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Abstract

OBJECTIVE To evaluate the effect of anesthesia-associated hypotension on final motor and urinary function in paraplegic dogs without nociception that underwent hemilaminectomy because of acute, severe thoracolumbar intervertebral disk herniation (IVDH).

DESIGN Retrospective case series.

ANIMALS 56 paraplegic dogs with acute thoracolumbar IVDH and absent nociception.

PROCEDURES Medical records were reviewed, and signalment, history, anesthetic details, and results of serial neurologic assessments performed for at least 4 weeks after surgery were recorded. Motor function was retrospectively scored with a 5-point scale, and urinary function was scored with a 3-point scale. Hypotension was defined as MAP ≤ 60 mm Hg or SAP ≤ 80 mm Hg for at least 2 consecutive readings 5 minutes apart. Associations between hypotension and outcome were assessed by use of the Fisher exact test.

RESULTS Thirty-three (59%) patients experienced hypotension during anesthesia. Thirty-four (61%) patients (20/33 with and 14/23 without hypotension) regained ambulation. Whether dogs regained motor or urinary function was not significantly associated with the occurrence of hypotension (P = 0.35 and P = 0.86, respectively), the duration of hypotension (P = 0.213 and P = 0.274), or the lowest blood pressure recorded (P = 0.556 and P = 0.699).

CONCLUSIONS AND CLINICAL RELEVANCE For this group of dogs undergoing hemilaminectomy because of acute, severe thoracolumbar IVDH, anesthesia-associated hypotension was not significantly associated with whether dogs regained motor or urinary function after surgery. However, normotension should be the goal in all patients with spinal cord injuries, especially patients undergoing general anesthesia.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare the analgesic effects of intra-articularly administered saline (0.9% NaCl) solution, morphine, dexmedetomidine, and a morphine-dexmedetomidine combination in dogs undergoing stifle joint surgery for cranial cruciate ligament rupture.

Design—Randomized, controlled, clinical trial.

Animals—44 dogs with cranial cruciate ligament rupture that underwent tibial tuberosity advancement (TTA) or tibial plateau leveling osteotomy (TPLO).

Procedures—Dogs received intra-articular injections of saline solution (0.2 mL/kg [0.09 mL/lb]), morphine (0.1 mg/kg [0.045 mg/lb]), dexmedetomidine (2.5 μg/kg [1.14 μg/lb]), or a combination of morphine (0.1 mg/kg) and dexmedetomidine (2.5 μg/kg). Intra-articular injections of the stifle joint were performed after completion of the corrective osteotomy procedure, just prior to skin closure. Signs of pain were assessed every 2 hours thereafter on the basis of mean behavioral and objective pain scores. Dogs with pain scores exceeding predetermined thresholds were given hydromorphone (0.05 mg/kg [0.023 mg/lb], SC) as rescue analgesia.

Results—Time to rescue analgesia did not significantly differ between dogs that underwent TTA versus TPLO. No significant difference in time to rescue analgesia was found among dogs receiving intra-articular injections of dexmedetomidine (median, 6 hours; range, 2 to 10 hours), morphine (median, 7 hours; range, 4 to 10 hours), or saline solution (median, 5 hours; range, 4 to 10 hours). However, time to rescue analgesia for dogs receiving intra-articular injection of the morphine-dexmedetomidine combination (median, 10 hours; range, 6 to 14 hours) was significantly longer than the time to rescue analgesia for other treatment groups.

Conclusions and Clinical Relevance—Intra-articular administration of the morphine-dexmedetomidine combination provided longer-lasting postoperative analgesia, compared with either morphine or dexmedetomidine alone, in dogs undergoing TTA or TPLO. (J Am Vet Med Assoc 2014;244:1291–1297)

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To investigate the effects of disk fenestration and ventral slot formation on vertebral motion unit (VMU) range of motion (ROM) and determine the effects of fenestration and ventral slot width on VMU ROM.

Sample Population—C5-C6 VMUs from 10 skeletally mature canine cadavers.

Procedures—Specimens were assigned to 2 groups (5 specimens/group). Surgery was performed in which width of a fenestration and a ventral slot was 33% (group 1) or 50% (group 2) the width of the vertebral body. Flexion-extension, lateral bending, and axial torsion ROMs were measured during loading before surgery, after fenestration, and after ventral slot formation. Range of motion was compared within groups to determine effects of surgical procedure on stability and between groups to determine effects of width of fenestration and ventral slot on stability.

Results—For both groups, fenestration resulted in a significant increase in ROM during flexion-extension, compared with results for intact specimens. Ventral slot formation resulted in a significant increase in ROM during flexion-extension and lateral bending, compared with results for intact specimens. Ventral slot formation resulted in a significant increase in ROM only during flexion-extension, compared with results for fenestrated specimens. There were no significant differences in ROM of the intact, fenestrated, and ventral slot specimens between groups.

Conclusions and Clinical Relevance—Analysis of these results suggests that fenestration and ventral slot procedures each affect the biomechanics of the C5-C6 VMU. Width of a fenestration or ventral slot up to 50% of the width of C5-C6 may be clinically acceptable.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate a technique for minimally invasive excisional brain biopsy and intracranial brachytherapy catheter placement in dogs.

Animals—5 healthy adult female dogs.

Procedures—Computed tomographic guidance was used to plan a biopsy trajectory to a selected area of brain with reference to a localizer grid. The procedure was performed through a 1-cm skin incision and 6-mm burr hole by use of a 9-gauge biopsy device. Five cylindrical samples (3 to 4 mm in diameter and 7 to 12 mm in length) were removed over 5 cycles of the vacuum-assisted tissue excision system, leaving approximately a 2-cm3 resection cavity. A balloon-tipped intracranial brachytherapy catheter was placed through the burr hole into the resection cavity, expanded with saline (0.9% NaCl) solution, and explanted 7 days later.

Results—4 of 5 dogs survived the procedure. The fifth died because of iatrogenic brain damage. Neurologic deficits were unilateral and focal. Twenty-four hours after surgery, all surviving dogs were ambulatory, 2 dogs exhibited ipsiversive circling, 4 had contralateral proprioceptive deficits, 3 had contralateral menace response deficits, 2 had a reduced contralateral response to noxious nasal stimulation, and 1 had dull mentation with intermittent horizontal nystagmus and ventrolateral strabismus. Neurologic status improved throughout the study period. Histologic quality of biopsy specimens was excellent.

Conclusions and Clinical Relevance—This technique enabled histologic diagnosis from high-quality biopsy specimens obtained through a minimally invasive technique and has potential applications for multimodal treatment of deep brain tumors in dogs.

Full access
in American Journal of Veterinary Research