Search Results

You are looking at 1 - 10 of 19 items for

  • Author or Editor: Peter W. Hellyer x
  • Refine by Access: All Content x
Clear All Modify Search
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To estimate the proportion of veterinarians working with feline patients in private practices who do or do not perform onychectomy and assess attitudes regarding and practices related to onychectomy in a large population of veterinary practitioners.

DESIGN Anonymous online survey.

SAMPLE 3,441 veterinarians.

PROCEDURES An online survey was provided to members of the Veterinary Information Network from June 18, 2014, through July 9, 2014. Descriptive statistics and frequency distributions for applicable response types were calculated, and Mann-Whitney U tests were conducted to compare responses to onychectomy-related opinion questions between respondents who indicated they did or did not perform the procedure. Not all respondents answered every question.

RESULTS 2,503 of 3,441 (72.7%) survey respondents reported performing onychectomy, and 827 (24.0%) indicated they did not; 1,534 of 2,498 (61.4%) performing the procedure reported a frequency of < 1 onychectomy/month. Most (2,256/3,023 [74.6%]) respondents who performed onychectomy indicated that they recommended nonsurgical alternatives. Surgical techniques and approaches to analgesia varied, with use of a scalpel only (1,046/1,722 [60.7%]) and perioperative administration of injectable opioids (1,933/2,482 [77.9%]) most commonly reported. Responses to opinion questions in regard to the degree of pain associated with onychectomy and recovery; whether declawing is a form of mutilation, is necessary in some cats for behavioral reasons, or is a necessary alternative to euthanasia in some cats; and whether state organizations should support a legislative ban on onychectomy differed significantly between respondents who did and did not perform the procedure.

CONCLUSIONS AND CLINICAL RELEVANCE Onychectomy is a controversial topic, and this was reflected in survey results. In this sample, most veterinarians performing the procedure reported that they did so infrequently, and most offered nonsurgical alternatives to the procedure.

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

Abstract

Objective—To measure cardiac output in healthy female anesthetized dogs by use of lithium dilution cardiac output and determine whether changes in mean arterial pressure were caused by changes in cardiac output or systemic vascular resistance.

Design—Prospective clinical study.

Animals—20 healthy female dogs.

Procedure—Dogs were anesthetized for ovariohysterectomy. Ten dogs breathed spontaneously throughout anesthesia, and 10 dogs received intermittent positive-pressure ventilation. Cardiovascular and respiratory measurements, including lithium dilution cardiac output, were performed during anesthesia and surgery.

Results—Mean arterial pressure and systemic vascular resistance index were low after induction of anesthesia and just prior to surgery and increased significantly after surgery began. Cardiac index (cardiac output indexed to body surface area) did not change significantly throughout anesthesia and surgery.

Conclusions and Clinical Relevance—Results provide baseline data for cardiac output and cardiac index measurements during clinical anesthesia and surgery in dogs. Changes in mean arterial pressure do not necessarily reflect corresponding changes in cardiac index. (J Am Vet Med Assoc 2005;227:1419–1423)

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

Abstract

Objective—To determine whether infusion of xylazine and ketamine or xylazine and propofol after sevoflurane administration in horses would improve the quality of recovery from anesthesia.

Animals—6 healthy adult horses.

Procedures—For each horse, anesthesia was induced by administration of xylazine, diazepam, and ketamine and maintained with sevoflurane for approximately 90 minutes (of which the last 60 minutes were under steady-state conditions) 3 times at 1-week intervals. For 1 anesthetic episode, each horse was allowed to recover from sevoflurane anesthesia; for the other 2 episodes, xylazine and ketamine or xylazine and propofol were infused for 30 or 15 minutes, respectively, after termination of sevoflurane administration. Selected cardiopulmonary variables were measured during anesthesia and recovery. Recovery events were monitored and subjectively scored.

Results—Cardiopulmonary variables differed minimally among treatments, although the xylazine-propofol infusion was associated with greater respiratory depression than was the xylazine-ketamine infusion. Interval from discontinuation of sevoflurane or infusion administration to standing did not differ significantly among treatments, but the number of attempts required to stand successfully was significantly lower after xylazine-propofol infusion, compared with the number of attempts after sevoflurane alone. Scores for recovery from anesthesia were significantly lower (ie, better recovery) after either infusion, compared with scores for sevoflurane administration alone.

Conclusions and Clinical Relevance—Xylazine-ketamine or xylazine-propofol infusion significantly improved quality of recovery from sevoflurane anesthesia in horses. Xylazine-ketamine or xylazine-propofol infusions may be of benefit during recovery from sevoflurane anesthesia in horses for which a smooth recovery is particularly critical. However, oxygenation and ventilation should be monitored carefully.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To assess the prevalence of medical errors (specifically, near misses [NMs] and adverse events [AEs]) and their personal and professional impact on veterinarians.

DESIGN Cross-sectional study.

SAMPLE Members of the Veterinary Information Network (n = 46,481).

PROCEDURES An electronic survey regarding veterinarians' experiences with NMs and AEs was distributed via email to an online veterinary community between September 24 and October 21, 2015. Responses were summarized and compared between genders by means of the χ2 test.

RESULTS 606 veterinarians completed the survey (1.3% response rate). Overall, 447 (73.8%) respondents reported involvement in ≥ 1 NM (n = 389 [64.2%]) or AE (179 [29.5%]). The NMs had a short-term (≤ 1 week) adverse impact on professional life for 68.0% (261/384) of respondents and longer-term negative impact for 36.4% (140/385). The impact on respondents' personal lives was similar (63.6% [245/385] and 33.5% [129/385], respectively). For AEs, these numbers were 84.1% (148/176), 56.2% (99/177), 77.8% (137/176), and 50.6% (89/175), respectively. Both NMs and AEs were more likely to negatively impact female veterinarians than male veterinarians.

CONCLUSIONS AND CLINICAL RELEVANCE These findings suggested that many veterinarians experience emotional distress after a medical error. Support should be provided to mitigate this adverse impact on the wellbeing of veterinarians and, potentially, their future patients.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the effect of a constant-rate infusion of fentanyl on minimum alveolar concentration (MAC) of isoflurane and to determine the interaction between fentanyl and a benzodiazepine agonist (diazepam) and antagonist (flumazenil) in isoflurane-anesthetized dogs.

Animals—8 mixed-breed adult dogs.

Procedure—Dogs were anesthetized with isoflurane 3 times during a 6-week period. After a 30-minute equilibration period, each MAC determination was performed in triplicate, using standard techniques. Fentanyl was administered as a bolus (10 µg/kg of body weight, IV) that was followed by a constant infusion (0.3 µg/kg per min, IV) throughout the remainder of the experiment. After determining isoflurane-fentanyl MAC in triplicate, each dog received saline (0.9% NaCl) solution, diazepam, or flumazenil. After 30 minutes, MAC was determined again.

Results—Fentanyl significantly decreased isoflurane MAC (corrected to a barometric pressure of 760 mm Hg) from 1.80 ± 0.21 to 0.85 ± 0.14%, a reduction of 53%. Isoflurane-fentanyl-diazepam MAC (0.48 ± 0.29%) was significantly less than isoflurane-fentanylsaline MAC (0.79 ± 0.21%). Percentage reduction in isoflurane MAC was significantly greater for fentanyldiazepam (74%), compared with fentanyl-saline (54%) or fentanyl-flumazenil (61%). Mean fentanyl concentrations for the entire experiment were increased over time and were higher in the diazepam group than the saline or flumazenil groups.

Conclusion and Clinical Relevance—Fentanyl markedly decreased isoflurane MAC in dogs. Diazepam, but not flumazenil, further decreased isoflurane-fentanyl MAC. Our results indicate that diazepam enhances, whereas flumazenil does not affect, opioid-induced CNS depression and, possibly, analgesia in dogs. (Am J Vet Res 2001;62:555–560)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate effects of injection with a nonsteroidal anti-inflammatory drug (NSAID) followed by oral administration of an NSAID on the gastrointestinal tract (GIT) of healthy dogs.

Animals—6 healthy Walker Hounds.

Procedures—In a randomized, crossover design, dogs were administered 4 treatments consisting of an SC injection of an NSAID or control solution (day 0), followed by oral administration of an NSAID or inert substance for 4 days (days 1 through 4). Treatment regimens included carprofen (4 mg/kg) followed by inert substance; saline (0.9% NaCl) solution followed by deracoxib (4 mg/kg); carprofen (4 mg/kg) followed by carprofen (4 mg/kg); and carprofen (4 mg/kg) followed by deracoxib (4 mg/kg). Hematologic, serum biochemical, and fecal evaluations were conducted weekly, and clinical scores were obtained daily. Endoscopy of the GIT was performed before and on days 1, 2, and 5 for each treatment. Lesions were scored by use of a 6-point scale.

Results—No significant differences existed for clinical data, clinicopathologic data, or lesion scores in the esophagus, cardia, or duodenum. For the gastric fundus, antrum, and lesser curvature, an effect of time was observed for all treatments, with lesions worsening from before to day 2 of treatments but improving by day 5.

Conclusions and Clinical Relevance—Sequential administration of NSAIDs in this experiment did not result in clinically important gastroduodenal ulcers. A larger study to investigate the effect of sequential administration of NSAIDs for longer durations and in dogs with signs of acute and chronic pain is essential to substantiate these findings.

Full access
in American Journal of Veterinary Research