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  • Author or Editor: Peter W. Hellyer x
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Abstract

Objective—To compare indicators of postoperative pain and behavior in dogs with and without a lowdose ketamine infusion added to usual perioperative management.

Design—Prospective, randomized, blinded clinical study.

Animals—27 dogs undergoing forelimb amputation.

Procedure—Dogs were anesthetized with glycopyrrolate, morphine, propofol, and isoflurane. Thirteen dogs were treated with ketamine IV, as follows: 0.5 mg/kg (0.23 mg/lb) as a bolus before surgery, 10 µg/kg/min (4.5 µg/lb/min) during surgery, and 2 µg/kg/min (0.9 µg/lb/min) for 18 hours after surgery. Fourteen dogs received the same volume of saline (0.9% NaCl) solution. All dogs received an infusion of fentanyl (1 to 5 µg/kg/h [0.45 to 2.27 µg/lb/h]) for the first 18 hours after surgery. Dogs were evaluated for signs of pain before surgery, at the time of extubation, and 1, 2, 3, 4, 12, and 18 hours after extubation. Owners evaluated their dogs' appetite, activity, and wound soreness on postoperative days 2, 3, and 4.

Results—Dogs that received ketamine infusions had significantly lower pain scores 12 and 18 hours after surgery and were significantly more active on postoperative day 3 than dogs that received saline solution infusions.

Conclusions and Clinical Relevance—Results suggest that perioperative administration of low doses of ketamine to dogs may augment analgesia and comfort in the postoperative surgical period. (J Am Vet Med Assoc 2002;221:72–75)

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To survey practicing veterinarians regarding their perceptions of and experiences with cases of suspected or confirmed animal abuse and related state laws.

DESIGN Cross-sectional study.

POPULATION Members of the Veterinary Information Network (VIN; n = 34,144) who were in veterinary practice at the time of the survey.

PROCEDURES A survey was designed and distributed online to all VIN members from January 26 to February 28, 2015. Responses were compiled, and binary logistic regression analysis was performed to identify factors that influenced decisions or perceptions regarding animal abuse encounters and related legislation.

RESULTS 1,209 completed surveys were received (3.5% response rate); 1,155 (95.5%) surveys were submitted by currently practicing veterinarians. One thousand five (87.0%) practicing veterinarians reported having encountered at least 1 case of animal abuse while in practice; 561 (55.8%) of these veterinarians indicated that they had reported at least 1 case. The most common reasons selected for reporting abuse were to protect the animal, ethical beliefs, and to protect other animals in the household. The most common reasons selected for not reporting the abuse were uncertainty that the animal had been abused, belief that client education would be better, and belief that the injury or illness was accidental versus intentional. Most respondents were unaware of the current status of laws in their state regarding animal abuse reporting.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a need for state and national veterinary and humane-law enforcement organizations to increase communication and education efforts on recognition and reporting by veterinarians of animal abuse and the related laws.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To understand the experiences of owners of dogs with chronic pain and explore owner perceptions of their pets' pain.

DESIGN Observational study.

SAMPLE 10 owners of dogs with chronic pain.

PROCEDURES Owners were interviewed by means of a semistructured and conversational technique. Interviews were then transcribed and analyzed with standard qualitative methodology to code for major themes.

RESULTS Major themes that were identified included changes in owner schedule, effects on owner relationships, and necessary resources when owning a pet with chronic pain. Owners discussed their perceptions of their pets' pain, and several participants referred to empathizing with their pet owing to their own experiences with pain. Owners also suggested ways that veterinarians can support them during the experience of owning a dog with chronic pain.

CONCLUSIONS AND CLINICAL RELEVANCE By understanding the impact of chronic pain on dog owners and appreciating how owners perceive pain in their pets, veterinarians may be able to provide better care for patients and clients.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the degree of postoperative pain in dogs undergoing elective castration or ovariohysterectomy (OHE); determine whether an association exists between surgeon experience, incision length, or surgery duration and degree of postoperative pain; and determine whether analgesic treatment decreases expression of postoperative pain behaviors.

Design—Randomized controlled clinical trial.

Animals—426 client-owned dogs undergoing OHE or castration.

Procedures—Dogs underwent OHE or castration performed by an experienced veterinarian or a fourth-year veterinary student. Dogs were randomly assigned to 1 of 4 treatment groups: no perioperative analgesic treatment (n = 44), preoperative administration of morphine (144), preoperative administration of nalbuphine (119), and postoperative administration of ketoprofen (119). Dogs were evaluated while in the hospital before anesthesia and for 4 hours after surgery and once a day at home for 3 days after surgery.

Results—Dogs in all 4 groups had significant increases in overall pain scores after surgery, compared with baseline scores. There were significant differences among groups, with control dogs having significantly higher increases in overall pain scores than dogs in the other groups. Factors that did not influence the frequency or severity of pain-related behaviors included breed, individual hospital, anesthetic induction protocol, surgeon experience, and duration of surgery.

Conclusions and Clinical Relevance—Results suggested that dogs expressed behaviors suggestive of pain following OHE and castration, that analgesic treatment mitigated the expression of pain-related behaviors, and that surgeon experience and surgery duration did not have any effect on expression of pain-related behaviors.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate perioperative administration of gabapentin as an adjunct for analgesia in dogs undergoing amputation of a forelimb.

Design—Randomized, controlled trial.

Animals—30 client-owned dogs.

Procedures—On the day before surgery, a baseline pain evaluation was performed in each dog by use of multiple pain assessment methods. Dogs then received gabapentin (10 mg/kg [4.5 mg/lb], PO, once, followed by 5 mg/kg [2.3 mg/lb], PO, q 12 h for 3 additional days) or a placebo. On the day of surgery, dogs were anesthetized and forelimb amputation was performed. Fentanyl was infused after surgery for 18 to 24 hours; use of other analgesics was allowed. In-hospital pain evaluations were repeated at intervals for 18 hours after surgery, and owners were asked to evaluate daily their dog's activity, appetite, and wound soreness for the first 3 days after discharge from the hospital. Results were analyzed by use of a repeated-measures ANOVA.

Results—Pain evaluation scores did not differ significantly between gabapentin and placebo groups in the hospital or at home after discharge.

Conclusions and Clinical Relevance—As an adjunct to other analgesics and anesthetics, gabapentin, at the dose and frequency used in this study, did not provide a significant benefit for the management of acute perioperative pain in dogs undergoing forelimb amputation. The small sample size and number of other confounding factors, such as aggressive use of other analgesics, limited the likelihood of detecting a benefit of gabapentin. Other gabapentin doses or dosing regimens warrant further study.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate μ-opioid receptors in synovial membranes of horses and determine whether these receptors are up-regulated in nerve endings during inflammation.

Sample Population—Synovial tissue obtained from 39 client-owned horses during arthroscopy and 14 research horses during necropsy; brain and synovial tissues were obtained during necropsy from 1 horse, and control tissues were obtained from a mouse.

Procedure—Horses were classified into 7 groups on the basis of histologically determined degree of inflammation. Binding of primary rabbit antibody developed against μ-opioid receptors in equine synovial tissue was studied, using western blot analysis. Synovial membranes were tested for μ-opioid receptors by immunohistochemical staining, using a diaminobenzidine-cobalt chloride chromogen. Homogenates of synovial membranes were evaluated by use of radioligand binding.

Results—Examination of western blots of equine thalamus revealed that rabbit antibody developed against μ-opioid receptors yielded a band (molecular weight, 55 kd) that corresponded with that of other opioid receptors. Use of immunohistochemical staining of synovial tissue revealed considerable staining in the proliferative lining layer and in regions surrounding vascular structures. Specific radioligand binding of tissue homogenates was found in all groups. We did not detect significant differences in binding between horses with inflammation and horses without inflammation.

Conclusions and Clinical Relevance—Results of immunohistochemical analysis and radioligand binding of tissue homogenates suggest that there are opioid receptors in synovial membranes of horses. Our results support the practice of intra-articular administration of opioids to relieve pain after arthroscopic surgery in horses. (Am J Vet Res 2001;62:1408–1412).

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate the use of xylazine and ketamine for total IV anesthesia in horses.

Animals—8 horses.

Procedure—Anesthetic induction was performed on 4 occasions in each horse with xylazine (0.75 mg/kg, IV), guaifenesin (75 mg/kg, IV), and ketamine (2 mg/kg, IV). Intravenous infusions of xylazine and ketamine were then started by use of 1 of 6 treatments as follows for which 35, 90, 120, and 150 represent infusion dosages (µg/kg/min) and X and K represent xylazine and ketamine, respectively: X35+K90 with 100% inspired oxygen (O2), X35+K120-O2, X35+K150-O2, X70+K90-O2, K150-O2, and X35+K120 with a 21% fraction of inspired oxygen (ie, air). Cardiopulmonary measurements were performed. Response to a noxious electrical stimulus was observed at 20, 40, and 60 minutes after induction. Times to achieve sternal recumbency and standing were recorded. Quality of sedation, induction, and recovery to sternal recumbency and standing were subjectively evaluated.

Results—Heart rate and cardiac index were higher and total peripheral resistance lower in K150-O2 and X35+K120-air groups. The mean arterial pressure was highest in the X35+K120-air group and lowest in the K150-O2 group (125 ± 6 vs 85 ± 8 at 20 minutes, respectively). Mean PaO2 was lowest in the X35+K120-air group. Times to sternal recumbency and standing were shortest for horses receiving K150-O2 (23 ± 6 minutes and 33 ± 8 minutes, respectively) and longest for those receiving X70+K90-O2 (58 ± 28 minutes and 69 ± 27 minutes, respectively).

Conclusions and Clinical Relevance—Infusions of xylazine and ketamine may be used with oxygen supplementation to maintain 60 minutes of anesthesia in healthy adult horses. (Am J Vet Res 2005;66:1002–1007)

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in American Journal of Veterinary Research

Abstract

Objective—To assess the pharmacokinetics and pharmacodynamics of morphine in llamas.

Animals—6 healthy adult llamas.

Procedures—Llamas received morphine sulfate in a randomized crossover design. In phase 1, they received IV or IM administration of morphine at 0.05 or 0.5 mg/kg, respectively; in phase 2, they received IV administration of morphine at 0.05, 0.25, or 0.5 mg/kg. Plasma morphine and morphine-6-glucuronide concentrations were determined by validated methods. Body temperature, heart rate, respiratory rate, sedation, and analgesia were assessed and compared with plasma concentrations by regression analysis.

Results—Total body clearance was similar between IV administration of morphine sulfate at 0.25 and 0.5 mg/kg (mean ± SD, 25.3 ± 6.9 mL/min/kg and 27.3 ± 5.9 mL/min/kg, respectively), and linearity was demonstrated between these doses. Bioavailability of morphine following IM administration at 0.5 mg/kg was 120 ± 30%. Body temperature and sedation increased as the dose of morphine administered increased. Heart rate was unaffected by varying doses. Respiratory rate decreased as dose increased. Analgesia was difficult to assess as a result of high individual variability. Intravenous administration of morphine at 0.25 mg/kg provided the most consistent increase in tolerance to electric stimulation. Pharmacodynamic modeling revealed a sigmoidal relationship between plasma concentration and sedation score.

Conclusions and Clinical Relevance—Morphine was characterized by a large apparent volume of distribution and high systemic clearance in llamas. A prolonged half-life was observed with IM injection. Intravenous administration of morphine sulfate at 0.25 mg/kg every 4 hours is suggested for further study.

Full access
in American Journal of Veterinary Research