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Audira G, Huang JC, Chen KHC, Kurnia KA, Vasquez RD, Roldan MJM, Lai YH, Hsiao CD, Yen CY. A comprehensive painkillers screening by assessing zebrafish behaviors after caudal fin amputation. Biomed Pharmacother 2023; 168:115641. [PMID: 37806085 DOI: 10.1016/j.biopha.2023.115641] [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: 07/05/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023] Open
Abstract
Recently, the usage of zebrafish for pain studies has increased in the past years, especially due to its robust pain-stimulated behaviors. Fin amputation has been demonstrated to induce a noxious response in zebrafish. However, based on the prior study, although lidocaine, the most used painkiller in zebrafish, has been shown to ameliorate amputated zebrafish behaviors, it still causes some prolonged effects. Therefore, alternative painkillers are always needed to improve the treatment quality of fin-amputated zebrafish. Here, the effects of several analgesics in recovering zebrafish behaviors post-fin amputation were evaluated. From the results, five painkillers were found to have potentially beneficial effects on amputated fish behaviors. Overall, these results aligned with their binding energy level to target proteins of COX-1 and COX-2. Later, based on their sub-chronic effects on zebrafish survivability, indomethacin, and diclofenac were further studied. This combination showed a prominent effect in recovering zebrafish behaviors when administered orally or through waterborne exposure, even with lower concentrations. Next, based on the ELISA in zebrafish brain tissue, although some changes were found in the treated group, no statistical differences were observed in most of the tested biomarkers. However, since heatmap clustering showed a similar pattern between biochemical and behavior endpoints, the minor changes in each biomarker may be sufficient in changing the fish behaviors.
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Affiliation(s)
- Gilbert Audira
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 320314, Taiwan
| | - Jong-Chin Huang
- Department of Applied Chemistry, National Pingtung University, Pingtung 90003, Taiwan
| | - Kelvin H-C Chen
- Department of Applied Chemistry, National Pingtung University, Pingtung 90003, Taiwan
| | - Kevin Adi Kurnia
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 320314, Taiwan; Department of Applied Chemistry, National Pingtung University, Pingtung 90003, Taiwan; Department of Chemistry, Chung Yuan Christian University, Taoyuan 320314, Taiwan
| | - Ross D Vasquez
- Department of Pharmacy, Research Center for Natural and Applied Sciences, University of Santo Tomas, Manila 1008, Philippines
| | - Marri Jmelou M Roldan
- Faculty of Pharmacy, The Graduate School, University of Santo Tomas, Manila 1008, Philippines
| | - Yu-Heng Lai
- Department of Chemistry, Chinese Culture University, Taipei 11114, Taiwan
| | - Chung-Der Hsiao
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 320314, Taiwan; Department of Chemistry, Chung Yuan Christian University, Taoyuan 320314, Taiwan; Center for Nanotechnology, Chung Yuan Christian University, Taoyuan 320314, Taiwan; Research Center for Aquatic Toxicology and Pharmacology, Chung Yuan Christian University, Taoyuan 320314, Taiwan.
| | - Cheng-Yo Yen
- Department of Orthopedics, E-Da Cancer Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung, Taiwan.
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Ziaei Darounkolaei N, Mousavi Kiasary SMS, Behzadi A, Nabavi Mosavi N, Ferdowsi SM. Instrument shank-assisted ovariohysterectomy: a randomized clinical trial of surgical and pain alleviation efficiency of a single-person modified technique. Front Vet Sci 2023; 10:1210089. [PMID: 37915948 PMCID: PMC10616265 DOI: 10.3389/fvets.2023.1210089] [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: 04/21/2023] [Accepted: 10/03/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives To evaluate a modified ovariohysterectomy (OHE) technique performed by a single person and compare it with the conventional method based on time efficiency, trauma, and postoperative pain. Methods In a prospective, randomized, experimental study, 18 healthy, large, deep-chested, mixed-breed intact female dogs were randomly allocated to conventional (n = 9) and instrument shank-assisted (n = 9) groups. On the basis of video recordings, the various surgical step durations were analyzed: total surgery time (TST), pedicle intervention time (PIT), suspensory release time (SRT), shanking time (ShT), clamping time (ClpT), ligating time (LigT), and closure time (CT). The Glasgow composite pain scale short-form (GCMPS-SF), university of Melbourne pain scale (UMPS), and Visual Analogue Scales (VAS) were used to measure pain. C-reactive protein (CRP) fluctuation was also investigated. These evaluations were completed before and 6, 24, 48, and 72 h postoperatively. Results Instrument shank-assisted OHE was less time-consuming than conventional OHE (p = 0.005), improved PIT by 30.7% (6.44 min for both pedicles, p = 0.014), and correlated strongly with TST (ρ = 0.862, p = 0.003 and ρ = 0.955, p = 0.000, respectively). The two method's surgical step durations were also TST = 47.40 ± 9.9 vs. 34.70 ± 6.7 min, PIT = 20.96 ± 5.78 vs. 14.52 ± 3.73 min, SRT = 78.97 ± 69.10 vs. ShT = 20.39 ± 8.18 s (p = 0.035), ClpT = 50.66 ± 45.04 vs. 63.55 ± 37.15 s (p = 0.662), LigT = 12.82 ± 3.37 vs. 8.02 ± 3.11 min (p = 0.005), and CT = 16.40 ± 4.5 vs. 11.60 ± 2.5 min (p = 0.013), respectively. While both techniques inflicted pain on the animals, the novel approach resulted in a reduction of pain at T6 (GCMPS-SF, p = 0.015 and VAS, p = 0.002), T24 (UMPS, p = 0.003), and T48 (GCMPS-SF, p = 0.015 and UMPS, p = 0.050). Both methods exhibited a peak in CRP level after 24 h, which subsequently returned to baseline after 48 h. However, the shank-assisted method demonstrated a significantly lower reduction in CRP level at the 48-h compared to the other group (p = 0.032). Conclusion Instrument shank-assisted technique permitted ovarian removal without an assistant, less damage to animals and reducing its time when compared to a conventional technique, and resulting in an alternative that causes less surgical stress and fatigue. Further research with a larger population size is required to determine the serum CRP levels as an alternative pain biomarker.
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Affiliation(s)
- Navid Ziaei Darounkolaei
- Babol Branch, Department of Surgery and Radiology, Faculty of Veterinary Medicine, Islamic Azad University, Babol, Iran
| | - Seyed Mohamad Sadegh Mousavi Kiasary
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Amirhoushang Behzadi
- Babol Branch, Faculty of Veterinary Medicine, Islamic Azad University, Babol, Iran
| | - Niki Nabavi Mosavi
- Babol Branch, Department of Surgery and Radiology, Faculty of Veterinary Medicine, Islamic Azad University, Babol, Iran
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Henze IS, Navarro Altuna V, Steiger JI, Torgerson PR, Kutter APN. Evaluation of the Analgesic Efficacy of Undiluted Intraperitoneal and Incisional Ropivacaine for Postoperative Analgesia in Dogs after Major Abdominal Surgery. Animals (Basel) 2023; 13:ani13091489. [PMID: 37174527 PMCID: PMC10177421 DOI: 10.3390/ani13091489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Recommendations for intraperitoneal (IP) and incisional (INC) administration of local anaesthetics after visceral surgery exist, but evidence is scarce. This prospective, randomized, blinded, controlled, clinical trial compared postoperative pain in dogs undergoing major abdominal surgery. Sixteen client-owned dogs were anaesthetized with a standardized balanced protocol including opioids and received either 2 mg/kg ropivacaine IP (0.27 mL/kg) and a 1 mg/kg INC splash (0.13 mL/kg) or equal volumes of saline. Influence of the treatment on heart rate (HR) and postoperative pain was assessed using the Short Form of the Glasgow Composite Pain Scale (GCPS-SF), a dynamic interactive visual analogue scale (DIVAS) and mechanical nociceptive threshold testing (MNT). Data was tested with mixed ordinal regression and log linear mixed models for 0.5, 1, 2, 3, 4, 6, 8, 10 and 12 h after extubation. Rescue analgesia was given to 3/8 dogs after ropivacaine and 0/8 dogs after saline. GCPS-SF and MNT were not different between groups. DIVAS was slightly higher after ropivacaine (odds increased by 5.44 (confidence interval (CI) 1.17-9.96, p = 0.012)), and HR after ropivacaine was 0.76 * that after saline (CI 0.61-0.96, p = 0.02) with no effect of time (p = 0.1). Undiluted ropivacaine IP and INC was not beneficial for postoperative analgesia.
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Affiliation(s)
- Inken S Henze
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Victoria Navarro Altuna
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Joëlle I Steiger
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Paul R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Annette P N Kutter
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
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Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital. Animals (Basel) 2022; 12:ani12151939. [PMID: 35953928 PMCID: PMC9367294 DOI: 10.3390/ani12151939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 01/01/2023] Open
Abstract
This study compared four methods to provide intraoperative analgesia during canine ovariohysterectomy in a veterinary teaching hospital. A retrospective study was designed to assess the nociceptive response, cardiorespiratory stability, quality of recovery and complications of four analgesic protocols: epidural analgesia (EPIDURAL group), Quadratus Lumborum block (QLB group), Transversus Abdominis Plane block (TAP group), and just systemic analgesia (GENERAL group). Undergraduate students carried out all the loco-regional techniques under the direct supervision of a qualified anaesthetist. A total of 120 cases met the inclusion criteria and were included in the study and were distributed as follows: 22, 27, 32 and 39 cases with EPIDURAL, GENERAL, QLB and TAP groups, respectively. Data were analysed with statistical software R using different statistical methods. Significant differences among groups were defined as p < 0.05. Based on our results, all the groups needed the same number of rescue analgesia during the intra-operative period. The use of loco-regional techniques anticipated a better quality of recovery compared with the general group. The EPIDURAL group showed a statistically lower expired fraction of sevoflurane. No differences were found regarding complications. In conclusion, these four analgesic methods are suitable and safe to be performed for canine ovariohysterectomy, although loco-regional techniques might have some advantages.
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An Observational Survey Study on the Use of Locoregional Anaesthesia in Non-Conventional Species: Current Practice and Potential Future Developments. Animals (Basel) 2022; 12:ani12111448. [PMID: 35681912 PMCID: PMC9179915 DOI: 10.3390/ani12111448] [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: 03/25/2022] [Revised: 05/10/2022] [Accepted: 06/02/2022] [Indexed: 12/10/2022] Open
Abstract
The objectives of this study were to investigate the current attitudes of veterinarians towards the use of locoregional anaesthesia in non-conventional animal species and to identify areas for future useful research on this topic. A questionnaire was circulated online. A total of 417 veterinarians, including American and European specialists/specialists-in-training in both zoological medicine and anaesthesia/analgesia (ACZM/ECZM and ACVAA/ECVAA), participated in the study. Fifty-nine percent of respondents performed locoregional anaesthesia in rabbits, with intratesticular injections and local infiltration being the most commonly-reported techniques. ACZM/ECZM specialists reportedly performed dental blocks in rabbits more frequently than ACVAA/ECVAA specialists (p = 0.030). Forty percent of respondents performed locoregional anaesthesia in rodents, with intratesticular injections, topical/splash blocks and local infiltration being the most commonly reported techniques. The proportions of respondents who reportedly used locoregional anaesthesia in ferrets, birds and reptiles were 37.9%, 34.5% and 31.2%, respectively. The use of Tuohy (p < 0.001) and spinal needles (p < 0.001), as well as of ultrasonography (p = 0.009) and nerve-stimulators (p < 0.001), was more common among ACVAA/ECVAA compared to ACZM/ECZM specialists. Major topic areas for future research were identified as dental block techniques for rabbits and rodents and blocks for the wings of birds.
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Cicirelli V, Lacalandra GM, Cshe S, Mrenoshki D, Lillo E, Bianchi FP, Aiudi GG. Analgesic comparison between topical irrigation (splash block) versus injection of lidocaine on the ovarian pedicle in canine ovariectomy. Vet Med Sci 2022; 8:1893-1897. [PMID: 35611806 PMCID: PMC9514456 DOI: 10.1002/vms3.843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives The aim of this study was to compare the analgesic efficacy of topical irrigation versus injection of lidocaine on the ovarian pedicle to provide analgesia in bitches ovariectomy. In the current study were monitored: increased blood pressure, heart rate and respiratory rate to identify an acute intraoperative nociceptive response. These parameters were registered at six times during the surgical procedure: grasping of the ovary (time 1), dissection of the mesosalpinx (time 2), tightening of the first loop ligature (time 3), tightening of the second loop ligature (time 4), transection of the ovarian pedicle (time 5) and release of the ovary (time 6). Material and Methods Forty healthy bitches were randomly assigned in two groups (n = 20) to receive topical irrigation (splash block) of 2% lidocaine (C group) on both ovarian pedicle (2 mg/kg each), or an equal volume of lidocaine was injected at the same sites (R group). Results The results of the present study suggest that splash block may provide intraoperative analgesic effects equivalent to injection in the ovarian pedicle in dogs that have undergone ovariectomy. The lidocaine improved surgical analgesia during canine ovariectomy in both groups, and this action is not affected by the inoculation technique. Clinical significance Pain management in veterinary patients is a crucial component of appropriate patient care. Therefore, the need for achieving safer anaesthesia for surgical intervention is gaining much attention. Ovariectomy is a common surgical procedure in bitches with medium level of pain. This study concluded that considering its relative simplicity, low cost, and safety, both techniques could be used in daily clinical practice.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | | | - Sandor Cshe
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Daniela Mrenoshki
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Edoardo Lillo
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Paolo Bianchi
- Department and Clinic of Obstetrics and Animal Reproduction, University of Veterinary Medicine, Budapest, Hungary
| | - Giulio Guido Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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Cicirelli V, Matteo B, Di Bella C, Lacalandra GM, Aiudi G. The ultrasound-guided funicular block in cats undergoing orchiectomy: ropivacaine injection into the spermatic cord to improve intra and postoperative analgesia. BMC Vet Res 2022; 18:169. [PMID: 35538544 PMCID: PMC9088067 DOI: 10.1186/s12917-022-03279-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The orchiectomy in cats is a common surgical procedure with medium level of pain and for this reason requires intra and postoperative analgesia management. The aim of this study was to compare intra and postoperative pain in two groups of cats undergoing orchiectomy. Sixty healthy cats were randomly assigned in two groups (n = 30) to receive pre surgery ropivacaine hydrochloride (0.2 mL/kg at 0.5%) (R Group) or NaCl 0.9% (C group) into the spermatic cord. The intraoperative evaluation was carried out using the cardiorespiratory stability parameters and eventually administration of rescue analgesia. A rescue analgesia (fentanyl 2 µg/kg) was administered during orchiectomy in case of considerable increase of blood pressure, heart rate or respiratory rate. The postoperative evaluation was been done using scores following a UNESP-Botucatu multimodal scale for 6 h post-surgery. RESULTS As result, cats in R group responded better to surgical procedure, maintaining lower postoperative pain scores than C group. CONCLUSIONS The ultrasound-guided funicular block used in this study, as already demonstrated in dogs, is a good method to protect the cats from surgical pain and ensure a good level of surgical analgesia.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy.
| | - Burgio Matteo
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Caterina Di Bella
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | | | - Giulio Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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Gruen ME, Lascelles BDX, Colleran E, Gottlieb A, Johnson J, Lotsikas P, Marcellin-Little D, Wright B. 2022 AAHA Pain Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2022; 58:55-76. [PMID: 35195712 DOI: 10.5326/jaaha-ms-7292] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
These updated guidelines present a practical and logical approach to the assessment and management of acute and chronic pain in canine and feline patients. Recognizing pain is fundamental to successful treatment, and diagnostic guides and algorithms are included for assessment of both acute and chronic pain. Particularly for chronic pain, capturing owner evaluation is important, and pain-assessment instruments for pet owners are described. Expert consensus emphasizes proactive, preemptive pain management rather than a reactive, "damage control" approach. The guidelines discuss treatment options centered on preemptive, multimodal analgesic therapies. There is an extensive variety of pharmacologic and nonpharmacologic therapeutic options for the management of acute and chronic pain in cats and dogs. The guidelines include a tiered decision tree that prioritizes the use of the most efficacious therapeutic modalities for the treatment of acute and chronic pain.
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Affiliation(s)
- Margaret E Gruen
- North Carolina State University, Department of Clinical Sciences (M.E.G.)
| | - B Duncan X Lascelles
- North Carolina State University, Translational Research in Pain, Department of Clinical Sciences (B.D.X.L.)
| | | | | | | | | | - Denis Marcellin-Little
- University of California, Davis, Department of Surgical and Radiological Sciences (D.M-L.)
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Cicirelli V, Aiudi GG, Mrenoshki D, Lacalandra GM. Fentanyl patch versus tramadol for the control of postoperative pain in canine ovariectomy and mastectomy. Vet Med Sci 2021; 8:469-475. [PMID: 34953046 PMCID: PMC8959330 DOI: 10.1002/vms3.691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The purpose of the present study was to evaluate the postoperative analgesic efficacy of fentanyl patches versus subcutaneous tramadol after canine ovariectomy, with and without unilateral mastectomy. MATERIALS AND METHODS A total of 40 female dogs were included in the present study, all of which were domesticated, healthy and 4-12 years of age. The animals were divided into four groups (n = 10 per group) based on the surgery and the analgesic protocol used: the TO group only underwent ovariectomy, and received postoperative tramadol; the TM group underwent both ovariectomy and mastectomy, and received postoperative tramadol; the FO group only underwent ovariectomy, and received fentanyl patches; and the FM group underwent both ovariectomy and mastectomy, and received fentanyl patches. Postoperative pain was evaluated every 4 h for 24 h using a numeric analogue scale (NAS) and a modified Glasgow Composite Measure Pain Scale Short Form (CMPS-SF). RESULTS The results of the present study showed that patients in all four groups tolerated postoperative surgical stress well. Analysis of variance for repeated measures did not show significant differences in the NAS scores and in Glasgow CMPS-SF between groups in terms of pain scores or rescue analgesia. CLINICAL SIGNIFICANCE These results indicated that the analgesic effect of the fentanyl patch was similar to that of subcutaneous (SC) tramadol in female dogs after ovariectomy, with and without unilateral mastectomy, suggesting that the fentanyl patch may represent a valid supplementary tool for the control of postoperative pain in animals after surgery.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Giulio G Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Daniela Mrenoshki
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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Rezaeipour A, Naddaf H, Jalali SM, Sabiza S. Evaluation of intraperitoneal administration of morphine on post-operative pain management after ovariohysterectomy in dogs. Vet Med Sci 2021; 8:150-156. [PMID: 34821072 PMCID: PMC8788973 DOI: 10.1002/vms3.668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The present prospective randomized experimental study was designed to assess pain control with intraperitoneal morphine following ovariohysterectomy in dogs. A group of 12 mixed breed female dogs, aged 1-2 years, weighing 19.95 ± 0.95 kg were included. Forty minutes after sedation with 0.05 mg/kg intramuscular acepromazine 1%, anaesthesia was induced with propofol (4 mg/kg). The dogs were connected to the inhalation anaesthesia circuit using isoflurane. Ovariohysterectomy was performed, and before the closure of linea alba, the animals received intraperitoneal morphine (0.5 mg/kg) (in group M) and saline (0.2 ml/kg) (in group S). No significant difference was detected in total protein and glucose levels between the groups, while the cortisol level in group M was significantly lower than group S 1, 3 and 6 h after surgery. Furthermore, the comparison of the rectal temperature, heart rates and respiratory rates showed no major differences. Additionally, no significant alterations were detected between the groups considering the changes in the pain scores with simple descriptive score, Glasgow, University of Melbourne pain scale, sedation status and Sammarco methods. Finally, three cases in group S and two cases in group M were given an intramuscular analgesic rescue dose of morphine. Although a significant decline was observed in cortisol levels following intraperitoneal morphine administration, there were no beneficial changes in the efficiency of post-operative analgesia in status and clinical signs compared to the control group. Further studies are required to investigate intraperitoneal morphine effectiveness in post-operative pain management.
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Affiliation(s)
- Aida Rezaeipour
- DVM, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
| | - Hadi Naddaf
- Professor, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
| | - Seyedeh Missagh Jalali
- Associate Professor, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
| | - Soroush Sabiza
- Assistant Professor, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
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Fudge JM, Page B, Lee I. Evaluation of Targeted Bupivacaine, Bupivacaine-lidocaine-epinephrine, Dexamethasone, and Meloxicam for Reducing Acute Postoperative Pain in Cats Undergoing Routine Ovariohysterectomy. Top Companion Anim Med 2021; 45:100564. [PMID: 34314884 DOI: 10.1016/j.tcam.2021.100564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/04/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
This study compared bupivacaine (BUP), bupivacaine-lidocaine-epinephrine (BLE), dexamethasone (DEX), and meloxicam (MEL) targeted at specific, potentially painful sites for reducing acute postoperative pain in cats undergoing elective ovariohysterectomy. One hundred fifty-one cats were included in a prospective, randomized, double-blinded clinical trial. Anesthesia consisted of a standardized protocol including buprenorphine, ketamine, dexmedetomidine, and isoflurane. A ventral midline ovariohysterectomy was performed, and cats were administered targeted injections of 0.5% bupivacaine (2 mg/kg); a combined 0.25% bupivacaine (1 mg/kg), 1% lidocaine (2 mg/kg), and 1:100,000 epinephrine (0.005 mg/kg); dexamethasone (0.125 mg/kg); or meloxicam (0.2 mg/kg) intraoperatively at the ovarian suspensory ligaments, uterine body, and incisional subcutaneous tissues. A 0-10 Numeric Pain Rating Scale (NRS) was used to assess cats postoperatively, 1 hour and 3 hours after anesthesia recovery prior to a same day discharge. Pain scores among evaluators were in good agreement with an overall Intraclass Correlation Coefficient (ICC) of 0.7897 (95% Confidence Interval 0.795-0.8313). In all groups, overall pain scores 1-hour post anesthesia recovery were significantly higher than scores 3 hours post anesthesia recovery (P < .0001). Averaged pain scores compared among treatment groups did not differ at 1 hour post recovery. At 3-hours post anesthesia recovery, MEL group cats had significantly lower pain scores than the BLE group (P = .018). Study results indicate that early postoperative pain scores were similar for cats receiving local infiltrations of BUP, BLE, DEX, and MEL as part of a multimodal pain therapy for routine ovariohysterectomies. MEL showed somewhat better results 3 hours post anesthesia recovery, gaining significance over the BLE group.
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Affiliation(s)
| | | | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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12
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Use of Spinal Anaesthesia with Anaesthetic Block of Intercostal Nerves Compared to a Continuous Infusion of Sufentanyl to Improve Analgesia in Cats Undergoing Unilateral Mastectomy. Animals (Basel) 2021; 11:ani11030887. [PMID: 33804684 PMCID: PMC8003676 DOI: 10.3390/ani11030887] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with intercostal nerve block compared with a constant-rate infusion of sufentanyl citrate in cats undergoing unilateral mastectomy. This study demonstrated that the use of spinal anaesthesia with anaesthetic block of intercostal nerves, using levobupivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with invasive surgical procedures such as radical mastectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after spaying procedures in cats. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain and therefore optimise surgical results. This method, considering the relative simplicity of its execution, can be used in daily clinical practice. Abstract Unilateral mastectomy is a common surgical procedure in feline species and requires postoperative pain management. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with an intercostal nerve block, in comparison with the use of sufentanyl citrate administered as a constant-rate infusion (CRI). Twenty cats were randomly divided into two groups (n = 10/group) based on the analgesic protocol used: the first received loco-regional anaesthesia with levobupivacaine (LR group), and the second received a CRI of sufentanyl (SUF group). The evaluation criteria during surgery were the need for a bolus of fentanyl in the event of an increased heart rate or increased blood pressure. In the postoperative period, the levels of comfort/discomfort and pain were used to obtain a score according to the UNESP-Botucatu multimodal scale. Subjects who scored above seven received analgesic drug supplementation. Intraoperative analgesia was satisfactory, with good haemodynamic stability in both groups. Four patients in the LR group required an extra dose of methadone after they achieved the sternal decubitus position, whereas those in the SUF group required many more doses. The analgesia achieved in the LR group was more satisfactory than that in the SUF group.
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Farokhzad B, Sabiza S, Razi Jalali M, Baniadam A. Intraperitoneal administration of lidocaine or tramadol alone or in combination on postoperative pain after ovariohysterectomy in dogs. Vet Med Sci 2021; 7:634-641. [PMID: 33528116 PMCID: PMC8136923 DOI: 10.1002/vms3.437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/04/2021] [Accepted: 01/16/2021] [Indexed: 12/05/2022] Open
Abstract
The present prospective randomized experimental study aimed to assess the intraperitoneal (ip) administration of lidocaine or tramadol, alone or in combination, on postoperative pain management following ovariohysterectomy in dogs. Eighteen healthy female mixed‐breed dogs, aged 1–2 years, weighed 16.7 ± 3.8 kg, were used. Animals were sedated with acepromazine (0.1 mg/kg, intramuscular). Forty minutes later, anaesthesia was induced through intravenous titration with diazepam (0.5 mg/kg) and ketamine (10 mg/kg) and maintained with isoflurane 1.5%. Afterwards, ovariohysterectomy was performed, and prior to the closure of the linea alba, animals received lidocaine containing epinephrine (8.8 mg/kg, ip) in group L, tramadol (4 mg/kg, ip) in group T and lidocaine containing epinephrine (8.8 mg/kg, ip) plus tramadol (4 mg/kg, ip) in the LT group. Cortisol, vital signs and pain scoring systems were evaluated at different time points. Vital signs did not change among the groups. Cortisol level in the LT group significantly decreased compared to the L and T groups one, three and six hours after surgery. Pain scores also did not change among the groups based on Sammarco and Simple descriptive (SDS) scoring method. However, pain scores in the LT group were higher than the two other groups according to the University of Melbourne pain scale (UMPS) and the short form of Glasgow pain scale (CMPS‐SF). According to the obtained results, the combination of lidocaine and tramadol seemed to be able to provide better analgesia compared with their separate administration. Therefore, combined intraperitoneal administration of lidocaine (8.8 mg/kg) and tramadol (4 mg/kg) with a final volume of (0.2 ml/kg) following ovariohysterectomy is recommended.
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Affiliation(s)
- Behnam Farokhzad
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Soroush Sabiza
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Razi Jalali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Ali Baniadam
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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de O L Carapeba G, Nicácio IPGA, Stelle ABF, Bruno TS, Nicácio GM, Costa Júnior JS, Giuffrida R, Teixeira Neto FJ, Cassu RN. Comparison of perioperative analgesia using the infiltration of the surgical site with ropivacaine alone and in combination with meloxicam in cats undergoing ovariohysterectomy. BMC Vet Res 2020; 16:88. [PMID: 32178668 PMCID: PMC7075011 DOI: 10.1186/s12917-020-02303-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 03/03/2020] [Indexed: 01/31/2023] Open
Abstract
Background Infiltration of the surgical site with local anesthetics combined with nonsteroidal anti-inflammatory drugs may play an important role in improving perioperative pain control. This prospective, randomized, blinded, controlled clinical trial aimed to evaluate intraoperative isoflurane requirements, postoperative analgesia, and adverse events of infiltration of the surgical site with ropivacaine alone and combined with meloxicam in cats undergoing ovariohysterectomy. Forty-five cats premedicated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments (n = 15 per group): physiological saline (group S), ropivacaine alone (1 mg/kg, group R) or combined with meloxicam (0.2 mg/kg, group RM) infiltrated at the surgical site (incision line, ovarian pedicles and uterus). End-tidal isoflurane concentration (FE’ISO), recorded at specific time points during surgery, was adjusted to inhibit autonomic responses to surgical stimulation. Pain was assessed using an Interactive Visual Analog Scale (IVAS), UNESP-Botucatu Multidimensional Composite Pain Scale (MCPS), and mechanical nociceptive thresholds (MNT) up to 24 h post-extubation. Rescue analgesia was provided with intramuscular morphine (0.1 mg/kg) when MCPS was ≥6. Results Area under the curve (AUC) of FE’ISO was significantly lower (P < 0.0001) in the RM (17.8 ± 3.1) compared to S (23.1 ± 2.2) and R groups (22.8 ± 1.1). Hypertension (systolic arterial pressure > 160 mmHg) coinciding with surgical manipulation was observed only in cats treated with S and R (4/15 cats, P = 0.08). The number of cats receiving rescue analgesia (4 cats in the S group and 1 cat in the R and RM groups) did not differ among groups (P = 0.17). The AUC of IVAS, MCPS and MNT did not differ among groups (P = 0.56, 0.64, and 0.18, respectively). Significantly lower IVAS pain scores were recorded at 1 h in the RM compared to the R and S groups (P = 0.021–0.018). There were no significant adverse effects during the study period. Conclusions Local infiltration with RM decreased intraoperative isoflurane requirements and resulted in some evidence of improved analgesia during the early postoperative period. Neither R nor RM infiltration appeared to result in long term analgesia in cats undergoing ovariohysterectomy.
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Affiliation(s)
- Gabriel de O L Carapeba
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Isabela P G A Nicácio
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Ana Beatriz F Stelle
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Tatiane S Bruno
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Gabriel M Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - José S Costa Júnior
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Rogerio Giuffrida
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Francisco J Teixeira Neto
- Department of Veterinary Surgery and Animal Reproduction, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Renata N Cassu
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil. .,Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil.
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Gomes DR, Nicácio IPGA, Cerazo LML, Dourado L, Teixeira-Neto FJ, Cassu RN. Addition of magnesium sulfate to intraperitoneal ropivacaine for perioperative analgesia in canine ovariohysterectomy. J Vet Pharmacol Ther 2020; 43:355-363. [PMID: 32144805 DOI: 10.1111/jvp.12851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/06/2020] [Accepted: 02/15/2020] [Indexed: 01/09/2023]
Abstract
Magnesium may be used as an adjunctive analgesic for perioperative pain management because of its antinociceptive properties. This study investigated the analgesic efficacy of intraperitoneal ropivacaine combined with magnesium sulfate in canine ovariohysterectomy. Forty-five dogs sedated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments, administered intraperitoneally (n = 15 per group): saline solution (group S), 0.25% ropivacaine (3 mg/kg) alone (group R), or in combination with magnesium sulfate (20 mg/kg, group R-Mg). Intravenous fentanyl was given to control cardiovascular responses to surgical stimulation. Postoperative pain was assessed using an Interactive Visual Analog Scale (IVAS), the short form of the Glasgow Composite Pain Scale, and mechanical nociceptive thresholds. Morphine/meloxicam was administered as rescue analgesia. Intraoperatively, the R-Mg group required less fentanyl (p = .02) and exhibited higher incidence of hypotension (systolic arterial pressure <90 mm Hg, p = .006) compared with the S group. Lower IVAS pain scores were recorded during the first hour in the R-Mg group than the other groups (p = .007-.045). Postoperative rescue analgesia did not differ between groups. Intraperitoneal magnesium sulfate administration, in spite of decreasing intraoperative opioid requirements, increased the incidence of hypotension with minimal evidence of postoperative analgesic benefits.
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Affiliation(s)
- Denis R Gomes
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Isabela P G A Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Letícia M L Cerazo
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Larissa Dourado
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Francisco J Teixeira-Neto
- Department of Veterinary Surgery and Animal Reproduction, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Renata N Cassu
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
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Nicácio IP, Stelle ABF, Bruno TS, Nicácio GM, Costa JS, Cassu RN. Comparison of intraperitoneal ropivacaine and ropivacaine-dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy. Vet Anaesth Analg 2020; 47:396-404. [PMID: 32199795 DOI: 10.1016/j.vaa.2020.01.007] [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: 05/10/2019] [Revised: 12/20/2019] [Accepted: 01/05/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the intraperitoneal (IP) administration of ropivacaine or ropivacaine-dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy. STUDY DESIGN Prospective, randomized, blinded, positively controlled clinical study. ANIMALS A total of 45 client-owned cats were enrolled. METHODS The cats were administered intramuscular (IM) meperidine (6 mg kg-1) and acepromazine (0.05 mg kg-1). Anesthesia was induced with propofol and maintained with isoflurane. Meloxicam (0.2 mg kg-1) was administered subcutaneously in all cats after intubation. After the abdominal incision, the cats were administered one of three treatments (15 cats in each treatment): IP instillation of 0.9% saline solution (group Control), 0.25% ropivacaine (1 mg kg-1, group ROP) or ropivacaine and dexmedetomidine (4 μg kg-1, group ROP-DEX). During anesthesia, heart rate (HR), electrocardiography, noninvasive systolic arterial pressure (SAP) and respiratory variables were monitored. Sedation and pain were assessed preoperatively and at various time points up to 24 hours after extubation using sedation scoring, an interactive visual analog scale, the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT; von Frey anesthesiometer). Rescue analgesia (morphine, 0.1 mg kg-1) IM was administered if the MCPS ≥6. Data were analyzed using the chi-square test, Tukey test, Kruskal-Wallis test and Friedman test (p < 0.05). RESULTS HR was significantly lower in ROP-DEX compared with Control (p = 0.002). The pain scores, MNT, sedation scores and the postoperative rescue analgesia did not differ statistically among groups. CONCLUSIONS AND CLINICAL RELEVANCE As part of a multimodal pain therapy, IP ropivacaine-dexmedetomidine was associated with decreased HR intraoperatively; however, SAP remained within normal limits. Using the stated anesthetic protocol, neither IP ropivacaine nor ropivacaine-dexmedetomidine significantly improved analgesia compared with IP saline in cats undergoing ovariohysterectomy.
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Affiliation(s)
- Isabela Pga Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Ana Beatriz F Stelle
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Tatiane S Bruno
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Gabriel M Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - José S Costa
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Renata N Cassu
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil.
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Fudge JM, Page B, Mackrell A, Lee I. Evaluation of targeted bupivacaine for reducing acute postoperative pain in cats undergoing routine ovariohysterectomy. J Feline Med Surg 2020; 22:91-99. [PMID: 30720395 PMCID: PMC10814562 DOI: 10.1177/1098612x19826700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES This study sought to determine if bupivacaine targeted at specific, potentially painful sites could enhance postoperative analgesia in routine feline ovariohysterectomies. A secondary objective was to assess the utility of multiple acute pain scales for cats in a high-volume surgery setting. METHODS Two hundred and twelve cats were included in a prospective, randomized, double-blinded, placebo-controlled clinical trial. Anesthesia included buprenorphine, ketamine, dexmedetomidine and isoflurane. A ventral midline ovariohysterectomy was performed and cats were administered bupivacaine (2 mg/kg), placebo control (0.9% saline) or sham control (observation only) intraoperatively at the ovarian suspensory ligaments and vessels, uterine body and incisional subcutaneous tissues. Two pain scales were used to assess cats postoperatively. Initially, a multidimensional composite pain scale (MCPS) and a 0-10 numeric pain rating scale (NRS) were used. Subsequently, the MCPS was replaced with a modified Colorado State University Feline Acute Pain Scale (mCSU). Pain scores for the test groups were compared using a one-way ANOVA and a Holm-Bonferroni post hoc analysis when a difference was found (P <0.05). RESULTS Pain for the bupivacaine group was lower than the control groups at 1 h post-recovery and discharge, attaining significance with higher body weights. The P values were 0.008 and 0.004 for 1 h post-recovery and discharge, respectively. Pain scores between evaluators for the MCPS and NRS correlated poorly with r values for 1 h post-recovery and discharge of -0.08 and 0.22, respectively. Additionally, the MCPS proved difficult to use and time consuming, especially for feral and fractious patients, and was replaced with the mCSU. CONCLUSIONS AND RELEVANCE Targeted bupivacaine reduced early postoperative pain scores following routine feline ovariohysterectomies. The technique used was simple, requiring just over a minute to perform at minimal additional cost. The MCPS was not ideal for use in a high-volume spay setting.
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Affiliation(s)
| | | | | | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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Steagall PVM, Benito J, Monteiro B, Lascelles D, Kronen PW, Murrell JC, Robertson S, Wright B, Yamashita K. Intraperitoneal and incisional analgesia in small animals: simple, cost-effective techniques. J Small Anim Pract 2019; 61:19-23. [PMID: 31737915 DOI: 10.1111/jsap.13084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 08/26/2019] [Accepted: 09/30/2019] [Indexed: 11/27/2022]
Abstract
The World Small Animal Veterinary Association Global Pain Council (WSAVA-GPC) has recently published its first "capsule review" by Monteiro et al. These are short articles that present a brief assessment of the scientific evidence and practical recommendations on important, and sometimes controversial, subjects in pain management. The capsules will be published regularly in the Journal of Small Animal Practice, the official journal of the WSAVA. This second article discusses the use of intraperitoneal and incisional analgesia in small animal practice, including their limitations and recommendations by the authors.
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Affiliation(s)
- P V M Steagall
- Department of Clinical Sciences, Université de Montréal, Montreal, Quebec, J2S 2M2, Canada
| | - J Benito
- Department of Clinical Sciences, Université de Montréal, Montreal, Quebec, J2S 2M2, Canada
| | - B Monteiro
- Department of Clinical Sciences, Université de Montréal, Montreal, Quebec, J2S 2M2, Canada
| | - D Lascelles
- Translational Research in Pain Program, Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, 27606, USA
| | - P W Kronen
- Veterinary Anaesthesia Service - International, Winterthur, 8400, Switzerland
| | - J C Murrell
- Highcroft Veterinary Referrals, Whitchurch, Bristol, BS14 9BE, UK
| | - S Robertson
- Lap of Love Veterinary Hospice, Lutz, Florida, 33549, USA
| | - B Wright
- Mistral Vet, Fort Collins, Colorado, 80534, USA
| | - K Yamashita
- Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido, 069-8501, Japan
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Arenillas M, Caro-Vadillo A, Gómez de Segura IA. Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy. Open Vet J 2019; 9:157-163. [PMID: 31360656 PMCID: PMC6626154 DOI: 10.4314/ovj.v9i2.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/09/2019] [Indexed: 11/17/2022] Open
Abstract
The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist's main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg-1) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg-1) and midazolam (0.2 mg kg-1) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5-10 μg kg-1 h-1) and paracetamol (15 mg kg-1) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5-5 μg kg-1 minute-1) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg-1) and incisional bupivacaine (2 mg kg-1) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.
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Affiliation(s)
- Mario Arenillas
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
| | - Alicia Caro-Vadillo
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
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Mwangi WE, Mogoa EM, Mwangi JN, Mbuthia PG, Mbugua SW. A systematic review of analgesia practices in dogs undergoing ovariohysterectomy. Vet World 2018; 11:1725-1735. [PMID: 30774265 PMCID: PMC6362335 DOI: 10.14202/vetworld.2018.1725-1735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022] Open
Abstract
Aim This was a systematic review conducted to evaluate the analgesic drugs and techniques used in the management of pain in dogs undergoing ovariohysterectomy. Materials and Methods Systematic searches in PubMed, Google Scholar, and ScienceDirect were conducted for peer-reviewed articles written in English and published from 1995 to 2015. The key search words were dogs, ovariohysterectomy, pain, and analgesics. This was followed by a manual search of the references within the primary data sources. Inclusion and exclusion of studies and data extraction were performed independently by two reviewers. All randomized studies evaluating the effects of analgesics during ovariohysterectomy in dogs were included. Results A total of 31 trials met the criteria and were, therefore, included in the study. Data on the type of analgesic drugs used, the technique of administration, and the need for rescue analgesia were extracted from the papers. Individual analgesic protocols were used in 83.9% of the studies compared to multimodal drug therapy, which was used in 16.1% of the studies. Opioids were used in 39.0% of studies, nonsteroidal anti-inflammatory drugs (NSAIDs) in 19.4%, a combination of NSAIDs and opioids in 19.4%, local analgesics in 6.5%, and acupuncture in 3.2% of the studies. Drug administration was done using three approaches that included pre-operative (64.5%), post-operative (22.6%) as well as combined pre- and post-operative approach (12.9%). In 77.4% of the studies, administration of analgesics was done once, while in 12.9%, it was done as a 72-h post-operative course. 24-h and 48-h courses of post-operative pain therapy were done in 6.5% and 3.2% of the studies, respectively. About 57% of the dogs in the control groups required rescue analgesia as compared to 21.6% in the single and 11.3% in multimodal drug therapy groups. The requirement for rescue analgesics was highest in dogs treated using acupuncture (43.8%) and lowest in dogs treated using NSAID-opioid combination (8.6%). Fewer dogs among those that received pain medication preoperatively and postoperatively required rescue analgesia compared to those in groups given drugs before and after surgery only. More dogs (26.4%) among those given analgesics only once postoperatively required rescue analgesia as compared to those that received analgesics daily for 72 h (4.4%). Conclusions This study provides evidence that opioids are the mainstream analgesic drugs used in managing acute post-operative pain in dogs' post-ovariohysterectomy. In addition, multimodal drug therapy, particularly, NSAID-opioids combination is more effective for pain management than single drug administration. Administering analgesics both before and after surgery is associated with better outcomes and so is a protracted course of post-operative pain therapy. Although these practices should be encouraged, controlled studies should be conducted to conclusively determine the best practices for pain management in dogs undergoing ovariohysterectomy.
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Affiliation(s)
- Willy E Mwangi
- Department of Clinical Studies, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Eddy M Mogoa
- Department of Clinical Studies, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - James N Mwangi
- Department of Clinical Studies, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Paul G Mbuthia
- Department of Veterinary Pathology, Microbiology, and Parasitology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Susan W Mbugua
- Department of Clinical Studies, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
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Lambertini C, Kluge K, Lanza-Perea M, Bruhl-Day R, Kalchofner Guerrero KS. Comparison of intraperitoneal ropivacaine and bupivacaine for postoperative analgesia in dogs undergoing ovariohysterectomy. Vet Anaesth Analg 2018; 45:865-870. [DOI: 10.1016/j.vaa.2018.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/13/2018] [Accepted: 06/19/2018] [Indexed: 11/25/2022]
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Vicente D, Bergström A. Evaluation of intraoperative analgesia provided by incisional lidocaine and bupivacaine in cats undergoing ovariohysterectomy. J Feline Med Surg 2018; 20:922-927. [PMID: 29019444 PMCID: PMC11129246 DOI: 10.1177/1098612x17735167] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives The objective of this study was to assess the intraoperative analgesic effect of preoperative infiltration of the incision site with lidocaine or a mixture of lidocaine with bupivacaine in cats undergoing ovariohysterectomy (OHE). Methods This was a prospective, randomised clinical study. Healthy female intact cats (n = 75) undergoing OHE under medetomidine-ketamine-buprenorphine anaesthesia were assigned randomly into three treatment groups (n = 25 per group) to receive one of two local anaesthesia protocols or placebo preoperatively in the midline incision: lidocaine 1.5 mg/kg (group GL) or mixture of lidocaine 1 mg/kg and bupivacaine 1 mg/kg (group GLB) or sodium chloride 0.9% (control group). Blood pressure, heart and respiratory rate, temperature, muscle tonus and pupillary reflex were registered during surgery. During recovery, the cats were observed for side effects. Postoperative analgesia was provided with meloxicam (0.2 mg/kg). Most cats were rechecked 2 weeks postoperatively to remove skin sutures. Results There was no significant difference between groups regarding breed, age, body weight, surgical time and postoperative complication rate. The majority of the cats (60%) included in the control group received a supplemental bolus of propofol during surgery, when compared with 43% and 44% of the cats included in the GL and GLB groups, respectively. Heart rate was significantly higher ( P <0.05) in the control group at the time of excision of the second ovary and the uterine body. Mean arterial pressure (MAP) was stable in both treatment groups; in contrast, it tended to increase in the control group. Heart rate and MAP were similar between treatment groups. Conclusions and relevance Preoperative incisional block with only lidocaine or combined with bupivacaine seems to produce a similar intraoperative analgesia in cats undergoing OHE. Despite the similar intraoperative analgesic effect between treatment groups, the combination of lidocaine and bupivacaine reduced the required doses, and had a faster onset of action and prolonged effect.
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Affiliation(s)
- David Vicente
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Swedish University of Agricultural Sciences, Veterinary Medicine and Animal Sciences, Uppsala, Sweden
| | - Annika Bergström
- Swedish University of Agricultural Sciences, Veterinary Medicine and Animal Sciences, Uppsala, Sweden
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ERMUTLU CELALŞAHİN. Comparison of effect on postoperative pain of use of xylazine-ketamine or propofol prior to sevoflurane-induced inhalation anesthesia in dogs. MEHMET AKIF ERSOY ÜNIVERSITESI VETERINER FAKÜLTESI DERGISI 2018. [DOI: 10.24880/maeuvfd.401245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Benito J, Monteiro BP, Beauchamp G, Lascelles BDX, Steagall PV. Evaluation of interobserver agreement for postoperative pain and sedation assessment in cats. J Am Vet Med Assoc 2017; 251:544-551. [DOI: 10.2460/javma.251.5.544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Merema DK, Schoenrock EK, Boedec KL, McMichael MA. Effects of a transdermal lidocaine patch on indicators of postoperative pain in dogs undergoing midline ovariohysterectomy. J Am Vet Med Assoc 2017; 250:1140-1147. [DOI: 10.2460/javma.250.10.1140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kalchofner Guerrero KS, Campagna I, Bruhl-Day R, Hegamin-Younger C, Guerrero TG. Intraperitoneal bupivacaine with or without incisional bupivacaine for postoperative analgesia in dogs undergoing ovariohysterectomy. Vet Anaesth Analg 2016; 43:571-8. [DOI: 10.1111/vaa.12348] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 06/10/2015] [Indexed: 11/27/2022]
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Benito J, Monteiro B, Lavoie AM, Beauchamp G, Lascelles BDX, Steagall PV. Analgesic efficacy of intraperitoneal administration of bupivacaine in cats. J Feline Med Surg 2016; 18:906-912. [DOI: 10.1177/1098612x15610162] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to evaluate the analgesic efficacy of intraperitoneal (IP) bupivacaine in cats undergoing ovariohysterectomy (OVH). Methods Forty-five cats were included in a randomized, prospective, blinded study after owners’ written consent was obtained. The anesthetic protocol included acepromazine–buprenorphine–propofol–isoflurane. A ventral midline incision was made and cats (n = 15/group) were administered either IP saline 0.9% (negative and positive control groups; NG and PG, respectively) or IP bupivacaine (2 mg/kg; bupivacaine group; BG). Cats in the PG received meloxicam (0.2 mg/kg SC). An OVH was performed and postoperative pain was evaluated using a dynamic interactive visual analog scale (DIVAS), the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT) for up to 8 h after the end of surgery. Postoperative sedation was evaluated using DIVAS. Rescue analgesia was provided with buprenorphine and/or meloxicam. Repeated measures linear models and a Cochran–Mantel–Haenszel test were used for statistical analysis ( P <0.05). Results There was a significant effect of treatment on the number of times rescue analgesia was administered ( P = 0.002) (PG, n = 2, 13%; NG, n = 12, 80%; BG, n = 4, 27%) with the number of rescues being higher in the NG group than in the PG ( P = 0.0004) and BG ( P = 0.02) groups. The DIVAS, MCPS and MNT were significantly different when compared with baseline values at different time points; however, data were not significantly different among groups. Conclusions and relevance Treatments PG and BG produced similar analgesia in terms of pain scores, number of times rescue analgesia was administered and MNT. Based on rescue analgesia, IP administration of bupivacaine provides analgesia in cats after OVH.
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Affiliation(s)
- Javier Benito
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Beatriz Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Anne-Marie Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Guy Beauchamp
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, NC, USA
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
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Benito J, Monteiro BP, Beaudry F, Lavoie AM, Lascelles BDX, Steagall PV. Pharmacokinetics of bupivacaine after intraperitoneal administration to cats undergoing ovariohysterectomy. Am J Vet Res 2016; 77:641-5. [DOI: 10.2460/ajvr.77.6.641] [Citation(s) in RCA: 16] [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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Istvan SA, Walker JM, Hansen BD, Hanel RM, Marks SL. Presumptive intraperitoneal envenomation resulting in hemoperitoneum and acute abdominal pain in a dog. J Vet Emerg Crit Care (San Antonio) 2015; 25:770-7. [PMID: 26176976 DOI: 10.1111/vec.12341] [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: 04/16/2013] [Accepted: 05/20/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the clinical features, diagnostic findings, treatment, and outcome of a dog with acute abdominal pain and hemoperitoneum secondary to a presumptive intraperitoneal (IP) snakebite. CASE SUMMARY A 10-month-old castrated male mixed-breed dog was evaluated for suspected snake envenomation. The dog presented recumbent and tachycardic with signs of severe abdominal pain. Two cutaneous puncture wounds and hemoperitoneum were discovered during evaluation. Ultrasonographic examination revealed communication of the wounds with the peritoneal cavity. The dog was treated with supportive care, parenteral analgesia, packed red blood cell and fresh frozen plasma transfusions, crotalid antivenom, and placement of an IP catheter to provide local analgesia. The dog recovered fully and was discharged 5 days after initial presentation. NEW OR UNIQUE INFORMATION PROVIDED To our knowledge, this is the first report of IP envenomation accompanied by hemorrhage treated with continuous IP analgesia in the veterinary literature.
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Affiliation(s)
- Stephanie A Istvan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607
| | - Julie M Walker
- the Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706
| | - Bernard D Hansen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607
| | - Rita M Hanel
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607
| | - Steven L Marks
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607
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