OBJECTIVE To evaluate the effects of topical ophthalmic application of 0.5% proparacaine hydrochloride solution (PHCL; containing 0.01% benzalkonium chloride as preservative) on aerobic bacterial culture results for naturally occurring infected corneal ulcers in dogs.
DESIGN Clinical trial.
ANIMALS 25 client-owned dogs with infected corneal ulcers (24 unilaterally affected and 1 bilaterally affected; only 1 eye included/dog) examined between June 2008 and May 2011.
PROCEDURES Swab samples for aerobic bacterial culture were collected from the periphery of each corneal ulcer before and approximately 1 minute after topical ophthalmic application of 1 drop of PHCL. Numbers of aerobic bacterial species isolated from affected eyes were compared between sample collection points and between other variables (ie, side [left or right] of affected eye, prior treatments, and patient age, sex, and neuter status).
RESULTS There was no significant difference between numbers of aerobic bacterial species isolated per eye or overall aerobic bacterial culture results (positive or negative) before versus after PHCL application. Similarly, prior treatment had no significant effect on aerobic bacterial culture results for samples collected at either point. The most commonly isolated bacteria before and after PHCL application were Staphylococcus spp (40% and 48%, respectively), followed by Streptococcus spp (23% and 22%, respectively).
CONCLUSIONS AND CLINICAL RELEVANCE Topical ophthalmic application of PHCL did not significantly affect aerobic bacterial culture results for naturally occurring infected corneal ulcers in dogs as assessed in this study. Therefore, topical ophthalmic PHCL application could be useful in clinical settings prior to sample collection to relieve patient discomfort and to aid in sample acquisition without compromising aerobic bacterial culture results.
To assess single-day and multiday repeatability of weight distribution (stance) data obtained with a commercial analyzer for dogs with naturally occurring hind limb lameness.
46 dogs (15 and 31 for single-day and multiday trials, respectively).
For single-day trials, 5 to 10 measurements/trial were collected to determine body weight (BW), weight distribution on each limb, and forelimb and hind limb symmetry indices (SIs). The dog was removed from the room and returned immediately; 5 trials were performed. For multiday trials, measurements were performed in the same manner on 2 sequential days. Data were compared among trials (single-day measurements) and between days (multiday measurements). Repeatability (correlation coefficients and Lin concordance correlation coefficients [LCCCs]) and variability (coefficients of variation [CVs]) were assessed.
In single-day trials, BW (r = 0.999), weight distribution on the lame hind limb (r = 0.915) and contralateral hind limb (r = 0.948), and hind limb SI (r = 0.964) were each significantly correlated among trials. In multiday trials, BW results were similar; weight distribution on the lame hind limb and contralateral hind limb and hind limb SI were each less closely but still significantly correlated between days. The LCCCs were highest for BW, weight distribution on the contralateral hind limb, and hind limb SI in single-day trials and for BW and weight bearing on the contralateral and lame hind limbs in multiday trials. The CVs were lowest for BW and highest for forelimb SI in both trial types.
CONCLUSIONS AND CLINICAL RELEVANCE
The analyzer used allowed repeatable measurement of BW and weight distribution on the hind limbs of dogs with hind limb lameness. Measurement of forelimb stance variables was not repeatable in this group of dogs.
To determine plasma tramadol concentrations in cats following a single dose of oral and transdermal formulations and the pharmacokinetics for and the concentration of tramadol in the transdermal formulation.
8 healthy client-owned domestic shorthair cats.
1 cat was orally administered 1 dose of tramadol (2 mg/kg), and 7 cats received 1 dose of a proprietary compounded tramadol gel product (median actual dose, 2.8 mg/kg) applied to their inner pinnae. Plasma tramadol concentrations were measured with high-performance liquid chromatography–mass spectrometry at fixed times over 24 hours.
Plasma tramadol concentrations were undetectable or much lower (range, < 1 to 4.3 ng/mL) following application of the transdermal formulation, compared with those following oral administration (maximum plasma tramadol concentration, 261.3 ng/mL [at 4 hours]). Tramadol pharmacokinetics for the transdermal formulation could not be determined. Tramadol concentrations of the transdermal gel product exceeded the estimated label dose in all analyzed gel samples, with concentrations greater than the 90% to 110% United States Pharmacopeia standard for compounded drugs.
CONCLUSIONS AND CLINICAL RELEVANCE
Application of 1 dose of the proprietary transdermal formulation did not yield clinically relevant plasma tramadol concentrations in cats. Although this proprietary formulation is currently available to prescribing veterinarians, it should be used with caution.
Objective—To measure strain in the common calcaneal tendon during trotting in dogs and to compare strain before and after immobilization of the tarsal joint.
Procedures—A microminiature strain gauge was surgically implanted on the tendinous portion of the gastrocnemius muscle. Surface electromyography (EMG) values, percentage strain, and ground reaction forces were measured before and after immobilization. Peak vertical force; vertical impulse; initial, maximum, and final strain; and peak-to-peak EMG amplitude were recorded. Data were analyzed by use of a repeated-measures ANOVA and paired t tests.
Results—Timing of strain data correlated closely with foot strike of the hind limb and EMG activity in all dogs. Maximum tendon strain was simultaneous with peak vertical force. Continued muscle contraction was evident after immobilization. There was no significant difference in maximum strain after immobilization, compared with maximum strain during normal motion. Minimum strain, both at the beginning and end of the strain curve, was sig-nificantly decreased for the immobilized state, compared with results for nonimmobilized joints.
Conclusions and Clinical Relevance—Immobilization of the tarsal joint did not eliminate calcaneal tendon strain during weight bearing in dogs. Decreased isometric muscle contraction during the swing phase of the gait could account for smaller minimum strain in immobilized joints. Immobilization is frequently applied after Achilles tendon rupture to alleviate strain and force on the sutured repair, with possible complications because of the immobilization method. Consideration of these findings could be important in adjusting current treatment recommendations.
Objective—To identify common errors in film and digital radiographs provided by referring veterinarians and determine the effect of such errors on the perceived diagnostic quality of image sets.
Sample—135 sets of radiographic images acquired by referring veterinarians for client-owned small animals evaluated at a university hospital.
Procedures—Sets of radiographs were prospectively collected and evaluated for proper performance of various radiographic technical variables including exposure, collimation, positioning, inclusion of all appropriate views, presence of artifacts, radiation safety, and labeling. Sets of radiographs were subjectively determined to be of diagnostic or nondiagnostic quality by 2 evaluators.
Results—The variables exposure, correct positioning, absence of artifacts, and acquisition of all appropriate views were significantly associated with a determination of diagnostic quality for radiograph sets. Correct patient labeling, radiation safety, and x-ray beam centering and collimation were not associated with a determination of diagnostic quality for radiograph sets. The number of categories with errors was significantly associated with identification of radiograph sets as having diagnostic or nondiagnostic quality. Digital radiographs had a significantly lower number of image artifacts and significantly higher frequency of proper labeling versus film radiographs.
Conclusions and Clinical Relevance—Results of this study suggested the technical variables proper exposure, proper positioning, absence of artifacts, and acquisition of all appropriate views were important for acquisition of sets of radiographs of high diagnostic quality. Identification of these errors and adjustment of radiographic technique to eliminate such errors would aid veterinarians in obtaining radiographs of high diagnostic quality and may reduce misinterpretation.
To investigate the effects of short-term and prolonged topical instillation of 0.1% diclofenac sodium, 0.5% ketorolac tromethamine, and 0.03% flurbiprofen sodium on corneal sensitivity (CS) in ophthalmologically normal cats.
12 healthy adult domestic shorthair cats.
In the first of 2 study phases, each cat received 0.1% diclofenac sodium, 0.5% ketorolac tromethamine, 0.03% flurbiprofen sodium, and saline (0.9% NaCl; control) solutions (1 drop [0.05 mL]/eye, q 5 min for 5 treatments) in a randomized order with a 2-day washout period between treatments. For each cat, an esthesiometer was used to measure CS before treatment initiation (baseline) and at 15, 30, 45, and 60 minutes after the last dose. There was a 2-day washout period between phases. The second phase was similar to the first, except each treatment was administered at a dosage of 1 drop/eye, twice daily for 5 days and CS was measured before treatment initiation and at 15 minutes and 24 and 48 hours after the last dose. The Friedman test was used to evaluate change in CS over time.
None of the 4 treatments had a significant effect on CS over time in either study phase.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that neither short-term nor prolonged topical instillation of 3 NSAID ophthalmic solutions had any effect on the CS of healthy cats. Given potential differences in cyclooxygenase expression between healthy and diseased eyes, further investigation of the effects of topical NSAID instillation in the eyes of cats with ocular surface inflammation is warranted.
To assess the time to completion, number of errors, and knot-holding capacity (KHC) for starting and ending square knots (SSKs and ESKs) of a continuous pattern and Aberdeen knots tied by veterinary students and to investigate student perceptions of knot security and knot-tying difficulty for the 3 knot types.
16 second-year veterinary students.
Students created 3 (4-throw) SSKs, 3 (5-throw) ESKs, and 3 (3 + 1 configuration) Aberdeen knots with 2-0 polydioxanone on a custom test apparatus. Time to complete each knot, the number of errors in each knot, and student ratings of knot-tying difficulty and confidence in knot security were recorded. Each knot was tested to failure on a uniaxial tensiometer to determine KHC and mode of failure. Variables of interest were compared by repeated-measures ANOVA or the Friedman test with post hoc pairwise comparisons.
Mean knot completion time for Aberdeen knots was significantly less than mean completion time for SSKs or ESKs. Mean KHC was significantly lower for ESKs than for SSKs; KHC for Aberdeen knots was not compared with these values because of methodological differences. Median error rate was higher for ESKs than for other knot types. Mean difficulty rating for Aberdeen knots was lower than that for ESKs. Most tested knots failed by breakage at the knot.
CONCLUSIONS AND CLINICAL RELEVANCE
Aberdeen knots appeared to be easy for veterinary students to learn and were completed more rapidly and with fewer errors than ESKs. Including this type of knot in surgical skills curriculum for novices may be beneficial.
Objective—To measure ocular effects (blood-aqueous barrier breakdown and intraocular pressure [IOP]) following aqueocentesis performed with needles of various sizes in dogs.
Animals—28 healthy adult dogs.
Procedures—24 dogs underwent unilateral aqueocentesis (24 treated eyes and 24 contra-lateral untreated eyes); 25-, 27-, or 30-gauge needles were used in 3 treatment groups (n = 8/group). Four dogs were untreated controls. Aqueocentesis was performed during sedation and topical anesthesia. Anterior chamber fluorophotometry was performed before and after aqueocentesis on day 1. On days 2 through 5, sedation and fluorophotometry were repeated. Intraocular pressure was measured with a rebound tonometer at multiple time points.
Results—Aqueocentesis resulted in blood-aqueous barrier breakdown detected via fluorophotometry in all treated eyes, with barrier reestablishment by day 5. On day 2, the contralateral untreated eyes of all 3 groups also had significantly increased fluorescence. Use of a 25-gauge needle resulted in a significant increase in treated eyes' anterior chamber fluorescence on days 3 and 5 as well as a significant increase in IOP 20 minutes following aqueocentesis, compared with the other treatment groups.
Conclusions and Clinical Relevance—Aqueocentesis performed with a 25-gauge needle resulted in the greatest degree of blood-aqueous barrier breakdown and a brief state of intraocular hypertension. Use of a 27- or 30-gauge needle is recommended for aqueous paracentesis. A consensual ocular reaction appeared to occur in dogs following unilateral traumatic blood-aqueous barrier breakdown and may be of clinical importance.
OBJECTIVE To evaluate clinical efficacy of hydrocodone-acetaminophen and tramadol for treatment of postoperative pain in dogs undergoing tibial plateau leveling osteotomy (TPLO).
ANIMALS 50 client-owned dogs.
PROCEDURES Standardized anesthetic and surgical protocols were followed. Each patient was randomly assigned to receive either tramadol hydrochloride (5 to 7 mg/kg, PO, q 8 h; tramadol group) or hydrocodone bitartrate–acetaminophen (0.5 to 0.6 mg of hydrocodone/kg, PO, q 8 h; hydrocodone group) for analgesia after surgery. The modified Glasgow composite measure pain scale was used to assess signs of postoperative pain at predetermined intervals by an investigator who was blinded to treatment group. Scoring commenced with the second dose of the assigned study analgesic. Pain scores and rates of treatment failure (ie, dogs requiring rescue analgesia according to a predetermined protocol) were compared statistically between groups.
RESULTS 12 of 42 (29%; 5/19 in the hydrocodone-acetaminophen group and 7/23 in the tramadol group) dogs required rescue analgesic treatment on the basis of pain scores. Median pain score for the hydrocodone group was significantly lower than that of the tramadol group 2 hours after the second dose of study analgesic. The 2 groups had similar pain scores at all other time points.
CONCLUSIONS AND CLINICAL RELEVANCE Overall, differences in pain scores between dogs that received hydrocodone-acetaminophen or tramadol were minor. The percentage of dogs with treatment failure in both groups was considered unacceptable.
OBJECTIVE To evaluate the pharmacokinetics of hydrocodone (delivered in combination with acetaminophen) and tramadol in dogs undergoing tibial plateau leveling osteotomy (TPLO).
ANIMALS 50 client-owned dogs.
PROCEDURES Dogs were randomly assigned to receive tramadol hydrochloride (5 to 7 mg/kg, PO, q 8 h; tramadol group) or hydrocodone bitartrate–acetaminophen (0.5 to 0.6 mg of hydrocodone/kg, PO, q 8 h; hydrocodone group) following TPLO with standard anesthetic and surgical protocols. Blood samples were collected for pharmacokinetic analysis of study drugs and their metabolites over an 8-hour period beginning after the second dose of the study medication.
RESULTS The terminal half-life, maximum serum concentration, and time to maximum serum concentration for tramadol following naïve pooled modeling were 1.56 hours, 155.6 ng/mL, and 3.90 hours, respectively. Serum concentrations of the tramadol metabolite O-desmethyltramadol (M1) were low. For hydrocodone, maximum serum concentration determined by naïve pooled modeling was 7.90 ng/mL, and time to maximum serum concentration was 3.47 hours. The terminal half-life for hydrocodone was 15.85 hours, but was likely influenced by delayed drug absorption in some dogs and may not have been a robust estimate. Serum concentrations of hydromorphone were low.
CONCLUSIONS AND CLINICAL RELEVANCE The pharmacokinetics of tramadol and metabolites were similar to those in previous studies. Serum tramadol concentrations varied widely, and concentrations of the active M1 metabolite were low. Metabolism of hydrocodone to hydromorphone in dogs was poor. Further study is warranted to assess variables that affect metabolism and efficacy of these drugs in dogs.