Objective—To determine clinical features, outcome, risk factors for death, and efficacy of IV administration of lidocaine as a prophylactic treatment for ischemic reperfusion injury in gastric dilatation and volvulus (GDV) in dogs.
Design—Retrospective case series.
Animals—112 dogs with GDV.
Procedures—Data pertaining to breed; time lag to admission; clinical, clinicopathologic, and surgical findings; lidocaine treatment; and postoperative complications were assessed for association with outcome.
Results—German Shepherd Dogs (28.6%) and Great Danes (17%) were significantly over-represented. Risk factors for death included time lag (≥ 5 hours vs < 5 hours) from onset of clinical signs to admission (46.0% vs 11.3%), rectal temperature (≤ 38°C vs > 38°C [< 100.4°F vs > 100.4°F]) at admission (40.0% vs 14.9%), presence or absence of ARF (67.0% vs 23.3%), presence or absence of suspected gastric wall necrosis (59.3% vs 16.0%), and untreated gastric wall necrosis, compared with treated gastric wall necrosis (100% vs 47.6%). Overall mortality rate was 26.8%; no significant differences were detected in mortality rate or postoperative complications between dogs that received lidocaine IV prior to surgical intervention (52.0%) and dogs that did not (48.0%). Mean ± SD hospitalization time was longer in the lidocaine treatment group (3.5 ± 1.9 days vs 2.5 ± 1.4 days).
Conclusions and Clinical Relevance—Presence of the identified risk factors should warrant aggressive treatment. Lidocaine treatment was not associated with mortality rate or postoperative complications, but was associated with prolonged hospitalization time.
Objective—To establish an anesthetic protocol suitable for surgical interventions in hippopotami (Hippopotamus amphibius).
Design—Prospective case series.
Animals—10 adult male hippopotami undergoing castration.
Procedures—A combination of medetomidine (60 to 80 µg/kg [27.3 to 36.4 µg/lb]) and ketamine (1 mg/kg [0.45 mg/lb]) was administered IM on the basis of mean estimated weights of 1,330 ± 333 kg (2,926 ± 733 lb; median, 1,350 kg [2,790 lb]; range, 900 to 2,000 kg [1,980 to 4,400 lb]). Monitoring included sequential blood gas analyses, pulse oximetry, and capnography. Reversal of anesthesia with atipamezole (0.34 ± 0.06 mg/kg [0.15 ± 0.027 mg/lb]; median, 0.33 mg/kg [0.15 mg/lb]; range, 300 to 500 mg total dose]) was uneventful and rapid in all cases.
Results—Complete immobilization and a surgical anesthetic plane were achieved 27 ± 11.8 minutes (median, 24.5 minutes [range, 14 to 44 minutes]) after initial injection. Anesthesia (97.3 ± 35.3 minutes; median, 95 minutes [range, 57 to 188 minutes]) was maintained with 3.4 ± 2.2 (median, 3) additional doses of ketamine (0.1 to 0.4 mg/kg [0.045 to 0.18 mg/lb]). Transitory apnea of 4.71 ± 2.87 minutes (median, 4 minutes [range, 1 to 9 minutes]) was documented in 5 animals. Apnea during anesthesia was viewed as a physiologic condition in this semiaquatic mammal because related vital parameters (heart rate, pH, peripheral hemoglobin oxygen saturation as measured by pulse oximetry, venous partial pressure of CO2, and lactate and HCO3 concentrations) remained unchanged and did not differ significantly than those parameters for the 5 animals with continuous respiration.
Conclusions and Clinical Relevance—Both in captivity and in the wild, common hippopotami are difficult to anesthetize. The combination of medetomidine and ketamine provided an excellent surgical plane of anesthesia and a self-limiting dive response.