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Abstract

Objective—To determine the validity of the information on the World Wide Web concerning veterinary anesthesia in dogs and to determine the methods dog owners use to obtain that information.

Design—Web-based search and client survey.

Subjects—73 Web sites and 92 clients.

Procedures—Web sites were scored on a 5-point scale for completeness and accuracy of information about veterinary anesthesia by 3 board-certified anesthesiologists. A search for anesthetic information regarding 49 specific breeds of dogs was also performed. A survey was distributed to the clients who visited the University of Georgia Veterinary Teaching Hospital during a 4-month period to solicit data about sources used by clients to obtain veterinary medical information and the manner in which information obtained from Web sites was used.

Results—The general search identified 73 Web sites that included information on veterinary anesthesia; these sites received a mean score of 3.4 for accuracy and 2.5 for completeness. Of 178 Web sites identified through the breed-specific search, 57 (32%) indicated that a particular breed was sensitive to anesthesia. Of 83 usable, completed surveys, 72 (87%) indicated the client used the Web for veterinary medical information. Fifteen clients (18%) indicated they believed their animal was sensitive to anesthesia because of its breed.

Conclusions and Clinical Relevance—Information available on the internet regarding anesthesia in dogs is generally not complete and may be misleading with respect to risks to specific breeds. Consequently, veterinarians should appropriately educate clients regarding anesthetic risk to their particular dog.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To determine the outcome in birds undergoing inhalation anesthesia and identify patient or procedure variables associated with an increased likelihood of anesthesia-related death.

DESIGN Retrospective case series.

ANIMALS 352 birds that underwent inhalation anesthesia.

PROCEDURES Medical records of birds that underwent inhalation anesthesia from January 1, 2004, through December 31, 2014, at a single veterinary referral hospital were reviewed. Data collected included date of visit, age, species, sex, type (pet, free ranging, or wild kept in captivity), body weight, body condition score, diagnosis, procedure, American Society of Anesthesiologists status, premedication used for anesthesia, drug for anesthetic induction, type of maintenance anesthesia, route and type of fluid administration, volumes of crystalloid and colloid fluids administered, intraoperative events, estimated blood loss, duration of anesthesia, surgery duration, recovery time, recovery notes, whether birds survived to hospital discharge, time of death, total cost of hospitalization, cost of anesthesia, and nadir and peak values for heart rate, end-tidal partial pressure of carbon dioxide, concentration of inhaled anesthetic, and body temperature. Comparisons were made between birds that did and did not survive to hospital discharge.

RESULTS Of 352 birds, 303 (86%) were alive at hospital discharge, 12 (3.4%) died during anesthesia, 15 (4.3%) died in the intensive care unit after anesthesia, and 22 (6.3%) were euthanatized after anesthesia. Overall, none of the variables studied were associated with survival to hospital discharge versus not surviving to hospital discharge.

CONCLUSIONS AND CLINICAL RELEVANCE Results confirmed previous findings that indicated birds have a high mortality rate during and after anesthesia, compared with mortality rates published for dogs and cats.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the relationship between different body positions during recumbency on the cranial migration of epidurally injected methylene blue in canine cadavers.

Sample Population—21 fresh cadavers of clinically normal adult female mixed-breed dogs.

Procedure—Dogs were randomly assigned to the following 3 groups: dogs remaining in right lateral recumbency (n = 7), dogs rotated from left to right lateral recumbency (7), and dogs rotated from dorsal to right lateral recumbency (7). Each dog received an epidural injection of 0.05% methylene blue (0.1 mL/kg) at the lumbosacral space. A dorsal laminectomy of the vertebral column was made, and cranial extent of methylene blue in 4 quadrants (right lateral, left lateral, ventral, and dorsal) was determined by examining dura mater staining.

Results—No significant difference was found among groups in regard to body weight or body condition score. Epidural cranial migration of methylene blue in the right lateral quadrant was significantly greater in dogs that remained in right lateral recumbency than in dogs that were rotated from left to right lateral recumbency. No significant difference was found within groups for epidural cranial migration of methylene blue between each quadrant. No significant relationship was found between body weight or body condition score and epidural cranial migration of methylene blue.

Conclusions and Clinical Relevance—Body positioning and amount of recumbency time influence cranial migration of epidurally injected methylene blue. If greater cranial migration of an epidurally administered drug is desired, placing the patient in lateral recumbency with the surgical site on the dependent side may precede surgery.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine the effect of an intervention (educational campaign) on hand hygiene (HH) and health-care workers' (HCWs') perceptions of HH.

Design—Prospective observational study and cross-sectional survey.

Sample—Observed opportunities for HH performed by HCWs before (n = 222) and after (249) intervention, measures of HH product usage, and surveys distributed to 300 HCWs.

Procedures—Data were collected by means of direct observation, measurement of HH product consumption, and surveys of HCWs.

Results—Adherence rates of HCWs for HH practices before and after the intervention were 27% (61/222 observations) and 29% (73/249 observations), respectively. Combined HH and glove use adherence rates before and after the intervention were 84% (186/222 observations) and 81% (201/249 observations), respectively. Before intervention, the highest combined HH and glove use adherence rate was detected for technicians (90% [57/63 observations]) and for opportunities after exposure to a patient's bodily fluids (100% [5/5 opportunities]). Rate of use of alcohol-based antimicrobial hand rubs (AHRs) and amount of HH products used did not significantly change during the study. Survey response rates were 41% (122) and 21% (62) before and after the intervention, respectively. Availability of AHRs and role modeling of HH (performance of HH each time it is warranted) were considered the factors most likely to increase HH adherence rates by survey respondents.

Conclusions and Clinical Relevance—Results indicated the intervention did not increase HH adherence or use of AHRs. High rates of glove use before the start of the study may have been a confounding factor. Future educational campaigns should indicate that glove use should not supersede HH.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the effects of IM administration of acepromazine, hydromorphone, or the acepromazine-hydromorphone combination on degree of sedation in clinically normal dogs and to compare 2 sedation scoring techniques.

Design—Prospective, randomized, blinded, controlled trial.

Animals—46 random-source dogs.

Procedures—Dogs were assigned to receive IM administrations of acepromazine (0.5 mg/kg [0.23 mg/lb]; n = 12), hydromorphone (0.1 mg/kg [0.045 mg/lb]; 11), acepromazine-hydromorphone (0.5 mg/kg and 0.1 mg/kg, respectively; 12), or saline (0.9% NaCI) solution (0.05 mL/kg [0.023 mL/lb]; 11). Sedation scores were determined at 0 (time of administration), 15, 30, 45, and 60 minutes by use of a subjective scoring system (SSS) and a simple numeric rating scale (NRS).

Results—Acepromazine caused significantly greater sedation than did saline solution at 15, 30, 45, and 60 minutes. Acepromazine-hydromorphone caused significantly greater sedation than did saline solution at 15, 30, 45, and 60 minutes and than did hydromorphone alone at 30 minutes. Hydromorphone alone did not cause significantly greater sedation than did saline solution. All treatments, including saline solution, caused significantly greater sedation at 45 and 60 minutes, compared with sedation at time 0. There was a significant correlation (r 2 = 0.72) between scores obtained with the SSS and NRS, but the NRS was less sensitive for detecting clinically important sedation.

Conclusions and Clinical Relevance—Administration of acepromazine or acepromazine-hydromorphone caused sedation in clinically normal dogs, whereas administration of hydromorphone alone did not. The NRS was a less-reliable measure of sedation.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify and critically evaluate the quality of evidence of the most commonly used pharmacologic, nutraceutical, and purported slow-acting drugs of osteoarthritis for the management of osteoarthritis in dogs by use of the FDA's evidence-based medicine scoring system.

Design—Systematic review.

Sample Population—16 clinical trials.

Procedures—A broad bibliographic search was performed prior to May 2006. Inclusion criteria focused on prospective trials evaluating commonly used medical treatment interventions for the management of osteoarthritis in dogs and published in peer-reviewed journals. The analysis consisted of the following: study design rating, quality factor rating, quantity rating, consistency rating, relevance to disease risk reduction rating, and cumulative strength of evidence ranking.

Results—4 trials evaluating meloxicam were rated as type I.Three trials evaluating carprofen were rated as type I, and 2 trials were rated as type III. One trial evaluating each of the following agents was rated as type 1: etodolac; P54FP; polysulfated glycosaminoglycan; and a combination of chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate. Two trials evaluating pentosan polysulphate and 2 trails evaluating green-lipped mussels were rated as type I. One trial evaluating hyaluronan was rated as type III.

Conclusions and Clinical Relevance—A high level of comfort exists for meloxicam that the claimed relationship is scientifically valid and that its use is clinically efficacious for the treatment of osteoarthritis in dogs.A moderate level of comfort exists for carprofen; etodolac; pentosan polysulphate; green-lipped mussels; P54FP; polysulfated glycosaminoglycans; and a combination of chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate. An extremely low level of comfort exists for hyaluronan.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To identify the preferences of small animal veterinary clients for the timing of communication during CPR and whether these clients prefer the veterinarian or pet owner to decide on the termination of resuscitation.

SAMPLE

Surveys (n = 1,648) were completed between January 20 and February 3, 2023, by clients of the Wilford and Kate Bailey Small Animal Teaching Hospital.

METHODS

This cross-sectional observational study used an anonymous internet-based survey distributed to 28,000 clients of an academic small animal veterinary hospital. The survey included 16 questions asking for the respondents’ demographics, healthcare professional status, questions pertaining to CPR, and preference for timing of communication during CPR, veterinary team members to speak to, and the decision on termination of resuscitation. An optional open comment section was provided.

RESULTS

The response rate was 7.5%, including 2,127 responses, with 1,648 complete responses used for further analysis. Of the respondents, 56% and 63% (when asked using a short and long scenario question, respectively) would prefer to be informed about their pet undergoing CPR after CPR has ended. Most clients (84%) wanted the veterinarian to decide when to stop CPR. In the comments section, clients predominantly emphasized that patient care should always be prioritized over client communication.

CLINICAL RELEVANCE

This study contributes to a better understanding of veterinary clients’ preferences and may help improve client communication and decision-making during CPR. More studies are warranted to reach a wider population before broad recommendations can be made.

Open access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine effects of duration and type of anesthetic on tear production in dogs.

Animals—8 female Beagles.

Procedures—Each dog was randomly allocated into 1 of 4 groups according to a Latin square design to receive anesthesia as follows: 1 hour with isoflurane, 1 hour with desflurane, 4 hours with isoflurane, and 4 hours with desflurane. Each dog was anesthetized with the selected inhalant 4 times during a 4-week period, with at least 5 days separating anesthetic episodes. Aqueous tear production was measured via the Schirmer I tear test at baseline and 10 minutes, 30 minutes, and 1 hour after induction of anesthesia as well as 2, 3, and 4 hours after induction for the 4-hour groups. Tear production was also measured after the dogs were standing after recovery from anesthesia and 2, 10, and 22 hours after recovery from anesthesia.

Results—Aqueous tear production was significantly reduced in dogs during anesthesia and returned to baseline values immediately after recovery and until 10 hours after anesthesia in all treatment groups. Inhalant type and duration had no significant effect. Neither lateral recumbency nor left versus right eyes had a significant effect.

Conclusions and Clinical Relevance—Results suggested that inhalant anesthetics did not reduce tear production after anesthesia and that longer-duration anesthesia did not cause decreased tear production, compared with shorter-duration anesthesia.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine whether a heat and moisture exchange device (HME) prevents a decrease in body temperature in isoflurane-anesthetized dogs undergoing orthopedic procedures.

Design—Blinded randomized controlled clinical trial.

Animals—60 privately owned dogs weighing at least 15 kg (33 lb).

Procedures—Dogs were randomly assigned to 1 of 3 treatment groups (n = 20/group): HME placed immediately after anesthetic induction with isoflurane, after transfer to the operating room, or not at all. The device consisted of a hygroscopic filter placed between the endotracheal tube and the Y piece of the anesthesia circuit. Each dog was positioned on a circulating warm water blanket and had a forced-air warming blanket placed over its body. Body temperature was monitored after transfer to the operating room with a probe placed in the thoracic aspect of the esophagus.

Results—Study groups did not differ significantly with respect to body weight, body condition score, reproductive status, breed, surgical procedure, preoperative sedative and opioid administration, anesthetic induction drug, local nerve block technique, or operating room assignment. There were no significant differences among groups in esophageal temperature variables, interval between anesthetic induction and surgery, surgery duration, anesthesia duration, or oxygen flow rate. However, the relationship between temperature delta and body weight was significant and relevant (R 2 = 0.23), as was the association between temperature nadir and body weight (R 2= 0.10). As body weight increased, the temperature delta decreased and temperature nadir increased. No other significant relationships were identified.

Conclusions and Clinical Relevance—Inclusion of an HME in healthy dogs undergoing anesthesia for an elective orthopedic surgery did not facilitate maintenance of body temperature throughout the procedure.

Full access
in Journal of the American Veterinary Medical Association