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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the analgesic efficacy of epidural administration of morphine or a morphine-bupivacaine combination administered before orthopedic surgery in dogs that received opioid premedication.

Design—Prospective, randomized, blinded, clinical study.

Animals—36 healthy adult dogs that underwent elective orthopedic surgery on a pelvic limb.

Procedures—Each dog received 1 of 3 epidural treatments before surgery. Anesthetic and supportive care protocols were standardized. Dogs under going different surgical procedures were randomly allocated among the 3 treatment groups. Respiratory and cardiovascular variables, end-tidal isoflurane concentration, and requirements for rescue analgesia were monitored. Postsurgical analgesia was evaluated with a multiparametric pain scoring system and by determination of rescue analgesia requirements and cortisolemia.

Results—The morphine-bupivacaine combination was associated with lower values than morphine or a saline solution for intraoperative arterial blood pressure; minimum and maximum isoflurane requirements; and postoperative pain scores, rescue analgesia requirements, and plasma cortisol concentrations. Values obtained after administration of morphine alone were not significantly different from those obtained after administration of saline solution for most variables.

Conclusions and Clinical Relevance—The preoperative epidurally administered morphine-bupivacaine combination induced better analgesia than morphine alone and should be considered for use in clinical patients. The degree of hemodynamic depression associated with the combination was considered acceptable for healthy patients undergoing elective surgery.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To assess the analgesic effects of 2 doses of meloxicam on the degree of postoperative orthopedic pain in pigeons.

Animals—21 domestic pigeons (Columba livia).

Procedures—In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Birds were randomly allocated to receive saline (0.9% NaCl) solution (control) or meloxicam (0.5 mg/kg [low dose] or 2.0 mg/kg [high dose]). The first treatment was administered IM after surgery was completed. Subsequent treatments were administered PO every 12 hours for 9 days. Degree of postoperative pain was assessed for the first 4 days after surgery by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 pain scales, and analysis of video-recorded partial ethograms for bird activity and posture.

Results—No significant differences were observed between the control group and the low-dose meloxicam group in any tested variable. The high-dose meloxicam group had a greater degree of weight bearing on the affected limb from the second to the fourth postoperative day as well as lower pain scores for at least the first 2 postoperative days, compared with the other groups. Return to presurgical behavior was achieved faster in pigeons that received high-dose meloxicam than in the other groups. No adverse effects were observed.

Conclusions and Clinical Relevance—Administration of meloxicam at 0.5 mg/kg appeared ineffective in minimizing postoperative orthopedic pain in pigeons, but the 2.0 mg/kg dose provided quantifiable analgesia that appeared safe in this species in experimental conditions.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate the relationship between end-tidal partial pressure of CO2 (ETCO2) and PaCO2 in isoflurane-anesthetized harp seals.

Animals—Three 5-month-old 25- to 47-kg harp seals (Phoca groenlandica).

Procedures—PaCO2 was determined in serial arterial samples from isoflurane-anesthetized seals and compared with concomitant ETCO2 measured with a side-stream microstream capnograph. Twenty-four paired samples were subjected to linear regression analysis and the Bland-Altman method for assessment of clinical suitability of the 2 methods (ie, PaCO2 and ETCO2 determinations). The influence of ventilation rate per minute (VR) on the ETCO2 to PaCO2 difference (P[ET-a] CO2) was examined graphically.

Results—The correlation coefficient between the 2 measurements was 0.94. The level of agreement between ETCO2 and PaCO2 varied considerably. Values of ETCO2 obtained with a VR of < 5 underestimated PaCO2 to a greater degree (mean bias, −4.01 mm Hg) and had wider limits of agreement of −13.10 to 5.07 mm Hg (−4.01 mm Hg ± 1.96 SD), compared with a VR of ≥ 5 (mean bias, −2.24 mm Hg; limits of agreement, −7.79 to 3.30 mm Hg).

Conclusions and Clinical Relevance—These results indicate that a microstream sidestream capnograph provides a noninvasive, sufficiently accurate estimation of PaCO2 with intermittent positive ventilation at a VR ≥ 5 in anesthetized harp seals.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine prevalence of adverse effects associated with epidural administration of morphine with or without bupivacaine in dogs and cats undergoing surgery and evaluate effects of epidural administration of morphine on postoperative pain severity.

Design—Retrospective study.

Animals—242 dogs and 23 cats.

Procedure—Morphine with or without bupivacaine was administered prior to surgery with a Tuohy needle, spinal needle, or epidural catheter. In 18 dogs that underwent surgery twice, results of preemptive epidural administration of morphine with or without bupivacaine were compared with results of systemic administration of oxymorphone and ketoprofen.

Results—The delivered fraction of isoflurane was significantly lower in animals given morphine and bupivacaine than in animals given morphine alone. Analgesia was of significantly longer duration in dogs given morphine and bupivacaine than in dogs given morphine alone. During anesthesia, mild respiratory and cardiovascular depression was reported. Seven dogs and 2 cats had urine retention, and 2 dogs developed pruritus. Six dogs vomited when a second dose of morphine was given epidurally the day after surgery. Eight of 72 dogs had delayed hair growth. In 18 dogs that underwent surgery twice, the delivered fraction of isoflurane was significantly lower and the duration of analgesia was significantly longer when morphine with or without bupivacaine was given epidurally than when oxymorphone and ketoprofen were given.

Conclusions and Clinical Relevance—Results suggest that preemptive epidural administration of morphine with or without bupivacaine is a safe and effective method of inducing long-lasting analgesia in dogs and cats and is superior to standard management of postoperative pain with repeated injection of oxymorphone and ketoprofen. (J Am Vet Med Assoc 2002;221:666–672)

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To validate a model of postfracture pain in perching birds.

Animals—21 adult domestic pigeons (Columba livia).

Procedures—In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Degree of postoperative pain was evaluated 6 times/d for 4 days by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 numeric rating pain scales for assessment of pain (all of which involved the observer in the same room as the bird), and analysis of video-recorded (observer absent) partial ethograms for bird activity and posture. Measurements obtained were compared with data collected before the surgery to evaluate the ability of these methods to detect pain.

Results—The weight-bearing load differential was a sensitive, specific, reliable, and indirect measure of fracture-associated pain in the model used. Two of 4 tested pain scales (fractured limb position and subjective evaluation of degree of pain) were sensitive and specific for detecting pain and were reliable in a research setting. Interobserver reliability of the 4 pain scales was excellent. Partial ethograms were sensitive for identifying pain-associated behavior in pigeons, particularly during the first 2 days after surgery.

Conclusions and Clinical Relevance—The fracture pain model was reliable and reproducible and may be useful for experimental studies involving postsurgical pain in pigeons. Weight-bearing load differential was the most sensitive and specific means of determining degree of pain in pigeons during the first 4 days after hind limb fracture induction.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate antinociceptive effects of IV administration of hydromorphone alone or followed by buprenorphine or butorphanol to cats.

ANIMALS 6 healthy adult cats.

PROCEDURES In a randomized, blinded crossover design, cats received each of 4 treatments in which 2 IV injections were given 30 minutes apart: 2 of saline (0.9% NaCl) solution (Sal-Sal) or 1 each of hydromorphone HCl and saline solution (H-Sal), hydromorphone and buprenorphine HCl (H-Bupre), or hydromorphone and butorphanol tartrate (H-Butor). Skin temperature and thermal threshold were recorded before (baseline) and for 12 hours after the first injection. Percentage of maximum possible effect (%MPE) and thermal excursion (TE) were compared among treatments and measurement points.

RESULTS Compared with baseline values, skin temperature was higher from 0.75 to 2 hours after the first injection for H-Sal; at 0.5, 1, 3, and 4 hours for H-Bupre; from 0.5 to 3 hours for H-Butor; and from 0.5 to 1 hours for Sal-Sal. Thermal excursion was higher than at baseline from 0.25 to 2 hours for H-Sal and H-Bupre and 0.25 to 0.75 hours for H-Butor; %MPE increased from 0.25 to 2 hours for H-Sal, 0.25 to 3 hours for H-Bupre, and 0.25 to 0.75 hours for H-Butor. Results were similar for comparisons with Sal-Sal, except TE was greater for H-Sal versus Sal-Sal and TE and %MPE were greater for H-Bupre versus Sal-Sal from 0.25 to 1 hours after the first injection.

CONCLUSIONS AND CLINICAL RELEVANCE Butorphanol administration decreased the duration of antinociception achieved with hydromorphone administration in cats. This opioid interaction and its impact on pain management require additional investigation.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To compare glomerular filtration rate (GFR) as estimated from Patlak plot analysis by use of single-slice computed tomography (CT) with that obtained from clearance of plasma inulin in pigs.

Animals—8 healthy anesthetized juvenile pigs.

Procedures—All pigs underwent precontrast, whole-kidney, helical CT; postcontrast single-slice dynamic CT; and postcontrast, whole-kidney CT for volume determination. On dynamic images, corrected Hounsfield unit values were determined for each kidney and the aorta. A Patlak plot for each kidney was generated, and plasma clearance per unit volume was multiplied by renal volume to obtain whole-animal contrast clearance. Mean GFR determined via inulin clearance (Inu-GFR) was measured from each kidney and correlated to mean GFR determined via CT (CT-GFR) for the left kidney, right kidney, and both kidneys by use of linear regression and Bland-Altman analyses.

Results—CT-GFR results from 7 pigs were valid. Total and right kidney Inu-GFR were correlated with total and right kidney CT-GFR (total, R 2 = 0.85; right kidney, R 2 = 0.86). However, left kidney CT-GFR was poorly correlated with left kidney Inu-GFR (R 2 = 0.47). Bland-Altman analysis revealed no significant bias between Inu-GFR and CT-GFR for the left kidney, right kidney, or both kidneys.

Conclusions and Clinical Relevance—CT-GFR as determined by use of a single-slice acquisition technique, low-dose of iohexol, and Patlak plot analysis correlated without bias with Inu-GFR for the right kidney and both kidneys (combined). This technique has promise as an accurate CT-GFR method that can be combined with renal morphologic evaluation.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To develop a whole-kidney computed tomography (CT) technique that would allow 3-point Patlak plot determination of glomular filtration rate (GFR) and assess the correlation of GFR determined via CT (CT-GFR) with GFR determined via renal plasma clearance of inulin (Inu-GFR) in pigs.

Animals—6 healthy anesthetized pigs.

Procedures—Each pig underwent 3-phase whole-kidney helical CT (arterial, early, and late parenchymal phases) before and after contrast medium administration. After contrast medium administration, corrected Hounsfield unit values were determined for each kidney and the aorta. A 3-point Patlak plot for each kidney was generated, and plasma clearance per unit volume was multiplied by renal volume to obtain whole-animal CT-GFR. Correlations of mean Inu-GFR for the left and right kidneys (and combined [total] values) with the corresponding CT-GFRs were assessed via linear regression and Bland-Altman analyses.

Results—Left kidney, right kidney, and total CT-GFRs were good predictors of the respective Inu-GFR values (r 2 = 92.3%, r 2 = 85.5%, and r 2 = 93.7%, respectively). For the left kidney, no significant bias between Inu-GFR and CT-GFR was detected. Right kidney and total CT-GFRs underestimated the corresponding Inu-GFRs (mean underestimation, −8.4 mL•min−1 and −12.6 mL•min−1, respectively).

Conclusions and Clinical Relevance—Three-phase whole-kidney CT with Patlak plot analysis of GFR may underestimate right kidney and total Inu-GFRs in pigs. The Patlak plot generated may be sensitive to nonlinearity caused by temporal variation in GFR. Nonetheless, the 3-phase CT approach offers some practical advantages for simultaneous evaluation of renal morphology and measurement of GFR.

Full access
in American Journal of Veterinary Research