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Multimodal analgesia is the foundation of opioid‐sparing analgesia protocols in major surgery, being locoregional anaesthesia their keystone. Its aim is to provide adequate analgesia while minimising opioid requirements, and thus opioid‐related adverse effects. The blossoming of ultrasound‐guided fascial plane blocks offers a new spectrum of safer and simpler alternatives to traditional locoregional anaesthesia techniques. This report describes the anaesthetic management of a dog and a cat that underwent bilateral thoracotomy for treatment of chylothorax. The multimodal analgesia protocol consisted of preoperative methadone, ultrasound‐guided serratus plane and erector spinae plane blocks, and epidural catheter for postoperative analgesia management. The combination of these techniques allowed for a reduction of perioperative opioid requirements, good‐quality recovery and opioid‐free analgesia in the postoperative period. [ABSTRACT FROM AUTHOR]

The infections caused by the HSV-1 virus induce lesions on the lips, mouth, face, and eye. In this study, an ethosome gel loaded with dimethyl fumarate was investigated as a possible approach to treat HSV-1 infections. A formulative study was conducted, evaluating the effect of drug concentration on size distribution and dimensional stability of ethosomes by photon correlation spectroscopy. Ethosome morphology was investigated by cryogenic transmission electron microscopy, while the interaction between dimethyl fumarate and vesicles, and the drug entrapment capacity were respectively evaluated by FTIR and HPLC. To favor the topical application of ethosomes on mucosa and skin, different semisolid forms, based on xanthan gum or poloxamer 407, were designed and compared for spreadability and leakage. Dimethyl fumarate release and diffusion kinetics were evaluated in vitro by Franz cells. The antiviral activity against HSV-1 was tested by plaque reduction assay in Vero and HRPE monolayer cells, while skin irritation effect was evaluated by patch test on 20 healthy volunteers. The lower drug concentration was selected, resulting in smaller and longer stable vesicles, mainly characterized by a multilamellar organization. Dimethyl fumarate entrapment in ethosome was 91% w/w, suggesting an almost total recovery of the drug in the lipid phase. Xanthan gum 0.5%, selected to thicken the ethosome dispersion, allowed to control drug release and diffusion. The antiviral effect of dimethyl fumarate loaded in ethosome gel was demonstrated by a reduction in viral growth both 1 h and 4 h post-infection. Moreover, the patch test demonstrated the safety of the ethosomal gel applied on the skin. [ABSTRACT FROM AUTHOR]

A 13.9 kg, 4‐year‐old, male cocker spaniel dog was scheduled for cystotomy. Premedication consisted of intravenous medetomidine (5 µg/kg), induction with propofol (1 mg/kg, intravenous) and anaesthesia maintenance with isoflurane in O2 100%. A medetomidine constant‐rate infusion (1 µg/kg/h) was administered throughout. A bilateral quadratus lumborum block with 3 ml of 0.5% bupivacaine (each side) was performed, and intermittent positive‐pressure ventilation was initiated. At the end of the surgery, medetomidine constant‐rate infusion and intermittent positive‐pressure ventilation ceased. The patient remained in apnoea and developed severe hypercapnia (end‐tidal carbon dioxide: 12 kPa). Thirty minutes after isoflurane discontinuation, respiratory muscles movement started. Three days before, the dog underwent a mini‐hemilaminectomy (similar anaesthetic protocol) without complications. Epidural/spinal migration from the right quadratus lumborum block was suspected, although the definitive cause of transient respiratory arrest after bilateral quadratus lumborum block could not be ascertained. We advise caution when performing quadratus lumborum if previous neighbouring spinal surgery was performed. [ABSTRACT FROM AUTHOR]

Skin fungal infection is still a serious public health problem due to the high number of cases. Even though medicines are available for this disease, drug resistance among patients has increased. Moreover, access to medicine is restricted in some areas. One of the therapeutic options is herbal medicine. This study aims to develop an ethosome formulation loaded with Zingiber zerumbet (L.) Smith. rhizome extract for enhanced antifungal activity in deep layer skin, which is difficult to cure. Ethosomes were successfully prepared by the cold method, and the optimized formulation was composed of 1% (w/v) phosphatidylcholine and 40% (v/v) ethanol. Transmission electron microscope (TEM) images revealed that the ethosomes had a vesicle shape with a diameter of 205.6–368.5 nm. The entrapment of ethosomes was 31.58% and could inhibit the growth of Candida albicans at a concentration of 312.5 μg/mL. Finally, the ethosome system significantly enhanced the skin penetration and retention of the active compound (zerumbone) compared with the liquid extract. This study showed that Z. zerumbet (L.) rhizome extract could be loaded into ethosomes. The findings could be carried over to the next step for clinical application by conducting further in vivo penetration and permeation tests. [ABSTRACT FROM AUTHOR]

In this study, the transdermal fate of vesicular nanosystems was investigated. Particularly, ethosomes based on phosphatidylcholine 0.9% w/w and transethosomes based on phosphatidylcholine 0.9 or 2.7% w/w plus polysorbate 80 0.3% w/w as an edge activator were prepared and characterized. The vesicle mean size, morphology and deformability were influenced by both phosphatidylcholine and polysorbate 80. Indeed, the mean diameters of ethosome were around 200 nm, while transethosome's mean diameters were 146 or 350 nm in the case of phosphatidylcholine 0.9 or 2.7%, w/w, respectively. The highest deformability was achieved by transethosomes based on phosphatidylcholine 0.9%, w/w. The three types of vesicular nanosystems were applied on explanted human skin maintained in a bioreactor. Transmission electron microscopy demonstrated that all vesicles were able to enter the skin, keeping their structural integrity. Notably, the vesicle penetration capability was influenced by their physical-chemical features. Indeed, ethosomes reached keratinocytes and even the dermis, phosphatidylcholine 0.9% transethosomes were found in keratinocytes and phosphatidylcholine 2.7% transethosomes were found only in corneocytes of the outer layer. These findings open interesting perspectives for a differentiated application of these vesicles for transdermal drug delivery as a function of the cutaneous pathology to be addressed. [ABSTRACT FROM AUTHOR]

Simple Summary: A pain assessment is essential to provide appropriate pain relief. The Feline Grimace Scale© (FGS) is a facial expression-based acute pain scale used in feline medicine; increased FGS scores could indicate acute pain in cats requiring analgesia. However, it is unknown if some sedatives and/or anesthetics can bias pain assessment using the FGS. This study aimed to investigate the effects of sedation with dexmedetomidine-butorphanol followed by anesthesia with propofol-isoflurane on the FGS scores of healthy cats. The cats were video-recorded before and up to 24 h after sedation and general anesthesia. Images collected from the videos were randomized and scored independently by four raters who were masked to the treatments. Dexmedetomidine and butorphanol significantly increased the FGS scores at 20 min after administration. General anesthesia with propofol and isoflurane significantly increased the FGS scores at 0.5 h post-anesthesia, but not after. There were no other statistically significant findings. In conclusion, sedation with dexmedetomidine and butorphanol and general anesthesia with propofol and isoflurane increase FGS scores and may bias clinical pain assessment. Although the effects were short-lived, they should be taken into account during acute pain assessment. This study aimed to evaluate the effects of sedation and anesthesia on Feline Grimace Scale© (FGS) scores. Twelve healthy cats were included in a prospective, blinded and randomized, cross-over study with a 14 day wash-out. Saline or dexmedetomidine-butorphanol (Dex-But) was administered intramuscularly before an anesthetic induction with propofol and maintenance with isoflurane. Saline or atipamezole (Dex-But) was administered at the end of the general anesthesia. Video-filming/image capturing was performed before and up to 24 h post-anesthesia. A total of 125 images were evaluated by four raters blinded to the treatment groups using the FGS (ear position/orbital tightening/muzzle tension/whiskers change/head position; action units (AU); scores 0–2 for each AU). The effects of the sedation/anesthesia were analyzed (p < 0.05). The total FGS and each AU scores were significantly higher with Dex-But than with saline 20 min post-sedation. In the saline group, the total FGS, orbital tightening, and whiskers and head position scores were significantly higher than baseline at 0.5 h post-anesthesia. In the Dex-But group, the total FGS and each AU scores were significantly higher after sedation, whereas the orbital tightening scores were significantly higher at 0.5 h post-anesthesia when compared with the baseline. None of the other comparisons between or within the groups was significantly different. The sedation with dexmedetomidine-butorphanol and anesthesia with propofol-isoflurane changed the FGS scores on a short-term basis; consequently, they may bias acute pain assessment. [ABSTRACT FROM AUTHOR]

Simple Summary: C-reactive protein is a major positive acute phase protein in dogs. It is commonly used as a marker of inflammation that, although nonspecific, is highly sensitive. The high clinical value lies in its rapid response and relatively short half-life time; these qualities make the C-reactive protein a good therapeutic guide; among others, it can be used to determine when an antimicrobial therapy could be ceased. Various tests are available on the market and the measurement is becoming a part of routine biochemistry blood panels in many countries. Although it is very useful, especially in conjunction with white blood cell count or other acute phase response proteins measurements, it does not allow a complete evaluation as a single parameter. Acute phase response is a nonspecific reaction to disturbances in homeostasis during which the production of some Acute Phase Proteins (APPs) is stimulated; they are sensitive but nonspecific markers of systemic inflammatory processes. The major positive APP in dogs is the C-reactive protein (CRP). The dynamic of its concentration changes fast, rising and decreasing rapidly with the onset and removal of the inflammatory stimulus. It increases within the first 4–24 h after the stimulus and reaches up to a 50–100-fold increase of the baseline level. It has been documented that this APP's concentration is elevated during several diseases, such as pyometra, panniculitis, acute pancreatitis, polyarthritis, sepsis, immune-mediated hemolytic anemia, and neoplasia in dogs. In clinical practice, canine CRP is mostly measured to detect and monitor systemic inflammatory activity and the efficacy of treatments, because it is a more sensitive marker than shifts in leukocyte counts. Blood serum CRP concentration is becoming a part of routine biochemistry panels in many countries. In this article, changes in CRP concentration and its clinical application in healthy and diseased dogs are discussed. [ABSTRACT FROM AUTHOR]

Simple Summary: Nonhuman primates (NHPs) mimic most aspects of the human and play a critical role in translational research of neurological diseases. Functional connectivity is frequently examined using resting-state functional MRI (rsfMRI) to assess the functional abnormality in the anesthetized animal brain. As anesthetics show different effects on physiology and neural activity in a dose-dependent manner, specific and safe anesthesia procedures must be considered and applied to keep the animal from stress and motion during rsfMRI scanning. In this review, typical anesthesia protocols and rsfMRI techniques for NHPs are summarized. An optimal anesthesia protocol and rsfMRI scanning protocol for NHPs are introduced. Nonhuman primates (NHPs) are the closest living relatives of humans and play a critical and unique role in neuroscience research and pharmaceutical development. General anesthesia is usually required in neuroimaging studies of NHPs to keep the animal from stress and motion. However, the adverse effects of anesthesia on cerebral physiology and neural activity are pronounced and can compromise the data collection and interpretation. Functional connectivity is frequently examined using resting-state functional MRI (rsfMRI) to assess the functional abnormality in the animal brain under anesthesia. The fMRI signal can be dramatically suppressed by most anesthetics in a dose-dependent manner. In addition, rsfMRI studies may be further compromised by inter-subject variations when the sample size is small (as seen in most neuroscience studies of NHPs). Therefore, proper use of anesthesia is strongly demanded to ensure steady and consistent physiology maintained during rsfMRI data collection of each subject. The aim of this review is to summarize typical anesthesia used in rsfMRI scans of NHPs and the effects of anesthetics on cerebral physiology and functional connectivity. Moreover, the protocols with optimal rsfMRI data acquisition and anesthesia procedures for functional connectivity study of macaque monkeys are introduced. [ABSTRACT FROM AUTHOR]

Background: Diabetic neuropathy (DN) is the most prevalent and problematic consequence of diabetes mellitus, with the highest rates of morbidity and death, as well as a significant financial burden on diabetes treatment. Aside from commercially available formulations, substantial research on herbal-based natural therapies to treat hyperglycemia and related consequences is underway. Objectives: The major aim of the study was to use an ethosomal gel to improve transdermal penetration of Curcuma longa and Boswellia serrata and to overcome the challenges of low transdermal drug delivery permeability. Materials and Methods: Curcuma longa and Boswellia serrata loaded ethosomes were made using a cold process with various amounts of ethanol and soya lecithin, and were improved based on entrapment efficiency, vesicular size, and ex-vivo investigations. Results: The optimized ethosomal formulation was then put into a gel and evaluated. Ex-vivo tests were conducted with Curcuma longa and Boswellia serrata ethosomal gels, which were compared to plain gel. The ethosomal system produced vesicles with sizes ranging from 1 to 100 nm, a spherical, smooth surface, and a maximum entrapment efficiency of Ne9. A modified ethosomal system (Ne9) was introduced into the gel and studied further. Conclusion: According to the findings, the ethosomal gel has a lot of potential for transdermal Curcuma longa and Boswellia serrata administration. [ABSTRACT FROM AUTHOR]

Background: Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives: To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals: None. Methods: A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results: The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance: Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE. [ABSTRACT FROM AUTHOR]

Simple Summary: Many analgesic protocols are described to manage pain during ovariohysterectomy. Over the past few years, loco-regional anaesthesia techniques have been introduced in veterinary anaesthesia. Therefore, students should be aware of these techniques and trained on them. This retrospective study assessed four different methods of providing analgesia for ovariohysterectomy (i.e., epidural analgesia (EPIDURAL), quadratus lumborum block (QLB), transversus abdominis plane (TAP) block, or systemic analgesia (GENERAL). Undergraduate students performed all the loco-regional anaesthesia procedures under the direct supervision of a qualified anaesthetist. Considering the inclusion criteria, 120 dogs were included in this study (22 EPIDURAL, 32 QLB, 39 TAP, 27 GENERAL). Based on our study results, we can conclude that all these four analgesic protocols are suitable for controlling nociception during ovariohysterectomy. All of them required a similar number of analgesic rescues and showed a very low rate of complications. No matter the technique, loco-regional anaesthesia showed better quality of recovery than just systemic analgesia. A significatively lower dose of methadone was used for premedication in the loco-regional anaesthesia groups compared with the systemic analgesia group. Epidural analgesia was the only technique in which the concentration of the volatile agent was lower than in the other groups. No complications related to loco-regional anaesthesia techniques were recorded; therefore, this indicates that it would be safe for students to perform when the procedure is conducted under direct supervision. This study compared four methods to provide intraoperative analgesia during canine ovariohysterectomy in a veterinary teaching hospital. A retrospective study was designed to assess the nociceptive response, cardiorespiratory stability, quality of recovery and complications of four analgesic protocols: epidural analgesia (EPIDURAL group), Quadratus Lumborum block (QLB group), Transversus Abdominis Plane block (TAP group), and just systemic analgesia (GENERAL group). Undergraduate students carried out all the loco-regional techniques under the direct supervision of a qualified anaesthetist. A total of 120 cases met the inclusion criteria and were included in the study and were distributed as follows: 22, 27, 32 and 39 cases with EPIDURAL, GENERAL, QLB and TAP groups, respectively. Data were analysed with statistical software R using different statistical methods. Significant differences among groups were defined as p < 0.05. Based on our results, all the groups needed the same number of rescue analgesia during the intra-operative period. The use of loco-regional techniques anticipated a better quality of recovery compared with the general group. The EPIDURAL group showed a statistically lower expired fraction of sevoflurane. No differences were found regarding complications. In conclusion, these four analgesic methods are suitable and safe to be performed for canine ovariohysterectomy, although loco-regional techniques might have some advantages. [ABSTRACT FROM AUTHOR]

In this study, transethosomes were investigated as potential delivery systems for dimethyl fumarate. A formulative study was performed investigating the effect of the composition of transethosomes on the morphology and size of vesicles, as well as drug entrapment capacity, using cryogenic transmission electron microscopy, photon correlation spectroscopy, and HPLC. The stability of vesicles was evaluated, both for size increase and capability to control the drug degradation. Drug release kinetics and permeability profiles were evaluated in vitro using Franz cells, associated with different synthetic membranes. The in vitro viability, as well as the capacity to improve wound healing, were evaluated in human keratinocytes. Transmission electron microscopy enabled the evaluation of transethosome uptake and intracellular fate. Based on the obtained results, a transethosome gel was further formulated for the cutaneous application of dimethyl fumarate, the safety of which was evaluated in vivo with a patch test. It was found that the phosphatidylcholine concentration affected vesicle size and lamellarity, influencing the capacity to control dimethyl fumarate's chemical stability and release kinetics. Indeed, phosphatidylcholine 2.7% w/w led to multivesicular vesicles with 344 nm mean size, controlling the drug's chemical stability for at least 90 days. Conversely, phosphatidylcholine 0.9% w/w resulted in 130 nm sized unilamellar vesicles, which maintained 55% of the drug over 3 months. These latest kinds of transethosomes were able to improve wound healing in vitro and were easily internalised by keratinocytes. The selected transethosome gel, loading 25 mg/mL dimethyl fumarate, was not irritant after cutaneous application under occlusion, suggesting its possible suitability in the treatment of wounds caused by diabetes mellitus or peripheral vascular diseases. [ABSTRACT FROM AUTHOR]

Opiates have a long history of medical use as effective analgesics associated with well‐described side effects, including euphoria, respiratory depression, constipation, bradycardia, and histamine release, among others. The search for opiate analogs that retain effective analgesic qualities without detrimental side effects has yielded numerous compounds, including buprenorphine. Early studies of buprenorphine demonstrated analgesic effectiveness with a favorable safety profile, leading to the approval of formulations for use in humans. Since then, advances in receptor theory and molecular cloning of opioid receptors have led to a deeper understanding of buprenorphine pharmacology. More recent studies of receptor affinity and intrinsic activity have shown that buprenorphine is a μ‐ and κ‐opioid receptor agonist, a nociceptin orphanin peptide agonist, and a δ‐opioid receptor antagonist. Buprenorphine appears to have a primary spinal analgesic mechanism with complex supraspinal actions. It is considered a full agonist for pain but a partial agonist for other clinical endpoints such as respiratory depression. In feline medicine, buprenorphine is approved as low‐ and high‐concentration injectable solutions, in addition to the most recently introduced long‐acting transdermal formulation. Several investigational and compounded formulations have also been evaluated. There are contrasting differentiable features that include pharmacokinetics, onsets‐ and durations‐of‐action, routes of administration, and formulation constituents. Available buprenorphine formulations allow clinicians to select a formulation based on the anticipated duration of pain associated with various surgical procedures, and to provide interventions as needed. In light of the newly approved transdermal buprenorphine solution in cats and progress in buprenorphine pharmacology, the objective of this review is to examine the history and pharmacology of buprenorphine relative to full opioid agonists, where appropriate, integrating these insights into advances within feline medicine. [ABSTRACT FROM AUTHOR]

The research focussed on development and evaluation of ethosome as an effective delivery of antigen that eliminates need for frequent dose of antigen while improving patient compliance for Hepatitis B. Prepared a single dose HBsAg ethosomal vaccine using a cold method and applied a central composite design optimisation using particles size, zeta potential and entrapment efficiency as dependent variables. Further, selected batch was assessed for their morphology, in vitro release, interaction, haemocompatibility, histological (ex vivo skin permeation) and stability studies. Further, proceeded for in-vivo study, administered in BALB/c mice via nasal route to check the immunological activity and compared with single and multiple doses of ethosome to booster doses of alum-HBsAg vaccine. Immunological marker like immunoglobulin (IgG and IgA) and cytokines (interleukin-2 and interferon-Y) were measured by ELISA techniques. The prepared ethosome showed minimum particle size (93.98 ± 4.6), 15.0 ± 2.83 mV zeta potential, with maximum entrapment efficiency (66.25 ± 8.6%). Physicochemical characterisation reveal the sustained release, haemocampatibile, and stable nature of ethosome. Further, ex-vivo skin permeation showed safely administration of drug by nasal route without toxicity. The in vivo study, found the higher immunological response observed in BALB/c mice, compare to alum-HBsAg vaccine. The single dose of ethosome showed sufficient effective and measurable immunoglobulin and cytokines levels. A single dose of ethosome is sufficient for the complete immunological response not require booster administration. The potency of ethosomes have to produce a protective immune response, as well as their ability to explore and target the immunological environment through nasal route. [ABSTRACT FROM AUTHOR]

(1) Background: The double pelvic osteotomy (DPO) is a prophylactic surgical procedure associated with 0.4% incidence of sciatic nerve injury. The piezoelectric cutting tool is a surgical device able to involve only mineralized tissue avoiding neurovascular tissue and other soft tissue. This study aimed to evaluate the sciatic nerve injury observed in dogs underwent iliac osteotomy performed using the piezoelectric cutting tool. (2) Methods: Dogs underwent DPO performed with piezoelectric cutting tool were included. Neurological assessment was performed 6 and 24 h after surgery and then repeated 12 days, 4 and 8 weeks after surgery. Temporary and or permanent sciatic nerve injury were recorded. (3) Results: 84 DPOs performed in fifty dogs were included. No temporary/permanent neurological disease associated with iatrogenic damage of the sciatic nerve were observed. (4) Conclusions: The iliac osteotomy performed with piezoelectric cutting tool was not associated to iatrogenic sciatic nerve injury. [ABSTRACT FROM AUTHOR]

Common injectable anesthetics in cats are alpha-2 receptor agonists and tiletamine/zolazepam. Xylazine shows higher rate of side effects because its lower specificity to alpha-2 receptors than dexmeditomidine. However, the use of drug combinations in cats is not much known. Therefore, alternative anesthetic combination should be investigated. Here, we examined the use of tiletamine/zolazepam with two doses of dexmedetomidine in cats. A total of 24 female cats, weight 3.05 ± 0.10 kg (mean ± SEM). Cats were randomly blinded given intramuscularly injection (IM) with either of such drug combination, representing dosage of low dose dexmedetomidine 7.5 µg/kg with tiletamine/zolazepam 3 mg/kg; TD-Lo (n=8), high dose dexmedetomidine 15 µg/kg with tiletamine/zolazepam 3 mg/kg; TD-Hi (n=8), or xylazine 0.6 mg/kg with tiletamine/zolazepam 3 mg/kg; TX (n=8). After the IM injection, the sedative, analgesic, and cardiorespiratory effects and body temperature were assessed. All treatments showed clinically comparable induction effects resulting in spontaneous lateral/sternal recumbency and loss of paw withdrawal reflex within 7 minutes; TDLo (4.125 ± 0.74 min), TD-Hi (4.5 ± 0.32 min), and TX (4.12 ± 0.58 min). Notably, anesthesia time or the time from absent to regain of paw withdrawal reflex (Time LOPR to ROPR) was significantly higher in TD-Hi (52.75 ± 1.17 min) compared to TD-Lo (42.62 ± 2.51 min) and TX (41.12 ± 2.53 min); p<0.01. Likewise, a significant higher of time from IM to ROPR in TD-Hi (57.25 ± 1.29 min) were indicated vs in TD-Lo (46.75 ± 2.88 min; p<0.05), and vs in TX (45.25 ± 2.43 min; p<0.01). No vomiting or any adverse events were reported in all groups. TD-Lo, TD-Hi, and TX produced overall comparable cardiorespiratory effect with no significantly differences in all physiological values; heart rate (HR), respiratory rate (RR), body temperature (T), systolic arterial pressure (SAP), mean arterial pressure (MAP), diastolic arterial pressure (DAP), and tissue oxygen saturation (SpO2). TD supplied the effective anesthesia duration for ≥ 42 minutes, which can be fully reversed by atipamizole. [ABSTRACT FROM AUTHOR]

Two adult medium‐sized dogs presented with generalised tonic‐clonic seizures associated with meningiomas, one affecting the right parietal lobe and the other both frontal and olfactory lobes. Both underwent craniotomy and received multimodal anaesthetic protocols, including a peripheral nerve scalp block (frontal, zygomaticotemporal and major occipital nerves) based on a previous cadaveric study. For one dog, an intraoperative magnetic resonance imaging was performed; the bupivacaine block wore off after 280 minutes and was repeated with good effect before surgery resumed. The second dog had dexmedetomidine added to bupivacaine at the outset. The block lasted, as judged by pain assessment, at least 6 hours. We found that regional anaesthesia of the scalp was manageable to perform in a timely manner, showed good perioperative clinical effect and was likely prolonged by the addition of dexmedetomidine. [ABSTRACT FROM AUTHOR]

The beneficial effects of performing regional anaesthesia techniques as part of a pre‐emptive analgesic strategy are to improve perioperative analgesia and reduce opioid and general anaesthetic drug requirements. In prey species, an early recovery of voluntary motor function, especially after a regional anaesthesia, is essential for the animal's health and welfare. To reduce motor paralysis, a low volume and concentration of local anaesthetic should be administered close to the targeted nerve. This is the first report of an ultrasound (14 MHz linear probe)‐ and nerve stimulation (0.2 mA; 0.3 second; 2 Hz)‐guided saphenous and sciatic nerve blocks using bupivacaine (0.125%; 0.2 mL/kg per nerve) in a rabbit. Drug consumption, physiological response to surgery and postoperative pain scoring were used to determine block success. The ultrasound‐ and nerve stimulation‐guided sciatic and saphenous nerve blocks could be recommended as part of multimodal pain management in rabbits undergoing appropriate pelvic limb orthopaedic surgeries. [ABSTRACT FROM AUTHOR]

The present study is aimed to design ethosomes and transethosomes for topical administration of quercetin. To overcome quercetin low bioavailability, scarce solubility and poor permeability that hamper its pharmaceutical use, the drug was loaded in ethosomes and transethosomes based on different concentrations of phosphatidylcholine. Vesicle morphology was studied by cryogenic transmission electron microscopy, while size distribution and quercetin entrapment capacity were evaluated up to 3 months, respectively, by photon correlation spectroscopy and high-performance liquid chromatography. The antioxidant property was studied by photochemiluminescence test. Quercetin release and permeation was investigated in vitro, using Franz cells associated to different membranes. In vitro assays were conducted on human keratinocytes and melanoma cells to study the behavior of quercetin-loaded nano-vesicular forms with respect to cell migration and proliferation. The results evidenced that both phosphatidylcholine concentration and quercetin affected the vesicle size. Quercetin entrapment capacity, antioxidant activity and size stability were controlled using transethosomes produced by the highest amount of phosphatidylcholine. In vitro permeation studies revealed an enhancement of quercetin permeation in the case of transethosomes with respect to ethosomes. Notably, scratch wound and migration assays suggested the potential of quercetin loaded-transethosomes as adjuvant strategy for skin conditions. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effects of midazolam-ketamine alone or in combination with dexmedetomidine or tramadol in a constant rate infusion (CRI) on the minimum infusion rate (MIR) of propofol and the cardiorespiratory function in cats undergoing an ovariohysterectomy (OH). This was a prospective, randomised, blinded clinical study. Twenty-four healthy female mixed-breed cats were premedicated with ketamine and midazolam. Propofol was used for the induction and maintenance of the anaesthesia (starting at 18 mg/kg/h). Cats were assigned to groups (n = 8) to receive one of the following intravenous treatments: midazolam-ketamine group (MKG; ketamine 0.6 mg/kg/h); midazolam-ketamine-dexmedetomidine group [MKDG; ketamine 0.6 mg/kg/h and dexmedetomidine loading dose (LD) 1 mg/kg, CRI 1 mg/kg/h)] or midazolam-ketamine-tramadol group [MKTG; ketamine 0.6 mg/kg/h and tramadol (LD 2 mg/kg, CRI 1 mg/kg/h)]. During the OH, the propofol infusion was adjusted based on the clinical signs to maintain adequate anaesthetic depth. Selected variables were measured before (T0) and after (T1) the anaesthesia induction and during six surgical time points (T2–T7). The mean arterial pressure was higher and the heart rate was lower in MKDG at T1 (than in MKG and MKTG). The mean ± SD MIR of propofol were 17.4 ± 3.2, 15.0 ± 2.8 and 12.6 ± 3.5 mg/kg/h for MKG, MKTG, and MKDG, respectively. We conclude that, compared to midazolam-ketamine alone, midazolam-ketamine-tramadol and midazolam-ketamine- dexmedetomidine reduced the MRI of propofol by 13.8% and 27.5%, respectively, without significant changes in the selected indicators. [ABSTRACT FROM AUTHOR]

The objective of the present study was to compare between three anesthetic protocols for long-term anesthesia (2 h); protocol 1: xylazine (1mg/kg)/ketamine (10mg/kg) and inhalation of isoflurane in 100% of oxygenprotocol 2: xylazine (1mg/kg)/ketamine (10mg/kg) and propofol (24mg/kg/h) by CRI, and protocol 3: propofol (5mg/kg) and propofol (12mg/kg/h) by CRI. Three clinically healthy adult mongrel dogs of both sexes were used. Food and water were withheld for 12 and 6 h before induction of anesthesia, respectively. Intravenous catheter was placed in the cephalic vein. A wash-out period of 15 days was allowed between protocols. For all protocols (1, 2, and 3), physiological parameters were recorded using a patient monitor. Depth of anesthesia and muscle relaxation were determined by recording various reflexes. Times of first limb movement, regaining swallowing reflex and extubation, sternal recumbency, and standing were recorded. Quality of recovery was also recorded. Venous blood samples were collected into EDTA-containing Vacutainer tubes immediately before anesthesia, 10min after induction with ketamine/propofol, one hour and two h of anesthesia and after complete recovery for hematological analysis by using an automated machine. Data were recorded and expressed as mean ± SD and analyzed with commercial statistical software. Results revealed slight variations among animals of the three protocols in the physiological parameters. The quality and depth of anesthesia were excellent in dogs anesthetized with isoflurane and were good in dogs during propofol infusion. The duration of deep anesthesia during propofol infusion was shorter than isoflurane, with the shortest duration in protocol 3. There were variations among animals of the three protocols in the recovery parameters. The mean scores of the recovery quality were 4.3, 4.7, and 4 for protocols 1, 2, and 3, respectively, which sited between good and excellent scores of recoveries. Slight ataxia was recorded in a dog of protocol 1. However, ataxia and urination were recorded in dogs of protocols 1 and 2. In conclusion, the effect of isoflurane and propofol on physiological parameters of dogs during long-term anesthesia was minimum and recovery was uneventful. The quality and depth of anesthesia were excellent in dogs anesthetized with isoflurane and were good in dogs during propofol infusion. The duration of deep anesthesia during propofol infusion was shorter than isoflurane, with the shortest duration in protocol 3 (12mg/kg/h). Isoflurane provides more reliable and consistent anesthetic plane plus it's not expensive as propofol. However, it requires special equipment. Propofol achieved effective anesthesia, with fast induction and less hypothermia than isoflurane administration. Apnea was recorded in two dogs after initial induction with propofol. [ABSTRACT FROM AUTHOR]

Background: In Iran, the emergency departments (EDs) have largely adopted the emergency severity index (ESI) to prioritize the emergency patients, however emergency medical services (EMS) mainly triage the patients based on the paramedics' gestalt. The National Early Warning Score (NEWS) is a recommended prehospital triage in the UK. We aimed to compare prehospital NEWS and ED ESI for predicting severe outcomes in emergency patients.Methods: An observational study was conducted in a university-affiliated ED between January and April 2021. Adult patients who arrived in the ED by EMS were included. EMS providers calculated the patients' NEWS upon arriving on the scene using an Android NEWS application. In the ED, triage nurses utilized the ESI algorithm to prioritize patients with higher clinical risk. Then, Research nurses recorded patients' 30-day severe outcomes (death or ICU admission). Finally, The prognostic properties of ESI and NEWS were evaluated.Results: One thousand forty-eight cases were included in the final analysis, of which 29 (2.7%) patients experienced severe outcomes. The difference between the prehospital NEWS and ED ESI in predicting severe outcomes was not statistically significant (AUC = 0.825, 95% CI: 0.74-0.91 and 0.897, 95% CI, 0.83-0.95, for prehospital NEWS and ESI, respectively).Conclusion: Our findings indicated that prehospital NEWS compares favorably with ED ESI in predicting 30-day severe outcomes in emergency patients. [ABSTRACT FROM AUTHOR]

(1) Background: Theranostic approaches in the management of cholecystokinin subtype 2 receptor (CCK2R)-positive tumors include radiolabeled gastrin and CCK motifs. Moving toward antagonist-based CCK2R-radioligands instead, we herein present three analogs of the nonpeptidic CCK2R-antagonist Z360, GAS1/2/3. Each was conjugated to a different chelator (DOTA, NODAGA or DOTAGA) for labeling with medically relevant trivalent radiometals (e.g., Ga-68, In-111, Lu-177) for potential use as anti-CCK2R cancer agents; (2) Methods: The in vitro properties of the thee analogs were compared in stably transfected HEK293-CCK2R cells. Biodistribution profiles were compared in SCID mice bearing twin HEK293-CCK2R and wtHEK293 tumors; (3) Results: The GAS1/2/3 analogs displayed high CCK2R-affinity (lower nM-range). The radioligands were fairly stable in vivo and selectively targeted the HEK293-CCK2R, but not the CCK2R-negative wtHEK293 tumors in mice. Their overall pharmacokinetic profile was found strongly dependent on the radiometal-chelate. Results could be visualized by SPECT/CT for the [111In]In-analogs; (4) Conclusions: The present study highlighted the high impact of the radiometal-chelate on the end-pharmacokinetics of a new series of Z360-based radioligands, revealing candidates with promising properties for clinical translation. It also provided the impetus for the development of a new class of nonpeptidic radioligands for CCK2R-targeted theranostics of human cancer. [ABSTRACT FROM AUTHOR]

Background: In equine anaesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research. Risk factors, including age, type and duration of procedure or temperament may influence recovery quality. Unfortunately, the anaesthetist is unable to control for these factors, therefore various pharmacological interventions and recovery methods have been developed with the objective of improving recovery quality. However, no consensus among anaesthetists has been reached for many of these interventions and their implications for recovery‐related mortality and morbidity. Objectives: To conduct a systematic review of the published evidence relating to risk factors and interventions in the recovery period which may influence recovery quality from equine general anaesthesia (GA). Study design: A systematic evaluation of the equine veterinary literature using the GRADE framework. Methods: A literature search was performed and studies were assessed for eligibility by both authors utilising PRISMA guidelines. Studies meeting inclusion criteria were evaluated by both authors, categorically summarised and the quality of evidence for each sub‐topic was assessed using the GRADE framework. Results: Thirty‐nine studies were identified which directly assessed the impact of risk factors and recovery interventions on recovery quality after equine GA. There was evidence to support that peri‐anaesthetic risk factors such as anaesthesia duration, American Society of Anesthesiologists (ASA) physical status and surgical procedure influenced recovery quality. We also identified sufficient evidence that administration of α‐2 adrenoreceptor agonists immediately prior to recovery, improves recovery quality. Main limitations: The validity of the results of some studies may have been compromised by missing data and small sample sizes. Conclusions: Recovery quality is influenced by factors including: anaesthesia duration, ASA physical status and surgical procedure. Recovery quality can be improved by the administration of an α‐2 adrenoreceptor agonist immediately prior to recovery. [ABSTRACT FROM AUTHOR]

A 4‐year 9‐month‐old beagle was presented for a 2‐week history of acute onset of lowered tail carriage and faecal incontinence. Neurological examination was unremarkable except for an absent perineal reflex, there was no history of trauma. Blood work was unremarkable. Lumbosacral and coccygeal CT pre‐ and post‐intravenous contrast revealed a large sacrococcygeal disc extrusion with mineralised material extending from the level of S2 and to midbody of Cd1. A dorsal laminectomy was performed from the cranial margin of S2 to the caudal margin of Cd1. A large volume of mineralised disc material was removed. The material was confirmed on histopathology to be consistent with extruded nucleus pulposus. The patient regained faecal continence within 3 days of hospital discharge. Based on a literature search this is the first report of a sacrococcygeal disc extrusion resulting in faecal incontinence, with successful surgical management. [ABSTRACT FROM AUTHOR]

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Biofilm formation by Propionibacterium acnes is known to cause failure of anti-acne treatment. Conventional therapies for acne are typically inadequate. Accordingly, in this study, we evaluated the therapeutic potential of photodynamic therapy (PDT) using hexyl-aminolevulinate (HAL)-loaded ethosomes (ESs) against the biofilms of P. acnes in vitro and P. acnes–induced inflammatory acne model in vivo. The antibacterial effects of HAL ESs were evaluated using XTT colorimetric assays and scanning electron microscopic observations of morphological changes. P. acnes was intradermally injected into the ears of Sprague-Dawley rats, and the anti-inflammatory effects of HAL ESs were measured by determining changes in appearance, histology, and the antibacterial effects by P. acnes abundance in ear tissues compared with blank control ESs, HAL alone, and 5-aminolevulinic acid (ALA) alone. The highest reduction in viability in P. acnes biofilms was observed after treatment with 5 mg/mL HAL ESs. Notably, blank control ESs also showed significant inhibitory effects. Furthermore, HAL ESs had superior therapeutic effects in the rat model compared with HAL or ALA solutions. The observed therapeutic effects of HAL ESs against P. acnes biofilms and P. acnes–induced inflammation suggest that PDT with HAL-loaded ESs may have potential applications in the treatment of acne. [ABSTRACT FROM AUTHOR]

This study aimed to compare acute phase proteins in cats undergoing ovariohysterectomy (OHE) by median celiotomy or left flank laparotomy approach. Nineteen native intact queens were used. Cats were randomly divided into four groups for midline (Test, n=5 and control, n=5) and left flank (Test, n=5 and control, n=4) ovariohysterectomy. Blood samples were taken immediately before surgery, 24, 48, 72 hours, and 7 days after surgery for assessment of Alpha-1-acid glycoprotein (AGP), total protein, and albumin values. According to the results, standard and left flank OHE approaches increased AGP levels, but no significant difference was observed compared to the control group (p > 0.05). No significant difference was observed on serum total protein and albumin levels using standard and left flank OHE approaches compared to the control group (p > 0.05). The results suggested two surgical procedures had the same effect on acute-phase proteins in ovariohysterectomized cats. [ABSTRACT FROM AUTHOR]

Case summary: An 8.75-year-old male neutered Burmese cat was referred for treatment of pyothorax. The cat was responsive, cardiovascularly stable and tachypnoeic (40 breaths/min) on arrival. Medical management of pyothorax was initiated, bilateral thoracic drains were placed and thoracic lavage using aliquots of saline 0.9% was performed every 4 h. Regional analgesia was provided using 1 mg/kg of intrapleural bupivacaine divided equally between the left and right hemithoraxes every 6 h. On the second day of hospitalisation, the cat developed hypersalivation, mydriasis and tonic–clonic seizure activity 25 mins after accidental intrapleural administration of a 10 mg/kg bupivacaine overdose. Cardiovascular compromise was also noted; the cat became bradycardic (120 beats/min) and blood pressure decreased to 110 mmHg. Clinical signs resolved after administration of intravenous lipid emulsion (ILE) as an intravenous (IV) bolus (1.5 ml/kg over 5 mins), followed by a continuous rate infusion (0.25 ml/kg/min over 25 mins). Local anaesthetic intrapleural anaesthesia was discontinued. There was recrudescence of clinical signs 10 h post-overdose and repeat ILE 20% infusion was required. The cat was discharged with no ongoing complications. Relevance and novel information: Treatment of IV local anaesthetic systemic toxicity with ILE has been reported in cats. To our knowledge, this is the first reported case of intrapleural bupivacaine overdose with initial response and resolution of clinical signs followed by recrudescence and subsequent successful treatment using ILE. [ABSTRACT FROM AUTHOR]

A 2‐year‐old female intact huacaya alpaca weighing 66.6 kg presented for the removal of a bone sequestrum from the distal femur. Nerve stimulator‐guided femoral and sciatic nerve blocks were applied to provide analgesia for distal femoral surgery. The blocks were simple to perform using existing equipment and current techniques translated from small animals. The techniques reported here for both femoral and sciatic nerve blocks in an alpaca can be used as an alternative to an ultrasound‐guided approach, especially in field situations where additional expensive equipment may not be available or desirable. [ABSTRACT FROM AUTHOR]

An 11‐year‐old, 22 kg, male neutered English Staffordshire Bull Terrier, in which a pheochromocytoma was removed from the left retroperitoneal space, was referred to investigate the regrowth of a mass in the same region. A neuroendocrine tumour, compatible with pheochromocytoma, was cytologically diagnosed after ultrasound‐guided fine‐needle aspirates, and the dog underwent explorative celiotomy. A combination of thoracic epidural anaesthesia, dexmedetomidine and magnesium sulphate infusion was used intraoperatively to control nociception and potential haemodynamic changes caused by sudden catecholamines release. Postoperative analgesia was provided by administering 0.12% levobupivacaine through the thoracic epidural catheter and oral paracetamol and gabapentin. Postoperative methadone was administered twice during the first 24 postoperative hours only. Two days after the surgery, the dog was anaemic and packed red blood cells were administered. No other complications occurred, and the dog was discharged from the hospital 5 days following surgery. [ABSTRACT FROM AUTHOR]

The paper presents the distribution of natural radionuclides in soils with various clay minerals of Davanagere district. The activity concentration of natural radionuclides in soil were measured using NaI(TI) gamma spectrometry and the minerals present in the soils were identified using Fourier–transform infrared spectroscopy. The normality of the frequency distribution curve of 226Ra, 232Th and 40K concentration was verified using Kolmogorov–Smirnov test. The major trace minerals observed in the soils were determined based on the intensity of corresponding peaks. The soil with clay minerals Quartz and Hematite showed higher radionuclide content. [ABSTRACT FROM AUTHOR]

Tramadol (TR) is an analgesic drug used to treat moderate-to-severe pain but it induces seizure even at therapeutic doses. The exact mechanism of TR-inducing seizure is not clear but inhibition of the serotonin, GABA, and nitrous oxide (NOS) pathways are the commonly proposed mechanisms. Adenosinergic system has a crucial function in the modulation of seizure. Also, oxidative damage is an unavoidable effect of the seizure. This study was conducted to evaluate the role of the adenosinergic system on the seizure and oxidative stress biomarkers induced by TR using antagonist of the adenosinergic receptors in the Albino mice. For that purpose, generated clonic seizure, as seizure threshold, was evaluated by TR. Caffeine (CAF; 8 mg/kg, i.p.), a nonselective antagonist of adenosine receptors, was administered 1 hour before the seizure induction. The seizure threshold significantly increased by CAF-treated group when compared to TR group (p < 0.001). Oxidative stress biomarkers such as reactive oxygen species, protein carbonyl content, and lipid peroxidation significantly decreased and glutathione content significantly increased by CAF in brain mitochondria compared to the TR group, whereas oxidative biomarkers significantly increased in the TR group compared to the control group. The results of the present study suggested that the adenosinergic system is involved in seizure induced by TR and meanwhile, inhibition of adenosine receptors can decrease the TR seizure threshold and also decrease the induced oxidative damage in the brain mitochondria. [ABSTRACT FROM AUTHOR]

Background: Flumazenil antagonises the actions of benzodiazepines. There has been no prior research specifically investigating this anaesthetic reversal agent for horses. Objectives: To determine the effects of flumazenil administration in horses on (a) ventilatory parameters after midazolam‐ketamine induction and maintenance with isoflurane in oxygen and on (b) the characteristics of recovery from general anaesthesia. Study design: Blinded, randomised, crossover experiment. Methods: Six horses were randomly assigned to receive high‐dose flumazenil (Fhigh, 20 µg/kg), low‐dose flumazenil (Flow, 10 µg/kg) and saline (control). Cardioventilatory parameters were monitored. After 90 minutes of isoflurane anaesthesia, a bolus of Fhigh, Flow or saline was administered i.v. The horses were recovered using head and tail rope assistance. The times to first movement, to achievement of sternal recumbency, to the first attempt to stand and the total recovery time were determined. The recovery quality was evaluated using a 115‐point recovery scoring system. The cardioventilatory parameters and recovery times were analysed using mixed‐effects regression analyses. Intraclass correlation (ICC) analysis was used to evaluate the recovery scores. A Mann‐Whitney U test assessed the relationship between recovery score and flumazenil administration. Results: A significant difference with flumazenil administration was found for SpO2, mean arterial pressure, I:E ratio, minute volume of ventilation (MV) and peak inspiratory pressure. There was a significant difference with flumazenil administration for the time to sternal recumbency, the time to the first attempt to rise and the total recovery time. There was no significant difference in total recovery score with flumazenil administration. Main limitations: Plasma levels of midazolam and flumazenil were not obtained. Conclusions: Flumazenil has a dose‐dependent effect on MV and recovery time, which may make it useful in cases for which a prolonged anaesthetic recovery is undesirable. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the effect of intramuscular (IM) administration of xylazine- ketamine -nalbuphine compared to xylazine-ketamine combination in cats subjected to median Celiotomy. Six clinically healthy adult castrated male cats (aged between 1-2 years and body weight about 1.8 to 2.6 kg) were randomly allocated into two groups; anesthesia was IM induced with xylazine-ketamine-nalbuphine combination (XKN group; n = 3), and xylazine-ketamine alone (XK group; n = 3). Following induction, cats underwent ventral median Celiotomy. Basic physiological parameters, analgesic and sedative scores were recorded at 5, 10, 15, 20, 30, 60, 90, and 120 min postoperatively (PO). Post-operative pain-related behaviors were also assessed. The XKN group showed shorter times to lateral and sternal recumbency and longer times to first head lift and standing position than XK group (P ≤ 0.05). Sedation score revealed a significant (P ≤ 0.05) difference between both groups at 20, 30, 60 and 120 min PO. Cats in the XKN group exhibited lower post-operative pain -related behavior than those in the XK. Nalbuphine improves sedation and postoperative analgesia of xylazineketamine combination in cats. [ABSTRACT FROM AUTHOR]

Background: Pain thresholds may differ between animal species. It may even vary among individuals of the same species. Therefore, assessing pain in animals is challenging. Aims: The objective of the present study was to compare the analgesic effects of tramadol with morphine. Methods: The study was carried out on randomly selected 20 dogs with tumors in different breeds and gender. After induction of anesthesia with propofol, dogs were intubated, and anesthesia was maintained with sevoflurane. Intravenous fentanyl citrate was used for intraoperative analgesia after stabilization of the anesthesia. When the tumors were surgically removed and the operation was completed, dogs were divided into two groups to give the postoperative analgesic agent. The first 10 dogs to be investigated were identified as the morphine group and the second 10 dogs as the tramadol group. Postoperative pain scores, heart rates, respiratory rates, and body temperatures were recorded at 0, 4, 8, 12, 16, 20, and 24 hours after the operation. Results: Pain scores were lower in the morphine group than in the tramadol group during all postoperative processes. Conclusion: As a result, it was determined that tramadol has immediate analgesic effects than morphine; however, morphine provides better analgesia than tramadol. [ABSTRACT FROM AUTHOR]

In this article, dexmedetomidine (Dex) was used to prevent neurological disorders in patients anesthetized with sevoflurane and the effect was analyzed using ultrasound images based on the restoration algorithm of the linear system model. Children injected with Dex were in the experimental group, while children injected with normal saline were in the control group. The mean arterial pressure (MAP), arterial oxygen saturation (SpO2), heart rate (HR), Pediatric anesthesia agitation scale (PAED) score, Face, Legs, Activity, Cry, Consolability (FLACC) score, and adverse drug event (ADE) in the two groups were compared before the injection (T1), at 5 min (T2), 10 min (T3), and 20 min (T4) after the injection, and when the patient came to himself (T5). It was found that in contrast with the control group, the MAP in the experimental group at T2, T3, and T4 periods was lower, while it was higher at T5 period and its HR at T2, T3, T4, and T5 periods was higher (P < 0.05); the PAED and FLACC scores were lower (P < 0.05), and the incidence of ADE (10.53%) was lower than that in the control group (31.58%) (P < 0.05). However, SpO2 at different periods showed no obvious differences between the two groups (P > 0.05). In conclusion, the restoration algorithm-based ultrasound images had high quality, and they demonstrated good application value in evaluating the effect of Dex to prevent neurological disorders in patients anesthetized by sevoflurane. [ABSTRACT FROM AUTHOR]

Opioids are considered the gold standard to manage acute or chronic or mild to severe pain. Tramadol is a widely prescribed analgesic drug for dogs and cats; it has a synthetic partial agonism on µ-opioid receptors and inhibits the reuptake of norepinephrine and serotonin. However, the biotransformation and resultant metabolites differ between species and depend on cytochrome P450 interactions. Dogs mainly produce the inactive N-desmethyl tramadol metabolite, whereas cats exhibit an improved antinociceptive effect owing to rapid active O-desmethyltramadol metabolite production and a longer elimination half-life. Tapentadol, a novel opioid with dual action on µ-receptors and noradrenaline reuptake inhibitory activity, is a promising option in dogs, as it is less reliant on metabolic activation and is unaffected by cytochrome polymorphisms. Although scientific evidence on the analgesic activity of tapentadol in both species remains limited, experimental studies indicate potential benefits in animals. This review summarizes and compares the pharmacology, pharmacokinetics, and therapeutic efficacy of tramadol and tapentadol in dogs and cats with different pain conditions. According to the available data, tramadol seems a more suitable therapeutic option for cats and should preferably be used as a component of multimodal analgesia in both species, particularly dogs. Tapentadol might possess a superior analgesic profile in small animals, but additional studies are required to comprehensively evaluate the activity of this opioid to manage pain in dogs and cats. [ABSTRACT FROM AUTHOR]

A cockerel (Gallus gallus domesticus) was presented for lameness investigation. A CT scan of the left leg and a bone marrow biopsy were planned. Both procedures were performed under general anaesthesia and, before the biopsy was performed, a sciatic nerve block was achieved with levobupivacaine 0.5% (0.75 mg/kg), aided by an electrical nerve locator. The nerve was located through a lateral approach, with a motor response to stimulation similar to that described in mammals. The efficacy of the block was assessed as satisfactory during the procedure. Postoperatively, the pain was subjectively assessed, but no pain scales were employed, as none are validated for birds. No iatrogenic complications occurred; therefore, this nerve block could be considered as a part of a multimodal approach to perioperative pain management. [ABSTRACT FROM AUTHOR]

To evaluate the use of ketamine-medetomidine-midazolam total intravenous infusion as part of a balanced anaesthetic technique for surgical castration in horses. Five healthy Standardbred cross colts were premedicated with IV acepromazine (0.01-0.02 mg/kg), medetomidine (7 μg/kg) and methadone (0.1 mg/kg) and anaesthesia induced with IV ketamine (2.2 mg/kg) and midazolam (0.06 mg/kg). Horses were anaesthetised for 40 min with an IV infusion of ketamine (3 mg/kg/h), medetomidine (5 μg/kg/h) and midazolam (0.1 mg/kg/h) while routine surgical castration was performed. Cardiorespiratory variables, arterial blood gases, and anaesthetic depth were assessed at 5 to 10 min intervals. Post-anaesthesia recovery times were recorded, and the quality of the recovery period was assessed. The anaesthetic period and surgical conditions were acceptable with good muscle relaxation and no additional anaesthetic required. The median (range) time from cessation of the infusion to endotracheal tube extubation, head lift and sternal recumbency were 17.2 (7-35) min, 25 (18.9-53) min and 28.1 (23-54) min, respectively. The quality of anaesthetic recovery was good, with horses standing 31.9 (28-61) min after the infusion was ceased. During anaesthesia, physiological variables, presented as a range of median values for each time point were: heart rate 37-44 beats/min, mean arterial pressure 107-119 mmHg, respiratory rate 6-13 breaths/min, arterial partial pressure of oxygen 88-126 mmHg, arterial partial pressure of carbon dioxide 52-57 mmHg and pH 7.36-7.39. In conclusion, the co-administration of midazolam, ketamine and medetomidine as in IV infusion, when used as part of a balanced anaesthetic technique, was suitable for short term anaesthesia in horses undergoing castration. [ABSTRACT FROM AUTHOR]

Case series summary: The erector spinae plane (ESP) block consists of an interfascial injection of local anaesthetic between the erector spinae muscle group and the transverse processes of the thoracic vertebrae. This block targets the dorsal rami of the thoracic spinal nerves to desensitise the cutaneous area near the dorsal midline, the paraspinal muscles, the dorsal vertebral laminae and the facet joints. The purpose of this case series is to describe the perioperative analgesic effect and complications of ultrasound-guided ESP block with bupivacaine in three cats undergoing spinal surgery. Only one cardiovascular response was recorded in this case series. Just one cat received intraoperative rescue analgesia. Cats 1 and 2 recorded just one high pain score in the first 24 h postoperatively, and cat 3 recorded three high pain scores. The total amount of methadone given in the 24 h postoperatively was 0.6 mg/kg in cat 1, 0.9 mg/kg in cat 2 and 0.8 mg/kg in cat 3. All three cats suffered mild and transient intraoperative complications, which were easily addressed. There were no postoperative complications. Relevance and novel information: This case series documents a novel locoregional anaesthesia technique as an alternative to traditional systemic analgesia. The technique is part of a multimodal analgesia approach for spinal surgery in cats. Perioperative analgesic effect and complications presented in this case series are evaluated and discussed. [ABSTRACT FROM AUTHOR]

Tanshinone (TAN), a class of bioactive components in traditional Chinese medicinal plant Salvia miltiorrhiza, has antibacterial and anti-inflammatory effects, can enhance blood circulation, remove blood stasis, and promote wound healing. For these reasons it has been developed as a drug to treat acne. The purpose of this study was to evaluate the therapeutic effects of TAN in rats with oleic acid-induced acne and to explore its possible mechanisms of action through the identification of potential lipid biomarkers. In this study, a rat model of acne was established by applying 0.5 ml of 80% oleic acid to rats' back skin. The potential metabolites and targets involved in the anti-acne effects of TAN were predicted using lipidomics. The results indicate that TAN has therapeutic efficacy for acne, as supported by the results of the histological analyses and biochemical index assays for interleukin (IL)-8, IL-6, IL-β and tumor necrosis factor alpha. The orthogonal projection of latent structure discriminant analysis score was used to analyze the lipidomic profiles between control and acne rats. Ninety-six potential biomarkers were identified in the skin samples of the acne rats. These biomarkers were mainly related to glycerophospholipid and sphingolipid metabolism, and the regulation of their dysfunction is thought to be a possible therapeutic mechanism of action of TAN on acne. [ABSTRACT FROM AUTHOR]

A dog with a large abdominal mass underwent coeliotomy. Before surgery, the dog was anaemic, hypoalbuminaemic and had a grade III out of VI left sided holosystolic heart murmur; no signs related to heart failure were detected on thoracic radiographs. After intramuscular administration of methadone, anaesthesia was induced intravenously (IV) with fentanyl and propofol and maintained with isoflurane in oxygen. Lungs were mechanically ventilated using a volume‐controlled setting. To manage ventilation asynchrony, atracurium was administered IV. Concurrent hypotension did not respond to lowering the isoflurane concentration, crystalloid and colloid boluses administration, and dobutamine infusion. Surgery lasted 40 minutes, and the mass was easily removed. At end of surgery, neostigmine was administered IV slowly, and a progressive improvement of arterial blood pressure was recorded. The animal was then allowed to breathe spontaneously, and isoflurane was discontinued. Recovery from general anaesthesia was uneventful. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of national early warning scoring system (NEWS) implementation in identifying patients at risk of clinical deterioration at an emergency hospital. Background: Early warning score has been developed to facilitate early detection of deterioration by categorizing a patients' severity of illness and prompting nursing staff to request a medical review at specific trigger points. Patients and Methods: A prospective, control/intervention groups', quasi-experimental design was utilized. A sample of 364 adult patients were admitted to the inpatient unit at an emergency hospital for six months. The patients were divided into a study group (174 patients) and a control group (190 patients). All study patients were followed up to either death or hospital discharge before and after implementing a new observation chart. The patients' outcomes were compared and analyzed between both groups. Results: In the intervention period, compared to the control period, a significant reduction was seen in the number of cardiopulmonary arrest (4.7% vs 1.1%, p = 0.046), unplanned ICU admission (5.3% vs 1.7%, p = 0.049), emergency surgery (6.3% vs 0%, p = 0.001), acute kidney injury (6.8% vs 1.1%, p = 0.006). As well, there was a significant increase in the number of patients receiving medical reviews following clinical deterioration in terms of escalation plan (3.2% vs 26.4%, p = < 0.001). Conclusion: The implementation of NEWS was associated with a significant improvement in patients' outcomes in hospital wards, increases in the frequency of vital signs measurements, and an increase in the number of medical reviews following clinical instability. [ABSTRACT FROM AUTHOR]