• 1. Gillette EL, LaRue SM, Gilette SM. Normal tissue tolerance and management of radiation injury. Semin Vet Med Surg (Small Anim) 1995; 10: 209213.

    • Search Google Scholar
    • Export Citation
  • 2. Harris D, King GK, Bergman PJ. Radiation therapy toxicities. Vet Clin North Am Small Anim Pract 1997; 27: 3746.

  • 3. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991; 21: 109122.

    • Search Google Scholar
    • Export Citation
  • 4. Benedict SH, Yenice KM, Followill D, et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 2010; 37: 40784101.

    • Search Google Scholar
    • Export Citation
  • 5. Keall PJ, Mageras GS, Balter JM, et al. The management of respiratory motion in radiation oncology: report of AAPM Task Group 76. Med Phys 2006; 33: 38743900.

    • Search Google Scholar
    • Export Citation
  • 6. Hau E, Rains M, Browne L, et al. Minimal benefit of respiratory-gated radiation therapy in the management of thoracic malignancy. J Med Imaging Radiat Oncol 2013; 57: 704712.

    • Search Google Scholar
    • Export Citation
  • 7. McNally EM, Robertson SA, Pablo LS. Comparison of time to desaturation between preoxygenated and nonpreoxygenated dogs following sedation with acepromazine maleate and morphine and induction of anesthesia with propofol. Am J Vet Res 2009; 70: 13331338.

    • Search Google Scholar
    • Export Citation
  • 8. Dugdale A. Veterinary anaesthesia: principles to practice. Ames, Iowa: Wiley-Blackwell, 2010; 88.

  • 9. Santanilla JI. The crashing ventilated patient. In: Winters ME, DeBlieux P, Marcolini EG, eds. Emergency department resuscitation of the critically ill. Vasalia, Calif: American College of Emergency Physicians, 2011; 1522.

    • Search Google Scholar
    • Export Citation
  • 10. Redondo JI, Rubio M, Soler G, et al. Normal values and incidence of cardiorespiratory complications in dogs during general anaesthesia. A review of 1281 cases. J Vet Med A Physiol Pathol Clin Med 2007; 54: 470477.

    • Search Google Scholar
    • Export Citation
  • 11. Petersen PM, Aznar MC, Berthelsen AK, et al. Prospective phase II trial of image-guided radiotherapy in Hodgkin lymphoma: benefit of deep inspiration breath-hold. Acta Oncol 2015; 54: 6066.

    • Search Google Scholar
    • Export Citation

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Neuromuscular blockade and inspiratory breath hold during stereotactic body radiation therapy for treatment of heart base tumors in four dogs

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  • 1 Department of Small and Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.
  • | 2 Department of Small and Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.
  • | 3 Department of Small and Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.
  • | 4 Department of Small and Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.
  • | 5 Department of Small and Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.

Abstract

CASE DESCRIPTION 4 dogs were examined because of pleural effusion and ventricular tachycardia, coughing and supraventricular tachycardia, appendicular osteosarcoma, and syncopal episodes.

CLINICAL FINDINGS In all 4 dogs, a heart base tumor was identified by means of thoracic CT.

TREATMENT AND OUTCOME In all 4 dogs, the heart base tumors were treated by means of stereotactic body radiation therapy. Dogs were anesthetized, and neuromuscular blockade was achieved with atracurium or vecuronium. A circle rebreathing system with 15 m (50 feet) of anesthetic tubing coursing through the vault wall was used to connect the patient to the anesthesia machine, which was located in the control room. After a brief period of hyperventilation, an inspiratory breath was held at 20 cm H2O for the duration of beam delivery. Each beam delivery lasted between 30 and 100 seconds. Immediately following the breath hold, assisted ventilation was resumed. Mean treatment delivery time for each patient was 26 minutes; mean total anesthesia time was 89 minutes. All patients recovered without complications. There was no evidence of hemoglobin desaturation or hypercapnia during the anesthetic procedure.

CLINICAL RELEVANCE The technique allowed for control of the respiration cycle from outside the radiation vault and a short overall treatment time. No adverse effects were encountered. This procedure should be considered when delivering radiation to structures within the thoracic cavity.

Abstract

CASE DESCRIPTION 4 dogs were examined because of pleural effusion and ventricular tachycardia, coughing and supraventricular tachycardia, appendicular osteosarcoma, and syncopal episodes.

CLINICAL FINDINGS In all 4 dogs, a heart base tumor was identified by means of thoracic CT.

TREATMENT AND OUTCOME In all 4 dogs, the heart base tumors were treated by means of stereotactic body radiation therapy. Dogs were anesthetized, and neuromuscular blockade was achieved with atracurium or vecuronium. A circle rebreathing system with 15 m (50 feet) of anesthetic tubing coursing through the vault wall was used to connect the patient to the anesthesia machine, which was located in the control room. After a brief period of hyperventilation, an inspiratory breath was held at 20 cm H2O for the duration of beam delivery. Each beam delivery lasted between 30 and 100 seconds. Immediately following the breath hold, assisted ventilation was resumed. Mean treatment delivery time for each patient was 26 minutes; mean total anesthesia time was 89 minutes. All patients recovered without complications. There was no evidence of hemoglobin desaturation or hypercapnia during the anesthetic procedure.

CLINICAL RELEVANCE The technique allowed for control of the respiration cycle from outside the radiation vault and a short overall treatment time. No adverse effects were encountered. This procedure should be considered when delivering radiation to structures within the thoracic cavity.

Contributor Notes

Dr. Kelsey's present address is College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607.

Dr. Kubicek's present address is Angell Animal Medical Center, 350 South Huntington Ave, Boston, MA 02130.

Dr. Bacon's present address is School of Veterinary Medicine, University of Surrey, Guildford, Surrey GU2 7XH, England, and Fitzpatrick Referrals Oncology and Soft Tissue, 70 Priestley Rd, Eashing, Surrey GU7 2QQ, England.

Dr. Robertson's present address is College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Address correspondence to Dr. Kubicek (lkubicek@mspca.org).