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- Author or Editor: R. Neil Hooper x
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Abstract
Objective—To determine risk factors associated with development of postoperative ileus in horses undergoing surgery for colic.
Design—Case-control study
Animals—69 horses that developed ileus after surgery for colic and 307 horses that did not develop postoperative ileus.
Procedure—Signalment, history, clinicopathologic data, treatment, lesions, and outcome were obtained from medical records.
Results—Variables associated with increased risk of postoperative ileus included age > 10 years, Arabian breed, PCV ≥ 45%, high serum concentrations of protein and albumin, anesthesia > 2.5 hours' duration, surgery > 2 hours' duration, resection and anastomosis, and lesions in the small intestine. Enterotomy reduced the risk of postoperative ileus. After multivariate logistic regression, the final model included the variables Arabian breed, PCV ≥ 45%, lesion type, duration of surgery (> 2 hours vs ≤ 2 hours), and pelvic flexure enterotomy.
Conclusions and Clinical Relevance—Results suggest that by evaluating certain factors, horses at increased risk of postoperative ileus may be recognized before the condition develops. Preventative treatment and early intervention may be instituted in these horses. Shortening surgery time and performing an enterotomy may decrease the probability of horses developing postoperative ileus. (J Am Vet Med Assoc 2001;219:72–78)
Abstract
Objective
To evaluate disposition of fentanyl in goats after IV and transdermal administration.
Animals
8 healthy 2-year-old goats weighing 31.8 to 53.6 kg (mean ± SD, 40.4 ± 7.5 kg).
Procedure
Each goat was given 2 treatments consisting of fentanyl administered IV (2.5 μg/kg of body weight) and via a transdermal patch (50 μg/h). There was a 2-month interval between treatments. Blood samples were collected at specified times and analyzed in duplicate to determine plasma fentanyl concentrations. Pharmacokinetic values were calculated, using a computerized modeling program.
Results
Administration of fentanyl was tolerated by all goats. Intravenous administration of fentanyl resulted in a transitory increase in rectal temperature that was not clinically important. Terminal elimination half-life after IV administration was 1.20 ± 0.78 h, volume of distribution at steady state was 1.51 ± 0.39 L/kg, and systemic clearance was 2.09 ± 0.62 L/kg/h. Transdermal administration of fentanyl resulted in variable plasma concentrations, with peak plasma concentrations ranging from 1.12 to 16.69 ng/ml (mean ± SD, 6.99 ± 6.03 ng/ml) and time to peak concentration ranging from 8 to 18 hours (mean ± SD, 13 ± 4.5 hours). After removal of the transdermal patch, mean ± SD terminal elimination half-life was 5.34 ± 5.34 hours.
Conclusions and Clinical Relevance
Intravenous administration of fentanyl (2.5 μg/kg) in goats results in a relatively short half-life that will limit its use for management of pain. Transdermal administration of fentanyl (50 μg/h) in goats results in variable plasma concentrations that may exceed those anticipated on the basis of a theoretical delivery rate, but stable plasma concentrations of fentanyl may not be achieved. (Am J Vet Res 1999;60:986–991)
Summary
The association between various management factors and development of colic was studied in 821 horses treated for colic and 821 control horses treated for noncolic emergencies by practicing veterinarians in Texas between Oct 1, 1991 and Dec 31, 1992. History of previous colic and history of previous abdominal surgery were found to be significantly associated with colic. Change in stabling conditions during the 2 weeks prior to the time of examination, recent change in diet, and recent change in level of activity significantly increased the risk for development of colic. Changes in activity level, diet, and stabling conditions were identified as potentially alterable risk factors for colic. Logistic regression was used to adjust for the effects of all variables found to be significantly associated with colic by means of univariate analysis, and only history of previous colic, history of previous abdominal surgery, and history of recent change in diet remained significantly associated with colic. Results of this study indicate that a proportion of colic cases might be prevented by minimizing changes in management practices.
Objective
To determine typical alterations in acid-base balance and serum electrolyte concentrations in cattle grouped on the basis of age, breed type, hydration status, clinical signs, and underlying disease.
Design
Retrospective study.
Animals
632 cattle.
Procedure
Information on blood pH, Pvo2, Pvco2, HCO3 − concentration, and base excess (BE) as well as serum or plasma sodium, potassium, chloride, and total carbon dioxide concentrations was obtained. Values for calves (ie, cattle ≥ 1 month old) were compared with values for cattle ≥ 1 month old. Within each age-group, values were compared for cattle grouped on the basis of breed type, previous treatment, and hydration status. Proportions of cattle with various disorders for which values were within, greater than, or less than reference ranges were determined.
Results
BE, pH, and HCO3 − concentration were significantly higher and Pvco2 and sodium, potassium, and chloride concentrations were significantly lower among cattle ≥ 1 month old than calves. Base excess and HCO3- concentration were significantly lower among dairy than beef calves. Sodium and potassium concentrations were significantly lower among dairy than beef cattle ≥ 1 month old. A higher proportion of cattle that did not survive had a high anion gap than cattle that did survive. Sodium, potassium, and chloride concentrations were significantly lower among dehydrated cattle than cattle that were not dehydrated.
Clinical Implications
Because certain alterations were consistently found in some groups of cattle, it may be possible to make reasonable predictions of alterations in acid-base balance and serum electrolyte concentrations when laboratory evaluations are not available. (J Am Vet Med Assoc 1998;212:1769–1775)
Abstract
Objective—To examine the effect of various clinical tracks within the veterinary medical clinical curriculum at Texas A&M University on clinical diagnostic proficiency as determined by pre- and post-training assessment. We expected that the clinical track chosen by the student would impact their measured outcome with bias toward higher scores in their chosen field.
Design—Prospective cohort study.
Study Population—32 students from the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University.
Procedures—By use of standardized, written case scenarios, clinical reasoning was assessed twice: once prior to the clinical (fourth) year of the curriculum and again at completion of the clinical year. Students demonstrated their abilities to collect and organize appropriate clinical data (history, physical examination, and laboratory findings), determine clinical diagnoses, and formulate and implement acceptable treatment modalities. Data from clinical assessments were compared for a given cohort and correlated with other measures (eg, grades, standardized test scores, and species-specific curricular track).
Results—Differences were detected in clinical diagnostic proficiency among students in different clinical tracks and for different species groups in the case scenarios. Tracking by species group in the clinical veterinary curriculum appeared to affect development of clinical reasoning and resulted in differential proficiency among cases for differing species groups.
Conclusions and Clinical Relevance—Differences in clinical experiences between small animal tracks and all other track opportunities (large animal, mixed animal, and alternative) influenced the development of clinical proficiency in fourth-year veterinary students during their clinical training period.
