Stereoselective Pharmacokinetics of Ketamine Administered at a Low Dose in Awake Dogs

The present study aimed to examine the stereoselective pharmacokinetics of racemic ketamine in dogs at low doses. The secondary aims were to identify associated behavioural effects and propose a ketamine infusion rate. The study was conducted on nine intact male beagles, with each dog undergoing two treatments (BOL and INF). For treatment BOL, an intravenous bolus of 1 mg/kg was administered over 2 min. The treatment INF involved an initial bolus of 0.5 mg/kg given over 1 min, followed by an infusion at 0.01 mg/kg/min for 1 h. Blood samples were collected for pharmacokinetic analysis. The median R/S enantiomer ratio of ketamine remained close to 1 throughout the study. Levels of S-norketamine were significantly higher than those of R-norketamine across all time points. Based on the collected data, the infusion rate predicted to achieve a steady-state racemic ketamine plasma concentration of 150 ng/mL was 0.028 mg/kg/min. Higher scores for behavioural effects were observed within the first five minutes following bolus administration. The most common behaviours observed were disorientation, head movements and staring eyes. Furthermore, employing ROC curve analysis, a racemic ketamine plasma concentration of 102 ng/mL was defined as the cut-off value, correlating with the occurrence of undesirable behavioural patterns.

Wet adhesive hydrogels to correct malacic trachea (tracheomalacia) A proof of concept

Tracheomalacia (TM) is a condition characterized by a weak tracheal cartilage and/or muscle, resulting in excessive collapse of the airway in the newborns. Current treatments including tracheal reconstruction, tracheoplasty, endo- and extra-luminal stents have limitations. To address these limitations, this work proposes a new strategy by wrapping an adhesive hydrogel patch around a malacic trachea. Through a numerical model, first it was demonstrated that a hydrogel patch with sufficient mechanical and adhesion strength can preserve the trachea's physiological shape. Accordingly, a new hydrogel providing robust adhesion on wet tracheal surfaces was synthesized employing the hydroxyethyl acrylamide (HEAam) and polyethylene glycol methacrylate (PEGDMA) as main polymer network and crosslinker, respectively. Ex vivo experiments revealed that the adhesive hydrogel patches can restrain the collapsing of malacic trachea under negative pressure. This study may open the possibility of using an adhesive hydrogel as a new approach in the difficult clinical situation of tracheomalacia.

Development and in vivo validation of phospholipid-based depots for the sustained release of bupivacaine

By direct deposition of the drug at the local site of action, injectable depot formulations - intended for treatment of a local disease or for local intervention - are designed to limit the immediate exposure of the active principle at a systemic level and to reduce the frequency of administration. To overcome known drawbacks in the production of some marketed phospholipid-based depots, here we propose to manufacture drug-loaded negatively charged liposomes through conventional technologies and to control their aggregation mixing a solution of divalent cations prior to administration. We identified phosphatidylglycerol (PG) as the most suitable phospholipid for controlled aggregation of the liposomes and to modulate the release of the anesthetic bupivacaine (BUP) from liposomal depots. In vivo imaging of the fluorescently-labelled liposomes showed a significantly higher retention of the PG liposomes at the injection site with respect to zwitterionic ones. In situ mixing of PG liposomes with calcium salts significantly extended the area under the curve of BUP in plasma compared to the non-depot system. Overall, controlling the aggregation of negatively charged liposomes with divalent cations not only modulated the particle clearance from the injection site but also the release in vivo of a small amphipathic drug such as BUP.

A minimally-invasive serial cerebrospinal fluid sampling model in conscious Göttingen minipigs

Drug concentrations in cerebrospinal fluid (CSF) are typically used as a as a surrogate measure of their availability in the CNS, and CSF penetration in animal studies are used for assessment of CNS drug delivery in early preclinical drug development. The minipig is a valid alternative to dogs and non-human primates as non-rodent species in preclinical research, but this species presents anatomical peculiarities that make the serial collection of CSF technically challenging. A minimally-invasive serial cerebrospinal fluid collection model via catheterization of the subarachnoid space in conscious minipigs was developed allowing assessment of longitudinal drug pharmacokinetics in the central nervous system in preclinical research. Shortly, the subarachnoid space was accessed in the anesthetized minipig by puncture with a Tuohy needle; when CSF was flowing through the needle a catheter was advanced and thereafter tunneled and fixed on the back. The PK of peptide A administered subcutaneously was performed and CSF could be sampled in the conscious animals for up to 48 h. When compared to the plasma kinetic data, there was a clear difference in the elimination phase of Pept. A from CSF, with an apparent longer average terminal half-life in CSF. The 3Rs are addressed by reducing the number of animals needed for a pharmacokinetic profile in central nervous system and by improving the validity of the model avoiding biases due to anesthesia, blood contamination, and inter-individual variability.

Analgesic Efficacy of Subcutaneous-Oral Dosage of Tramadol after Surgery in C57BL/6J Mice

This study investigated the analgesic activity of tramadol in female C57BL/6J mice by using a single subcutaneous injection (25 mg/kg) of tramadol combined with the same dose given in drinking water for 24 h. We then evaluated the pharmacokinetics of tramadol and its active metabolite O-demethyltramadol (M1). To evaluate pain and analgesic efficacy, we performed clinical and behavioral assessment, burrowing tests, and activity analysis and measured body weight, food and water intake in mice that were untreated (control) or underwent analgesia only (T); anesthesia and surgery (AS); or anesthesia, surgery, and analgesia (AS+T). The plasma concentration of tramadol decreased rapidly whereas, for more than 18 h, the M1 level remained stable and above its minimal analgesic concentration for humans. Total food and water intake over 24 h was comparable among all groups. Although T mice consumed tramadol-treated water in sufficient amount and frequency, AS and AS+T animals showed decreased drinking frequency during the first 4 h after surgery. Compared with control and T groups, composite pain scores and burrowing latencies increased significantly in both AS and AS+T mice after surgery, suggesting postsurgical pain. However, AS and AS+T mice did not differ significantly after surgery. In conclusion, although naïve animals ingested a sufficient amount of the drug and plasma levels appeared sufficiently high, mice markedly reduced water intake immediately after surgery. Consequently, even in combination with an initial drug injection, the subsequent voluntary tramadol intake was insufficient to reduce signs of postsurgical pain significantly after laparotomy.

Drawing the line in clinical treatment of companion animals: recommendations from an ethics working party

Modern veterinary medicine offers numerous options for treatment and clinicians must decide on the best one to use. Interventions causing short-term harm but ultimately benefitting the animal are often justified as being in the animal's best interest. Highly invasive clinical veterinary procedures with high morbidity and low success rates may not be in the animal's best interest. A working party was set up by the European College of Veterinary Anaesthesia and Analgesia to discuss the ethics of clinical veterinary practice and improve the approach to ethically challenging clinical cases. Relevant literature was reviewed. The 'best interest principle' was translated into norms immanent to the clinic by means of the 'open question argument'. Clinical interventions with potential to cause harm need ethical justification, and suggest a comparable structure of ethical reflection to that used in the context of in vivo research should be applied to the clinical setting. To structure the ethical debate, pertinent questions for ethical decision-making were identified. These were incorporated into a prototype ethical tool developed to facilitate clinical ethical decision-making. The ethical question 'Where should the line on treatment be drawn' should be replaced by 'How should the line be drawn?'

Diagnoses and Treatment of Dental Disorders in a Research Colony of Macaca fascicularis: A Case Series

During daily routine oral examinations in a research colony of nonhuman primates (NHPs, Macaca fascicularis), a variety of oral-dental lesions were identified. A dental care program was established based on these findings. Based on the presence of dental clinical signs and their severity, 31 animals were triaged to be examined and treated by a veterinarian. Clinical examination consisted of visual inspection using a periodontal probe/explorer and full or partial mouth dental radiographs. Treatment was performed during the same procedure. Some animals had a follow-up examination including radiographs months later. Four common dental diseases were diagnosed: periodontal disease, caries, tooth fracture, and tooth attrition. Less frequent were dental abscess, enamel hypomineralization, gingival hyperplasia, hypercementosis, tooth luxation, tooth dysplasia, root resorption, abrasion. Less severe periodontal disease was treated conservatively. If severely affected, teeth were extracted. Well-circumscribed caries without endodontic involvement were treated by composite restoration. Teeth with extensive caries and pulp involvement were extracted. Teeth with exposed pulp were treated via extraction or orthograde root canal treatment. In this case series, 27 (87%) of 31 NHPs exhibited at least 1 moderate to severe dental lesion that required treatment. The presumable improvement in welfare and weight of oral/dental lesions for the overall health status in research NHPs encourages us to continue this program prospectively.

Preliminary pharmacokinetics of tramadol hydrochloride after administration via different routes in male and female B6 mice

OBJECTIVE

1) To determine the pharmacokinetics of tramadol hydrochloride and its active metabolite, O-desmethyltramadol (M1), after administration through different routes in female and male C57Bl/6 mice; 2) to evaluate the stability of tramadol solutions; and 3) to identify a suitable dose regimen for prospective clinical analgesia in B6 mice.

STUDY DESIGN

Prospective, randomized, blinded, parallel design.

ANIMALS

A total of 18 male and 18 female C57Bl/6 mice (20-30 g).

METHODS

Mice were administered 25 mg kg^-1 tramadol as a bolus [intravenously (IV), intraperitoneally (IP), subcutaneously (SQ), orally per gavage (OS_gavage)] over 25 hours [orally in drinking water (OS_water) or Syrspend SF (OS_Syrsp)]. Venous blood was sampled at six predetermined time points over 4 to 31 hours, depending on administration route, to determine tramadol and M1 plasma concentrations (liquid chromatography and tandem mass spectrometry detection). Pharmacokinetic parameters were described using a noncompartmental model. The stability of tramadol in water (acidified and untreated) and Syrspend SF (0.20 mg mL^-1) at ambient conditions for 1 week was evaluated.

RESULTS

After all administration routes, C_max was >100 ng mL^-1 for tramadol and >40 ng mL^-1 for M1 (reported analgesic ranges in man) followed by short half-lives (2-6 hours). The mean tramadol plasma concentration after self-administration remained >100 ng mL^-1 throughout consumption time. M1 was found in the OS_Syrs group only at 7 hours, whereas it was detectable in OS_water throughout administration. Tramadol had low oral bioavailability (26%). Short-lasting side effects were observed only after IV administration. Water and Syrspend SF solutions were stable for 1 week.

CONCLUSIONS AND CLINICAL RELEVANCE

1) At the dose administered, high plasma concentrations of tramadol and M1 were obtained, with half-life depending on the administration route. 2) Plasma levels were stable over self-consumption time. 3) Solutions were stable for 1 week at ambient conditions.

Refinement of a model of repeated cerebrospinal fluid collection in conscious rats

The cannulation of the cisterna magna in rats for in vivo sampling of cerebrospinal fluid serves as a valuable model for studying the delivery of new drugs into the central nervous system or disease models. It offers the advantages of repeated sampling without anesthesia-induced bias and using animals as their own controls. An established model was retrospectively reviewed for the outcomes and it was hypothesized that by refining the method, i.e. by (1) implementing pathophysiological-based anesthesia and analgesia, (2) using state-of-the-art peri-operative monitoring and supportive care, (3) increasing stability of the cement-cannula assembly, and (4) selecting a more adaptable animal strain, the outcome in using the model - quantified by peri-operative mortality, survival time and stability of the implant - could be improved and could enhance animal welfare. After refinement of the technique, peri-operative mortality decreased significantly (7 animals out of 73 compared with 4 out of 322; P = 0.001), survival time increased significantly (36 ± 14 days compared with 28 ± 18 days; P < 0.001), as well as the stability of the cement-cannula assembly (47 ± 8 days of adhesion compared with 33 ± 15 days and 34 ± 13 days using two other cement types; P < 0.001). Overall, the 3R concept of Russell and Burch was successfully addressed and animal welfare was improved by (1) the reduction in the total number of animals needed as a result of lower mortality or fewer euthanizations due to technical failure, and frequent use of individual rats over a time frame; and (2) improving the scientific quality of the model.

Anaesthesia with medetomidine-ketamine-isoflurane with and without midazolam, in eight captive chimpanzees (Pan troglodytes) premedicated with oral zuclopenthixol

In 8 captive adult chimpanzees of various ages premedicated with oral zuclopenthixol anaesthesia was induced intramuscularly with a combination of medetomidine and ketamine (40 or 50 µg/kg and 5 mg/kg, IM, respectively), with and without midazolam (0.05 mg/kg), and maintained with isoflurane in oxygen. At the end of the procedure, sedation was reversed with atipamezole (0.25 mg/kg, IM) and sarmazenil (0.005 mg/kg, IM) when midazolam had been administered. Oral zuclopenthixol resulted in tranquillization of the whole group and only one animal required a second dart injection to achieve adequately deep anaesthesia. Effective and reliable anaesthesia was achieved in all apes; the depth of hypnosis was stable and sudden arousal did not occur. Physiological parameters remained within normal ranges in the majority of the animals; however, manageable anaesthesia-related complications, namely apnoea after darting, hypotension, hypoventilation, hypoxemia and prolonged recovery, occurred in 6 out of 8 animals. The use of monitoring devices was essential to guarantee adequate management of these complications.

β-Secretase (BACE1) inhibitors with high in vivo efficacy suitable for clinical evaluation in Alzheimer's disease

An extensive fluorine scan of 1,3-oxazines revealed the power of fluorine(s) to lower the pKa and thereby dramatically change the pharmacological profile of this class of BACE1 inhibitors. The CF3 substituted oxazine 89, a potent and highly brain penetrant BACE1 inhibitor, was able to reduce significantly CSF Aβ40 and 42 in rats at oral doses as low as 1 mg/kg. The effect was long lasting, showing a significant reduction of Aβ40 and 42 even after 24 h. In contrast to 89, compound 1b lacking the CF3 group was virtually inactive in vivo.

Two cases of intraoperative herniation of the endotracheal tube cuff

During anaesthesia for elective procedures, 2 dogs developed acute airway obstruction caused by herniation of the endotracheal cuff. This is an uncommon but potentially fatal complication especially when minimal monitoring of the patient leads to late recognition of the condition. The most typical symptoms are decreased thoracic excursions and tidal volume, absence of gas flow through the endotracheal tube, change in the capnographic waves morphology and increased airway pressures. In both cases desaturation of haemoglobin (measured by pulse oximetry) occurred in-between 6 and 8 minutes after cuff herniation. All signs normalised following partial deflation of the cuff. Careful management of cuff pressures especially when nitrous oxide is used, awareness of the condition and monitoring of the patient can prevent fatal consequences.

Pancuronium dose refinement in experimental pigs used in cardiovascular research

OBJECTIVE

To quantify the dose of pancuronium required to obtain moderate neuromuscular blockade as monitored by acceleromyography (NMB(mod) : train-of-four count of ≤2) as a part of a balanced anaesthetic protocol in pigs used in cardiovascular research.

STUDY DESIGN

Prospective cross-sectional study.

ANIMALS

Five pigs (median body weight: 60 (range 60-63) kg).

METHODS

Anaesthesia was induced with xylazine, ketamine, atropine and midazolam and maintained with isoflurane in O(2) :air and fentanyl. Pigs received 0.1 mg kg(-1) pancuronium initial bolus to reach NMB(mod) followed by 0.1 mg kg(-1) hour(-1) constant rate infusion (CRI). During anaesthesia a twitch count of 3 or measureable T4/T1 ratio indicated unsatisfactory NMB. In this case additional 0.4 mg boluses of pancuronium were administered IV to effect in addition to the CRI. Descriptive statistical analysis was performed to express the median and range of the bolus and CRI dose of pancuronium in pigs. Cardiovascular parameters were analyzed at selected time points with Friedman Repeated Measures Analysis on Ranks. Spearman Rank test was used to evaluate correlation between parameters.

RESULTS

Acceleromyographic monitoring of NMB is feasible in anaesthetized pigs. The median initial dose and rate of pancuronium required to achieve NMB(mod) were 0.10 (range 0.10-0.13) mg kg(-1) and 0.11 (range 0.10-0.21) mg kg(-1) hour(-1) , respectively. The administration rate showed considerable individual variation.

CONCLUSIONS AND CLINICAL RELEVANCE

These pancuronium doses can be used as a guideline to achieve NMB(mod) in pigs as part of a balanced anaesthetic protocol. Instrumental NMB monitoring is essential because of individual kinetic variations and compliance to monitoring guidelines.

Plasma levels of a low-dose constant-rate-infusion of ketamine and its effect on single and repeated nociceptive stimuli in conscious dogs

This study quantitatively investigated the analgesic action of a low-dose constant-rate-infusion (CRI) of racemic ketamine (as a 0.5 mg kg(-1) bolus and at a dose rate of 10 microg kg(-1) min(-1)) in conscious dogs using a nociceptive withdrawal reflex (NWR) and with enantioselective measurement of plasma levels of ketamine and norketamine. Withdrawal reflexes evoked by transcutaneous single and repeated electrical stimulation (10 pulses, 5 Hz) of the digital plantar nerve were recorded from the biceps femoris muscle using surface electromyography. Ketamine did not affect NWR thresholds or the recruitment curves after a single nociceptive stimulation. Temporal summation (as evaluated by repeated stimuli) and the evoked behavioural response scores were however reduced compared to baseline demonstrating the antinociceptive activity of ketamine correlated with the peak plasma concentrations. Thereafter the plasma levels at pseudo-steady-state did not modulate temporal summation. Based on these experimental findings low-dose ketamine CRI cannot be recommended for use as a sole analgesic in the dog.

Noninvasive assessment of the facilitation of the nociceptive withdrawal reflex by repeated electrical stimulations in conscious dogs

OBJECTIVE

To investigate the facilitation of the nociceptive withdrawal reflex (NWR) by repeated electrical stimuli and the associated behavioral response scores in conscious, nonmedicated dogs as a measure of temporal summation and analyze the influence of stimulus intensity and frequency on temporal summation responses.

ANIMALS

8 adult Beagles.

PROCEDURES

Surface electromyographic responses evoked by transcutaneous constant-current electrical stimulation of ulnaris and digital plantar nerves were recorded from the deltoideus, cleidobrachialis, biceps femoris, and cranial tibial muscles. A repeated stimulus was given at 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, and 1.1 x I(t) (the individual NWR threshold intensity) at 2, 5, and 20 Hz. Threshold intensity and relative amplitude and latency of the reflex were analyzed for each stimulus configuration. Behavioral reactions were subjectively scored.

RESULTS

Repeated sub-I(t) stimuli summated and facilitated the NWR. To elicit temporal summation, significantly lower intensities were needed for the hind limb, compared with the forelimb. Stimulus frequency did not influence temporal summation, whereas increasing intensity resulted in significantly stronger electromyographic responses and nociception (determined via behavioral response scoring) among the dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs, it is possible to elicit nociceptive temporal summation that correlates with behavioral reactions. These data suggest that this experimental technique can be used to evaluate nociceptive system excitability and efficacy of analgesics in canids.

Influence of surgical approach on the efficacy of the intervertebral disk fenestration: a cadaveric study

OBJECTIVES

To investigate the influence of different approach angles on the amount of nucleus pulposus removed during intervertebral disc fenestration in dogs.

METHODS

Twenty cadavers of beagle dogs were randomly divided into four groups: a control group and three treatment groups in which intervertebral fenestration was performed using either a dorsal, dorsolateral or lateral approach between the 12th thoracic and second lumbar spaces. The volume of nucleus pulposus, the weight of the residual nucleus pulposus and the angle of the working sector were measured. The ratio of the residual nucleus pulposus weight to the nucleus pulposus volume was used to evaluate the efficacy of the performed fenestration. Data were analysed with Kruskal-Wallis analysis of variance between groups on ranks with correction for ties and Bonferroni correction for multiple comparisons. Correlation between ratio and working angle was calculated using a Spearman's rank test (P<0.05).

RESULTS

The calculated ratio of nuclear weight to volume was significantly less in the lateral approach group than that in the other groups. The working sector was widest in the dorsolateral approach group, but this did not correlate with efficient fenestration.

CLINICAL SIGNIFICANCE

Using the lateral approach for intervertebral disc fenestration may increase the efficiency of the fenestration procedure.

Comparison of the cardiopulmonary effects of anesthesia maintained by continuous infusion of ketamine and propofol with anesthesia maintained by inhalation of sevoflurane in goats undergoing magnetic resonance imaging

OBJECTIVE

To compare the cardiopulmonary effects of anesthesia maintained by continuous infusion of ketamine and propofol with anesthesia maintained by inhalation of sevoflurane in goats undergoing magnetic resonance imaging.

ANIMALS

8 Saanen goats.

PROCEDURES

Goats were anesthetized twice (1-month interval) following sedation with midazolam (0.4 mg/kg, IV). Anesthesia was induced via IV administration of ketamine (3 mg/kg) and propofol (1 mg/kg) and maintained with an IV infusion of ketamine (0.03 mg/kg/min) and propofol (0.3 mg/kg/min) and 100% inspired oxygen (K-P treatment) or induced via IV administration of propofol (4 mg/kg) and maintained via inhalation of sevoflurane in oxygen (end-expired concentration, 2.3%; 1X minimum alveolar concentration; SEVO treatment). Cardiopulmonary and blood gas variables were assessed at intervals after induction of anesthesia.

RESULTS

Mean +/- SD end-expired sevoflurane was 2.24 +/- 0.2%; ketamine and propofol were infused at rates of 0.03 +/- 0.002 mg/kg/min and 0.29 +/- 0.02 mg/kg/min, respectively. Overall, administration of ketamine and propofol for total IV anesthesia was associated with a degree of immobility and effects on cardiopulmonary parameters that were comparable to those associated with anesthesia maintained by inhalation of sevoflurane. Compared with the K-P treatment group, mean and diastolic blood pressure values in the SEVO treatment group were significantly lower at most or all time points after induction of anesthesia. After both treatments, recovery from anesthesia was good or excellent.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that ketamine-propofol total IV anesthesia in goats breathing 100% oxygen is practical and safe for performance of magnetic resonance imaging procedures.

Quantitative assessment of nociceptive processes in conscious dogs by use of the nociceptive withdrawal reflex

OBJECTIVE

To investigate the feasibility of evoking the nociceptive withdrawal reflex (NWR) from fore and hind limbs in conscious dogs, score stimulus-associated behavioral responses, and assess the canine NWR response to suprathreshold stimulations.

ANIMALS

8 adult Beagles.

PROCEDURE

Surface electromyograms evoked by transcutaneous electrical stimulation of ulnaris and digital plantar nerves were recorded from the deltoideus, cleidobrachialis, biceps femoris, and tibialis cranialis muscles. Train-of-five pulses (stimulus(train)) were used; reflex threshold (I(t train)) was determined, and recruitment curves were obtained at 1.2, 1.5, and 2 x I(t train). Additionally, a single pulse (stimulus(single)) was given at 1, 1.2, 1.5, 2, and 3 x I(t train). Latency and amplitude of NWRs were analyzed. Severity of behavioral reactions was subjectively scored.

RESULTS

Fore- and hind limb I(t train) values (median; 25% to 75% interquartile range) were 2.5 mA (2.0 to 3.6 mA) and 2.1 mA (1.7 to 2.9 mA), respectively. At I(t train), NWR latencies in the deltoideus, cleidobrachialis, biceps femoris, and cranial tibialis muscles were not significantly different (19.6 milliseconds [17.1 to 20.5 milliseconds], 19.5 milliseconds [18.1 to 20.7 milliseconds], 20.5 milliseconds [14.7 to 26.4 milliseconds], and 24.4 milliseconds [17.1 to 40.5 milliseconds], respectively). Latencies obtained with stimulus(train) and stimulus(single) were similar. With increasing stimulation intensities, NWR amplitude increased and correlated positively with behavioral scores.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs, the NWR can be evoked from limbs and correlates with behavioral reactions. Results suggest that NWR evaluation may enable quantification of nociceptive system excitability and efficacy of analgesics in individual dogs.

Continuous extradural analgesia in a cow with complex regional pain syndrome

A chronic pain syndrome, similar to the complex regional pain syndrome (CRPS) described in human beings, was diagnosed in a cow with persisting severe pelvic limb lameness. Diagnosis was based on the disproportionate relationship between the severity and duration of pain and the lesion, the failure of conventional analgesic and surgical therapy and the presence of characteristic clinical features. Multimodal therapy, i.e. a mixture of methadone, ketamine and bupivacaine was administered continuously for 17 days via an extradural catheter to counteract nociceptive hypersensitization. Doses were adjusted daily after assessing the effect, using a composite pain score. Physiotherapy was also performed. The diagnosis of CRPS in cattle is unusual. In this case, treatment was successful and the cow was discharged mildly lame and in improving physical condition. Long-term extradural analgesia proved to be safe and effective in the treatment of this syndrome, which was nonresponsive to conventional therapy.

Accidental entrapment of an endo-bronchial blocker tip by a surgical stapler during selective ventilation for lung lobectomy in a dog

OBJECTIVE

To describe the use of an endobronchial blocker (EBB) and to perform selective ventilation during pulmonary lobe resection via thoracotomy in a dog and report its accidental stapling in the resection site.

STUDY DESIGN

Clinical case report.

ANIMAL

One female dog with a suspected abscess or neoplasia of the right caudal pulmonary lobe.

METHODS

One-lung ventilation was performed using a wire-guided EBB to seal the contaminated parenchyma and facilitate surgical access. The affected lung parenchyma was resected and the resection site was closed with staples.

RESULTS

Lobar resection was performed successfully, but the loop of the EBB guide wire was inadvertently entrapped in the staple line of the lobectomy. Staples were removed to release the wire loop, and the resulting air leak caused loss of ventilation control until the parenchyma was re-sealed.

CONCLUSIONS

We recommend removing the wire guide associate with the EBB after successful lung separation to avoid accidents that could have life-threatening consequences if not recognized.

CLINICAL RELEVANCE

One-lung ventilation is useful to isolate healthy parenchyma from diseased parenchyma during lobectomy. Anesthesiologists and surgeons need to be aware of the potential complications associated with use of EBB.

Blood/gas partition coefficients of halothane, isoflurane and sevoflurane in horse blood

BACKGROUND

Blood/gas partition coefficients (lambda(b/g)) for volatile agents in horse blood are reported for halothane but not for isoflurane and sevoflurane. We measured the lambda(b/g) of halothane, isoflurane and sevoflurane in the blood of fasted horses. The correlation with age, weight and some haematological and biochemical variables was studied. The temperature correction factor for isoflurane solubility was calculated.

METHODS

Twenty-four horses were randomly allocated to halothane (n=8), isoflurane (n=8) or sevoflurane (n=8). Blood samples were taken after 10 h' fasting. Calculation of lambda(b/g) was based on the measurement of anaesthetic partial pressures in blood at 37 degrees C, which was achieved with tonometer equilibration and headspace gas chromatography.

RESULTS

Mean lambda(b/g) was 1.66 (SD 0.06) for halothane, 0.92 (0.04) for isoflurane, and 0.47 (0.03) for sevoflurane. The lambda(b/g) values were all significantly lower than in humans (P<0.001). No correlation was found between lambda(b/g) and weight, age, haematocrit, plasma triglycerides, cholesterol or total bilirubin. The change in isoflurane solubility per 1 degrees C temperature increase was -2.63 (0.13)%.

CONCLUSION

The lambda(b/g) values of halothane, isoflurane and sevoflurane in fasted horses are significantly lower than those reported in humans. The lambda(b/g) for halothane in this study agrees with values reported in the literature but a positive correlation with plasma triglycerides could not be confirmed. Knowledge of lambda(b/g) can refine models of anaesthetic uptake.

[Unilateral laparoscopic cryptorchidectomy in a llama]

Cryptorchism is an inherited congenital abnormality characterized by the failure of one or both testes to descend into the scrotum. Diagnosis can be difficult if the retained testicular tissue cannot be localized during clinical examination and the history of the animal is unknown, or if the animal shows persistent male behaviour despite the history of successful previous castration. The present case report describes the history of a cryptorchid Lama and the techniques of general anesthesia and laparoscopic cryptorchidectomy advocated.