of Environmental and Life Sciences, Department and Clinic of Surgery, 50-366 Wrocław, Poland;
| | - Małgorzata Ochota
- Wrocław University of Environmental and Life Sciences, Department of Reproduction and Clinic of Farm Animals, 50-366 Wrocław, Poland;
- Correspondence:
| | - Wojciech Niżański
- Wrocław University of Environmental and Life Sciences, Department of Reproduction and Clinic of Farm Animals, 50-366 Wrocław, Poland;
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15
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Fusi J, Faustini M, Bolis B, Veronesi MC. Apgar score or birthweight in Chihuahua dogs born by elective Caesarean section: which is the best predictor of the survival at 24 h after birth? Acta Vet Scand 2020; 62:39. [PMID: 32703251 PMCID: PMC7376849 DOI: 10.1186/s13028-020-00538-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background In the dog, the correct management of parturition and the prompt neonatal evaluation and assistance can reduce the perinatal mortality rates that are particularly high in toy breeds. Newborn evaluation and factors addressing prognosis are pivotal to guarantee the correct neonatal assistance. Assessment of the Apgar score with viability classification and birthweight are recognized as predictors for neonatal survival in dogs, but breed-specific data are needed for a more feasible application in the dog species, in which wide differences among breeds are known. The present study aimed therefore to: (a) assess the role of Apgar score and birthweight as predictors for the survival of Chihuahua newborn puppies in the first 24 h of life; (b) to assess a cut-off of the Apgar score and birthweight values that can predict the survival of Chihuahua newborn puppies in the first 24 h after birth; (c) to assess the possible effect played by maternal parity, newborn gender and litter-size on Apgar score in Chihuahua newborn puppies, in order to provide breed-specific data for a better neonatal assistance. Results Data obtained from 176 normal developed Chihuahua puppies born by elective Caesarean section, showed that 62%, 28% and 10% of puppies were classified in the Apgar score classes 7–10, 4–6 and 0–3, respectively, with survival at 24 h after birth of 97%, 96%, 39%, in the three Apgar classes of viability, respectively. Apgar score was a better predictor for survival at 24 h after birth than birthweight (AUC 0.93, P < 0.0001; AUC 0.69, P < 0.01, respectively). Litter-size of 7 puppies/litter plays a negative effect on Apgar score. Apgar score is a better predictor of survival at 24 h than birthweight, and the best cut-off of Apgar score for survival at 24 h after birth is 4, with 96% sensitivity and 77% specificity. Conclusions The different proportion of “normal viable” and “less viable” neonates in comparison to other studies highlights that Chihuahua puppies born by elective Caesarean section should be carefully evaluated at birth to provide correct assistance.
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16
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De Cramer KGM, Nöthling JO. Towards scheduled pre-parturient caesarean sections in bitches. Reprod Domest Anim 2020; 55 Suppl 2:38-48. [PMID: 32374484 DOI: 10.1111/rda.13669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 03/02/2020] [Indexed: 11/27/2022]
Abstract
Elective caesarean section (CS) is the safest means of delivering the litter in bitches in specific situations. Timeously performing elective pre-parturient CSs at a fixed time would be convenient and prevent emergency CSs and foetal demise. This review proposes a method of performing elective pre-parturient CSs which is safe for both the bitch and puppies. Brachycephaly, small litters and large litters, preceding litter delivered by CS and trial of labour after a preceding CS are identified as factors increasing the need for CS whereas emergency CS is identified as factor increasing foetal demise. The first day of cytological dioestrus more precisely predicts the day of onset of spontaneous parturition than the first day of the LH surge or the dates during oestrus on which progesterone (P4) first exceeds 6 nM or 16 nM. Foetal biparietal diameter at the time of onset of spontaneous parturition varies too much to accurately predict readiness for CS. During the last few days of gestation, P4 with cut-off concentrations at 15.8, 8.7 and 3.18 nM, but not plasma cortisol concentrations, hold promise as predictors of onset of parturition and when to perform pre-parturient CSs. A protocol associating medetomidine hydrochloride as premedicant with propofol as induction agent and sevoflurane as maintenance is safe for scheduled CS and yields good maternal and puppy survival rates at delivery, 2 hr and 7 days after CSs. Clinicians have to pay attention to the haematocrit of bitches at the time of cervical dilatation which is at the lower end of the normal reference ranges for non-pregnant dogs and to the decline in haematocrit during CS (as a proxy for blood loss) which is approximately 7% for both parturient (open cervix) and pre-parturient (closed cervix) CSs. Pre-parturient CSs can be scheduled and performed 57 days after onset of cytological dioestrus with puppy survival rates of 99%. Collectively, these studies provide a protocol to safely perform elective CSs in a large proportion of the obstetric population at a convenient time of the day but more research is required with larger numbers to establish whether this practice is routinely safe and safe in all breeds.
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Affiliation(s)
- Kurt G M De Cramer
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Johan O Nöthling
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
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17
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Pereira KHNP, Correia LECDS, Oliveira ELR, Bouéres CS, Cyrino MA, Leis Filho AF, Cruz RKS, Angrimani DDSR, de Souza FF, Chiacchio SB, Lourenço MLG. Effects of clamping umbilical cord on the neonatal viability of puppies delivered by cesarean section. J Vet Med Sci 2020; 82:247-253. [PMID: 31932533 PMCID: PMC7041982 DOI: 10.1292/jvms.19-0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In human neonates, when the umbilical cord is kept intact postpartum, blood continues to
flow to the neonate, but this procedure might be difficult in dogs owing to a shorter
umbilical cord and several neonates in a litter. However, it might be possible to detach
the placenta and keep the umbilical cord intact, allowing residual blood to flow to the
puppies. This study compared the effects of clamping versus no clamping of the umbilical
cord in dogs born by cesarean section on neonatal vitality. The puppies were assessed by
Apgar and reflex scores. Fifty puppies delivered from 16 bitches were randomly allocated
to receive immediate umbilical cord clamping (n=25) or no clamping for at least 3 min
after the onset of breathing (n=25). The puppies were assessed during the first 5 min of
life and 10 min after the first assessment. The no clamping group showed significantly
higher Apgar scores (second assessment, P<0.01) and reflex scores
(first and second assessments, P<0.05) than the clamping group,
implying higher vitality in the no clamping group. The differences observed between the
moments (first versus second assessment) of each group was significant
(P<0.01), revealing higher vitality in the second assessment. The
results suggest that keeping the umbilical cord intact for at least 3 min after the onset
of breathing may contribute to increased vitality in puppies delivered by cesarean section
without any negative consequences.
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Affiliation(s)
- Keylla Helena Nobre Pacifico Pereira
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Luiz Eduardo Cruz Dos Santos Correia
- Department of Animal Breeding and Nutrition, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Elton Luís Ritir Oliveira
- Department of Veterinary Anesthesiology and Surgery, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Cristiano Silva Bouéres
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Marina Andrade Cyrino
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Antônio Fernandes Leis Filho
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | | | - Daniel De Souza Ramos Angrimani
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Fabiana Ferreira de Souza
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Simone Biagio Chiacchio
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
| | - Maria Lucia Gomes Lourenço
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo 18616-681, Brazil
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18
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Melandri M, Alonge S, Peric T, Bolis B, Veronesi MC. Effects of Alfaxalone or Propofol on Giant-Breed Dog Neonates Viability During Elective Caesarean Sections. Animals (Basel) 2019; 9:E962. [PMID: 31766134 PMCID: PMC6912762 DOI: 10.3390/ani9110962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 11/11/2022] Open
Abstract
Attention must be paid to C-section anesthesia effects on mother and offspring. Alfaxalone induction results in improved puppy viability when compared to propofol. The present study aims to evaluate effects of alfaxalone or propofol induction for elective C-section on newborns, expressed as Apgar score and fetal fluids cortisol concentration. Anesthesia was induced with alfaxalone 3 mg/kg iv in 5 bitches (group A), and propofol 4 mg/kg iv in another 5 (group P), maintained with isoflurane. Amniotic and allantoic fluids were collected to determine cortisol concentration. Apgar score, litter size, newborn gender, birth-weight, maternal age, and parity were recorded. ANOVA, U Mann-Whitney test and ANCOVA assessed the effects of drugs on the Apgar score and fetal fluids cortisol. Thirty-six puppies were randomly selected for the study: 16 from group A and 20 from group P. Only the Apgar score significantly differed between groups. ANCOVA confirmed a significantly higher Apgar score in group A underlining the influence of fetal fluids cortisol concentrations, both resulting in covariates. Present results confirm the effect of anesthesia on the Apgar score of newborns, which is significantly higher for alfaxalone than propofol, suggesting the use of fetal fluids cortisol as a covariate. These findings could be a starting point for further investigations when less viable puppies are detected or expected, such as during an emergency C-section.
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Affiliation(s)
- Monica Melandri
- Società Veterinaria “Il Melograno” Srl, 21018 Sesto Calende, Varese, Italy;
| | - Salvatore Alonge
- Società Veterinaria “Il Melograno” Srl, 21018 Sesto Calende, Varese, Italy;
| | - Tanja Peric
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy;
| | - Barbara Bolis
- Department of Veterinary Medicine, Università degli Studi di Milano, 20100 Milan, Italy; (B.B.); (M.C.V.)
| | - Maria C Veronesi
- Department of Veterinary Medicine, Università degli Studi di Milano, 20100 Milan, Italy; (B.B.); (M.C.V.)
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19
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Conze T, Jurczak A, Fux V, Socha P, Wehrend A, Janowski T. Survival and fertility of bitches undergoing caesarean section. Vet Rec 2019; 186:416. [PMID: 31582573 DOI: 10.1136/vr.105123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 07/10/2019] [Accepted: 08/28/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND With the increasing popularity of planned caesarean section, the need for knowledge regarding this surgery has become increasingly important. The reported death and survival rates for caesarean sections vary widely. Another important aspect is the fertility rate in subsequent oestrous after caesarean section. The aim of this study was to investigate the mortality and survival rate of bitches during caesarean section. Additionally, the fertility of bitches after caesarean sections was determined. METHODS Caesarean sections which were performed in the years 1997-2009 at two university clinics were evaluated retrospectively. A distinction was made between bitches in which a conservative caesarean section was performed and bitches with a caesarean section followed by an ovariohysterectomy. RESULTS A total of 482 caesarean sections were included in the study. The overall mortality rate was 3.11 per cent, with 2.59 per cent during or after a conservative caesarean section and 4.19 per cent during or after caesarean section with ovariohysterectomy. The reason for ovariohysterectomy was the owner's preference in 63 bitches (47.01 per cent); in 71 (52.98 per cent) bitches, ovariohysterectomy was performed due to a medical indication. The fertility rate after caesarean section was 100 per cent. CONCLUSION The results show a high mortality rate during and after caesarean section. On the other hand, caesarean section does not seem to have a big impact on further fertility. Further studies are needed to investigate possible reduction of litter sizes and the suitability of caesarean section in subsequent pregnancies.
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Affiliation(s)
- Theresa Conze
- Faculty of Veterinary Medicine, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals with Ambulatory Service, Giessen, Germany
| | - Andrzej Jurczak
- Department of Animal Reproduction with Clinic, Uniwersytet Warminsko-Mazurski, Olsztyn, Poland
| | - Vanessa Fux
- Faculty of Veterinary Medicine, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals with Ambulatory Service, Giessen, Germany
| | - Piotr Socha
- Department of Animal Reproduction with Clinic, Uniwersytet Warminsko-Mazurski, Olsztyn, Poland
| | - Axel Wehrend
- Faculty of Veterinary Medicine, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals with Ambulatory Service, Giessen, Germany
| | - Tomasz Janowski
- Department of Animal Reproduction with Clinic, Uniwersytet Warminsko-Mazurski, Olsztyn, Poland
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20
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Proctor-Brown LA, Cheong SH, Diel de Amorim M. Impact of decision to delivery time of fetal mortality in canine caesarean section in a referral population. Vet Med Sci 2019; 5:336-344. [PMID: 30839178 PMCID: PMC6682920 DOI: 10.1002/vms3.163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
In human medicine, there is a recommended decision to delivery interval (DDI), which allows for the optimization of protocols and systematic review of hospital success. In veterinary medicine, no such guideline has been established or investigated. The purpose of this study was to investigate the relationship between the interval from the decision to perform a caesarean section and the delivery of the neonates and fetal mortality at the time of surgery. One hundred and fifty canine caesarean sections were evaluated retrospectively. Caesarean cases were dichotomized to those that had at least one perinatal death and cases where all puppies survived. Factors that increased the likelihood of at least one perinatal death at caesarean section were: cases that presented as an emergency caesarean section, the dam presenting with a fetus in the vaginal canal, the dam not having a history of previous caesareans sections, and being multiparous. Even though there was no association of DDI with likelihood of having perinatal death, timing related factors that increased the likelihood of having at least one perinatal death at caesarean section were: cases where total anaesthesia time was longer than 2 h; time from induction to start of surgery was longer than 45 min and surgical time longer than 75 min. In conclusion, time is a factor in the success of canine caesarean sections and further research is needed to better define the optimal decision to delivery time in canine caesarean sections in order to optimize fetal survival and hospital protocol success rates.
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Affiliation(s)
- Lauren A Proctor-Brown
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Soon Hon Cheong
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Mariana Diel de Amorim
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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21
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Groppetti D, Di Cesare F, Pecile A, Cagnardi P, Merlanti R, D'Urso ES, Gioeni D, Boracchi P, Ravasio G. Maternal and neonatal wellbeing during elective C-section induced with a combination of propofol and dexmedetomidine: How effective is the placental barrier in dogs? Theriogenology 2019; 129:90-98. [PMID: 30826722 DOI: 10.1016/j.theriogenology.2019.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/14/2019] [Accepted: 02/21/2019] [Indexed: 01/05/2023]
Abstract
Anaesthetics administered during C-section (CS) can cross the placenta and the foetal blood-brain barrier contributing to distress up to neonatal mortality. Therefore, to prevent neonatal risks, sedatives and analgesics are not commonly administered to the bitch until all pups are delivered. This study aims to evaluate the effect of a new anaesthetic and analgesic protocol for elective CS in dogs, focused on both maternal and neonatal wellbeing. General anaesthesia was induced by a combination of propofol (PPF) and dexmedetomidine (DEX) and maintained with isoflurane. DEX was added to PPF in order to provide analgesia and to reduce PPF dose. Propofol and DEX concentrations in maternal blood, amniotic fluid, and placenta were correlated to maternal and neonatal parameters. Maternal pain score was assessed with Glasgow Composite Measure Pain Scale short-form. Nine healthy purebred dogs scheduled for elective CS delivered 54 pups. The 77.8% of pups were vigorous at birth and assigned to the highest Apgar score (AS). The lowest AS was recorded in pups from mothers receiving additional doses of PPF (p < 0.001). Apgar scores improved with the increase in time between induction and pups' extraction, starting from 30 min after induction (p < 0.01). This study could contribute to clarify the controversy about the optimal extraction's time of pups after induction i.e. the best time between PPF administration and birth. No bitch showed post-operative pain or required additional analgesic doses based on their pain score. Maternal blood PPF and DEX, as well as placental PPF concentrations, decreased over time (p < 0.01). Conversely, placental DEX was fair uniformly detected in littermate pups. Both PPF and DEX were not detectable in amniotic fluid. Placenta resulted an effective barrier against foetal DEX exposure, making this protocol safe, analgesic and advisable for elective CS in dogs.
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Affiliation(s)
- Debora Groppetti
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy.
| | - Federica Di Cesare
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Via Celoria 10, 20133, Milan, Italy
| | - Alessandro Pecile
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
| | - Petra Cagnardi
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Via Celoria 10, 20133, Milan, Italy
| | - Roberta Merlanti
- Department of Comparative Biomedicine and Food Science, Università degli Studi di Padova, Viale dell'Università 16, 35020, Legnaro, Padova, Italy
| | - Elisa S D'Urso
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
| | - Daniela Gioeni
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
| | - Patrizia Boracchi
- Department of Clinical Sciences and Community Health, Università; degli Studi di Milano, Via Vanzetti 5, 20133, Milan, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine, Università degli Studi di Milano, via Celoria 10, 20133, Milan, Italy
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22
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Jasmine F, Antonella C, Massimo F, Alberto P, Maria Cristina V. The usefulness of claws collected without invasiveness for cortisol and dehydroepiandrosterone (sulfate) monitoring in healthy newborn puppies after birth. Theriogenology 2018; 122:137-143. [DOI: 10.1016/j.theriogenology.2018.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/17/2018] [Accepted: 09/14/2018] [Indexed: 12/22/2022]
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23
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Alonge S, Melandri M. Effect of delivery management on first-week neonatal outcome: How to improve it in Great Danes. Theriogenology 2018; 125:310-316. [PMID: 30502623 DOI: 10.1016/j.theriogenology.2018.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/16/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
Abstract
A different incidence of neonatal complications has been reported in several species according to the duration of the various labour stages and the type of delivery. Trauma associated with dystocia may result in the release of neonatal catecholamines and cortisol that negatively affect neonatal metabolism, thus survival. Aim of the present study was to assess how the first-week neonatal outcome is affected by a different management of parturition. Clinical records of 46 Great Dane litters from 8 different kennels were evaluated retrospectively. Data were grouped in 3 categories: vaginal delivery (VD), emergency C-section (ES), planned C-section (PS). The risk of stillbirth, early neonatal mortality and perinatal mortality was calculated at puppy and at litter level in each group. Data were statistically compared by the ANOVA and Chi-Square test (p < 0.05). Seventy-eight puppies were naturally delivered (VD), 120 experienced dystocia at birth that required emergency C-section (ES) and 105 came from planned C-section (PS). No statistical difference in neonatal bodyweight and litter size was observed among groups. In PS, both stillbirth and neonatal mortality resulted significantly lower than in VD and ES, resulting in the lowest observed perinatal mortality. The number of litters with stillbirth was significantly higher in ES than VD and PS. The number of litters with neonatal mortality resulted significantly lower in PS than VD and ES. The overall perinatal mortality in VD resulted statistically influenced from both stillbirth and neonatal mortality, while it resulted strongly affected by the high stillbirth in ES. No difference was observed for PS perinatal mortality. Present results, reporting a high incidence of dystocia as well as high perinatal and neonatal mortality, lead us to evaluate the opportunity to plan an elective C-section in Great Dane bitches, in order to minimize perinatal mortality.
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Affiliation(s)
- Salvatore Alonge
- Società Veterinaria "Il Melograno" Srl, Sesto Calende, Varese, Italy.
| | - Monica Melandri
- Società Veterinaria "Il Melograno" Srl, Sesto Calende, Varese, Italy.
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Romagnoli N, Barbarossa A, Cunto M, Ballotta G, Zambelli D, Armorini S, Zaghini A, Lambertini C. Evaluation of methadone concentrations in bitches and in umbilical cords after epidural or systemic administration for caesarean section: A randomized trial. Vet Anaesth Analg 2018; 46:375-383. [PMID: 30981587 DOI: 10.1016/j.vaa.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 09/13/2018] [Accepted: 10/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To measure plasma methadone concentrations in bitches and the umbilical cords of their puppies after systemic or epidural administration. STUDY DESIGN Prospective, randomized, clinical study. ANIMALS A total of 27 healthy pregnant female dogs undergoing caesarean section, 4.3 ± 2.3 years of age and weighing 19.9 ± 13.2 kg. METHODS The dogs were randomly divided into three groups: 1) intramuscular methadone (0.3 mg kg-1) (group MET; n = 9); 2) epidural methadone (0.1 mg kg-1) (group METEPI; n = 9); and 3) epidural lidocaine (4.4 mg kg-1) [group CON (control group); n = 9]. Ten minutes before induction, methadone was administered intramuscularly to the group MET dogs. Anaesthesia was induced with propofol and maintained with isoflurane. Cardiovascular and respiratory parameters were monitored throughout the anaesthesia. After induction, epidural anaesthesia was administered to dogs in groups METEPI and CON. Before any treatment (T0) and, as soon as the last foetus was removed from the uterus (T1), venous blood samples were collected from each dog into heparinized tubes; the umbilical cords were collected and stored at -80 °C until pharmacological analysis was carried out. The samples were analysed using ultra performance liquid chromatography. RESULTS The cardiorespiratory parameters of the bitches and of the puppies at birth, and the Apgar scores did not differ significantly between groups. At T1 both the median maternal methadone plasma concentration and the median methadone umbilical cord concentration were higher in group MET compared to group METEPI (p = 0.0018 and p = 0.004, respectively). The maternal plasma concentration was higher than the concentration in the umbilical cords (p = 0.05) in group METEPI but not in group MET (p = 0.25). CONCLUSIONS AND CLINICAL RELEVANCE Epidural methadone (0.1 mg kg-1) administered to bitches undergoing caesarean section is associated with lower umbilical cord methadone concentrations as compared with intramuscularly administered methadone at higher dosages (0.3 mg kg-1).
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Affiliation(s)
- Noemi Romagnoli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Andrea Barbarossa
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Marco Cunto
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
| | - Giulia Ballotta
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Daniele Zambelli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Sara Armorini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Anna Zaghini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Carlotta Lambertini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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De Cramer KGM, Nöthling JO. Curtailing parturition observation and performing preparturient cesarean section in bitches. Theriogenology 2018; 124:57-64. [PMID: 30343200 DOI: 10.1016/j.theriogenology.2018.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 10/28/2022]
Abstract
Properly planned elective cesarean section (CS) in bitches is considered safe and justified for some breeds. Therefore, planning a scheduled (fixed date and time) preparturient CS in bitches belonging to a subpopulation where a CS is unavoidable, seems justified. The first day of cytological diestrus (D0) was used to predict the date of parturition. The aims of this study were to (1) compare the mortality of puppies delivered by preparturient CS to those delivered by parturient CS, (2) determine the extent to which a preparturient CS (performed at 08:00 on D57, while the cervix is closed) would shorten gestation, (3) compare the level of progesterone at the time of preparturient CS to that at the time of parturient CS, (4) compare the change in hematocrit before and after CS for parturient- and preparturient CSs. Out of 99 gestations for which D0 was known and a preparturient CS planned, the CS was performed at the scheduled time in 61%, before the scheduled time because cervical dilatation had started in 32% and before the scheduled time in 7% because the bitches had started showing signs of impending parturition, although their cervices were still closed. This study showed high neonatal survival ratios and good Apgar scores after preparturient CS with 99% of puppies delivered by preparturient CS born alive and 98.8% surviving to 2 h. Performing preparturient CSs shortened gestation by four to 52 h. Progesterone level was significantly higher at the time of preparturient CSs than at the time of parturient CSs. Further studies are required to determine whether preparturient CSs on D57 are routinely safe in all breeds, does not affect long term survival of the puppies and to timeously identify bitches in which parturition starts prior to the date and time for the scheduled elective preparturient CS.
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Affiliation(s)
- K G M De Cramer
- Department of Production Animals, Faculty of Veterinary Science, University of Pretoria, South Africa.
| | - J O Nöthling
- Department of Production Animals, Faculty of Veterinary Science, University of Pretoria, South Africa.
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Liao C, Xu D, Liu X, Fang Y, Yi J, Li X, Guo B. Iridium (III) complex-loaded liposomes as a drug delivery system for lung cancer through mitochondrial dysfunction. Int J Nanomedicine 2018; 13:4417-4431. [PMID: 30104875 PMCID: PMC6071621 DOI: 10.2147/ijn.s170035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background and aim Iridium (Ir)-based complex is a potential antitumor ingredient, but its poor physicochemical properties such as hydrophobicity and low biocompatibility hamper further application. Liposome provides a potential delivery approach for improving the poor physicochemical property and reducing the side effects of antitumor drug. In this study, we aimed at incorporating Ir ([Ir(ppy)2(BTCP)]PF6) into liposomes to enhance the biocompatibility and sustained release of Ir for intravenous administration and to elucidate the mechanism in A549 cells. Materials and methods Ir-loaded PEGylated liposomes (Lipo-Ir) were formulated by thin-film dispersion and ultrasonic method. Morphology, size distribution, and zeta potential of Lipo-Ir were examined by transmission electron microscopy (TEM) and Zetasizer. The released profile and biocompatibility were investigated by dialysis method and hemolysis test, respectively. Additionally, the cytotoxic activity and mechanism of Lipo-Ir and Ir inducing apoptosis in A549 cells were evaluated. Results Lipo-Ir can keep sustained release, excellent biocompatibility, and physical stability. The average particle size, polydispersity index, zeta potential, encapsulation efficiency, and drug loading are 112.57±1.15 nm, 0.19±0.02, −10.66±0.61 mV, 94.71%±3.21%, and 4.71%±0.41%, respectively. 3-(4,5-dimethylthiazole)-2,5-diphenltetraazolium bromide (MTT) assay show that Lipo-Ir and Ir display high cytotoxicity against selected cancer cells. Furthermore, the apoptotic features of morphology, depolarization of mitochondrial membrane potential, increase in the reactive oxygen species (ROS) levels, and disorder of Ca2+ homeostasis are observed after treating A549 cells with Ir and Lipo-Ir. Besides, Lipo-Ir can arrest the cell growth in G0/G1 phase. Conclusion The studies demonstrate that Lipo-Ir can trigger apoptosis in A549 cells via ROS-mediated mitochondrial dysfunctions, and the biocompatible and sustained Lipo-Ir will be a promising drug delivery system.
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Affiliation(s)
- Cancheng Liao
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
| | - Danqiao Xu
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
| | - Xiaohong Liu
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
| | - Yuqi Fang
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
| | - Jun Yi
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
| | - Xiaofang Li
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
| | - Bohong Guo
- Department of Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China,
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Comparison of 3 anesthetic protocols for the elective cesarean-section in the dog: Effects on the bitch and the newborn puppies. Anim Reprod Sci 2018; 190:53-62. [PMID: 29395686 DOI: 10.1016/j.anireprosci.2018.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/18/2018] [Accepted: 01/20/2018] [Indexed: 11/20/2022]
Abstract
This study assessed the influence of 3 different anesthetic protocols based on the quality of anesthesia induction and maintenance in four dog breeds (French Bulldog, n = 13; Yorkshire terrier, n = 12; Chihuahua, n = 10; Bull Terrier, n = 10) subjected to cesarean section. Neonatal mortality, birth defects and newborn viability were assessed. All females were pre-medicated with morphine (IM), and then were assigned to three different anesthetic protocols: group P (n = 17), anesthesia was induced with propofol (IV) and then also maintained with propofol until the complete delivery of puppies and then anesthesia was maintained afterwards with sevoflurane; group PS (n = 14), anesthesia was induced with IV propofol, and maintenance of the anesthesic plan was performed with sevoflurane; group PES (n = 14) the females were induced by propofol and an epidural anesthesia was then performed, anesthesia was then maintained with propofol until the complete extraction of all puppies and then anesthesia was maintained afterwards with sevoflurane. Throughout the surgery, group PES required a lower concentration of sevoflurane (p < 0.05), and extra doses of propofol or fentanyl during inhalatory anesthesia were not required. Mean values of heart rate (p < 0.01) were higher in females from groups P and PS. Mean values of blood pressure values were lower (p < 0.01) in group PES as compared with the other two groups. Birth defects were detected in 3.1% (5/162) of the neonates, with a significantly higher incidence (p < 0.05) in French bulldog puppies. Neonatal viability was assessed using a modified Apgar score model; Apgar score was defined immediately after delivery (Apgar0) and a second score was assessed 60 min after delivery (Apgar60). Apgar0 scores were significantly different between the groups, showing neonates of group PES the highest values (p < 0.05). In Apgar60, more than 94% of puppies were already classified as normal viability neonates (7-10 score) and no differences were observed between groups. This study confirmed that females of group PES showed a higher quality of anesthesia during surgery and a vitality of puppies immediately after delivery. Regardless of the anesthetic protocol used, French bulldog females and puppies required more clinical care than other breeds.
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Puppy survival and vigor associated with the use of low dose medetomidine premedication, propofol induction and maintenance of anesthesia using sevoflurane gas-inhalation for cesarean section in the bitch. Theriogenology 2017; 96:10-15. [PMID: 28532824 DOI: 10.1016/j.theriogenology.2017.03.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 03/19/2017] [Accepted: 03/22/2017] [Indexed: 11/24/2022]
Abstract
The safety of an anesthetic protocol consisting of medetomidine hydrochloride (7 μg/kg iv) as premedicant, propofol, (1-2 mg/kg iv) as induction agent and sevoflurane, at 2% in oxygen for maintenance of anesthesia was studied in 292 cesarean sections (CSs) and 2232 puppies delivered. Medetomidine effects were reversed using atipamezole hydrochloride at 50 μg/puppy sc immediately following delivery and in the bitch iv immediately following surgery. The protocol's safety for puppies was expressed using survival immediately, 2 h and 7 d after delivery, and Apgar scores (measurement starting 15 min after delivery of the last puppy). The maternal survival rate was established immediately, 2 h and 7 d after cesarean section (CS). The CSs included 148 on Boerboel, 84 on English bulldog and 60 on other purebred bitches, which resulted in 1378, 541 and 313 puppies, respectively. Boerboel, English bulldog and other purebred bitches yielded 97.39%, 96.67% and 91.69% live puppies at delivery, 95.43%, 88.35% and 89.78% alive by 2 h and 89.19%, 79.11% and 84.03% alive by 7 d. Sixteen (1.16%), 32 (5.59%) and 4 (1.28%) malformed Boerboel, English bulldog and other purebred puppies were euthanized. Thirty five, 18 and 26, Boerboel, English bulldog and other purebred puppies were stillborn respectively, of which 12, 9 and 15, respectively had been discovered dead upon ultrasound examination immediately before CS. After correction for fetuses found dead on ultrasound examination and malformed euthanized puppies, 98.21%, 95.60% and 94.30% of Boerboel, English bulldog and other purebred puppies survived until 2 h and 91.78%, 87.17% and 88.26% until 7 d. Two-hour survival rates are negatively correlated to the proportion of puppies in a litter with scores of 8 or below (r = 0.14, P = 0.01, n = 292 litters) and tends to be positively correlated to the lowest Apgar score in a litter (r = 0.11, P = 0.05, n = 292 litters). This study shows that medetomidine hydrochloride in the protocol used is a safe premedicant in bitches prior to cesarean section and is associated with good puppy vigor as well as 2 h and 7 d puppy survival rates. The use of medetomidine as premedicant permitted use of less than half the dose of propofol usually required as induction agent.
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Alef M. [Anaesthesia for canine caesarean section - an evidence-based approach]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2017; 45:27-38. [PMID: 28116412 DOI: 10.15654/tpk-160890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/02/2016] [Indexed: 11/13/2022]
Abstract
In recent years, several new studies on anaesthesia for caesarean section have been published. This paper refers to these and ground-breaking research on risk factors affecting the puppies. Based on the available evidence, a recommendation for an anaesthetic procedure is given and in addition, alternatives are discussed. Induction with propofol or alfaxalone and maintenance by inhalation anaesthesia appears to be the method with the least risk. Intraoperatively, an adequate and low-risk analgesia is achieved by an epidural anaesthesia. Opioids allow an adequate maternal pain management after delivery of the puppies as well as postoperatively. A stabilisation of the dam before induction and an optimised oxygen supply are additional basal requirements.
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Affiliation(s)
- Michaele Alef
- Prof. Dr. Michaele Alef, Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig, An den Tierkliniken 23, 04103 Leipzig, E-Mail:
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Bolis B, Prandi A, Rota A, Faustini M, Veronesi MC. Cortisol fetal fluid concentrations in term pregnancy of small-sized purebred dogs and its preliminary relation to first 24 hours survival of newborns. Theriogenology 2016; 88:264-269. [PMID: 28234232 DOI: 10.1016/j.theriogenology.2016.09.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/31/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022]
Abstract
Along the perinatal period, in mammals, cortisol (C) plays a pivotal role in the final intrauterine fetal maturation and in the early neonatal adaptation. Because of the scarce knowledge about canine perinatology, the present study was aimed to assess the C concentrations in amniotic and allantoic fluids collected, without invasiveness, from small-sized, purebred newborn puppies born by elective cesarean section, at term of pregnancy. Possible correlations between fetal fluid C concentrations and maternal parity, litter size, birth weight, Apgar score, were evaluated. In addition, the possible effect of fetal fluid C concentrations on newborn survival at 24 hours of age, and the effect of the litter or the newborn gender on fetal fluid C concentrations were also assessed. The results, obtained from 50 born alive, normal-weight puppies, without gross physical malformation, showed that C concentration was higher in allantoic than in amniotic fluid (P < 0.01), even if a strong positive correlation between the two fluids C concentration was found (P < 0.0001; R = 0.83). Neither amniotic nor allantoic C concentrations were correlated to maternal parity, litter size, birth weight, and Apgar score. Interestingly, higher amniotic (P < 0.05), but not allantoic, C concentrations were found in puppies not surviving at 24 hours after birth. Therefore, it could be suggested that this parameter may be useful for the recognition, at birth, of puppies needing special surveillance during the first day of age. A significant (P < 0.001) effect of the litter in both amniotic and allantoic C concentrations was found. In conclusion, the present results showed that in small-sized purebred puppies, born at term by elective cesarean section, the exact fetal, maternal, or placental source contributing to fetal fluid C concentrations remains to be clarified. From a clinical perspective, however, the evaluation of amniotic C concentration at birth seems useful for the detection of puppies that need special surveillance during the first 24 hours of age, and should be coupled to the early newborn evaluation by Apgar score. However, the small total number of newborns, and especially of the dead puppies enrolled in the present study, suggests that further, more-focused investigations on a large number of subjects are needed before the method could be considered for application in the clinical practices.
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Affiliation(s)
- B Bolis
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy; ECAR Resident Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy.
| | - A Prandi
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, Udine, Italy
| | - A Rota
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - M Faustini
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - M C Veronesi
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
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Veronesi MC. Assessment of canine neonatal viability-the Apgar score. Reprod Domest Anim 2016; 51 Suppl 1:46-50. [PMID: 27670940 DOI: 10.1111/rda.12787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Perinatal mortality is relatively high in dogs, with deaths peaking around the time of birth and during the first week of age. Among the several causes of canine perinatal mortality, whelping is the greatest cause. Therefore, early neonatal assistance at birth should be mandatory with dogs. In comparison with human neonatology, knowledge and technological ability in canine neonatology is tremendously scarce. The Apgar score for the newborn viability assessment at birth represents a feasible method for the prompt recognition of newborns that will need special assistance immediately after birth. The five parameters of the Apgar score were adapted to the canine species by different studies. Advantages and limits, as well as clinical applications, are presented and discussed in further detail. It was concluded that the Apgar score represents the easiest and simplest, non-invasive and reliable method, that could be performed under every clinical and practical condition, for newborn puppies viability evaluations and short-term survival prognosis.
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Affiliation(s)
- M C Veronesi
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy.
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Conde Ruiz C, Del Carro AP, Rosset E, Guyot E, Maroiller L, Buff S, Portier K. Alfaxalone for total intravenous anaesthesia in bitches undergoing elective caesarean section and its effects on puppies: a randomized clinical trial. Vet Anaesth Analg 2015; 43:281-90. [PMID: 26451686 DOI: 10.1111/vaa.12298] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 02/27/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the effects and reliability of alfaxalone constant rate infusion (CRI) in comparison to isoflurane to maintain anaesthesia in bitches undergoing elective caesarean section. STUDY DESIGN Prospective, randomized, 'blinded' clinical trial. ANIMALS Twenty-two client-owned bitches and 94 puppies. METHODS Bitches were randomly assigned to receive an alfaxalone CRI [0.2 mg kg(-1) minute(-1) intravenously (IV), and once the last puppy was delivered, the dose was halved; n = 11] or 2% (vaporizer dial setting) isoflurane (n = 11) for maintenance of anaesthesia. All dogs were induced with alfaxalone (3 mg kg(-1) ) IV. Additional alfaxalone (0.3 mg kg(-1) IV) was administered if the depth of anaesthesia was inadequate and the total dose was calculated. Bitches were mechanically ventilated. Analgesia was administered after the delivery of puppies. Physiological variables were recorded every 5 minutes. The bitches' recovery times were also recorded. Quality of induction and recovery were evaluated. Puppies' vigour was evaluated with a modified Apgar score at 5 and 60 minutes after birth. Puppies' survival rates at 24 and 48 hours and at 15 days were recorded. Data were analysed using an anova, Student's t-test or Wilcoxon rank-sum test. RESULTS The rescue dose of alfaxalone was higher (p = 0.01); bitches' recoveries were longer (p < 0.001) and puppies' Apgar scores were significantly lower at 5 and 60 minutes (p < 0.001 and p = 0.003, respectively) with alfaxalone than with isoflurane. However, no significant differences were found for puppies' survival between groups. CONCLUSIONS AND CLINICAL RELEVANCE Alfaxalone CRI seems to be a possible protocol for puppies and bitches undergoing elective caesarean sections. However, bitches recovered more slowly and puppy Apgar scores were lower in comparison to isoflurane.
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Affiliation(s)
- Clara Conde Ruiz
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Andrea P Del Carro
- Section of Biotechnology and Theriogenology, CERREC & CRB-ANIM, Université de Lyon, VetAgro Sup 1, Marcy l'Etoile, France
| | - Emilie Rosset
- Section of Biotechnology and Theriogenology, CERREC & CRB-ANIM, Université de Lyon, VetAgro Sup 1, Marcy l'Etoile, France
| | - Emilie Guyot
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Laura Maroiller
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Samuel Buff
- Section of Biotechnology and Theriogenology, CERREC & CRB-ANIM, Université de Lyon, VetAgro Sup 1, Marcy l'Etoile, France
| | - Karine Portier
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France.,INSERM, UMR-1060, CarMeN, Lyon, France
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Ferreira JP, Dzikit TB, Zeiler GE, Buck R, Nevill B, Gummow B, Bester L. Anaesthetic induction and recovery characteristics of a diazepam-ketamine combination compared with propofol in dogs. J S Afr Vet Assoc 2015; 86:1258. [PMID: 26244579 PMCID: PMC6138176 DOI: 10.4102/jsava.v86i1.1258] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/18/2015] [Accepted: 03/26/2015] [Indexed: 11/18/2022] Open
Abstract
Induction of anaesthesia occasionally has been associated with undesirable behaviour in dogs. High quality of induction of anaesthesia with propofol has been well described while in contrast variable induction and recovery quality has been associated with diazepam-ketamine. In this study, anaesthetic induction and recovery characteristics of diazepam-ketamine combination with propofol alone were compared in dogs undergoing elective orchidectomy. Thirty-six healthy adult male dogs were used. After habitus scoring (simple descriptive scale [SDS]), the dogs were sedated with morphine and acepromazine. Forty minutes later a premedication score (SDS) was allocated and general anaesthesia was induced using a combination of diazepam-ketamine (Group D/K) or propofol (Group P) and maintained with isoflurane. Scores for the quality of induction, intubation and degree of myoclonus were allocated (SDS). Orchidectomy was performed after which recovery from anaesthesia was scored (SDS) and times to extubation and standing were recorded. Data were analysed using descriptive statistics and Kappa Reliability and Kendall Tau B tests. Both groups were associated with acceptable quality of induction and recovery from anaesthesia. Group P, however, was associated with a poorer quality of induction (p = 0.014), prolonged induction period (p = 0.0018) and more pronounced myoclonus (p = 0.003), but had better quality of recovery (p = 0.000002) and shorter recovery times (p = 0.035) compared with Group D/K. Diazepam-ketamine and propofol are associated with acceptable induction and recovery from anaesthesia. Propofol had inferior anaesthetic induction characteristics, but superior and quicker recovery from anaesthesia compared with diazepam-ketamine.
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Affiliation(s)
- Jacques P Ferreira
- Department of Companion Animal Clinical Studies, University of Pretoria.
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Metcalfe S, Hulands-Nave A, Bell M, Kidd C, Pasloske K, O'Hagan B, Perkins N, Whittem T. Multicentre, randomised clinical trial evaluating the efficacy and safety of alfaxalone administered to bitches for induction of anaesthesia prior to caesarean section. Aust Vet J 2014; 92:333-8. [PMID: 25156052 DOI: 10.1111/avj.12223] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 11/26/2022]
Affiliation(s)
- S Metcalfe
- Applecross Veterinary Hospital; 9 Sleat Road, Applecross Western Australia 6153 Australia
| | | | - M Bell
- Craigieburn Animal Hospital; Craigieburn Victoria Australia
| | - C Kidd
- Manly Road Veterinary Hospital; Manly West Queensland Australia
| | - K Pasloske
- Jurox Pty Ltd; Rutherford New South Wales Australia
| | - B O'Hagan
- Jurox Pty Ltd; Rutherford New South Wales Australia
| | - N Perkins
- AusVet Animal Health Services Pty Ltd; Toowoomba Queensland Australia
| | - T Whittem
- Faculty of Veterinary Science; University of Melbourne, Veterinary Clinical Centre; Werribee Victoria Australia
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Mathews K, Kronen PW, Lascelles D, Nolan A, Robertson S, Steagall PVM, Wright B, Yamashita K. Guidelines for Recognition, Assessment and Treatment of Pain. J Small Anim Pract 2014; 55:E10-68. [DOI: 10.1111/jsap.12200] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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