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Gates MC, Littlewood KE, Kongara K, Odom TF, Sawicki RK. Cross-sectional survey of anaesthesia and analgesia protocols used to perform routine canine and feline ovariohysterectomies. Vet Anaesth Analg 2020; 47:38-46. [PMID: 31918840 DOI: 10.1016/j.vaa.2019.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/06/2019] [Accepted: 06/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To collect baseline descriptive data on the anaesthesia and analgesia protocols used by New Zealand veterinarians in first-opinion practice when performing routine canine and feline ovariohysterectomies. STUDY DESIGN Cross-sectional survey. ANIMALS Not applicable. METHODS An online survey was conducted asking respondents for: 1) preoperative patient assessment; 2) preanaesthetic medication and induction drugs used; 3) anaesthesia maintenance drug choices and monitoring equipment used; and 4) postoperative analgesia drug selections and monitoring for ovariohysterectomy performed in healthy adult dogs and cats. RESULTS The survey was completed by 472 veterinarians, of whom 282 provided responses for canine ovariohysterectomy and 361 provided responses for feline ovariohysterectomy. Approximately 23% of canine ovariohysterectomies and 13% of feline ovariohysterectomies had preanaesthetic bloodwork performed. There were 74 unique premedication/induction drug combinations reported for canine ovariohysterectomies and 94 for feline ovariohysterectomies. The most commonly used drug combinations were acepromazine, morphine ± propofol and butorphanol, ketamine and medetomidine for canine and feline ovariohysterectomies respectively. Most animals were intubated, and anaesthesia was maintained with isoflurane in oxygen. Use of intravenous catheters, fluid administration, heat support, and monitoring equipment varied. There were 41 unique postoperative analgesia drug combinations reported for canine ovariohysterectomies and 20 for feline ovariohysterectomies. Canine ovariohysterectomies were most commonly administered injectable opioids on the day of surgery followed by 3 days of oral non-steroidal anti-inflammatory drugs (NSAIDs), whereas feline ovariohysterectomies were usually administered a single injection of an opioid or NSAID or both on the day of surgery. Most animals were seen within 7-10 days for re-examination and/or suture removal. CONCLUSIONS AND CLINICAL RELEVANCE Veterinarians use a wide range of anaesthesia and analgesia protocols for routine ovariohysterectomies. Further research is needed comparing the safety and efficacy of commonly used protocols to determine whether there are opportunities to improve the level of patient welfare.
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Affiliation(s)
- M Carolyn Gates
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North, 4474, New Zealand.
| | - Katherine E Littlewood
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North, 4474, New Zealand
| | - Kavitha Kongara
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North, 4474, New Zealand
| | - Thomas F Odom
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North, 4474, New Zealand
| | - Robert K Sawicki
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North, 4474, New Zealand
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HEMATOLOGIC EVALUATION IN GUANS ( PENELOPE OBSCURA) UNDER PHYSICAL RESTRAINT AND ISOFLURANE ANESTHESIA. J Zoo Wildl Med 2018. [PMID: 29517440 DOI: 10.1638/2016-0125r2.1] [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: 11/21/2022] Open
Abstract
Hematology is an important health indicator in birds, but the stress from capture or anesthesia can cause alterations in blood count. This study aimed to evaluate the differences found in blood counts among guans ( Penelope obscura) under physical restraint and anesthetized with isoflurane. Thirty-two free-range guans from the Brazilian Institute of Environment and Renewable Natural Resources (IBAMA) Park were enrolled in the study. After physical restraint, blood samples were obtained from the ulnar vein and placed in heparinized tubes. The birds were anesthetized with isoflurane and after 45 min, when the animals were still anesthetized, a blood sample from the jugular vein was collected. Data were analyzed by paired t-test, and the differences were analyzed with Tukey's test. Decreases in red blood cell counts, hemoglobin concentrations, and packed cell volumes, and increased mean corpuscular hemoglobin concentrations were observed when animals were under general anesthesia. Decreases in total plasma protein, fibrinogen, and thrombocytes were detected after anesthesia. It was concluded that isoflurane influences the hematologic parameters, and those effects should be considered when interpreting hematologic values.
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Adamik KN, Yozova ID, Regenscheit N. Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care. J Vet Emerg Crit Care (San Antonio) 2016; 25:20-47. [PMID: 25655725 DOI: 10.1111/vec.12283] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/14/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To (1) review the development and medical applications of hydroxyethyl starch (HES) solutions with particular emphasis on its physiochemical properties; (2) critically appraise the available evidence in human and veterinary medicine, and (3) evaluate the potential risks and benefits associated with their use in critically ill small animals. DATA SOURCES Human and veterinary original research articles, scientific reviews, and textbook sources from 1950 to the present. HUMAN DATA SYNTHESIS HES solutions have been used extensively in people for over 30 years and ever since its introduction there has been a great deal of debate over its safety and efficacy. Recently, results of seminal trials and meta-analyses showing increased risks related to kidney dysfunction and mortality in septic and critically ill patients, have led to the restriction of HES use in these patient populations by European regulatory authorities. Although the initial ban on the use of HES in Europe has been eased, proof regarding the benefits and safety profile of HES in trauma and surgical patient populations has been requested by these same European regulatory authorities. VETERINARY DATA SYNTHESIS The veterinary literature is limited mostly to experimental studies and clinical investigations with small populations of patients with short-term end points and there is insufficient evidence to generate recommendations. CONCLUSIONS Currently, there are no consensus recommendations regarding the use of HES in veterinary medicine. Veterinarians and institutions affected by the HES restrictions have had to critically reassess the risks and benefits related to HES usage based on the available information and sometimes adapt their procedures and policies based on their reassessment. Meanwhile, large, prospective, randomized veterinary studies evaluating HES use are needed to achieve relevant levels of evidence to enable formulation of specific veterinary guidelines.
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Affiliation(s)
- Katja N Adamik
- Department of Veterinary Clinical Medicine, Division of Small Animal Emergency and Critical Care, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Smith MR, Greer RJ. Pilot study on the effect of subcutaneous administration of lactated Ringer's solution on biochemistry parameters in healthy euvolemic cats. Vet Med Sci 2016; 2:47-53. [PMID: 29067180 PMCID: PMC5645823 DOI: 10.1002/vms3.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 12/01/2015] [Accepted: 12/09/2015] [Indexed: 11/12/2022] Open
Abstract
Subcutaneous fluid administration is a commonly used therapy in veterinary practice. Its safety and efficacy have been demonstrated in human clinical studies, but have only rarely been discussed in the veterinary literature. This prospective observational study was performed to evaluate changes during a 24 h period in serum biochemistries associated with administration of lactated Ringer's solution subcutaneously to healthy cats. Lactated Ringer's solution was administered subcutaneously once to ten healthy, euvolemic cats at a dose of 22 mL kg−1. Blood biochemistry analytes were sampled at baseline and at serial time points for a total of 24 h. Changes in biochemical analytes at each time point were compared to baseline and evaluated for statistical significance. Serum blood urea nitrogen (BUN) was significantly less than baseline at 4, 6, 12, 18, and 24 h post‐infusion. Serum creatinine was significantly less than baseline at 2, 4 and 6 h. Packed cell volume (PCV) was significantly less than baseline at 6, 12, 18, and 24 h. Total plasma proteins were significantly less than baseline at all time points. Serum electrolytes did not change from baseline at any time point. Urine specific gravity was significantly increased from baseline only at 6 h post‐Lactated Ringer's solution (LRS) administration. Subcutaneous administration of lactated Ringer's solution appears to result in haemodilution with minimal change to serum electrolyte concentrations in clinically normal, euvolemic cats.
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Affiliation(s)
- M Ryan Smith
- Emergency and Critical CareVeterinary Specialty Services1021 Howard George DriveManchesterMissouri63021
| | - Rebecca J Greer
- Emergency and Critical CareVeterinary Specialty Services1021 Howard George DriveManchesterMissouri63021
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Raftery AG, Morgan RA, MacFarlane PD. Perioperative trends in plasma colloid osmotic pressure in horses undergoing surgery. J Vet Emerg Crit Care (San Antonio) 2015; 26:93-100. [PMID: 26397385 DOI: 10.1111/vec.12369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 01/31/2014] [Accepted: 07/24/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To compare perioperative trends in plasma colloid osmotic pressure (COP) between horses undergoing orthopedic and colic surgery. DESIGN Prospective clinical study September 2009-January 2011. SETTING Veterinary university teaching hospital. ANIMALS Thirty-three healthy, client-owned horses presenting for orthopedic surgery (non-GI) and 85 client-owned horses presenting for emergency exploratory celiotomy (GI, gastrointestinal). INTERVENTIONS None. MEASUREMENTS Data relating to the horse's parameters on presentation, surgical lesion, post-operative management and survival were extracted from computerized clinical records. Heparinized blood samples were taken on presentation (PreOp, pre-operative), on recovery from anesthesia (T0), at 12 (T12) and 24 (T24) hours post recovery. COP was measured within 4 hours of collection. RESULTS There was no significant difference in PreOp or T0 COP between groups. Both groups had a significant decrease in COP during anesthesia. When compared to their respective pre-operative values, horses in the non-GI group had significantly increased COP at T12, whereas those in the GI group had significantly reduced COP. This trend was continued at T24. Horses in the GI group placed on intravenous crystalloid isotonic fluids post-operatively had a significantly lower COP at T12 and T24. Horses in the GI group that did not survive had significantly lower post-operative COP values at T24. CONCLUSIONS Horses undergoing exploratory celiotomy had significantly lower COP post-operatively than those horses undergoing orthopedic surgery. This difference was more marked in those horses receiving isotonic crystalloid intravenous fluid therapy post-operatively and in those that did not survive to discharge. In the non-GI group an increase in COP post-operatively was common.
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Affiliation(s)
- Alexandra G Raftery
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, CH64 7TE, UK
| | - Ruth A Morgan
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, CH64 7TE, UK
| | - Paul D MacFarlane
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, CH64 7TE, UK
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Muir WW, Ueyama Y, Pedraza-Toscano A, Vargas-Pinto P, Delrio CL, George RS, Youngblood BL, Hamlin RL. Arterial blood pressure as a predictor of the response to fluid administration in euvolemic nonhypotensive or hypotensive isoflurane-anesthetized dogs. J Am Vet Med Assoc 2014; 245:1021-7. [DOI: 10.2460/javma.245.9.1021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jackson ML, Kerl ME, Tynan B, Mann FA. Comparison of whole blood and plasma colloid osmotic pressure in healthy cats. J Vet Emerg Crit Care (San Antonio) 2014; 24:408-13. [PMID: 25154356 DOI: 10.1111/vec.12205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 05/26/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To establish reference intervals for whole blood and plasma colloid osmotic pressure (COP) in healthy cats between the ages of 1 and 10 years using a cage-side colloid osmometer. DESIGN Prospective, observational study. SETTINGS University veterinary teaching hospital. ANIMALS Sixty-three healthy cats. INTERVENTIONS Phlebotomy. MEASUREMENTS AND MAIN RESULTS Whole blood COP mean was 24.4 (±2.78) mmHg and plasma COP mean was 24.3 (±2.59) mmHg. Reference interval for our study population of feline whole blood COP was 18.9 to 30.4 mmHg, and for our study population of feline plasma COP was 18.3 to 30.8 mmHg. Difference of paired whole blood COP and plasma COP was +0.23 ± 1.68 mmHg (P = 0.32). There was no significant difference when comparing COP from neutered male and neutered female cats. Total protein and albumin were significantly correlated with whole blood COP (total protein to whole blood COP P < 0.0001, r = 0.53; albumin to whole blood COP P <0.0001, r = 0.68) and plasma COP (total protein to plasma COP P = 0.0025, r = 0.41; albumin to plasma COP P < 0.0001, r = 0.66). CONCLUSIONS No significant difference was found between mean whole blood and plasma COP in this study population of cats. Even though not statistically significant, evaluation of paired whole blood COP and plasma COP did reveal a slight difference; therefore, it seems prudent to maintain sample consistency for serial evaluations in cats.
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Affiliation(s)
- Mary L Jackson
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, 900 East Campus Drive, Columbia, MO, 65211
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Abstract
The purpose of this article is to update the community of veterinarians performing general anesthesia in horses on fluid therapy. The rationale behind intraoperative fluid therapy, fluid dynamics, and various fluid options (crystalloids, hypertonic saline, colloids) is discussed. Additionally, electrolytes (calcium, potassium, and sodium) are included in the discussion in relation to general anesthesia and intraoperative fluid management.
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Carotenuto AM, Borghi L, Paltrinieri S, Giordano A, Moretti P, Giancamillo MD. Serum biochemical response to contrast media administration in anaesthetised dogs. Vet Rec 2013; 172:101. [DOI: 10.1136/vr.100867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A. M. Carotenuto
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - L. Borghi
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - S. Paltrinieri
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - A. Giordano
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - P. Moretti
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - M. Di Giancamillo
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
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Wendt-Hornickle EL, Snyder LBC, Tang R, Johnson RA. The effects of lactated Ringer's solution (LRS) or LRS and 6% hetastarch on the colloid osmotic pressure, total protein and osmolality in healthy horses under general anesthesia. Vet Anaesth Analg 2011; 38:336-43. [PMID: 21627758 DOI: 10.1111/j.1467-2995.2011.00622.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate changes in colloid osmotic pressure (COP), total protein (TP) and osmolality (OSM) during anesthesia in horses given intravenous lactated Ringer's solution (LRS) or LRS and hetastarch (HES). STUDY DESIGN Prospective, clinical trial. ANIMALS Fourteen horses presented for surgery. Mean age 8.3 ± 1.9 years; mean weight 452 ± 25 kg. METHODS Horses were premedicated with xylazine intravenously (IV); anesthesia was induced with ketamine and diazepam IV, and maintained with sevoflurane. Butorphanol was administered IV with pre-medications or immediately after induction. Xylazine was administered IV for recovery if necessary. LRS was administered IV to all horses with a target rate of 5-10 mL kg(-1) hour(-1). Half of the horses also received 6% HES, 2.5 mL kg(-1) over 1 hour in addition to LRS. Horses that received LRS only were considered the LRS group. Horses that received both LRS and HES were considered the LRS/HES group. Blood was drawn pre- and post-anesthesia, immediately following induction, and every 30 minutes throughout anesthesia. COP, TP and OSM were measured. RESULTS COP and TP significantly decreased at similar rates for both treatment groups from pre-anesthetic values. Pre-anesthetic COP was significantly greater in the LRS group when compared to the LRS/HES group pre-, post- and throughout anesthesia. In the LRS group post-anesthetic OSM was significantly different than the pre-anesthesia value and that for the LRS/HES group. CONCLUSIONS AND CLINICAL RELEVANCE Administration of IV HES (2.5 mL kg(-1), over 1 hour) in combination with LRS does not attenuate the decrease in COP typically seen during anesthesia with crystalloid administration alone. Based on these results, administration of HES at this rate and total volume would not be expected to prevent fluid shifts into the interstitium through its effects on COP.
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Affiliation(s)
- Erin L Wendt-Hornickle
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA.
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Carney KR, McKenzie EC, Mosley CA, Payton ME. Evaluation of the effect of hetastarch and lactated Ringer's solution on plasma colloid osmotic pressure in healthy llamas. J Am Vet Med Assoc 2011; 238:768-72. [PMID: 21401434 DOI: 10.2460/javma.238.6.768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the effects of hetastarch and lactated Ringer's solution (LRS) on plasma colloid osmotic pressure (pCOP) and other hematologic variables in healthy llamas. DESIGN Prospective crossover study. ANIMALS 6 healthy female llamas. Procedures-Llamas were administered LRS (45 mL/kg [20.5 mL/lb]) and, after a 3-day washout period, hetastarch (15 mL/kg [6.8 mL/lb]) during 60-minute IV infusions. Serum total protein, serum albumin, and hemoglobin concentrations and Hct were measured before each infusion (baseline), immediately after each infusion was completed (0 hours), and at 2, 4, 8, and 12 hours. The pCOP was measured at baseline and at 0, 2, 4, 8, 12, 24, 36, and 48 hours after each infusion was completed; additional measurements of pCOP were obtained 72 and 96 hours after hetastarch infusion. RESULTS Hetastarch administration significantly increased mean ± SEM pCOP from 23.5 ± 0.3 mm Hg (baseline) to a peak of 28.4 ± 0.6 mm Hg (12 hours); significant increases in pCOP persisted at 96 hours after hetastarch administration. Administration of LRS significantly decreased albumin and total protein concentrations; in addition, mean ± SEM pCOP decreased from 24.1 ± 0.4 mm Hg (baseline) to 18.0 ± 0.3 mm Hg (0 hours). Hetastarch administration caused more pronounced decreases in Hct (0 hours) and concentrations of hemoglobin (0 hours), albumin (all time points), and total protein (all time points) than did LRS administration. CONCLUSIONS AND CLINICAL RELEVANCE Hetastarch administration increased pCOP in healthy llamas for 96 hours with no clinically important complications.
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Affiliation(s)
- Katelyn R Carney
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
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Dismukes DI, Thomovsky EJ, Mann FA, Middleton JR. Effects of general anesthesia on plasma colloid oncotic pressure in dogs. J Am Vet Med Assoc 2010; 236:309-11. [DOI: 10.2460/javma.236.3.309] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Aarnes TK, Bednarski RM, Lerche P, Hubbell JAE, Muir WW. Effect of intravenous administration of lactated Ringer's solution or hetastarch for the treatment of isoflurane-induced hypotension in dogs. Am J Vet Res 2009; 70:1345-53. [DOI: 10.2460/ajvr.70.11.1345] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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