A 9-year-old 513-kg (1,128-lb) Thoroughbred gelding (horse 1) with a history of bilateral forelimb lameness localized to the feet of approximately 2 years' duration underwent general anesthesia to facilitate MRI of both front feet. A complete physical examination at the time of admission did not reveal any evidence of systemic abnormalities. Food, but not water, was withheld overnight.
Prior to anesthesia, the horse had a heart rate of 36 beats/min, respiratory rate of 16 breaths/min, and rectal temperature of 37.3°C (99.2°F). A 14-gauge catheter was aseptically placed in the right jugular vein and secured with a suture. The horse
A 6-year-old 8.4-kg (18.5-lb) castrated male domestic shorthair cat was examined by the small animal emergency service at the University of Illinois Veterinary Medical Teaching Hospital because of progressive subcutaneous emphysema of the head, neck, and thorax of 1 week's duration. Signs developed shortly after a routine dental procedure had been performed by the referring veterinarian.
Physical examination revealed severe subcutaneous emphysema extending from the head to the base of the tail and distally to the level of the carpal and tarsal joints. The cat was bright, alert, and responsive. Rectal temperature was 40°C (104°F), pulse rate was 160
OBJECTIVE To report complication rates following elective arthroscopy in horses and determine whether postoperative complication rates are higher for outpatient procedures, compared with inpatient procedures.
DESIGN Retrospective cohort study.
ANIMALS 357 client-owned horses that had undergone 366 elective arthroscopic procedures between January 2008 and February 2015.
PROCEDURES Medical records were retrospectively reviewed. Data collected included signalment, travel time to the hospital, clinical signs, joints treated, lesions diagnosed, medications administered, anesthesia and surgery times, details of the procedure (including closure method and surgeons involved), and hospitalization status (inpatient or outpatient). Inpatients were horses that remained hospitalized overnight, and outpatients were horses that were discharged in the afternoon of the day of surgery. The collected data were analyzed along with follow-up information to identify factors associated with postoperative complications and potentially associated with hospitalization status.
RESULTS Data were collected on 366 elective arthroscopic procedures (outpatient, n = 168 [46%]; inpatient, 198 [54%]). Complications that occurred included bandage sores, catheter problems, colic, diarrhea, postoperative discomfort, esophageal impaction, fever, incisional drainage, postanesthetic myopathy, persistent synovitis, persistent lameness, septic arthritis, and osteochondral fragments not removed during the original surgery. None of these complications were associated with hospitalization status (outpatient vs inpatient). However, Standardbreds were overrepresented in the outpatient group, and anesthesia and surgery times were longer for the inpatient group.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that outpatient elective arthroscopy in healthy horses could be performed safely and without a higher risk of complications, com pared with similar procedures performed on an inpatient basis.
Objective—To evaluate the righting reflex after topical application of a sevoflurane jelly in cane toads (Bufo marinus).
Animals—8 cane toads.
Procedures—Toads were 6 to 8 months of age and weighed (mean ± SD) 142.0 ± 25.2 g. Sevoflurane jelly was applied to the dorsum of each toad at a dose of 25 μL/g in trial 1 and 37.5 μL/g in trial 2. Toads were placed in dorsal recumbency every 30 seconds until loss of the righting reflex. Jelly was then removed by rinsing the toads with tap water. Toads were then left undisturbed in dorsal recumbency until return of the righting reflex. Chamber sevoflurane concentration was measured to determine vaporization.
Results—6 of 8 toads in trial 1 and 8 of 8 toads in trial 2 lost the righting reflex. Mean ± SD time to loss of the reflex was 8.2 ± 1.3 minutes for trial 1 and 8.3 ± 0.9 minutes for trial 2; this difference was not significant. Mean ± SD time to return of the reflex was 25.6 ± 26.2 minutes for trial 1 and 84.4 ± 47.2 minutes for trial 2; this difference was significant. Chamber sevoflurane concentration did not change significantly, compared with baseline (time 0) concentration, at any time in trial 1; however, there was a significant change in chamber sevoflurane concentration from baseline (time 0) concentration in trial 2. Chamber sevoflurane concentrations were not significantly different between trial 1 and trial 2 at any time. Mean ± SD chamber sevoflurane concentration was 0.46 ± 0.2% for trial 1 and 0.57 ± 0.28% for trial 2.
Conclusions and Clinical Relevance—Sevoflurane jelly applied topically at a dose of 37.5 μL/g induced a more reliable loss of righting reflex and longer recovery time than when applied at a dose of 25 μL/g in cane toads.
To determine factors associated with change in rectal temperature (RT) of dogs undergoing anesthesia.
In a prospective observational study, the RT of dogs undergoing anesthesia at 5 veterinary hospitals was recorded at the time of induction of anesthesia and at the time of recovery from anesthesia (ie, at the time of extubation). Demographic data, body condition score, American Society of Anesthesiologists (ASA) physical status classification, types of procedure performed and medications administered, duration of anesthesia, and use of heat support were also recorded. Multiple regression analysis was performed to determine factors that were significantly associated with a decrease or an increase (or no change) in RT. Odds ratios were calculated for factors significantly associated with a decrease in RT.
Among the 507 dogs undergoing anesthesia, RT decreased in 89% (median decrease, −1.2°C [-2.2°F]; range, −0.1°C to −5.7°C [–0.2°F to −10.3°F]), increased in 9% (median increase, 0.65°C [1.2°F]; range, 0.1°C to 2.1°C [3.8°F]), and did not change in 2%. Factors that significantly predicted and increased the odds of a decrease in RT included lower weight, ASA classification > 2, surgery for orthopedic or neurologic disease, MRI procedures, use of an α2-adrenergic or μ-opioid receptor agonist, longer duration of anesthesia, and higher heat loss rate. Lack of μ-opioid receptor agonist use, shorter duration of anesthesia, and lower heat loss rate were significantly associated with an increase in RT.
CONCLUSIONS AND CLINICAL RELEVANCE
Multiple factors that were associated with a decrease in RT in dogs undergoing anesthesia were identified. Knowledge of these factors may help identify dogs at greater risk of developing inadvertent perianesthetic hypothermia.
To compare measurements of left ventricular volume and function derived from 2-D transthoracic echocardiography (2DE), transesophageal echocardiography (TEE), and the ultrasound velocity dilution cardiac output method (UDCO) with those derived from cardiac MRI (cMRI) in healthy neonatal foals.
6 healthy 1-week-old Standardbred foals.
Foals were anesthetized and underwent 2DE, TEE, and cMRI; UDCO was performed simultaneously with 2DE. Images acquired by 2DE included the right parasternal 4-chamber (R4CH), left apical 4- and 2-chamber (biplane), and right parasternal short-axis M-mode (M-mode) views. The longitudinal 4-chamber view was obtained by TEE. Measurements assessed included left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), ejection fraction, stroke volume (LVSV), cardiac output (CO), and cardiac index (CI). Bland-Altman analyses were used to compare measurements derived from biplane, R4CH, and M-mode images and UDCO with cMRI-derived measurements. Repeatability of measurements calculated by 3 independent reviewers was assessed by the intraclass correlation coefficient.
Compared with cMRI, all 2DE and TEE modalities underestimated LVEDV and LVESV and overestimated ejection fraction, CO, and CI. The LVSV was underestimated by the biplane, R4CH, and TEE modalities and overestimated by UDCO and M-mode methods. However, the R4CH-derived LVSV, CO, and CI were clinically comparable to cMRI-derived measures. Repeatability was good to excellent for measures derived from the biplane, R4CH, M-mode, UDCO, and cMRI methods and poor for TEE-derived measures.
CONCLUSIONS AND CLINICAL RELEVANCE
All assessed modalities yielded clinically acceptable measurements of LVEDV, LVESV, and function, but those measurements should not be used interchangeably when monitoring patient progress.
Objective—To describe the health status of foals derived by use of somatic cell nuclear transfer (NT) at a university laboratory.
Design—Retrospective case series.
Animals—14 live-born NT-derived foals.
Procedures—Medical records from 2004 through 2008 were evaluated to identify all pregnancies resulting in live-born NT-derived foals. Information obtained included gestation length, birth weight, foaling complications, gross abnormalities of the fetal membranes, appearance of the umbilicus, mentation of the foal, limb deformities, and any other abnormalities detected in the neonatal period. Clinicopathologic data were also evaluated when available. Records of 4 recipient mares during gestation were included.
Results—Six foals were clinically normal for all evaluated variables. The most common abnormalities detected in the remaining 8 foals included maladjustment, enlarged umbilical remnant, and angular deformity of the forelimbs. Two foals died within 7 days after parturition; in the remaining foals, these conditions all resolved with medical or surgical management. Large offspring syndrome and gross abnormalities of the fetal membranes were not detected. The 12 surviving foals remained healthy.
Conclusions and Clinical Relevance—Associated problems of calves resulting from use of NT have been reported, but there are few data on the outcome of foals resulting from adult somatic cell NT in horses. Although this population of foals had a lower perinatal mortality rate than has been reported for NT-derived calves, some NT-derived foals required aggressive supportive care. Birth of foals derived from NT should take place at a center equipped to handle critical care of neonates.
To compare perceptions related to veterinary anesthesiologist involvement with anesthesia and pain management, benefits of a preanesthetic consultation (PAC) with an anesthesiologist, and quality of patient care between clients who did and did not participate in a PAC prior to their dogs’ elective orthopedic surgery.
80 dog owners.
Owners of dogs undergoing elective stifle joint surgery participated in the study. Participants were randomly assigned to PAC and control groups (n = 40 participants/group). The PAC group participated in a PAC with an anesthesiologist and completed a written survey (12 items with Likert-type response options). The control group completed a similar survey (identical except for 2 statements related to the PAC experience) without participating in a PAC. Results were compared between groups by statistical methods.
The proportion of clients in the PAC group who strongly agreed with the statements that a PAC was beneficial, their questions about the pet's anesthesia and pain management plan were answered, they knew who would perform anesthesia and what safeguards were in place, veterinary specialty hospitals should have an anesthesiologist on staff, they were willing to pay more to have an anesthesiologist supervise the anesthesia and pain management, and a PAC with an anesthesiologist should be standard of care in veterinary medicine was greater than that for control group clients. Responses to quality-of-care items did not differ between groups.
CONCLUSIONS AND CLINICAL RELEVANCE
Participating in a PAC was associated with more positive perceptions of anesthesiologists and knowledge about the anesthesia plan. Further research with a validated survey instrument is needed to confirm these findings.