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Marangoni S, Ubiali M, Ambrosini F, Jahnel L, Vilani JM, Steagall PV, Vilani RGDDC. Effects of different rates of propofol with or without S-ketamine on ventricular function in healthy cats - a randomized study. Front Vet Sci 2023; 10:1272949. [PMID: 38152595 PMCID: PMC10752607 DOI: 10.3389/fvets.2023.1272949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/24/2023] [Indexed: 12/29/2023] Open
Abstract
Propofol is used for anesthetic induction in cats and procedural sedation in countries where alfaxalone is not available. Studies have reported propofol-related effects in echocardiography variables in dogs and humans. However, there is a lack of echocardiography studies investigating propofol-related effects on cats. This study aimed to use echocardiography to investigate echocardiographic changes in three protocols using propofol: propofol-slow (2 mg/kg/min, PS); propofol-fast (8 mg/kg/min, PF); propofol-ketamine (S-ketamine 2 mg/kg bolus followed by propofol 2 mg/kg/min; PK) in healthy premedicated (gabapentin-buprenorphine-acepromazine; 200 mg/cat, 0.4, and 0.1 mg/kg, respectively), non-intubated cats. Echocardiographic measurements were obtained at three time points: baseline (before the administration of propofol), end of propofol titration (end-point, T0), and 15 min after T0 (T15). Propofol at a lower rate continued from T0 to T15. Echocardiographic and physiological variables included fractional shortening (FS%), ejection fraction (EF%), HR, BP, and others. Propofol requirements at T0 for PF, PS, and PK groups were 5.0 ± 0.9, 3.8 ± 0.7, and 2.4 ± 0.5 mg/kg, respectively. EF% neither change over time nor between groups. PF and PK showed a reduction in FS% at T0 (47 ± 6 to 34 ± 6 and 42 ± 6 to 36 ± 5, respectively). BP reduced significantly in PF and PS groups (136 ± 26 to 105 ± 13 and 137 ± 22 to 115 ± 15 mmHg, respectively). It is unclear whether changes in echocardiography variables were of clinical relevance related to treatment groups or a result of within-group individual responses.
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Affiliation(s)
- Sabrine Marangoni
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Matheus Ubiali
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Francieli Ambrosini
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Larissa Jahnel
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Julia M. Vilani
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Paulo V. Steagall
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Kim D, Park SG, Kim M. Interventional Heartworm Extraction in Two Dogs: The Clinical Application of Impedance Cardiography. Animals (Basel) 2023; 13:3127. [PMID: 37835733 PMCID: PMC10571723 DOI: 10.3390/ani13193127] [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: 09/07/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
Heartworm (HW) disease, caused by Dirofilaria immitis, is a life-threatening ailment in dogs. HW disrupts blood flow and decreases cardiac output (CO). The accurate monitoring of CO during HW extraction is pivotal for patient survival and overall health. OBJECTIVE This study aimed to assess the efficacy of using impedance cardiography (ICG) as a non-invasive approach for monitoring CO during interventional HW extraction. METHODS Two cases of HW infections were treated via surgical extraction. The CO and mean arterial pressure (MAP) were monitored using the ICG technique during the anesthesia stabilization, extraction process, and post-extraction phases. RESULTS In Case 1, the CO increased by 115% post-procedure, and in Case 2, the CO increased by 116%. In contrast, the MAP varied between the two cases. The ICG method provided real-time CO data without major disruptions during the extraction surgery. CONCLUSION The ICG technique for CO monitoring during interventional HW extractions is effective.
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Affiliation(s)
- Daesik Kim
- Veterinary Emergency Medicine, Department of Veterinary Clinical Science, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Seol-Gi Park
- Incheon Sky Animal Hospital, Incheon 21555, Republic of Korea
| | - Minsu Kim
- Veterinary Emergency Medicine, Department of Veterinary Clinical Science, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
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Whitehouse WH, Thomason JD, Thompson-Butler DA, Kelley MD, Cernicchiaro N, Tanner MC. A clinically utilized intravenous continuous rate infusion of diltiazem does not significantly decrease systolic function in healthy dogs. Am J Vet Res 2023; 84:ajvr.22.09.0158. [PMID: 36607773 DOI: 10.2460/ajvr.22.09.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine if left ventricular systolic function on echocardiography, systemic blood pressure, and electrocardiography change with a clinically accepted intravenous (IV) diltiazem constant rate infusion (CRI) compared to a control. ANIMALS 10 healthy client-owned adult dogs. PROCEDURES Prospective, masked, crossover study from May 27, 2021, to August 22, 2021. Dogs were randomized to receive diltiazem (loading dose of 240 μg/kg, IV followed by a CRI of 6 μg/kg/min for 300 minutes) or the same volume of 5% dextrose in water (D5W) administered IV followed by the opposite intervention after a 7-day washout. Blood pressure was monitored during each CRI, and echocardiographic and electrocardiographic studies were performed immediately before the CRI and during the last hour of the CRI. RESULTS Postdiltiazem systolic time interval (STI) (median, 0.30; range, 0.16 to 0.34) was significantly lower than post-D5W STI (median, 0.32; range, 0.22 to 0.40; P = .046). All other echocardiographic parameters did not differ significantly between each of the groups after receiving diltiazem or D5W. Systemic blood pressure did not change significantly with either diltiazem (P = .450) or D5W (P = .940), and none of the dogs became hypotensive at any point in the study. Expectedly, negative dromotropy was observed with diltiazem. CLINICAL RELEVANCE A significant decrease in left ventricular systolic function was not appreciated in healthy dogs receiving diltiazem at a clinically accepted intravenous infusion rate at this dosing regimen. Further studies are needed in dogs with cardiac disease.
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Affiliation(s)
- William H Whitehouse
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - Justin D Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - Dorothy A Thompson-Butler
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - Megan D Kelley
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - Natalia Cernicchiaro
- Center for Outcomes Research and Epidemiology and Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - Matthew C Tanner
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
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Donati PA, Tunesi M, Araos J. Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion. J Vet Emerg Crit Care (San Antonio) 2023; 33:29-37. [PMID: 36537869 DOI: 10.1111/vec.13272] [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: 09/28/2021] [Revised: 12/31/2021] [Accepted: 02/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the use of the caudal vena cava collapsibility index (CVCCI) and the inspiratory/minimum and expiratory/maximum diameters of the vena cava to predict fluid responsiveness in hospitalized, critically ill cats with hemodynamic and tissue perfusion abnormalities. DESIGN Diagnostic test study in a prospective cohort of hospitalized cats. SETTING Private practice referral hospital. ANIMALS Twenty-four hospitalized cats with spontaneous breathing and compromised hemodynamics and tissue hypoperfusion. INTERVENTIONS Ultrasonographic examination before and after fluid expansion with 10 ml/kg of lactated Ringer's solution. MEASUREMENTS AND MAIN RESULTS Fluid responsiveness was evaluated using the velocity-time integral (VTI) of the subaortic blood flow, by measuring it before and after a fluid load of 10 ml/kg of lactated Ringer's solution. The CVCCI was calculated using the following formula: (maximum diameter - minimum diameter / maximum diameter) × 100. Ten cats were fluid responders (42 %) and 14 were nonresponders (58 %). The area under the receiver operating characteristic curve (AUROC) with their 95% confidence interval for the predictors and the best cutoff values were as follows: CVCCI, AUROC = 0.83 (0.66-1.00) and cutoff = 31%; inspiratory/minimum diameter, AUROC = 0.86 (0.70-1.00) and cutoff = 0.24 cm; expiratory/maximum diameter, AUROC = 0.88 (0.74-1.00) and cutoff = 0.22 cm. A significant lineal correlation was observed between the percentage of increase in VTI after expansion and CVCCI (rs = 0.68, P < 0.001), expiratory/maximum diameter (rs = -0.72, P < 0.001), and inspiratory/minimum diameter (rs = -0.71, P < 0.001). The intraobserver and interobserver variability was low for VTI, and the expiratory/maximum diameter and inspiratory/minimum diameter were high for CVCCI. CONCLUSIONS Caudal vena cava measurements could be useful to predict the response to fluids in hospitalized cats with hemodynamic and tissue perfusion alterations. Additional studies are required to draw definitive conclusions about the role of these variables to guide fluid administration in cats.
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Affiliation(s)
- Pablo A Donati
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.,Cooperative Veterinary Intensive Care Unit (UCICOOP), Buenos Aires, Argentina
| | - Marcela Tunesi
- Cooperative Veterinary Intensive Care Unit (UCICOOP), Buenos Aires, Argentina
| | - Joaquin Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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Enokizono M, Mandour AS, Komeda S, Goya S, Takeuchi A, Katoh K, Yairo A, Yilmaz Z, Shimada K, Tanaka R. Hemodynamic effect of pimobendan following intramuscular and intravenous administration in healthy dogs: A pilot study. Front Vet Sci 2022; 9:969304. [PMID: 36311676 PMCID: PMC9597246 DOI: 10.3389/fvets.2022.969304] [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: 06/14/2022] [Accepted: 08/29/2022] [Indexed: 11/04/2022] Open
Abstract
Background Pimobendan is widely used for the treatment of dogs with heart failure via the oral route. A new injectable form of pimobendan is now available and its potential usefulness via intravenous route has been recently demonstrated in dogs. However, the cardiovascular effects of intramuscular (IM) administration of injectable pimobendan have not been investigated yet. Hypothesis IM administration of pimobendan may have the same hemodynamic effect as the IV route. Methods Six healthy Beagle dogs underwent a placebo-controlled double-blind crossover study. The early cardiovascular effects after a single dose of IM and IV injections of pimobendan (0.2 ml/kg; Pimo IM and Pimo IV, respectively) were compared to the same volume of IM placebo (Saline IM) in anesthetized dogs. Clinical [heart rate (HR) and blood pressure (BP)] and echocardiographic hemodynamic parameters [left ventricular (LV) inflow waveforms of diastolic early wave (eV), atrial systolic wave (aV), diastolic early mitral ring velocity (e′), peak velocity (pV), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR)] were monitored with 15 min intervals for 120 min. Results Diastolic BP decreased significantly at 30 min in Pimo IM compared to Saline IM. Mean eV and CO values significantly increased from 75 min, e′ from 60 min, pV from 75 min, and SV from 15 to 120 min, whereas SVR significantly decreased at 30–60 min in Pimo IM compared to those of Saline IM (P < 0.05). Compared with the Pimo IV, eV and pV were significantly lower at 30–60 min (P < 0.05) while SV was significantly higher at 90–105 min in Pimo IM (P < 0.05). Other hemodynamic parameters (BP, HR, SVR, CO, e′, and E/e′) did not significantly change between Pimo IM and IV. Conclusions The hemodynamic effect of pimobendan following IM and IV injection was described. Our results suggested that IM administration of pimobendan is equally comparable and possibly interchangeable with IV administration. This warrant further studies to investigate the clinical effectiveness of IM pimobendan in treating dogs with congestive heart failure or in heart failure cases unable to receive IV or oral administration.
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Affiliation(s)
- Masayuki Enokizono
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ahmed S. Mandour
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan,Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt,*Correspondence: Ahmed S. Mandour
| | - Syunta Komeda
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Seijirow Goya
- Department of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Aki Takeuchi
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Konosuke Katoh
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Akira Yairo
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Zeki Yilmaz
- Department of Internal Medicine, Faculty of Veterinary Medicine, Uludag University, Bursa, Turkey
| | - Kazumi Shimada
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan,Ryou Tanaka
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Donati PA, Tarragona L, Sandez Cordero I, Alzate D, Otero PE. Relationship between tricuspid annular plane systolic excursion, fluid responsiveness and volume status in hospitalised dogs with circulatory abnormalities. N Z Vet J 2022; 70:326-331. [PMID: 35719118 DOI: 10.1080/00480169.2022.2091676] [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: 10/18/2022]
Abstract
AIMS To evaluate the echocardiographic variable tricuspid annular plane systolic excursion normalised to body weight (TAPSEnorm) as a predictor of fluid responsiveness in hospitalised dogs with haemodynamic and tissue perfusion alterations and to investigate the association of left ventricular internal diameter in diastole normalised to body weight (LVIDdN) and aortic velocity time integral (VTIAo) with TAPSEnorm. METHODS A single-centre, prospective study was carried out in a cohort of spontaneously breathing dogs, hospitalised for any reason, with severe haemodynamic and tissue perfusion alterations. The echocardiographic variables TAPSEnorm, LVIDdN, and VTIAO were measured. A bolus of 30 mL/kg of lactated Ringer's solution was administered and then VTIAo was subsequently remeasured. Patients were classified as fluid responsive if VTIAo increased by ≥15% after fluid expansion, or non-responsive if VTIAo increased by <15% after fluid expansion. The area under the receiver operating characteristic (AUROC) curve was generated to evaluate the ability of TAPSE to predict fluid responsiveness. Simple regression models were used to assess the linear relationship between TAPSEnorm and LVIDdN or VTIAO. RESULTS TAPSEnorm was lower in fluid responsive dog (mean 0.57 (95% CI=0.50-0.64) cm/kg) compared to non-responders (mean 0.76 (95% CI=0.62-0.90) cm/kg). The AUROC for TAPSEnorm was 0.827 (95% CI=0.65-1.00). The optimal cut-off point was 0.76 with sensitivity of 80 (95% CI=28.4-99.5)% and specificity of 86.7 (95% CI=69.3-99.2)%, positive predictive value of 50 (95% CI=15.7-84.3)% and negative predictive value of 96.3 (95% CI=81-99.9)%. A monotonic linear relationship was observed between TAPSEnorm and LVIDdN (p<0.001) and between TAPSEnorm and VTIAo (p=0.001). CONCLUSIONS AND CLINICAL RELEVANCE TAPSEnorm could be useful in determining those dogs that are likely to respond to a fluid bolus from those that are likely to be non-responsive. Additionally, a positive linear association between the LVIDdN and the TAPSEnorm suggests that TAPSEnorm decreases at lower preload values. The present study results suggest that TAPSEnorm could be a valuable tool for evaluating blood volume status and fluid responsiveness in hospitalised dogs.
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Affiliation(s)
- P A Donati
- UCIcoop, Buenos Aires, Argentina.,Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - L Tarragona
- Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - D Alzate
- Hospital Veterinario Caninos y Felinos, Medellín, Colombia
| | - P E Otero
- Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Reader RC, Yang VK, Babyak JM, Abelson AL. The effects of two intramuscular sedation protocols on echocardiographic variables in cats following sedation and blood donation. J Vet Emerg Crit Care (San Antonio) 2021; 31:256-262. [PMID: 33713507 DOI: 10.1111/vec.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/15/2019] [Accepted: 08/24/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare effects of 2 IM sedation protocols, alfaxalone-butorphanol (AB) versus dexmedetomidine-butorphanol (DB), on echocardiographic (ECHO) variables in cats following sedation and blood donation. DESIGN Experimental randomized, blinded crossover study. SETTING University teaching hospital. ANIMALS Eleven client-owned healthy cats. INTERVENTIONS Cats received a baseline ECHO without sedation prior to their first donation. Cats were sedated intramuscularly with AB (alfaxalone, 2 mg/kg, and butorphanol, 0.2 mg/kg) for 1 donation and DB (dexmedetomidine, 10 μg/kg, and butorphanol 0.2, mg/kg) for another, with a minimum 6 weeks between donations. A post-sedation, post-donation ECHO was performed after each blood donation. MEASUREMENTS AND MAIN RESULTS Eight cats completed the study. Compared to baseline, DB combined with blood donation decreased heart rate (-84/min; P < 0.0001), fractional shortening (-16.5%; P < 0.0001), ejection fraction (-21.0%; P = 0.0002), and cardiac output (-292 mL/min, P = 0.0001); AB combined with blood donation increased heart rate (+45/min; P = 0.0003) and decreased left ventricular end diastolic volume (-1.57 mL; P < 0.0001). Compared to AB, DB decreased heart rate (-129/min; P < 0.0001) and fractional shortening (-21.6%; P < 0.0001) and increased left ventricular end-systolic (+1.14 mL; P = 0.0004) and diastolic volumes (+1.93 mL; P < 0.0002). Cats administered DB had a significant increase in regurgitant flow across mitral, aortic, and pulmonic valves following blood donation (P < 0.05). One cat administered DB developed spontaneous echo contrast in the left ventricle following donation. CONCLUSIONS AND CLINICAL RELEVANCE Compared to AB, DB had more pronounced effects on ECHO variables in cats following IM sedation and blood donation. Due to its minimal impact on ECHO variables, AB may be a more desirable sedation protocol in this population of cats.
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Affiliation(s)
- Rebecca C Reader
- Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, Massachusetts
| | - Vicky K Yang
- Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, Massachusetts
| | - Jonathan M Babyak
- Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, Massachusetts
| | - Amanda L Abelson
- Department of Clinical Sciences, Cummings Veterinary Medical Center at Tufts University, North Grafton, Massachusetts
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The effect of sildenafil on pulmonary haemodynamics in a canine model of chronic embolic pulmonary hypertension. Res Vet Sci 2020; 133:106-110. [PMID: 32961474 DOI: 10.1016/j.rvsc.2020.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/08/2020] [Accepted: 08/30/2020] [Indexed: 01/07/2023]
Abstract
The effects of different doses of orally administered sildenafil on pulmonary haemodynamics in dogs with pulmonary hypertension (PH) have not been documented in an invasive and quantitative manner. In this study, we examined the effects of oral sildenafil using a canine model of chronic embolic PH (CEPH). This CEPH model was created by repeatedly injecting microspheres through a catheter into the pulmonary artery under general anaesthesia at regular weekly intervals over several months. The CEPH dogs received 1, 2 or 4 mg/kg of sildenafil orally twice a day for seven days. Then, haemodynamic measurements including pulmonary artery pressure (PAP), systemic artery pressure (SAP), pulmonary artery wedge pressure (PAWP), right atrial pressure (RAP) and cardiac output (CO) were obtained after seven days of sildenafil administration via right heart catheterisation and oscillometric blood pressure measurements. Sildenafil was well tolerated in this study. Sildenafil administered at doses of 2 and 4 mg/kg significantly decreased systolic PAP compared with before administration. In addition, all doses of sildenafil significantly decreased the mean and diastolic PAP. Furthermore, 4 mg/kg of sildenafil significantly decreased PAP compared with 1 mg/kg. Sildenafil also significantly decreased pulmonary vascular resistance without notable changes in SAP or systemic vascular resistance. The PAWP, RAP and CO did not increase significantly at any doses. In conclusion, the oral administration of sildenafil to CEPH models decreased PAP in a dose-dependent manner.
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Dexmedetomidine low dose followed by constant rate infusion and antagonism by atipamezole in isoflurane-anesthetized cats: an echocardiographic study. Vet Anaesth Analg 2019; 46:43-54. [DOI: 10.1016/j.vaa.2018.09.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 11/19/2022]
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Sano H, Seo J, Wightman P, Cave NJ, Gieseg MA, Johnson CB, Chambers P. Evaluation of pulse pressure variation and pleth variability index to predict fluid responsiveness in mechanically ventilated isoflurane-anesthetized dogs. J Vet Emerg Crit Care (San Antonio) 2018; 28:301-309. [PMID: 29898246 DOI: 10.1111/vec.12728] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/29/2016] [Accepted: 08/19/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate whether pulse pressure variation (PPV) and pleth variability index (PVI) are more accurate than central venous pressure (CVP) for predicting fluid responsiveness in mechanically ventilated isoflurane-anesthetized dogs after premedication with acepromazine. DESIGN Prospective experimental trial. SETTING University teaching hospital. ANIMALS Twelve Harrier hound dogs. INTERVENTIONS Each dog was anesthetized and had a fluid challenge performed. This was repeated 4 weeks later for a total of 24 fluid challenges. After premedication with intramuscular acepromazine, anesthesia was induced with propofol and maintained with isoflurane. The dogs were mechanically ventilated with constant settings. The fluid challenge consisted of 10 mL/kg of 6% hydroxyethyl starch intravenously over 13 minutes. MEASUREMENTS AND MAIN RESULTS Before and after the fluid challenge, PPV, PVI, CVP, and other hemodynamics were recorded. Change in velocity time integral of pulmonary arterial blood flow by echocardiography was calculated as an indication of change in stroke volume. A fluid responder was defined as an increase in velocity time integral ≥ 15%. Receiver operator characteristic (ROC) curves were used to determine cutoff values. Areas under ROC curve were calculated and compared. Dogs responded on 14 fluid challenges and did not on 10. Cutoff values for PPV and PVI were 11% (sensitivity 79%; specificity 80%) and 9.3% (sensitivity 86%; specificity 70%), respectively. The areas under the ROC curve of PPV [0.85, 95% confidence interval (CI): 0.70-1.00, P = 0.038] and PVI (0.84, 95% CI: 0.68-1.00, P = 0.043) were significantly higher than CVP (0.56, 95% CI: 0.32-0.81). CONCLUSIONS PPV and PVI predicted fluid responsiveness more accurately than CVP and may be useful to guide fluid administration in mechanically ventilated isoflurane-anesthetized dogs after premedication with acepromazine.
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Affiliation(s)
- Hiroki Sano
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North 4442
| | - Joonbum Seo
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North 4442
| | - Paul Wightman
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North 4442
| | - Nick J Cave
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North 4442
| | - Mike A Gieseg
- Veterinary Health Research NZ, Hamilton 3240, New Zealand
| | - Craig B Johnson
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North 4442
| | - Paul Chambers
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North 4442
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Mantovani MM, Fantoni DT, Gimenes AM, de Castro JR, Flor PB, Ida KK, Schwartz DS. Clinical monitoring of cardiac output assessed by transoesophageal echocardiography in anaesthetised dogs: a comparison with the thermodilution technique. BMC Vet Res 2017; 13:325. [PMID: 29121915 PMCID: PMC5679384 DOI: 10.1186/s12917-017-1227-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 10/25/2017] [Indexed: 12/26/2022] Open
Abstract
Background Cardiac output (CO) is an important haemodynamic parameter to monitor in patients during surgery. However, the majority of the techniques for measuring CO have a limited application in veterinary practice due to their invasive approach and associated complexity and risks. Transoesophageal echocardiography (TEE) is a technique used to monitor cardiac function in human patients during surgical procedures and allows CO to be measured non-invasively. This prospective clinical study aimed to compare the transoesophageal echocardiography using a transgastric view of the left ventricular outflow tract (LVOT) and the thermodilution (TD) technique for the assessment of CO during mean arterial pressure of 65–80 mmHg (normotension) and <65 mmHg (hypotension) in dogs undergoing elective surgery. Eight dogs were pre-medicated with acepromazine (0.05 mg/kg, IM), tramadol (4 mg/kg, IM) and atropine (0.03 mg/kg, IM), followed by anaesthetic induction with propofol (3–5 mg/kg IV) and maintenance with isoflurane associated with a continuous infusion rate of fentanyl (bolus of 3 μg/kg followed by 0.3 μg/kg/min). The CO was measured by TEE (COTEE) and TD (COTD) at the end of expiration during normotension and hypotension (induced by isoflurane). Results There was a strong positive correlation between COTEE and COTD (r = 0.925; P < 0.0001). The bias between COTD and COTEE was 0.14 ± 0.29 L/min (limits of agreement, −0.44 to 0.72 L/min). The percentage error of CO measured by the two methods was 12.32%. In addition, a strong positive correlation was found between COTEE and COTD during normotension (r = 0.995; P < 0.0001) and hypotension (r = 0.78; P = 0.0223). Conclusions The results of this study indicated that the transgastric view of the LVOT by TEE was a minimally invasive alternative to clinically monitoring CO in dogs during anaesthesia. However, during hypotension, the CO obtained by TEE was less reliable, although still acceptable.
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Affiliation(s)
- Matheus M Mantovani
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil.
| | - Denise T Fantoni
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil. .,Faculdade de Medicina Veterinária e Zootecnia da Universidade Federal de São Paulo, Av. Prof Dr Orlando Marques de Paiva 87, São Paulo, SP, 05508-270, Brazil.
| | - André M Gimenes
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Jacqueline R de Castro
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Patrícia B Flor
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Keila K Ida
- Laboratório de Investigação Médica 8, Anestesiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Denise S Schwartz
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
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Tenenbaum S, Garcia-Pereira FL, Berry CR, Obert T. Comparison of cardiac output measured by use of computed tomography and thermodilution in dogs. Am J Vet Res 2017; 78:906-909. [PMID: 28738000 DOI: 10.2460/ajvr.78.8.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare cardiac output (CO) measured by use of CT coronary angiography and thermodilution (criterion-referenced standard) at various CO values, record adverse effects, and determine the time needed to measure CO. ANIMALS 5 healthy purpose-bred Beagles (2 males and 3 females). PROCEDURES A prospective nonrandomized crossover study was conducted. Dogs were premedicated with butorphanol tartrate (0.2 mg•kg-1, IM). Anesthesia was induced by IV administration of etomidate (1 to 2 mg•kg-1) and midazolam (0.25 mg•kg-1). Orotracheal intubation was performed, and anesthesia was maintained by administration of isoflurane. The CO was determined by use of thermodilution and by use of CT at 3 CO values. Dobutamine was infused at various rates to obtain the 3 CO values. RESULTS 13 values were obtained and analyzed. The mean ± SD difference between methods was 0.09 ± 0.71 L•min-1 (95% confidence interval [CI], 0.52 to -0.34 L•min-1). Only 1 of 13 values was located on the 100% agreement line (ie, 0 line), 7 of 13 values were located within the 95% CI, and 5 of 13 values were outside the 95% CI. CONCLUSIONS AND CLINICAL RELEVANCE For this study, there was poor agreement between the 2 methods. The 95% CI interval was 0.52 to -0.34 L•min-1, and 5 of 13 values were outside the 95% CI. Therefore, results for the CT method appeared to be inappropriate for use in making clinical decisions.
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de Moura RS, Bittar IP, da Silva LH, Villela ACV, Dos Santos Júnior MB, Borges NC, Franco LG. Sedative and cardiorespiratory effects of detomidine constant rate infusion in sheep. Lab Anim 2017; 52:51-58. [PMID: 28595508 DOI: 10.1177/0023677217714013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The use of sheep in experiments is widespread and is increasing worldwide, and so is the need to develop species-specific anaesthetic techniques to ensure animal safety. Previous studies have mentioned several protocols involving the administration of alpha-2 adrenergic agonists in sheep; however, assessment of the efficacy and safety of these infusion techniques is still relatively new. Thus, the aim of the present study is to assess the effectiveness of detomidine constant rate infusion (CRI) in sheep by measuring the cardiovascular and respiratory parameters, blood gas variables and sedation scores. Eight adult female Santa Inês sheep received 20 µg/kg of detomidine hydrochloride intravenously as a bolus loading dose, followed by an infusion rate of 60 µg/kg/h. The heart rates and respiratory rates changed continuously during the CRI period. No arrhythmias were observed. The reduction in arterial partial pressure of oxygen (PaO2) was not significant, but one animal showed signs of hypoxaemia (minimum PaO2 of 66.9 mmHg). The arterial partial pressure of carbon dioxide (PaCO2) increased, but the animals did not become hypercapnic. The bicarbonate (HCO3-), pH and base excess (BE) tended towards metabolic alkalosis. The cardiac output (CO), stroke volume (SV), cardiac index (CI) and ejection fraction (EF%) showed no significant changes. The fractional shortening (FS%) decreased slightly, starting at T45min. Sedation scores varied between 3 (0/10) after sedation and during recovery and 7 (0/10) during CRI. We concluded that administering detomidine at an infusion rate of 60 µg/kg/h in Santa Inês sheep is a simple technique that produces satisfactory sedation for minimally invasive procedures.
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Kellihan H, Stepien R, Hassen K, Smith L. Sedative and echocardiographic effects of dexmedetomidine combined with butorphanol in healthy dogs. J Vet Cardiol 2015; 17:282-92. [DOI: 10.1016/j.jvc.2015.08.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 08/06/2015] [Accepted: 08/10/2015] [Indexed: 11/26/2022]
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Canfrán S, Cediel R, Sández I, Caro-Vadillo A, Gómez de Segura IA. Evaluation of an oesophageal Doppler device for monitoring cardiac output in anaesthetised healthy normotensive dogs. J Small Anim Pract 2015; 56:450-5. [DOI: 10.1111/jsap.12362] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/02/2015] [Accepted: 03/09/2015] [Indexed: 12/26/2022]
Affiliation(s)
- S. Canfrán
- Department of Animal Medicine and Surgery, Veterinary Faculty; Complutense University of Madrid; Madrid 28040 Spain
| | - R. Cediel
- Department of Animal Medicine and Surgery, Veterinary Faculty; Complutense University of Madrid; Madrid 28040 Spain
| | - I. Sández
- Itinerant Anaesthesiology Service; Sinergia Veterinaria Madrid Spain
| | - A. Caro-Vadillo
- Department of Animal Medicine and Surgery, Veterinary Faculty; Complutense University of Madrid; Madrid 28040 Spain
| | - I. A. Gómez de Segura
- Department of Animal Medicine and Surgery, Veterinary Faculty; Complutense University of Madrid; Madrid 28040 Spain
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Shih AC, Case JB, Coisman JG, Isaza NM, Amora-Junior D, Maisenbacher HW. Cardiopulmonary Effects of Laparoscopic Ovariectomy of Variable Duration in Cats. Vet Surg 2014; 44 Suppl 1:2-6. [PMID: 25164690 DOI: 10.1111/j.1532-950x.2014.12241.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 05/01/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the cardiopulmonary effects of low-pressure (6 mmHg) peritoneal insufflation of varying duration in healthy cats during ovariectomy (OVE). STUDY DESIGN Prospective, randomized study. ANIMALS Female cats (n = 24). METHODS After anesthesia induction, cats had short (Short LAP; n = 8) or long duration (Long LAP; n = 8) laparoscopic ovariectomy, or Open OVE (Open; n = 8) for comparison. Hemodynamic and pulmonary measurements were recorded after induction of anesthesia (T0), 5 minutes after abdominal insufflation had reached 6 mmHg of pressure (T1), after the 2nd ovary had been resected (T2), after abdominal decompression (T3), and at the end of anesthesia, after abdominal closure (T4). Hemodynamic and pulmonary variables were compared between groups. RESULTS Low-pressure abdominal insufflation caused cardiopulmonary changes in cats. At T1 and T2, Long LAP and Short LAP caused a significant change in PvCO2 and RC when compared with Open. During T3, RC was lower only in Long LAP. At T2, there was decrease in SV, but not CO for Long LAP when compared with Open. CONCLUSIONS Duration of insufflation was associated with worsening of negative cardiopulmonary effects; however, these effects were reversible and resolved by the end of the procedure.
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Affiliation(s)
- Andre C Shih
- Department of Large Animal, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - J Brad Case
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - James G Coisman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Natalie M Isaza
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Dorli Amora-Junior
- Department de Medicina Veterinaria, University of Parana, Parana, Brazil
| | - Herbert W Maisenbacher
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
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Morgaz J, Granados MDM, Muñoz-Rascón P, Dominguez JM, Fernández-Sarmiento JA, Gómez-Villamandos RJ, Navarrete R. Comparison of thermodilution, lithium dilution, and pulse contour analysis for the measurement of cardiac output in 3 different hemodynamic states in dogs. J Vet Emerg Crit Care (San Antonio) 2014; 24:562-70. [PMID: 25142925 DOI: 10.1111/vec.12219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 07/14/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To (1) evaluate lithium dilution (LiDCO) and transpulmonary thermodilution (PiCCOTD ) in relation to traditional thermodilution (PAC-TD) for determining cardiac output (CO) in 3 different hemodynamic states in dogs and to (2) compare the continuous CO values obtained using power analysis (PulseCO) with continuous PiCCO (PiCCOc). DESIGN Prospective randomized study. SETTING University research laboratory. ANIMALS Fourteen healthy Beagles. INTERVENTIONS CO was measured using PAC-TD, LiDCO, and PiCCOTD in 3 different hemodynamic states induced in random order and defined on the basis of the mean arterial pressure (MAP). Normodynamic state was defined as the baseline MAP and 1 MAC sevoflurane. The hypodynamic state was induced with a deep level of sevoflurane anesthesia. The hyperdynamic state was induced with noradrenaline. After these measurements were obtained in each hemodynamic state, CO was monitored continuously for 30 min using PulseCO and PiCCOc. Agreement was assessed using Bland-Altman analysis and intraclass correlation coefficients, and a trend score was determined for the continuous CO measurements. MEASUREMENTS AND MAIN RESULTS There was good agreement among the 3 modalities of CO measurement in each hemodynamic state. The mean CIPAC-TD /CIPICCOTD bias was -0.04 ± 1.19 L/min/m(2) (limits of agreement, -2.37/1.93 L/min/m(2) ), and the mean CIPAC-TD /CILiDCO bias was -0.11 ± 1.55 L/min/m(2) (limits of agreement, -3.04/2.93 L/min/m(2) ). The mean CIPulseCO -CIPiCCOc bias was -0.04 ± 1.91 L/min/m(2) (limits of agreement, -1.95/1.87 L/min/m(2) ), which suggested good agreement. The CIPulseCO -CIPiCCOc trend score, calculated from 252 paired comparisons, was 93.3% positive after zone exclusion (∆CI < 15%). CONCLUSIONS Both LiDCO and PiCCOTD agreed well with PAC-TD for the measurement of CO under different hemodynamic conditions. Moreover, PiCCOc appears to be an accurate method for monitoring continuous CO in dogs as its performance for measurement was similar to that of PulseCO.
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Affiliation(s)
- Juan Morgaz
- Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain
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