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Donaldson AC, Meyer LCR, Fuller A, Buss PE. Comparison of the cardiovascular effects of immobilization with three different drug combinations in free-ranging African lions. CONSERVATION PHYSIOLOGY 2023; 11:coac077. [PMID: 36655170 PMCID: PMC9835075 DOI: 10.1093/conphys/coac077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/11/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
Thirty-six free-ranging lions (12 per group) were immobilized with tiletamine-zolazepam (Zoletil 0.6 mg/kg i.m.) plus medetomidine (0.036 mg/kg i.m.) (TZM), ketamine (3.0 mg/kg i.m.) plus medetomidine (0.036 mg/kg i.m.) (KM) or ketamine (1.2 mg/kg i.m.) plus butorphanol (0.24 mg/kg i.m.) plus medetomidine (0.036 mg/kg i.m.) (KBM). During immobilization cardiovascular variables were monitored at 5-minute intervals for a period of 30 minutes. Lions immobilized with all three drug combinations were severely hypertensive. Systolic arterial pressure was higher at initial sampling in lions immobilized with KM (237.3 ± 24.8 mmHg) than in those immobilized with TZM (221.0 ± 18.1 mmHg) or KBM (226.0 ± 20.6 mmHg) and decreased to 205.8 ± 19.4, 197.7 ± 23.7 and 196.3 ± 17.7 mmHg, respectively. Heart rates were within normal ranges for healthy, awake lions and decreased throughout the immobilization regardless of drug combination used. Lions immobilized with TZM had a higher occurrence (66%) of skipped heart beats than those immobilized with KBM (25%). The three drug combinations all caused negative cardiovascular effects, which were less when KBM was used, but adverse enough to warrant further investigations to determine if these effects can be reversed or prevented when these three combinations are used to immobilize free-living lions.
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Affiliation(s)
| | - Leith Carl Rodney Meyer
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, South Africa, 0110
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, South Africa, 2193
| | - Andrea Fuller
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, South Africa, 0110
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, South Africa, 2193
| | - Peter Erik Buss
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, South Africa, 0110
- Veterinary Wildlife Services, South African National Parks, Kruger National Park, Skukuza, South Africa, 1350
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Gauteng, South Africa, 0110
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Murphy KM, Rishniw M, Silverstein DC. Use of vasopressors for treatment of vasodilatory hypotension in dogs and cats by Diplomates of the American College of Veterinary Emergency and Critical Care. J Vet Emerg Crit Care (San Antonio) 2022; 32:714-722. [PMID: 35829666 DOI: 10.1111/vec.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 04/30/2021] [Accepted: 06/20/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify the most common practices of Diplomates of the American College of Veterinary Emergency and Critical Care (DACVECCs) as they relate to the recognition and treatment of hypotension in dogs and cats, particularly concerning the use of vasopressors in vasodilatory shock states. DESIGN A survey regarding vasopressor use was sent to all active DACVECCs using the Veterinary Information Network. Questions focused on respondent characteristics, method of recognition of hypotension, triggers for initiation of vasopressor therapy, first- and second-line vasopressor choice, and methods of determining response to therapy. SUBJECTS A total of 734 DACVECCs were invited to participate, and 203 Diplomates (27.7%) completed the survey. RESULTS For both dogs and cats, the most common first-line vasopressor was norepinephrine (87.9% in dogs and 83.1% in cats). The most common second-choice vasopressor was vasopressin (44.2% in dogs and 39.0% in cats). Cutoff values for initiating vasopressor therapy varied between species and modality used for blood pressure measurement. In general, most DACVECCs chose to initiate vasopressor therapy at a Doppler blood pressure <90 mm Hg or a mean arterial pressure of <60 or <65 mm Hg when using oscillometric or direct arterial blood pressure measurements in dogs and cats. CONCLUSIONS Most DACVECCs adhere to published human guidelines when choosing a first-line vasopressor. However, there is significant variability in blood pressure measurement technique, cutoffs for initiation of vasopressor use, and choice of second-line vasopressors.
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Affiliation(s)
- Kellyann M Murphy
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Mark Rishniw
- Veterinary Information Network, Davis, California, USA
| | - Deborah C Silverstein
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
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Koep JL, Taylor CE, Coombes JS, Bond B, Ainslie PN, Bailey TG. Autonomic control of cerebral blood flow: fundamental comparisons between peripheral and cerebrovascular circulations in humans. J Physiol 2021; 600:15-39. [PMID: 34842285 DOI: 10.1113/jp281058] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/25/2021] [Indexed: 01/12/2023] Open
Abstract
Understanding the contribution of the autonomic nervous system to cerebral blood flow (CBF) control is challenging, and interpretations are unclear. The identification of calcium channels and adrenoreceptors within cerebral vessels has led to common misconceptions that the function of these receptors and actions mirror those of the peripheral vasculature. This review outlines the fundamental differences and complex actions of cerebral autonomic activation compared with the peripheral circulation. Anatomical differences, including the closed nature of the cerebrovasculature, and differential adrenoreceptor subtypes, density, distribution and sensitivity, provide evidence that measures on peripheral sympathetic nerve activity cannot be extrapolated to the cerebrovasculature. Cerebral sympathetic nerve activity seems to act opposingly to the peripheral circulation, mediated at least in part by changes in intracranial pressure and cerebral blood volume. Additionally, heterogeneity in cerebral adrenoreceptor distribution highlights region-specific autonomic regulation of CBF. Compensatory chemo- and autoregulatory responses throughout the cerebral circulation, and interactions with parasympathetic nerve activity are unique features to the cerebral circulation. This crosstalk between sympathetic and parasympathetic reflexes acts to ensure adequate perfusion of CBF to rising and falling perfusion pressures, optimizing delivery of oxygen and nutrients to the brain, while attempting to maintain blood volume and intracranial pressure. Herein, we highlight the distinct similarities and differences between autonomic control of cerebral and peripheral blood flow, and the regional specificity of sympathetic and parasympathetic regulation within the cerebrovasculature. Future research directions are outlined with the goal to further our understanding of autonomic control of CBF in humans.
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Affiliation(s)
- Jodie L Koep
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Chloe E Taylor
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
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Murdock MA, Riccó Pereira CH, Aarnes TK, Cremer J, Lerche P, Bednarski RM. Sedative and cardiorespiratory effects of intramuscular administration of alfaxalone and butorphanol combined with acepromazine, midazolam, or dexmedetomidine in dogs. Am J Vet Res 2020; 81:65-76. [PMID: 31887090 DOI: 10.2460/ajvr.81.1.65] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the sedative and cardiorespiratory effects of IM administration of alfaxalone and butorphanol combined with acepromazine, midazolam, or dexmedetomidine in dogs. ANIMALS 6 young healthy mixed-breed hounds. PROCEDURES Dogs received each of 3 treatments (alfaxalone [2 mg/kg] and butorphanol [0.4 mg/kg] combined with acepromazine [0.02 mg/kg; AB-ace], midazolam [0.2 mg/kg; AB-mid], or dexmedetomidine [0.005 mg/kg; AB-dex], IM) in a blinded, randomized crossover-design study with a 1-week washout period between treatments. Sedation scores and cardiorespiratory variables were recorded at predetermined time points. Data were analyzed by use of mixed-model ANOVA and linear generalized estimating equations with post hoc adjustments. RESULTS All treatments resulted in moderate to deep sedation (median score, ≥ 15/21) ≤ 5 minutes after injection. Sedation scores did not differ among treatments until the 40-minute time point, when the score was higher for AB-dex than for other treatments. Administration of AB-dex resulted in median scores reflecting deep sedation until 130 minutes, versus 80 and 60 minutes for AB-ace and AB-mid, respectively, after injection. Heart rate, cardiac output, and oxygen delivery decreased significantly after AB-dex, but not AB-ace or AB-mid administration. Respiratory variables remained within clinically acceptable ranges after all treatments. Undesirable recovery characteristics were observed in 4 dogs after AB-mid treatment. Four dogs required atipamezole administration 180 minutes after AB-dex injection. CONCLUSIONS AND CLINICAL RELEVANCE All protocols produced reliable sedation. The results indicated that in young, healthy dogs, AB-mid may produce undesirable recovery characteristics; AB-dex treatment caused cardiovascular depression and should be used with caution.
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Skelding AM, Valverde A. Sympathomimetics in veterinary species under anesthesia. Vet J 2020; 258:105455. [PMID: 32564865 DOI: 10.1016/j.tvjl.2020.105455] [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: 10/17/2019] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
Sympathomimetic drugs mimic the physiological action of the sympathetic nervous system through interaction with adrenergic receptors. These drugs are commonly used to provide cardiovascular support in many veterinary species. Despite their common use, the literature evaluating their effectiveness can be somewhat limited depending on the species. This review details the mechanism of action of various sympathomimetic drugs and summarizes the literature that is available describing the efficacy of these drugs and their use in anesthetized veterinary species.
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Affiliation(s)
- Alicia M Skelding
- Toronto Animal Health Partners Emergency and Specialty Hospital, 1 Scarsdale Rd, North York, ON M3B 2R2, Canada.
| | - Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Gordon St and College Ave W, Guelph, ON N1G 2W1, Canada
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Ranninger E, Bettschart‐Wolfensberger R. Polymorphic tachycardia in an anaesthetised horse with an undiagnosed pheochromocytoma undergoing emergency coeliotomy. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Elisabeth Ranninger
- Department of Clinical Diagnostics and ServicesSection of AnaesthesiologyVetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Regula Bettschart‐Wolfensberger
- Department of Clinical Diagnostics and ServicesSection of AnaesthesiologyVetsuisse FacultyUniversity of ZurichZurichSwitzerland
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7
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Dyballa S, Miñana R, Rubio-Brotons M, Cornet C, Pederzani T, Escaramis G, Garcia-Serna R, Mestres J, Terriente J. Comparison of Zebrafish Larvae and hiPSC Cardiomyocytes for Predicting Drug-Induced Cardiotoxicity in Humans. Toxicol Sci 2019; 171:283-295. [PMID: 31359052 PMCID: PMC6760275 DOI: 10.1093/toxsci/kfz165] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular drug toxicity is responsible for 17% of drug withdrawals in clinical phases, half of post-marketed drug withdrawals and remains an important adverse effect of several marketed drugs. Early assessment of drug-induced cardiovascular toxicity is mandatory and typically done in cellular systems and mammals. Current in vitro screening methods allow high-throughput but are biologically reductionist. The use of mammal models, which allow a better translatability for predicting clinical outputs, is low-throughput, highly expensive, and ethically controversial. Given the analogies between the human and the zebrafish cardiovascular systems, we propose the use of zebrafish larvae during early drug discovery phases as a balanced model between biological translatability and screening throughput for addressing potential liabilities. To this end, we have developed a high-throughput screening platform that enables fully automatized in vivo image acquisition and analysis to extract a plethora of relevant cardiovascular parameters: heart rate, arrhythmia, AV blockage, ejection fraction, and blood flow, among others. We have used this platform to address the predictive power of zebrafish larvae for detecting potential cardiovascular liabilities in humans. We tested a chemical library of 92 compounds with known clinical cardiotoxicity profiles. The cross-comparison with clinical data and data acquired from human induced pluripotent stem cell cardiomyocytes calcium imaging showed that zebrafish larvae allow a more reliable prediction of cardiotoxicity than cellular systems. Interestingly, our analysis with zebrafish yields similar predictive performance as previous validation meta-studies performed with dogs, the standard regulatory preclinical model for predicting cardiotoxic liabilities prior to clinical phases.
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Affiliation(s)
- Sylvia Dyballa
- ZeClinics SL, IGTP (German Trias and Pujol Institute), Badalona 08916, Spain
| | - Rafael Miñana
- ZeClinics SL, IGTP (German Trias and Pujol Institute), Badalona 08916, Spain
| | - Maria Rubio-Brotons
- ZeClinics SL, IGTP (German Trias and Pujol Institute), Badalona 08916, Spain
| | - Carles Cornet
- ZeClinics SL, IGTP (German Trias and Pujol Institute), Badalona 08916, Spain
| | - Tiziana Pederzani
- ZeClinics SL, IGTP (German Trias and Pujol Institute), Badalona 08916, Spain
| | - Georgia Escaramis
- CIBER Epidemiology and Public Health
- Department of Biomedicine, Faculty of Life Science and Health, University of Barcelona 08036, Barcelona, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), UdG, Girona 17071, Spain
| | | | - Jordi Mestres
- Chemotargets SL, Parc Científic de Barcelona, Barcelona 08028, Spain
- Systems Pharmacology, Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical Research Institute, Barcelona 08002, Spain
- University Pompeu Fabra, PRBB (Barcelona Biomedical Research Park), Barcelona 08002, Spain
| | - Javier Terriente
- ZeClinics SL, IGTP (German Trias and Pujol Institute), Badalona 08916, Spain
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Boustead KJ, Zeiler G. Life‐threatening hyperkalaemia in a five‐year‐old rottweiler undergoing bilateral elbow arthroscopy. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Keagan John Boustead
- Companion Animal Clinical StudiesUniversity of PretoriaPretoriaSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
| | - Gareth Zeiler
- Companion Animal Clinical StudiesUniversity of PretoriaPretoriaSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
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Nakata TM, Kaji H, Matsuura N, Shimizu M, Tanaka R. Inotropic and lusitropic effects of incremental doses of dobutamine in dogs with right ventricular apical pacing-induced cardiac dysfunction. J Vet Pharmacol Ther 2019; 42:285-293. [PMID: 30724383 DOI: 10.1111/jvp.12752] [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: 10/30/2018] [Revised: 12/30/2018] [Accepted: 01/16/2019] [Indexed: 11/26/2022]
Abstract
This study aimed to assess the effects of incremental doses of dobutamine on diastolic function in healthy and rapid ventricular apical pacing (RVAP)-induced cardiac dysfunction anesthetized dogs. Inotropic and lusitropic effects of dobutamine (2, 4, 8, and 12 μg kg-1 min-1 ) were assessed through left ventricle (LV) pressure-volume relation and Doppler echocardiography in six female dogs before and after 8 weeks of RVAP. Peak rate of LV pressure fall (-dP/dtmin ) improved with doses >4 μg kg-1 min-1 in healthy (4,490 ± 970 vs. 3,265 ± 471 mmHg/s, p < 0.05) and >8 μg kg-1 min-1 in RVAP dogs (3,385 ± 1,122 vs. 1,864 ± 849 mmHg/s, p < 0.05) while the time constant of relaxation (tau) reduced with doses >4 μg kg-1 min-1 in both groups (healthy: 24.0 ± 3.7 vs. 28.2 ± 4.9 ms; RVAP: 32.6 ± 8.5 vs. 37.5 ± 11.4 ms, p < 0.05) comparing with baseline. Indices of relaxation (-dP/dtmin and tau) suggested preserved lusitropic response in contrast with markedly reduced indices of contractility in the RVAP group compared with healthy group at same infusion rates. Doppler echocardiography showed significant reduction of elastic recoil in failing hearts. The results of this study demonstrated maximal positive lusitropic effects of dobutamine at a dose of 8 μg kg-1 min-1 in ventricular pacing-induced cardiac dysfunction without further impairment of ventricular filling.
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Affiliation(s)
- Telma Mary Nakata
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Hideki Kaji
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Naoya Matsuura
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Miki Shimizu
- Department of Veterinary Radiology, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
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Hanson KR, Ware WA. Myocardial hypertrophy associated with long-term phenylpropanolamine use in a dog. J Am Vet Med Assoc 2018; 253:1452-1459. [PMID: 30451619 DOI: 10.2460/javma.253.11.1452] [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
CASE DESCRIPTION A 9-year-old spayed female Dalmatian was examined because of progressive pelvic limb paraparesis. CLINICAL FINDINGS The dog had a history of chronic urinary incontinence and had been treated with phenylpropanolamine (PPA) for almost 8.5 years. Intervertebral disk disease at T12-13 was diagnosed, and a hemilaminectomy was performed. Three days after surgery, the dog developed a ventricular tachyarrhythmia. Severe left and mild right ventricular hypertrophy were detected by echocardiography. TREATMENT AND OUTCOME The arrhythmia was controlled with sotalol. Phenylpropanolamine administration was discontinued immediately before surgery and was not resumed. Heart rate and rhythm and blood pressure were within reference limits, and the ventricular hypertrophy had almost completely resolved 5 months later. Sotalol administration was discontinued. Shortly after the 5-month recheck evaluation, PPA administration was resumed, albeit at a lower dosage than that before surgery, for control of urinary incontinence. At the 10-month recheck evaluation, the dog was hypertensive and ventricular hypertrophy had recurred. Discontinuation of PPA administration was recommended but not heeded. The dog developed marked azotemia 1.5 years after surgery, which was managed by the referring veterinarian, and was subsequently lost to follow-up. CLINICAL RELEVANCE The fact that the ventricular hypertrophy almost completely resolved when PPA administration was discontinued and then recurred after it was resumed strongly suggested the drug was an important contributing factor to the cardiac disease of this patient. Patients receiving PPA on a long-term basis should be frequently monitored for cardiac disease, and use of other adrenergic receptor agonists should be avoided in such patients.
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Abstract
Blood pressure monitoring and management is a vital part of the perianesthetic period. Disturbances in blood pressure, especially hypotension, can have significant impacts on the well-being of small animal patients. There are a variety of mechanisms present to control blood pressure, including ultra-short-, short-, and long-term mechanisms. Several conditions can contribute to decreased blood pressure, including anesthetics, tension pneumothorax, intermittent positive pressure ventilation, hypoxemia, hypercapnia, surgical positioning, and abdominal distension. If hypotension is encountered, the initial response is to provide appropriate fluid therapy. If this is inadequate, other interventions can be used to increase blood pressure and thereby increase perfusion.
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12
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Nielsen LK, Bracker K, Price LL. Administration of fenoldopam in critically ill small animal patients with acute kidney injury: 28 dogs and 34 cats (2008-2012). J Vet Emerg Crit Care (San Antonio) 2015; 25:396-404. [PMID: 25854861 DOI: 10.1111/vec.12303] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/26/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the clinical features and outcomes of critically ill dogs and cats with acute kidney injury (AKI) receiving fenoldopam infusions compared to patients with AKI that did not receive fenoldopam. DESIGN Retrospective clinical study from May 1, 2008 until June 1, 2012. SETTING Private emergency and specialty referral hospital. ANIMALS Client-owned dogs (28) and cats (34) with AKI that received fenoldopam compared with similar patients with AKI (30 dogs and 30 cats) that did not. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The medical records of 62 critically ill dogs and cats with AKI that received fenoldopam were reviewed. Presenting clinical signs, physical examination findings, and primary and secondary disease processes were identified in all patients. The mean number of days on fenoldopam was 1.5 days (range 0.3-4.0 days) for dogs and 1.9 days (range 1.0-4.0 days) for cats. Eleven of 28 (39%) dogs survived to discharge and 13 of 34 (38%) of the cats survived to discharge. Of the animals in the group receiving fenoldopam that died, the majority (84%) were euthanized. Potential adverse reactions were evaluated, with hypotension being the most commonly encountered adverse effect (7% of fenoldopam group [FG] dogs and 23% of FG cats). When compared with patients with AKI that did not receive fenoldopam, no significant differences were found between the groups with regards to survival, length of hospital stay, adverse effects, or changes in creatinine, BUN, or sodium concentrations except that patients receiving fenoldopam were significantly more likely to have received other renally active medications. CONCLUSIONS In this study of patients with AKI, fenoldopam administration at 0.8 μg/kg/min in dogs and 0.5 μg/kg/min in cats appeared relatively safe but was not associated with improvement in survival to discharge, length of hospital stay, or improvement in renal biochemical parameters when compared to patients with AKI not receiving fenoldopam.
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Affiliation(s)
| | | | - Lori Lyn Price
- Biostatistics Research Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA
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Chebroux A, Leece EA, Brearley JC. Ease of intravenous catheterisation in dogs and cats: a comparative study of two peripheral catheters. J Small Anim Pract 2015; 56:242-6. [DOI: 10.1111/jsap.12318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/22/2014] [Accepted: 11/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- A. Chebroux
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 0ES
| | - E. A. Leece
- Dick White Referrals; Station Farm; Newmarket Suffolk CB8 0UH
| | - J. C. Brearley
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 0ES
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14
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Peterson KL, Lee JA, Hovda LR. Phenylpropanolamine toxicosis in dogs: 170 cases (2004–2009). J Am Vet Med Assoc 2011; 239:1463-9. [DOI: 10.2460/javma.239.11.1463] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Butler AL. Goal-directed therapy in small animal critical illness. Vet Clin North Am Small Anim Pract 2011; 41:817-38, vii. [PMID: 21757095 DOI: 10.1016/j.cvsm.2011.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Monitoring critically ill patients can be a daunting task even for experienced clinicians. Goal-directed therapy is a technique involving intensive monitoring and aggressive management of hemodynamics in patients with high risk of morbidity and mortality. The aim of goal-directed therapy is to ensure adequate tissue oxygenation and survival. This article reviews commonly used diagnostics in critical care medicine and what the information gathered signifies and discusses clinical decision making on the basis of diagnostic test results. One example is early goal-directed therapy for severe sepsis and septic shock. The components and application of goals in early goal-directed therapy are discussed.
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Affiliation(s)
- Amy L Butler
- Veterinary Referral and Emergency Center, 318 Northern Boulevard, Clarks Summit, PA 18411, USA.
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