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Evaluation of inflammatory and hemostatic surgical stress responses in male cats after castration under general anesthesia with or without local anesthesia

Elena R. Moldal BVM&S, PhD1, Jolle Kirpensteijn DVM, PhD2, Annemarie T. Kristensen DVM, PhD3, H. Andreas Haga DVM, PhD4, Ane Nødtvedt DVM, PhD5, and Thomas Eriksen DVM, PhD6
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  • 1 Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, NO-0033 Oslo, Norway.
  • | 2 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, University of Utrecht, NL-3584 CM Utrecht, Netherlands.
  • | 3 Department of Small Animal Clinical Sciences, Faculty of Life Sciences, University of Copenhagen, DK-1870 Frederiksberg C, Denmark.
  • | 4 Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, NO-0033 Oslo, Norway.
  • | 5 Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, NO-0033 Oslo, Norway.
  • | 6 Department of Small Animal Clinical Sciences, Faculty of Life Sciences, University of Copenhagen, DK-1870 Frederiksberg C, Denmark.

Abstract

Objective—To characterize acute inflammatory and hemostatic surgical stress responses following castration in cats and to evaluate whether the addition of local anesthesia to the anesthetic protocol attenuates these responses.

Animals—39 male cats.

Procedures—Cats undergoing castration were randomly assigned to 2 groups: both groups underwent surgery with general anesthesia, and 1 group additionally received a local anesthetic (lidocaine [2.0 mg/kg in total, divided intratesticularly and SC]) prior to incision. Blood samples were collected after anesthetic induction (baseline) and 1, 5, and 24 hours later. Thromboelastography and coagulation variables (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) were analyzed; fibrinolysis was assessed with plasma D-dimer concentrations. The acute-phase response was evaluated via measurement of plasma fibrinogen and serum amyloid A (last time point, 28 hours) concentrations. Hematologic variables were analyzed at baseline and 1, 5, and 24 hours later.

Results—Evidence of hemostatic and inflammatory activation after surgery was detected in both groups. Maximum amplitude and G (global clot strength) were significantly increased at 24 hours, and significant, but not clinically relevant, decreases were detected in aPTT at 5 and 24 hours and in PT at 24 hours, compared with baseline values. Serum amyloid A concentrations were significantly higher at 24 and 28 hours than at baseline, and plasma fibrinogen concentration was significantly increased at 24 hours; WBC and RBC counts and Hct were significantly increased at multiple time points. No differences between groups were detected for any variables.

Conclusions and Clinical Relevance—Castration appeared to induce hypercoagulability and an acute-phase inflammatory response in cats. Local anesthesia with lidocaine did not attenuate this response.

Abstract

Objective—To characterize acute inflammatory and hemostatic surgical stress responses following castration in cats and to evaluate whether the addition of local anesthesia to the anesthetic protocol attenuates these responses.

Animals—39 male cats.

Procedures—Cats undergoing castration were randomly assigned to 2 groups: both groups underwent surgery with general anesthesia, and 1 group additionally received a local anesthetic (lidocaine [2.0 mg/kg in total, divided intratesticularly and SC]) prior to incision. Blood samples were collected after anesthetic induction (baseline) and 1, 5, and 24 hours later. Thromboelastography and coagulation variables (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) were analyzed; fibrinolysis was assessed with plasma D-dimer concentrations. The acute-phase response was evaluated via measurement of plasma fibrinogen and serum amyloid A (last time point, 28 hours) concentrations. Hematologic variables were analyzed at baseline and 1, 5, and 24 hours later.

Results—Evidence of hemostatic and inflammatory activation after surgery was detected in both groups. Maximum amplitude and G (global clot strength) were significantly increased at 24 hours, and significant, but not clinically relevant, decreases were detected in aPTT at 5 and 24 hours and in PT at 24 hours, compared with baseline values. Serum amyloid A concentrations were significantly higher at 24 and 28 hours than at baseline, and plasma fibrinogen concentration was significantly increased at 24 hours; WBC and RBC counts and Hct were significantly increased at multiple time points. No differences between groups were detected for any variables.

Conclusions and Clinical Relevance—Castration appeared to induce hypercoagulability and an acute-phase inflammatory response in cats. Local anesthesia with lidocaine did not attenuate this response.

Contributor Notes

Supported by the Research and Ethics Committee at the Norwegian School of Veterinary Science.

None of the authors have any financial or personal relationships that could inappropriately influence or bias the content of the paper.

The authors thank Fiorella Maria Sparta and Nora Elisabeth Zois for contributions to the practical aspects of the study, Mads Kjelgaard-Hansen and Bo Wiinberg for advice, and Claus Sivertsen Stjernegaard for assistance with laboratory analyses.

Address correspondence to Dr. Moldal (elena.moldal@nvh.no).