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Frequency of vomiting during the postoperative period in hydromorphone-treated dogs undergoing orthopedic surgery

Leah C. SternVCA Veterinary Referral and Emergency Center, 123 W Cedar St, Norwalk, CT 06854.

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Matthew P. PalmisanoVCA Veterinary Referral and Emergency Center, 123 W Cedar St, Norwalk, CT 06854.

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Abstract

Objective—To determine the frequency of postoperative vomiting in dogs undergoing routine orthopedic surgery that were treated with hydromorphone and whether that frequency would vary on the basis of administration route.

Design—Noncontrolled clinical trial.

Animals—58 client-owned dogs with cranial cruciate ligament deficiency.

Procedures—Before surgery, all dogs received hydromorphone (0.1 mg/kg [0.045 mg/lb], IM or IV) and 41 dogs also received acepromazine. Anesthesia was induced with diazepam and propofol and maintained with isoflurane in oxygen. Dogs subsequently underwent surgical stabilization of the stifle joint. After surgery, dogs were randomly assigned to receive hydromorphone (0.1 mg/kg) via one of the following routes: IM, IV quickly (for 1 to 2 seconds), or IV slowly (for approx 1 minute). Dogs were monitored for vomiting.

Results—A median of 4 doses of hydromorphone/dog was administered after surgery. One dog was observed to regurgitate once prior to postoperative IM administration of hydromorphone; no dogs vomited at any point during the study period, regardless of the method of hydromorphone administration.

Conclusions and Clinical Relevance—The method of hydromorphone administration had no apparent effect on the likelihood of dogs vomiting. Because no dogs vomited, a particular administration method cannot be recommended. However, findings suggested that hydromorphone can be administered to dogs following orthopedic surgery without a clinically important risk of vomiting or regurgitation.

Abstract

Objective—To determine the frequency of postoperative vomiting in dogs undergoing routine orthopedic surgery that were treated with hydromorphone and whether that frequency would vary on the basis of administration route.

Design—Noncontrolled clinical trial.

Animals—58 client-owned dogs with cranial cruciate ligament deficiency.

Procedures—Before surgery, all dogs received hydromorphone (0.1 mg/kg [0.045 mg/lb], IM or IV) and 41 dogs also received acepromazine. Anesthesia was induced with diazepam and propofol and maintained with isoflurane in oxygen. Dogs subsequently underwent surgical stabilization of the stifle joint. After surgery, dogs were randomly assigned to receive hydromorphone (0.1 mg/kg) via one of the following routes: IM, IV quickly (for 1 to 2 seconds), or IV slowly (for approx 1 minute). Dogs were monitored for vomiting.

Results—A median of 4 doses of hydromorphone/dog was administered after surgery. One dog was observed to regurgitate once prior to postoperative IM administration of hydromorphone; no dogs vomited at any point during the study period, regardless of the method of hydromorphone administration.

Conclusions and Clinical Relevance—The method of hydromorphone administration had no apparent effect on the likelihood of dogs vomiting. Because no dogs vomited, a particular administration method cannot be recommended. However, findings suggested that hydromorphone can be administered to dogs following orthopedic surgery without a clinically important risk of vomiting or regurgitation.

Contributor Notes

Presented as a poster at the American College of Veterinary Surgeons Veterinary Symposium, Washington, DC, October 2009.

The authors thank Dr. Jennifer Zambriski for assistance with the statistical analysis.

Address correspondence to Dr. Stern (leah.stern@vcahospitals.com).