Effect of sedation protocol on glomerular filtration rate in cats as determined by use of quantitative renal scintigraphy

Matthew D. Winter Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610

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Kristina G. Miles Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

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Dean H. Riedesel Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

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Abstract

Objective—To evaluate the effect of several sedation protocols on glomerular filtration rate (GFR) in cats as measured by use of quantitative renal scintigraphy and to analyze interobserver differences in GFR calculation.

Animals—5 cats (1 sexually intact male, 1 neutered male, and 3 sexually intact females).

Procedures—Effects on GFR of 3 sedation protocols commonly used at the Iowa State University College of Veterinary Medicine were evaluated. The protocols were medetomidine (11 μg/kg) and butorphanol tartrate (0.22 mg/kg) administered IM; ketamine hydrochloride (10 mg/kg) and midazolam (0.5 mg/kg) administered IV; and ketamine (10 mg/kg), midazolam (0.5 mg/kg), and acepromazine maleate (0.05 mg/kg) administered IM. Results for the 3 protocols were compared with results of GFR measurements obtained in these same cats without sedation (control protocol).

Results—No significant difference between GFR measurements was associated with the 3 sedation protocols, compared with GFR measurements for the control protocol. The greatest mean GFR values were for the medetomidine-butorphanol and ketamine-midazolam protocols. There were no significant differences between observers for calculation of GFR.

Conclusions and Clinical Relevance—Results suggested that none of the 3 sedation protocols had significant effects on GFR calculated by use of quantitative renal scintigraphy, compared with results for GFR evaluations performed in the cats when they were not sedated. No significant interobserver error was evident. However, the statistical power of this study was low, and the probability of a type II error was high.

Abstract

Objective—To evaluate the effect of several sedation protocols on glomerular filtration rate (GFR) in cats as measured by use of quantitative renal scintigraphy and to analyze interobserver differences in GFR calculation.

Animals—5 cats (1 sexually intact male, 1 neutered male, and 3 sexually intact females).

Procedures—Effects on GFR of 3 sedation protocols commonly used at the Iowa State University College of Veterinary Medicine were evaluated. The protocols were medetomidine (11 μg/kg) and butorphanol tartrate (0.22 mg/kg) administered IM; ketamine hydrochloride (10 mg/kg) and midazolam (0.5 mg/kg) administered IV; and ketamine (10 mg/kg), midazolam (0.5 mg/kg), and acepromazine maleate (0.05 mg/kg) administered IM. Results for the 3 protocols were compared with results of GFR measurements obtained in these same cats without sedation (control protocol).

Results—No significant difference between GFR measurements was associated with the 3 sedation protocols, compared with GFR measurements for the control protocol. The greatest mean GFR values were for the medetomidine-butorphanol and ketamine-midazolam protocols. There were no significant differences between observers for calculation of GFR.

Conclusions and Clinical Relevance—Results suggested that none of the 3 sedation protocols had significant effects on GFR calculated by use of quantitative renal scintigraphy, compared with results for GFR evaluations performed in the cats when they were not sedated. No significant interobserver error was evident. However, the statistical power of this study was low, and the probability of a type II error was high.

  • 1.

    Uribe D, Krawiec DR, Twardock AR, et al. Quantitative renal scintigraphic determination of the glomerular filtration rate in cats with normal and abnormal kidney function, using 99mTc-diethylenetriaminepentaacetic acid. Am J Vet Res 1992; 53: 11011107.

    • Search Google Scholar
    • Export Citation
  • 2.

    Kerl ME, Cook CR. Glomerular filtration rate and renal scintigraphy. Clin Tech Small Anim Pract 2005; 20: 3138.

  • 3.

    Twardock AR, Krawiec DR, Lamb CR. Kidney scintigraphy. Semin Vet Med Surg (Small Anim) 1991; 6: 164169.

  • 4.

    Twardock AR, Bahr A. Renal scinitgraphy. In: Daniel GB, Berry CR, eds. Textbook of veterinary nuclear medicine. 2nd ed. Knoxville, Tenn: American College of Veterinary Radiology, 2006; 330352.

    • Search Google Scholar
    • Export Citation
  • 5.

    Guyton AC, Hall JE. Urine formation by the kidneys I: glomerular filtration, renal blood flow, and their control. In: Guyton AC, Hall JE, eds. Textbook of medical physiology. 10th ed. Philadelphia: WB Saunders Co, 2000.

    • Search Google Scholar
    • Export Citation
  • 6.

    Cupples W, Braam B. Assessment of renal autoregulation. Am J Physiol Renal Physiol 2007; 292: F1105F1123.

  • 7.

    Loutzenhiser R, Griffen K, Williamson G, et al. Renal autoregulation: new perspectives regarding the protective and regulatory roles of the underlying mechanisms. Am J Physiol Regul Integr Comp Physiol 2006; 290: R1153R1167.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Cousins M, Skowronski G, Plummer J. Anaesthesia and the kidney. Anaesth Intensive Care 1983; 11: 292320.

  • 9.

    Reece WO. The kidneys. In: Swenson MJ, Reece WO, eds. Dukes' physiology of domestic animals. 11th ed. Ithaca, NY: Cornell University Press, 1993; 573603.

    • Search Google Scholar
    • Export Citation
  • 10.

    Stoelting R, Hillier S. Kidneys. In: Stoelting R, Hillier S, eds. Pharmacology and physiology in anesthesia practice. 4th ed. Philadelphia: Lippincott, Williams & Wilkins, 2006.

    • Search Google Scholar
    • Export Citation
  • 11.

    Talke P, Traber D, Richardson C, et al. The effect of alpha 2 agonist-induced sedation and its reversal with an alpha 2 antagonist on organ blood flow in sheep. Anesth Analg 2000; 90: 10601066.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Fusellier M, Desfontis JC, Madéc S, et al. Influence of three anesthetic protocols on glomerular filtration rate in dogs. Am J Vet Res 2007; 68: 807811.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Grimm J, Grimm K, Kneller S, et al. The effect of a combination of medetomidine-butorphanol and medetomidine, butorphanol, atropine on glomerular filtration rate in dogs. Vet Radiol Ultrasound 2001; 42: 458462.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    White P, Way W, Trevor A. Ketamine—its pharmacology and therapeutic uses. Anesthesiology 1982; 56: 119132.

  • 15.

    Morse Z, Sano K, Kanri T. Effects of midazolam-ketamine admixture in human volunteers. Anesth Prog 2004; 51: 7679.

  • 16.

    Boström I, Nyman G, Kampa N, et al. Effects of acepromazine on renal function in anesthetized dogs. Am J Vet Res 2003; 64: 590598.

  • 17.

    Newell SM, Ko JC, Ginn PE, et al. Effects of three sedative protocols on glomerular filtration rate in clinically normal dogs. Am J Vet Res 1997; 58: 446450.

    • Search Google Scholar
    • Export Citation
  • 18.

    Selmi AL, Barbudo-Selmi GR, Moreira CF, et al. Evaluation of sedative and cardiorespiratory effects of romfidine and romifidine-butorphanol in cats. J Am Vet Med Assoc 2002; 221: 506510.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Daniel GB, Mitchell SK, Mawby D, et al. Renal nuclear medicine: a review. Vet Radiol Ultrasound 1999; 40: 572587.

  • 20.

    Hecht S, Lane I, Daniel G, et al. Diuretic renal scintigraphy in normal cats. Vet Radiol Ultrasound 2008; 49: 589594.

  • 21.

    van Hoek I, Vandermeulen E, Duchateau L, et al. Comparison and reproducibility of plasma clearance of exogenous creatinine, exo-iohexol, endo-iohexol, and 51Cr-EDTA in young adult and aged healthy cats. J Vet Intern Med 2007; 21: 950958.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Adams L, Polzin D, Osborne C, et al. Influence of dietary protein/calorie intake on renal morphology and function in cats with 5/6 nephrectomy. Lab Invest 1994; 70: 347357.

    • Search Google Scholar
    • Export Citation

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