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McKenzie SR, Chiavaccini L, Moura RA, Santoro D. Comparison between dexmedetomidine and a combination of medetomidine-vatinoxan on muscle tissue saturation in privately-owned adult dogs undergoing intradermal testing. Res Vet Sci 2024; 171:105207. [PMID: 38460204 DOI: 10.1016/j.rvsc.2024.105207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/02/2024] [Accepted: 03/02/2024] [Indexed: 03/11/2024]
Abstract
This double-blinded randomized cross-over study compared the muscle tissue oxygen saturation (StO2) measured at the sartorius muscle after intramuscular (IM) injection of dexmedetomidine hydrochloride (HCl) and co-administration of vatinoxan HCl, a peripheral α2-adrenoceptor antagonist, and medetomidine HCl in healthy privately-owned dogs undergoing intradermal testing (IDAT). After written owner consent, dogs received IM injections of either dexmedetomidine (0.5 mg/m2, DEX) or medetomidine (1 mg/m2) and vatinoxan (20 mg/m2) (MVX). Once sedated, intradermal injections were given on the lateral thorax of each dog, and the study was repeated with the alternative sedation on the opposite side one week later. At the end of the study, sedation was reversed with atipamezole (5 mg/m2). Depth of sedation, cardiopulmonary parameters, StO2, and rectal temperature were recorded and compared using mixed effect linear models (α ≤ 0.05). MVX achieved adequate sedation faster [median (interquartile range), 10 (8, 10) minutes] compared to DEX [18 (15, 22) minutes; hazard ratio = 7.44, p = 0.013), with higher scores at 10- and 15-min post-injection. StO2 was significantly reduced for 30 min after injection (p < 0.001), independently of the treatment (p = 0.68). Cardiopulmonary variables favored MVX. However, higher heart rate did not correlate with improved StO2. There was no difference in either subjective or objective assessment of the wheal size between sedations (p > 0.05). Both sedation protocols, MVX and DEX, were deemed suitable for IDAT in dogs, with mild reductions in StO2 measured at the sartorius muscle that were not significantly different between treatments.
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Affiliation(s)
- Stuart R McKenzie
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., Gainesville, FL 32610, USA
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., Gainesville, FL 32610, USA.
| | - Raiane A Moura
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., Gainesville, FL 32610, USA
| | - Domenico Santoro
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., Gainesville, FL 32610, USA
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Gisler J, Chiavaccini L, Blum S, Montavon S, Spadavecchia C. Pressure pain mapping of equine distal joints: feasibility and reliability. Front Pain Res (Lausanne) 2024; 5:1342954. [PMID: 38726353 PMCID: PMC11079115 DOI: 10.3389/fpain.2024.1342954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Background Osteoarthritis is a prevalent degenerative joint disease initiating chronic pain and lameness in horses. While several objective gait analysis systems have been developed and validated to quantify lameness severity in horses, methods to evaluate whether peripheral sensitization contributes to the pain experienced are missing. Objectives To evaluate whether periarticular pressure pain mapping could be proposed as an auxiliary assessment tool in horses. Specific aims were to evaluate the feasibility and intra- and inter-rater reliability of pressure pain thresholds (PPT) determination at sites overlying the distal thoracic limb joints of clinically healthy horses. Study design Prospective, randomized validation study. Methods For feasibility assessment, PPT were measured with a hand-held digital algometer at six periarticular landmarks (2 sites per joint, 3 joints) bilaterally on the distal thoracic limb of 40 healthy horses (20 warmblood and 20 Freiberger). The joints tested were the metacarpophalangeal, on the latero-palmar and dorsal aspects (L-MCP and D-MCP), the proximal interphalangeal, on the dorsal and palmar aspect (D-PIP and P-PIP) and the distal interphalangeal, on the dorsal and lateral aspect (D-DIP and L-DIP). A feasibility score, ranging from 0 to 5, was attributed to each testing session. For intra- and inter-rater reliability assessment, L-MCP and D-MCP were selected to be tested again at 2 weeks intervals in 20 out of the 40 horses. Data were analyzed using a mixed-effect linear model to test differences in threshold per site and limb. Intra- and inter-rater correlation was calculated. Bland-Altman plots were performed to evaluate the variability of the measures. Results The procedure was considered feasible (score <2) in 95% of horses (95% CI 88%-100%). Overall, median [interquartile range (IQR)] PPT was 9.4 (7.5-11.3) N. No significant side differences were found. P-PIP and D-DIP recorded significantly lower PPT (p < 0.001 and p = 0.002, respectively) than L-MCP. Median (IQR) were 9.9 (7.3-12.4) N, 8.4 (6.1-10.5) N and 9.0 (7.4-10.6) N for L-MCP, P-PIP and D-DIP, respectively. The intra-rater agreement was 0.68 (95% CI 0.35-0.86) for L-MCP, and 0.50 (95% CI 0.08-0.76) for D-MCP. Inter-rater agreement was 0.85 (95% CI 0.66-0.94) for L-MCP and 0.81 (0.57, 0.92) for D-MCP. Main limitations Evaluation of feasibility was performed only for distal thoracic limbs joints; no data are provided for hind limbs or proximal joints. Only warmblood and Freiberger horses were included. Intra- and inter-rater reliability assessments were performed exclusively on data collected at the MCP joint. Conclusion Pressure pain mapping of distal thoracic limb joints was feasible in horses. Local sensitivity differed among sites and no side differences were noticed. Data collected from the MCP joint suggest highly variable, subject dependent intra-rater reliability, ranging from poor to good, and good to excellent inter-rater reliability. Further studies evaluating pathologic vs. healthy joints are needed before recommendations can be made about clinical usability and diagnostic validity.
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Affiliation(s)
- Jana Gisler
- Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Bern, Switzerland
- Veterinary Department of the SwissArmed Forces, Bern, Switzerland
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Severin Blum
- Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Bern, Switzerland
- Veterinary Department of the SwissArmed Forces, Bern, Switzerland
| | | | - Claudia Spadavecchia
- Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Chiavaccini L, Solari FP, Ham KM, Regier PJ, Vettorato E, Portela DA. Retroperitoneal hematoma after dorsal quadratus lumborum block in two dogs. Vet Anaesth Analg 2024; 51:112-114. [PMID: 38042673 DOI: 10.1016/j.vaa.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Ludovica Chiavaccini
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Francesca P Solari
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Kathleen M Ham
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Penny J Regier
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Enzo Vettorato
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Briley JD, Washington D, Westermeyer HD, Posner LP, Chiavaccini L. Comparison of a blind and an ultrasound-guided technique for Retrobulbar anesthesia in dogs undergoing unilateral subconjunctival enucleation. Vet Ophthalmol 2024; 27:79-85. [PMID: 37021439 DOI: 10.1111/vop.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/16/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE This study compared the quality of retrobulbar anesthesia using a blind inferior-temporal palpebral approach (ITP) with an ultrasound-guided supratemporal (ST) technique in dogs undergoing unilateral enucleation. ANIMAL STUDIED Twenty-one client-owned dogs were undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive ITP (n = 10) or ST (n = 11) with 0.5% ropivacaine at 0.1 mL/cm of neurocranial length. The anesthetist was blinded to the technique. Intraoperative data included cardiopulmonary variables, inhalant anesthetics requirement, and requirement for rescue analgesia (intravenous fentanyl 2.5 mcg/kg). Postoperative data included pain scores, sedation scores, and need for intravenous hydromorphone (0.05 mg/kg). Treatments were compared using Wilcoxon's rank sum test or Fisher's exact test as appropriate. Comparison of variables over time were tested using a mixed effect linear model on rank. Significance was set at p = 0.05. RESULTS Intraoperative cardiopulmonary variables and inhalant requirements were not different between groups. Dogs receiving ITP required median (interquartile range, IQR) 1.25 (0, 2.5) mcg/kg intraoperative fentanyl while those receiving ST required none (p < 0.01). Intraoperative fentanyl was required in 5/10 and 0/11 of dogs in the ITP and ST groups, respectively (p = 0.01). Postoperative analgesia requirements were not significantly different between groups; 2/10 and 1/10 dogs in the ITP and ST groups, respectively. Sedation score negatively affected pain score (p < 0.01). CONCLUSIONS The ultrasound-guided ST technique was more effective at decreasing intraoperative opioid requirements than the blind ITP approach in dogs undergoing unilateral enucleation.
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Affiliation(s)
- Jessica D Briley
- Department of Molecular Biomedical Sciences, Anesthesiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Hans D Westermeyer
- Department of Clinical Sciences, Comparative Ophthalmology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Lysa P Posner
- Department of Molecular Biomedical Sciences, Anesthesiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic and Population Medicine, Anesthesiology, College of Veterinary Medicine, University of Florida, Florida, Gainesville, USA
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Vettorato E, Schmidt KJ, Horgan MD, Chiavaccini L, Portela DA. Quadratus lumborum block as part of multimodal analgesia in a rabbit undergoing liver lobectomy. Vet Anaesth Analg 2023; 50:530-532. [PMID: 37777467 DOI: 10.1016/j.vaa.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 10/02/2023]
Affiliation(s)
- Enzo Vettorato
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Keaton Jenner Schmidt
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Molly Drake Horgan
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Alterisio MC, Micieli F, Valle GD, Chiavaccini L, Vesce G, Ciaramella P, Guccione J. Cardiovascular changes, laboratory findings and pain scores in calves undergoing ultrasonography-guided bilateral rectus sheath block before herniorrhaphy: a prospective randomized clinical trial. BMC Vet Res 2023; 19:191. [PMID: 37798785 PMCID: PMC10552199 DOI: 10.1186/s12917-023-03754-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The study aimed to assess the clinical utility of a multiparametric approach to measure the impact of bilateral ultrasound-guided rectus sheath blocks (RSB) on heart rate, serum cortisol concentrations, and pain in calves undergoing herniorraphy. Fourteen calves were randomly assigned to receive either the RSB (RSB group, n = 7, injected with 0.3 mL/kg of bupivacaine 0.25% and 0.15 µg/kg of dexmedetomidine per side) or a sham injection (CG group, n = 7, injected with an equivalent volume of sterile saline solution). Monitoring included (i) continuous Holter recording from 120 min pre-surgery to 120 min post-surgery; (ii) serum cortisol concentration (SC) at -150 min pre-surgery (baseline), induction time, skin incision, end of surgical procedure (EP-t), and then 30 min, 45 min, 60 min, 120 min, 360 min after recovery; (iii) UNESP-Botucatu pain evaluation at -150 min pre-surgery and 30 min, 45 min, 60 min, 120 min, 240 min, 360 min after recovery. RESULTS A significant difference in the heart rate was observed within the RSB group, in the time frame between 120 min to induction compared to the time frame between induction to EP-t period. The SC concentration was significantly higher in the CG at the skin incision. Calves in the RSB group recorded significantly lower pain scores at 45 min, 60 min, 120 and 240 min after recovery. CONCLUSIONS The study demonstrated that monitoring heart rate and serum cortisol concentrations effectively quantified the effects of RSB during surgery. At the same time, the UNESP-Botucatu pain scale identified effects post-surgery when the calves regained consciousness. Overall, ultrasound-guided RSB appeared to enhance the well-being of calves undergoing herniorrhaphy.
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Affiliation(s)
- Maria Chiara Alterisio
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Via Delpino 1, Napoli, 80137, Italy
| | - Fabiana Micieli
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Via Delpino 1, Napoli, 80137, Italy
| | - Giovanni Della Valle
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Via Delpino 1, Napoli, 80137, Italy
| | - Ludovica Chiavaccini
- Department of Comparative, Anesthesiology and Pain Management, Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave, Gainesville, 32608, FL, USA
| | - Giancarlo Vesce
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Via Delpino 1, Napoli, 80137, Italy
| | - Paolo Ciaramella
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Via Delpino 1, Napoli, 80137, Italy.
| | - Jacopo Guccione
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Via Delpino 1, Napoli, 80137, Italy
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Koehler P, Otero PE, Chiavaccini L, Romano M, Stern AW, Cavalcanti M, Portela DA. A non-inferiority study comparing the ultrasound-guided parasacral with a novel greater ischiatic notch plane approach in canine cadavers. Vet Anaesth Analg 2023; 50:439-445. [PMID: 37331905 DOI: 10.1016/j.vaa.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/05/2023] [Accepted: 05/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To describe the gross and ultrasound anatomy of the parasacral region and an ultrasound-guided greater ischiatic notch (GIN) plane approach aimed at staining the lumbosacral trunk (LST) in canine cadavers. To evaluate if the ultrasound-guided GIN plane approach is non-inferior to the previously described ultrasound-guided parasacral approach at staining the LST. STUDY DESIGN Prospective, randomized, non-inferiority experimental anatomic study. ANIMALS A total of 17 (23.9 ± 5.2 kg) mesocephalic canine cadavers. METHODS Anatomic and echographic landmarks, and the feasibility of performing a GIN plane technique were evaluated using two canine cadavers. The remaining 15 cadavers had each hemipelvis randomly assigned to be administered either parasacral or GIN plane injection of 0.15 mL kg-1 dye solution. The parasacral region was dissected after injections to assess the staining of LST, cranial gluteal nerve, pararectal fossa and pelvic cavity. The stained LST were removed and processed for histological evaluation of intraneural injections. A one-sided z-test for non-inferiority (non-inferiority margin -14%) was used to statistically evaluate the success of the GIN plane versus the parasacral approach. Data were considered statistically significant when p < 0.05. RESULTS The GIN plane and parasacral approach stained the LST in 100% and 93.3% of the injections, respectively. The success rate difference between treatments was 6.7% [95% confidence interval, -0.6 to 19.0%; p < 0.001 for non-inferiority]. The GIN plane and parasacral injections stained the LST for 32.7 ± 16.8 mm and 43.1 ± 24.3 mm, respectively (p = 0.18). No evidence of intraneural injection was found. CONCLUSIONS AND CLINICAL RELEVANCE The ultrasound-guided GIN plane technique resulted in nerve staining that was non-inferior to the parasacral technique and may be considered an alternative to the parasacral approach to block the LST in dogs.
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Affiliation(s)
- Perry Koehler
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Adam W Stern
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
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Portela DA, Di Franco C, Chiavaccini L, Araos J, Romano M, Otero PE, Biedrzycki AH, Schramel JP. Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses. Vet Anaesth Analg 2023:S1467-2987(23)00050-8. [PMID: 37055259 DOI: 10.1016/j.vaa.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (VTalv), airway (VDaw) and physiological (VDphys) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO2) elimination per breath (Vco2br-1), PaCO2, and the ratio of PaO2-to-fractional inspired oxygen (PaO2:FiO2). STUDY DESIGN Prospective research study. ANIMALS A group of eight healthy research horses undergoing laparotomy. METHODS Anesthetized horses were mechanically ventilated as follows: 6 breaths minute-1, tidal volume (VT) 13 mL kg-1, inspiratory-to-expiratory time ratio 1:2, positive end-expiratory pressure 5 cmH2O and EIP 0%. Vco2br-1 and expired tidal volume (VTE) of 10 consecutive breaths were recorded 30 minutes after induction, after adding 30% EIP and upon EIP removal to construct volumetric capnograms. A stabilization period of 15 minutes was allowed between phases. Data were analyzed using a mixed-effect linear model. Significance was set at p < 0.05. RESULTS The EIP decreased VDaw from 6.6 (6.1-6.7) to 5.5 (5.3-6.1) mL kg-1 (p < 0.001) and increased VTalv from 7.7 ± 0.7 to 8.6 ± 0.6 mL kg-1 (p = 0.002) without changing the VTE. The VDphys to VTE ratio decreased from 51.0% to 45.5% (p < 0.001) with EIP. The EIP also increased PaO2:FiO2 from 393.3 ± 160.7 to 450.5 ± 182.5 mmHg (52.5 ± 21.4 to 60.0 ± 24.3 kPa; p < 0.001) and Vco2br-1 from 0.49 (0.45-0.50) to 0.59 (0.45-0.61) mL kg-1 (p = 0.008) without reducing PaCO2. CONCLUSIONS AND CLINICAL RELEVANCE The EIP improved oxygenation and reduced VDaw and VDphys, without reductions in PaCO2. Future studies should evaluate the impact of different EIP in healthy and pathological equine populations under anesthesia.
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Portela DA, Cavalcanti M, Teixeira JG, Gandy KY, Zamora G, Stern AW, Jones R, Fuensalida SE, Chiavaccini L, Romano M, Otero PE. Lumbosacral plexus block using a combination of ultrasound-guided lateral pre-iliac and parasacral approaches in cats. Vet Anaesth Analg 2023; 50:188-196. [PMID: 36775670 DOI: 10.1016/j.vaa.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To describe an ultrasound-guided lateral pre-iliac (LPI) and parasacral (PS) approach in feline cadavers (phase I) and compare the perioperative analgesic use and complications in cats administered LPI and PS blocks (group PNB) or epidural anesthesia (group EPI) for pelvic limb surgery (phase II). STUDY DESIGN Experimental uncontrolled, anatomic and retrospective cohort study. ANIMALS A group of eight feline cadavers and 52 medical records. METHODS Bilateral LPI and PS approaches with 0.1 mL kg-1 of dye to stain the femoral and obturator nerves and the lumbosacral trunk, respectively, were performed on each cadaver. Nerve staining effect was evaluated upon dissections (phase I). Perioperative analgesics use, and complication rates were retrospectively compared between groups PNB and EPI (phase II). Continuous data were compared using the Mann-Whitney U test and the prevalence of events with Fisher's exact test. Differences were considered significant when p < 0.05. RESULTS Dissections revealed that the LPI approach stained 94% and 75% of the femoral and obturator nerves, respectively. The PS approach stained 100% of the lumbosacral trunks. Cats enrolled in group PNB (n = 23) were administered lower doses of intraoperative opioids than those in group EPI (n = 25) (p = 0.006). Intraoperative rescue analgesia was required in 60% and 17.4% of cats enrolled in groups EPI and PNB, respectively (p = 0.003). Group PNB required more intraoperative anticholinergics than group EPI (p = 0.02). There were no differences in postoperative pain scores, analgesic use and complication rates. CONCLUSIONS AND CLINICAL RELEVANCE The ultrasound-guided LPI and PS approach stained the femoral/obturator nerves and the lumbosacral trunk, respectively, in feline cadavers. Furthermore, PNB was associated with lower intraoperative opioid use and similar postoperative pain and analgesic use compared with epidural anesthesia in a cohort of cats undergoing surgery of the pelvic limb.
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Affiliation(s)
- Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Jorge G Teixeira
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Keith Y Gandy
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Gustavo Zamora
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Adam W Stern
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Rachel Jones
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Santiago E Fuensalida
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Micieli F, Guccione J, Della Valle G, Alterisio MC, Ciaramella P, Vesce G, Chiavaccini L. Clinical efficacy of an ultrasound-guided bilateral rectus sheath block for umbilical hernia repair in calves: A prospective randomized trial. Front Pain Res (Lausanne) 2023; 4:1051504. [PMID: 36860331 PMCID: PMC9969087 DOI: 10.3389/fpain.2023.1051504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/13/2023] [Indexed: 02/15/2023] Open
Abstract
Introduction Surgical umbilical hernia repair is a frequent procedure in newborn calves, requiring mandatory pain management. This study aimed to develop an ultrasound-guided rectus sheath block (RSB) and to evaluate its clinical efficacy in calves undergoing umbilical herniorrhaphy under general field anesthesia. Methods Gross and ultrasound anatomy of the ventral abdomen and the diffusion of a new methylene blue solution after injection within the rectus sheath were described in seven fresh calf cadavers. Then, fourteen calves undergoing elective herniorrhaphy were randomly assigned to receive either bilateral ultrasound-guided RSB with 0.3 mL/kg of bupivacaine 0.25% and 0.15 µg/kg of dexmedetomidine or 0.3 mL/kg of 0.9% NaCl (control). Intraoperative data included cardiopulmonary variables and anesthetic requirements. Postoperative data included pain scores, sedation scores and peri-incisional mechanical threshold assessed by force algometry at specific time points after anesthetic recovery. Treatments were compared using Wilcoxon rank-sum, Student's t-test, and Cox proportional hazard model as appropriate. Mixed effect linear models on rank, with random effect calf; fixed effects time, treatment, and their interaction were used to compare pain scores and mechanical thresholds over time. Significance was set at p = 0.05. Results and Discussion Calves receiving RSB recorded lower pain scores between 45 - 120 minutes (p < 0.05) and at 240 min after recovery (p = 0.02). And they recorded higher mechanical thresholds between 45 and 120 min after surgery (p < 0.05). Ultrasound-guided RSB provided effective perioperative analgesia in calves undergoing herniorrhaphy under field conditions.
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Affiliation(s)
- Fabiana Micieli
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy
| | - Jacopo Guccione
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy
| | - Giovanni Della Valle
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy
| | - Maria Chiara Alterisio
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy
| | - Paolo Ciaramella
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy
| | - Giancarlo Vesce
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States,Correspondence: Ludovica Chiavaccini
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Bini G, Bailey KM, Voyvodic JT, Chiavaccini L, Munana KR, Keenihan EK. Effects of alfaxalone, propofol and isoflurane on cerebral blood flow and cerebrovascular reactivity to carbon dioxide in dogs: A pilot study. Vet J 2023; 291:105939. [PMID: 36509393 DOI: 10.1016/j.tvjl.2022.105939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022]
Abstract
Propofol total intravenous anesthesia is a common choice to anesthetize patients with increased intracranial pressure, reducing cerebral blood flow while maintaining cerebrovascular reactivity to CO2. Propofol and alfaxalone are commonly used for total intravenous anesthesia in dogs, but the effects of alfaxalone on cerebral blood flow and cerebrovascular reactivity to CO2 are unknown. Our hypothesis was that alfaxalone would not be significantly different to propofol, while isoflurane would increase cerebral blood flow and decrease cerebrovascular reactivity to CO2. Six healthy hound dogs were evaluated in this randomized crossover trial. Dogs were anesthetized with 7.5 mg/kg propofol, 3 mg/kg alfaxalone or 8 % sevoflurane, mechanically ventilated and maintained with propofol (400 µg/kg/min), alfaxalone (150 µg/kg/min) or 1.7 % end-tidal isoflurane, respectively, with one week washout between treatments. Cerebral blood flow and cerebrovascular reactivity to CO2 during hypercapnic and hypocapnic challenges were measured using arterial spin labelling and blood oxygen level-dependent magnetic resonance imaging sequences, respectively. Median (interquartile range, IQR) normocapnic cerebral blood flow was significantly lower (P = 0.016) with alfaxalone compared to isoflurane, in the whole brain 15.39 mL/min/100 g (14.90-19.90 mL/min/100 g) vs. 34.10 mL/min/100 g (33.35-43.17 mL/min/100 g), the grey matter 14.57 mL/min/100 g (13.66-18.72 mL/min/100 g) vs. 32.37 mL/min/100 g (31.03-42.99 mL/min/100 g), the caudal brain 15.47 mL/min/100 g (13.37-21.45 mL/min/100 g) vs. 36.85 mL/min/100 g (32.50-47.18 mL/min/100 g) and the temporal lobe grey matter 18.80 mL/min/100 g (15.89-20.84 mL/min/100 g) vs. 43.32 (36.07-43.58 mL/min/100 g). Median (IQR) hypocapnic cerebrovascular reactivity to CO2 was significantly higher (P = 0.016) for alfaxalone compared to isoflurane 8.85 %S/mm Hg (6.92-10.44 %S/mm Hg) vs. 3.90 %S/mm Hg (3.80-4.33 %S/mm Hg). Alfaxalone maintained lower cerebral blood flow and higher hypocapnic cerebrovascular reactivity to CO2 than isoflurane.
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Affiliation(s)
- G Bini
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St., Columbus, OH 43210, USA.
| | - K M Bailey
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607 USA
| | - J T Voyvodic
- Brain Imaging and Analysis Center, Radiology Department, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, USA
| | - L Chiavaccini
- Department of Comparative, Diagnostic & Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave, Gainesville, FL 32608, USA
| | - K R Munana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA
| | - E K Keenihan
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607 USA
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Chiavaccini L, Cavalcanti M, De Gasperi D, Portela DA. Clinical efficacy of ultrasound-guided bilateral erector spinae plane block for standing lumbar spinous osteotomy in a horse. Vet Anaesth Analg 2022; 49:517-519. [PMID: 35764459 DOI: 10.1016/j.vaa.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego De Gasperi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Fackler BM, Chiavaccini L, Portela DA. Electrolocation-guided pudendal nerve block in a goat undergoing perineal urethrostomy. Vet Anaesth Analg 2022; 49:224-226. [DOI: 10.1016/j.vaa.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
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Bini G, Cohen EB, Chiavaccini L, Messenger KM, Bailey KM. Intravenous dexmedetomidine, morphine, or a combination can result in gallbladder wall thickening; with no significant association with plasma histamine concentrations. Vet Radiol Ultrasound 2022; 63:319-327. [PMID: 35006624 DOI: 10.1111/vru.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/21/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022] Open
Abstract
The gallbladder is routinely evaluated during ultrasonographic examinations in dogs. However, published studies describing the effects of sedative agents on gallbladder wall thickness are currently lacking. The aims of this prospective, blinded, randomized crossover pilot study were to test hypotheses that IV morphine would result in gallbladder wall thickening, that morphine administration would increase plasma histamine concentrations, and that combining IV morphine with dexmedetomidine would potentiate gallbladder wall thickening. Six healthy Beagle dogs were sedated with intravenous (IV) morphine 0.4 mg/kg (group M), dexmedetomidine 7 μg/kg (group D), or a combination of the two (group MD). Physiologic parameters were measured at baseline and at regular intervals until the last ultrasonographic scan. Ultrasonographic scans were performed at baseline, 90 s, and at 5, 15, 30, 45, 60, 90, and 120 min. Plasma histamine samples were taken at baseline, 90 s, and 5 and 60 min. Cochran's Q-test was used to compare gallbladder wall thickening between groups, while the association between histamine plasma concentration and gallbladder wall thickness was compared with a mixed-effects model. Baseline gallbladder wall thickness was not significantly different between groups. Six of 18 treatments/dogs (33%) developed gallbladder thickening, with no difference between groups. There was no significant difference in baseline plasma histamine concentrations between groups, and no association between plasma histamine concentration and gallbladder wall thickness. Gallbladder wall thickening was observed in at least one dog in each group, therefore caution is recommended for gallbladder wall thickness ultrasonographic interpretation in dogs when these drugs have been administered.
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Affiliation(s)
- Gianluca Bini
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Eli B Cohen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic & Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Kristen M Messenger
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | - Kate M Bailey
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
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Hovda T, Love L, Chiavaccini L. Risk factors associated with hypoxaemia in horses undergoing general anaesthesia: A retrospective study. Equine Vet J 2021; 54:1055-1063. [PMID: 34796547 DOI: 10.1111/evj.13541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Hypoxaemia is a common concern during equine general anaesthesia. The prevalence and predictors of hypoxaemia in horses undergoing elective anaesthesia in particular are poorly documented. OBJECTIVES To determine and compare the prevalence of hypoxaemia (defined as PaO2 ≤ 80 mm Hg, on the lowest value recorded) in horses undergoing anaesthesia for exploratory laparotomy and elective procedures, and to identify risk factors in both subpopulations. STUDY DESIGN Retrospective cohort study. METHODS Data were collected from 774 records of 708 horses undergoing general anaesthesia between April 2017 and August 2020. Potential predictors of hypoxaemia in horses undergoing anaesthesia for exploratory laparotomy or elective procedures were investigated separately by univariable penalised maximum likelihood logistic regression, followed by multivariable analysis. The lowest recorded PaO2 was used as a single data point for the determination of hypoxaemia and arterial oxygen partial pressure to fractional inspired oxygen ratio analysis. RESULTS Hypoxaemia was recorded in 23% horses undergoing exploratory laparotomy compared with 3.8% horses undergoing elective anaesthesia (P < .001). Multivariable analysis showed that weight above 550 kg, large intestinal lesions, and peak inspiratory pressure (PIP) above 30 cmH2 O were significantly associated with hypoxaemia in horses undergoing exploratory laparotomy. Soft tissue procedures and PIP >30 cmH2 O were significantly associated with hypoxaemia during elective anaesthesia. MAIN LIMITATIONS This study only considered the minimum PaO2 recorded during anaesthesia. Duration and treatment of hypoxaemia were not considered. CONCLUSIONS Based on the lowest PaO2 value during anaesthesia, in our population, horses undergoing anaesthesia for exploratory laparotomy were over six times more likely to become hypoxaemic than horses undergoing elective procedures. Bodyweight, type of procedure, and high PIP were predictors of hypoxaemia.
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Affiliation(s)
- Tyne Hovda
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Lydia Love
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Greco A, Costanza D, Senatore A, Bruzzese D, Micieli F, Chiavaccini L, Di Giancamillo M, Della Valle G, Vesce G, Brunetti A, Meomartino L. A computed tomography-based method for the assessment of canine retrobulbar cone volume for ophthalmic anaesthesia. Vet Anaesth Analg 2021; 48:759-766. [PMID: 34391668 DOI: 10.1016/j.vaa.2021.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/01/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop a comprehensive formula for calculating the volume of local anaesthetic solution used for retrobulbar anaesthesia in dogs with different skull morphologies. STUDY DESIGN Retrospective cohort imaging study. ANIMALS Skull computed tomography (CT) images of 188 dogs of different breeds collected between January 2009 and December 2017. METHODS Anatomical integrity of the orbit and adjacent structures, presenting complaint, clinical signs and CT findings were verified to exclude ocular abnormalities. The volume of the retrobulbar cone of 376 eyes was calculated using CT scans of the dogs' skulls. Additional data recorded included morphology of the skull, body weight, sex and size of the dogs, all of which were matched for possible association to the retrobulbar cone volume through univariable and multivariable linear regression models. Results of linear regression models were expressed as estimated beta coefficients with the corresponding 95% confidence intervals (95% CIs). RESULTS Using univariate analysis, the retrobulbar cone volume was positively associated with weight and male sex. In addition, brachycephalic and dolichocephalic dogs showed a larger retrobulbar cone volume than mesocephalic dogs, while sex was no longer significantly associated with the retrobulbar cone volume. In multivariate analysis, when considering all variables in the model, weight emerged as the strongest predictor (beta coefficient: 0.062 mL kg-1, 95% CI: 0.056-0.067 mL kg-1, p < 0.001). CONCLUSIONS and clinical relevance In the veterinary literature, there is no agreement on the precise volume of local anaesthetic solution that should be used to achieve intraconal retrobulbar anaesthesia in dogs. Here we suggest a formula to calculate the retrobulbar cone volume and, accordingly, the injection volume of local anaesthetic solution for effective retrobulbar anaesthesia.
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Affiliation(s)
- Adelaide Greco
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy; Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy.
| | - Dario Costanza
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy
| | - Andrea Senatore
- Centro Intedipartimentale di Ricerca sui Biomateriali, Università degli Studi di Napoli 'Federico II', Naples, Italy
| | - Dario Bruzzese
- Dipartimento di Sanità Pubblica, Università di Napoli 'Federico II', Naples, Italy
| | - Fabiana Micieli
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Ludovica Chiavaccini
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Mauro Di Giancamillo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Della Valle
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Giancarlo Vesce
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Arturo Brunetti
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli 'Federico II', Naples, Italy
| | - Leonardo Meomartino
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy; Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
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Chiavaccini L. REassessment Campaign On VEterinary Resuscitation: Has the time come for horses? EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L. Chiavaccini
- Department of Molecular and Biomedical Sciences College of Veterinary Medicine North Carolina State University Raleigh North Carolina USA
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Micieli F, Chiavaccini L, Mennonna G, Della Valle G, Prisco F, Meomartino L, Vesce G. An ultrasound-guided subparaneural approach to the sciatic nerve in the dog: a cadaver study. Vet Anaesth Analg 2020; 48:107-115. [PMID: 33339710 DOI: 10.1016/j.vaa.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 04/19/2020] [Accepted: 06/23/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe the gross and microscopic anatomy of the sciatic nerve paraneural sheath and to report an ultrasound (US)-guided subparaneural approach to the sciatic nerve in dogs, comparing two different volumes of injectate. STUDY DESIGN Prospective, randomized, anatomical study. ANIMALS A group of nine middle-sized adult Mongrel canine cadavers (18 limbs). METHODS The sciatic nerves of three pelvic limbs of two canine cadavers were identified, exposed and isolated between the greater trochanter and the popliteal fossa for gross anatomical and microscopic examination. An additional three pelvic limbs were surgically dissected on the lateral surface of the limb; the sciatic nerves were isolated, and a 26 gauge over-the-needle catheter was inserted through the paraneural sheath under direct visualization. A methylene blue solution was then slowly injected into the subparaneural compartment through the catheter under US visualization using an 8-13 MHz linear-array transducer. Subsequently, 12 pelvic limbs (six cadavers) were randomly allocated to one of two groups; using US-guided percutaneous subparaneural approach, either 0.1 or 0.05 mL kg-1of a 1:1 solution of methylene blue and 0.5% bupivacaine was injected. The spread of the dye solution and the amount of nerve staining were macroscopically scored. The stained sciatic nerves with their sheaths were then harvested for microscopic examination. RESULTS The paraneural sciatic nerve sheath was easily identified distinct from the nerve trunk both macroscopically and with US visualization, and microscopically. Complete staining was achieved in five of six (83.3%) sciatic nerves in each group; no difference was found in the amount of staining between the two groups. Microscopically, no signs of sciatic nerve intraneural injection were observed. CONCLUSIONS AND CLINICAL RELEVANCE The US-guided subparaneural injection of 0.05 mL kg-1 of a dye injectate resulted in satisfactory nerve staining without evidence of sciatic nerve intraneural injection.
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Affiliation(s)
- Fabiana Micieli
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Naples, Italy.
| | - Ludovica Chiavaccini
- Department of Medical Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Giuseppina Mennonna
- Interdepartmental Center of Veterinary Radiology, University of Napoli Federico II, Naples, Italy
| | - Giovanni Della Valle
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Naples, Italy
| | - Francesco Prisco
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Naples, Italy
| | - Leonardo Meomartino
- Interdepartmental Center of Veterinary Radiology, University of Napoli Federico II, Naples, Italy
| | - Giancarlo Vesce
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Naples, Italy
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Micieli F, Chiavaccini L, Paré MD, Chagas JB, Vesce G, Gianotti G. Comparison of the sedative effects of alfaxalone and methadone with or without midazolam in dogs. Can Vet J 2019; 60:1060-1064. [PMID: 31597990 PMCID: PMC6741817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This blinded, randomized, prospective study evaluated the sedative and physiologic effects of a combination of alfaxalone and methadone with or without midazolam in adult dogs. Sixteen dogs received methadone (0.5 mg/kg body weight) and alfaxalone (1 mg/kg body weight), either with or without midazolam (0.5 mg/kg body weight), by intramuscular injection. Quality of sedation, heart rate, respiratory rate, systolic arterial pressure, rectal temperature, arterial oxygen saturation of hemoglobin, and dose of alfaxalone required for endotracheal intubation were recorded. Sedation score increased over time in both groups; however, dogs premedicated with methadone and alfaxalone appeared significantly less sedated than dogs premedicated with midazolam at 15, 20, and 25 minutes post-injection (P = 0.04). Dogs receiving methadone and alfaxalone were almost 5 times more likely to show excitement than those receiving midazolam (P = 0.03). We concluded that adding midazolam to an intramuscular combination of methadone and alfaxalone cannot be recommended in healthy dogs.
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Affiliation(s)
- Fabiana Micieli
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Italy (Micieli, Vesce); Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Chiavaccini, Paré, Gianotti); SVS Centre for Companion Animal Health, Massey University, New Zealand (Chagas)
| | - Ludovica Chiavaccini
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Italy (Micieli, Vesce); Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Chiavaccini, Paré, Gianotti); SVS Centre for Companion Animal Health, Massey University, New Zealand (Chagas)
| | - Monique D Paré
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Italy (Micieli, Vesce); Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Chiavaccini, Paré, Gianotti); SVS Centre for Companion Animal Health, Massey University, New Zealand (Chagas)
| | - Joana Braun Chagas
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Italy (Micieli, Vesce); Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Chiavaccini, Paré, Gianotti); SVS Centre for Companion Animal Health, Massey University, New Zealand (Chagas)
| | - Giancarlo Vesce
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Italy (Micieli, Vesce); Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Chiavaccini, Paré, Gianotti); SVS Centre for Companion Animal Health, Massey University, New Zealand (Chagas)
| | - Giacomo Gianotti
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Italy (Micieli, Vesce); Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Chiavaccini, Paré, Gianotti); SVS Centre for Companion Animal Health, Massey University, New Zealand (Chagas)
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Floriano D, Sahagian MJ, Chiavaccini L. Impact of epidural bupivacaine on perioperative opioid requirements, recovery characteristics, and duration of hospitalization in dogs undergoing cystotomy: A retrospective study of 56 cases. Vet Surg 2019; 48:1330-1337. [PMID: 31328291 DOI: 10.1111/vsu.13290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/03/2019] [Accepted: 06/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare perioperative opioid consumption and duration of hospitalization (DOH) in anesthetized dogs receiving opioid-based analgesia (OBA) vs those receiving bupivacaine epidural-based analgesia (EPID) during cystotomy. STUDY DESIGN Retrospective cross-sectional study. ANIMALS Fifty-six client-owned dogs undergoing cystotomy. METHODS Clinical records of dogs undergoing cystotomy between January 2015 and December 2017 were reviewed. Demographic data, duration of anesthesia and surgery, anesthetic management, perioperative opioid consumption expressed in morphine equivalents (ME), perioperative use of adjuvant analgesics, time to first micturition, time to eat, time to ambulate, and DOH were recorded. Opioid consumption and DOH were compared with a Wilcoxon rank-sum test, followed by linear regression analysis as appropriate. Time to first micturition, time to eat, and time to walk unassisted were modeled with Cox-proportional hazard models. RESULTS Dogs treated with EPID during surgery required 1.5 mg/kg ME less compared with those treated with OBA (P = .04) during surgery. Three of 19 dogs treated with EPID vs 15 of 37 dogs receiving OBA required intraoperative adjuvant analgesics (P = .06). Dogs treated with EPID regained motor function slower than dogs treated with OBA (P = .01); however, there was no difference in time to urinate, time to eat, or DOH between treatments. CONCLUSION Perioperative lumbosacral epidural with bupivacaine reduced intraoperative opioid consumption in dogs anesthetized for cystotomy. CLINICAL SIGNIFICANCE The use of epidural bupivacaine in dogs undergoing cystotomy may reduce intraoperative opioid requirements without affecting return of bladder function or DOH.
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Affiliation(s)
- Dario Floriano
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael J Sahagian
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ludovica Chiavaccini
- Department of Molecular and Biomedical Sciences, North Carolina State University, Raleigh, North Carolina
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Micieli F, Chiavaccini L, Lamagna B, Vesce G, Santangelo B. Comparison of intraocular pressure and pupil diameter after sedation with either acepromazine or dexmedetomidine in healthy dogs. Vet Anaesth Analg 2018; 45:667-672. [DOI: 10.1016/j.vaa.2018.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/26/2018] [Accepted: 05/10/2018] [Indexed: 10/14/2022]
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Micieli F, Chiavaccini L, Lamagna B, Vesce G, Santangelo B. Comparison of intraocular pressure and pupillary diameter after premedication with either acepromazine or dexmedetomidine in healthy dogs. Vet Anaesth Analg 2017. [DOI: 10.1016/j.vaa.2017.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Micieli F, Duffee L, Chiavaccini L, Vesce G, Gianotti G. Evaluation of a combination of alfaxalone and methadone, with or without midazolam, for premedication in healthy dogs. Vet Anaesth Analg 2017. [DOI: 10.1016/j.vaa.2017.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodriguez JC, Koticha T, Eubanks DL, Rudek I, Molz FJ, Chiavaccini L, Claude A, Elder S, Wang HL. Influence of Microtextured Implant Surfaces on Peri-implantitis and Its Treatment: A Preclinical Trial. Int J Oral Maxillofac Implants 2017; 33:51–57. [PMID: 28817740 DOI: 10.11607/jomi.5599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The prevalence of peri-implantitis has increased significantly, forcing clinicians to search for ways to prevent it. Laser-microtextured surfaces promote soft tissue attachment and provide a tight seal around implants. Hence, the aim of this study was to examine the clinical, radiographic, and histologic features of ligature-induced peri-implantitis, as well as the effect of surgical treatment of these induced peri-implantitis lesions on laser-microtextured implants in a controlled animal model. MATERIALS AND METHODS Six mini-pigs (three males/three females) received 6 implants each (3 resorbable blast textured [RBT] implants and 3 laser-microtextured [LM] implants) in mandibular premolar sites, for a total of 36 implants. Two groups were identified based on the time point of sample analysis. After osseointegration was achieved, metal wire ligatures were placed and left for 12 weeks. Group 1 samples were then obtained, and group 2 samples received rescue therapy following a guided bone regeneration (GBR) protocol. Sample collection in group 2 was completed 12 weeks after the samples were submerged and treated. All samples were analyzed histologically and measurements were taken. RESULTS Four implants (three RBT, one LM) were lost at early time points because of implant instability. Interimplant distances and soft tissue thicknesses varied subtly between groups. More notable was the mean (± standard error of the mean) crestal bone loss (group 1: 1.860 ± 1.618 mm [LM] and 2.440 ± 2.691 mm [RBT]; group 2: 2.04 ± 1.613 mm [LM] and 3.00 ± 2.196 mm [RBT]) (P < .05), as demonstrated by a paired t test. Histologic pocket depth was also greater at RBT sites than at LM sites (4.448 ± 2.839 mm and 4.121 ± 2.251 mm, respectively, in group 1; and 3.537 ± 2.719 mm and 2.339 ± 1.852 mm, respectively [P < .005] in group 2). CONCLUSION LM implants had less crestal bone loss and shallower histologic pocket depth compared with their RBT counterparts. Also, LM implants had higher bone fill when a rescue therapy (GBR) was performed.
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Chiavaccini L, Claude AK, Meyer RE. Comparison of Morphine, Morphine-Lidocaine, and Morphine-Lidocaine-Ketamine Infusions in Dogs Using an Incision-Induced Pain Model. J Am Anim Hosp Assoc 2017; 53:65-72. [PMID: 28282236 DOI: 10.5326/jaaha-ms-6442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We aimed to compare antinociceptive effects of IV infusions of morphine (M), morphine-lidocaine (ML), or morphine-lidocaine-ketamine (MLK) combined, in a mild-to-moderate pain model in dogs. Eighteen adult hounds were heavily sedated with IV morphine (0.2 mg/kg) and dexmedetomidine to undergo thoracic skin incisions. After reversal, dogs were randomly assigned to receive loading doses of lidocaine and ketamine (MLK), lidocaine and saline (ML), or equivalent volume of saline (M), followed by 18 hr constant infusions of morphine (0.12 mg/kg/hr), lidocaine (3 mg/kg/hr) and ketamine (0.6 mg/kg/hr); morphine (0.12 mg/kg/hr) and lidocaine (3 mg/kg/hr); or morphine (0.12 mg/kg/hr), respectively. Pain was assessed with Short Form Glasgow Composite Measure Pain Scale and mechanical nociception with von Frey filaments (VFFS). Data were analyzed with linear mixed model on ranks. Independently of treatment, Short Form Glasgow Composite Measure Pain Scale was significantly higher than baseline for 24 hr (p < .0001), while VFFS was significantly lower than baseline for 48 hr post-recovery (p < .0001), with no difference between MLK and M groups. The ML group recorded significantly lower VFFS (p = .02) than the M group for the entire study. In conclusion, there was no significant analgesic difference between MLK and M alone.
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Affiliation(s)
| | - Andrew K Claude
- From the Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California (L.C.); and College of Veterinary Medicine, Department of Clinical Sciences, Mississippi State, Starkville, Mississippi (A.K.C., R.E.M.)
| | - Robert E Meyer
- From the Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California (L.C.); and College of Veterinary Medicine, Department of Clinical Sciences, Mississippi State, Starkville, Mississippi (A.K.C., R.E.M.)
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Chiavaccini L, Micieli F, Meomartino L, Duffee LR, Vesce G. A novel supra-temporal approach to retrobulbar anaesthesia in dogs: Preliminary study in cadavers. Vet J 2017; 223:68-70. [DOI: 10.1016/j.tvjl.2017.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/20/2017] [Accepted: 04/23/2017] [Indexed: 11/26/2022]
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Chiavaccini L, Claude AK, Lee JH, Ross MK, Meyer RE, Langston VC. Pharmacokinetics and pharmacodynamics comparison between subcutaneous and intravenous butorphanol administration in horses. J Vet Pharmacol Ther 2014; 38:365-74. [DOI: 10.1111/jvp.12191] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 10/31/2014] [Indexed: 11/30/2022]
Affiliation(s)
- L. Chiavaccini
- Department of Clinical Sciences; College of Veterinary Medicine; Mississippi State University; Mississippi State MS USA
| | - A. K. Claude
- Department of Clinical Sciences; College of Veterinary Medicine; Mississippi State University; Mississippi State MS USA
| | - J. H. Lee
- Department of Basic Sciences; Center for Environmental Health Sciences; College of Veterinary Medicine; Mississippi State University; Mississippi State MS USA
| | - M. K. Ross
- Department of Basic Sciences; Center for Environmental Health Sciences; College of Veterinary Medicine; Mississippi State University; Mississippi State MS USA
| | - R. E. Meyer
- Department of Clinical Sciences; College of Veterinary Medicine; Mississippi State University; Mississippi State MS USA
| | - V. C. Langston
- Department of Clinical Sciences; College of Veterinary Medicine; Mississippi State University; Mississippi State MS USA
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Claude AK, Dedeaux A, Chiavaccini L, Hinz S. Effects of maropitant citrate or acepromazine on the incidence of adverse events associated with hydromorphone premedication in dogs. J Vet Intern Med 2014; 28:1414-7. [PMID: 25146756 PMCID: PMC4895585 DOI: 10.1111/jvim.12414] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 05/14/2014] [Accepted: 06/17/2014] [Indexed: 11/28/2022] Open
Abstract
Background Vomiting is a common complication associated with the use of hydromorphine for pre‐emptive analgesia in dogs. The ideal anti‐emetic protocol for prevention of this complication has not been established. Hypothesis Maropitant administered concurrently or before hydromorphone would reduce the incidence of vomiting, signs of nausea, ptyalism, and increased panting compared to administration of acepromazine or a 0.9% saline control. Animals Sixty mixed‐breed female dogs scheduled for ovariohysterectomy. Methods Randomized, blinded, placebo‐controlled experimental study. Dogs were assigned to 4 experimental groups with 15 dogs per group. All groups received 0.2 mg/kg of hydromorphone IM. Group “Control” received 0.1 mL/kg saline SC 30–45 minutes before hydromorphone, group “Marop1” received 1 mg/kg maropitant SC 30–45 minutes before hydromorphone, group “Ace” received 0.02 mg/kg IM acepromazine 30–45 minutes before hydromorphone, and group “Marop2” received 1 mg/kg SC maropitant concurrently with hydromorphone. A trained and blinded observer documented adverse events from the time hydromorphone was administered until the time dogs were induced for surgery. Results Marop1 had significantly less vomiting (0%) compared to Control (87%; P < .01) and Ace (53%; P < .01). Marop2 had significantly less vomiting (27%) compared to Control (P < .01). Marop1 had significantly greater incidence of ptyalism (73%) compared to Ace (P < .01; 20%). Ace showed significantly less panting (33%) compared to Marop2 (93%; P < .01). Conclusions and Clinical Importance In healthy dogs, maropitant citrate administered before hydromorphone significantly decreases the incidence of vomiting in dogs but does not improve signs of nausea, ptyalism, or increased panting.
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Affiliation(s)
- A K Claude
- Mississippi State College of Veterinary Medicine, Mississippi State University, Starkville, MS
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Bova TL, Chiavaccini L, Cline GF, Hart CG, Matheny K, Muth AM, Voelz BE, Kesler D, Memili E. Environmental stressors influencing hormones and systems physiology in cattle. Reprod Biol Endocrinol 2014; 12:58. [PMID: 24996419 PMCID: PMC4094414 DOI: 10.1186/1477-7827-12-58] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/18/2014] [Indexed: 11/10/2022] Open
Abstract
Environmental stressors undoubtedly influence organismal biology, specifically the endocrine system that, in turn, impact cattle at the systems physiology level. Despite the significant advances in understanding the genetic determinants of the ideal dairy or beef cow, there is a grave lack of understanding of the systems physiology and effects of the environmental stressors that interfere with the endocrine system. This is a major problem because the lack of such knowledge is preventing advances in understanding gene-environment interactions and developing science-based solutions to these challenges. In this review, we synthesize the current knowledge on the nature of the major environmental stressors, such as climate (heat, cold, wind, and humidity), nutrition (feeds, feeding systems, and endocrine disruptors) and management (housing density and conditions, transportation, weaning practices). We summarize the impact of each one of these factors on cattle at the systems level, and provide solutions for the challenges.
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Affiliation(s)
- Toree L Bova
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
| | - Ludovica Chiavaccini
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA
| | - Garrett F Cline
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
| | - Caitlin G Hart
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
| | - Kelli Matheny
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
| | - Ashleigh M Muth
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
| | - Benjamin E Voelz
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
| | - Darrel Kesler
- Department of Animal Sciences, College of Agricultural, Consumer and Environmental Sciences, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA
| | - Erdoğan Memili
- Department of Animal and Dairy Sciences, College of Agriculture and Life Sciences, Mississippi State University, Mississippi State, MS 39762, USA
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Chiavaccini L, Claude AK, Meyer RE. An anesthetic protocol for adult heartworms removal in two cases of canine caval syndrome. Vet Anaesth Analg 2013; 41:105-6. [PMID: 24119070 DOI: 10.1111/vaa.12092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ludovica Chiavaccini
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA.
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Chiavaccini L, Hassel DM, Shoemaker ML, Charles JB, Belknap JK, Ehrhart E. Detection of calprotectin and apoptotic activity within the equine colon from horses with black walnut extract-induced laminitis. Vet Immunol Immunopathol 2011; 144:366-73. [DOI: 10.1016/j.vetimm.2011.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 07/29/2011] [Accepted: 08/08/2011] [Indexed: 11/27/2022]
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Chiavaccini L, Hassel D. Clinical Features and Prognostic Variables in 109 Horses with Esophageal Obstruction (1992-2009). J Vet Intern Med 2010; 24:1147-52. [DOI: 10.1111/j.1939-1676.2010.0573.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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