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Facial expressions are essential in animal communication, and facial expression-based pain scales have been developed for different species. Automated pain recognition offers a valid alternative to manual annotation with growing evidence across species. This study applied machine learning (ML) methods, using a pre-trained VGG-16 base and a Support Vector Machine classifier to automate pain recognition in caprine patients in hospital settings, evaluating different frame extraction rates and validation techniques. The study included goats of different breed, age, sex, and varying medical conditions presented to the University of Florida's Large Animal Hospital. Painful status was determined using the UNESP-Botucatu Goat Acute Pain Scale. The final dataset comprised images from 40 goats (20 painful, 20 non-painful), with 2,253 'non-painful' and 3,154 'painful' images at 1 frame per second (FPS) extraction rate and 7,630 'non-painful' and 9,071 'painful' images at 3 FPS. Images were used to train deep learning-based models with different approaches. The model input was raw images, and pain presence was the target attribute (model output). For the single train-test split and 5-fold cross-validation, the models achieved approximately 80% accuracy, while the subject-wise 10-fold cross-validation showed mean accuracies above 60%. These findings suggest ML's potential in goat pain assessment., (© 2024. The Author(s).)

Objective: To evaluate the feasibility of an ultrasound-guided technique targeting the medial branches of the dorsal ramus of the spinal nerves (DRSN) by injecting a dye solution at the caudal aspect of the base of lumbar mammillary processes [i.e. the retromammillary (RM) space]., Study Design: Feasibility, descriptive, anatomical study., Animals: Eleven canine cadavers., Methods: Using anatomical dissections, the relationship between the mammillary processes and the branches of the DRSN of the thoracolumbar and lumbar spine was studied in two cadavers. Subsequently, ultrasound-guided RM injections were administered in nine cadavers, randomly assigned to low volume (LV; 0.01 mL kg -1 ) of a dye solution at multiple points from L3 to L6 on one side, and high volume (HV; 0.4 mL kg -1 ) at a single L4 point on the contralateral side. Gross anatomical dissections were immediately performed after the injections. The RM injections were feasible if ultrasonographic landmarks were identifiable in at least 80% of cases, and 80% of LV injections showed medial branch staining. A one-sample binomial test was used for testing feasibility., Results: The medial branches emerged shortly after the DRSN exited the intervertebral foramen and traveled towards the caudal aspect of the base of the mammillary process, which served as the target injection point. With LV, 36 out of 36 (100%) injected medial branches were stained, meeting the criteria of feasibility (p < 0.001). The median (range) number of stained medial branches per cadaver were 4 (4-4) and 2 (1-3), with LV and HV, respectively. Although no lateral branches were stained with LV, 1 (0-2) was stained with HV. Neither ventral branch staining nor epidural spread was noted in any cadaver., Conclusions and Clinical Relevance: Ultrasound-guided RM injections are feasible and allow for selective staining of the medial branch of the DRSN in canine cadavers at the lumbar spine., (Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To compare perioperative opioid consumption in dogs undergoing pelvic limb surgeries and receiving a lumbosacral plexus block by combining a lumbar [lateral pre-iliac (LPI)] block with a lumbosacral trunk [i.e. parasacral (PS group) or greater ischiatic notch plane (GIN group)] block. Study design Retrospective, descriptive, exploratory, noninferiority cohort study., Methods: Medical records of 37 client-owned dogs were analyzed. Intraoperative (primary outcome) and postoperative (24 hours) opioid use, 24 hour cumulative pain scores and prevalence of complications were compared between the two groups. Opioid use was quantified in morphine equivalents (ME, mg kg -1 ). The noninferiority limit for intraoperative opioid consumption was set at 0.05 ME kg -1 hour -1 . Demographic data, procedure duration, surgery type and perioperative dexmedetomidine and ketamine use were also collected. A t-test or Wilcoxon rank-sum test, a Fisher's exact test and multivariable linear regression were used. Significance was set at p < 0.05., Results: The GIN and PS groups comprised 17 and 20 dogs, respectively. Total intraoperative ME consumption was 0.17 (0.11-0.21) and 0.22 (0.16-0.30) mg kg -1 hour -1 for the GIN and PS groups, respectively (p = 0.077). The noninferiority analysis adjusted by surgery type and body mass revealed that the mean difference between the groups (GIN - PS) was -0.039 (95% CI -0.11-0.03, p = 0.247) ME mg kg -1 hour -1 , indicating that the GIN group was not inferior to the PS group regarding intraoperative ME consumption. Dexmedetomidine and ketamine use, postoperative ME consumption and pain scores were similar between groups., Conclusions and Clinical Relevance: This retrospective study and preliminary observations support the clinical use of the GIN plane block, demonstrating its noninferiority to the PS block when combined with the LPI block for multimodal perioperative analgesia in dogs undergoing pelvic limb surgeries., (Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

In recent years, integrated data analysis has proven to be a valuable method for investigating complex systems, whether artificial or natural. The integrated analytical approach allows the simultaneous integration of data acquired from different analytical techniques employed for the same sample at the same time, leading to an expansion of the amount of information available. Surface tensiometry is a technique that was recently introduced in the Integrated Analytical Approach for investigating pharmaceutical dosage forms for topical application. Therefore, studies of rheological characterization, release, and skin permeation can be integrated with surface tensiometry measurements to develop chemical and rheological-surface correlation models, providing a new method for the quality control and process control of semisolid preparations. In this context, the aim of this research is to validate the utility of surface tensiometry measurements in the Integrated Analytical Approach and utilize these data to gain insights into the structure-surface correlation. The preparations chosen for this study were a PEG-gel, a lipogel, and an O/W cream containing carnitine as a model drug. The formulations were characterized using rheological measurements and evaluated for their carnitine release performance. Furthermore, surface tensiometry measurements were performed to rapidly and noninvasively assess the influence of carnitine on the surface properties of the semisolid preparations investigated. Our work demonstrated a close correlation between surface energy and structural data, showing the importance of surface tensiometry contribution in the noninvasive and rapid evaluation of the presence of carnitine in semisolid formulations.

The cholecystokinin type 2 receptor (CCK2-R) represents an ideal target for cancer therapy since it is overexpressed in several tumors and is associated with poor prognosis. Nastorazepide (Z-360), a selective CCK2-R antagonist, has been widely investigated as a CCK2-R ligand for targeted therapy; however, its high hydrophobicity may represent a limit to cell selectivity and optimal in vivo biodistribution. Here, we present three new fluorescent Z-360 derivatives ( IP-002 G -Rho, IP-002 L -Rho, and IP-002 M -Rho ) in which nastorazepide was linked, through spacers bearing different saccharides (glucose (G), lactose (L), and maltotriose (M)), to sulforhodamine B. A fourth compound ( IP-002 H -Rho ) with no pendant sugar was also synthesized as a control. Through two-dimensional (2D) and three-dimensional (3D) in vitro studies, we evaluated the compound association with and selectivity for CCK2-R-overexpressing cells (A431-CCK2-R + ) vs CCK2-R-underexpressing cells (A431 WT). 2D in vitro studies highlighted a progressive increase of IP-002 x -Rho association with A431-CCK2-R + cells according to the linker hydrophilicity, that is, maltotriose > lactose > glucose > hydrogen, with IP-002 M -Rho showing a 2.4- and a 1.36-fold higher uptake than IP-002 G -Rho and IP-002 L -Rho , respectively. Unexpectedly, IP-002 H -Rho showed a similar cell association to that of IP-002 L -Rho but with no difference between the two tested cell lines. On the contrary, association with A431-CCK2-R + cells as compared to the A431 WT was found to be 1.08-, 1.14-, and 1.37-fold higher for IP-002 G -Rho , IP-002 L -Rho , and IP-002 M -Rho , respectively, proving IP-002 M -Rho to be the best-performing compound, as also confirmed by competition studies. Trafficking studies on A431-CCK2-R + cells incubated with IP-002 M -Rho suggested the coexistence of receptor-mediated endocytosis and simple diffusion. On the contrary, a high and selective uptake of IP-002 M -Rho by A431-CCK2-R + cells only was observed on 3D scaffolds embedded with cells, underlining the importance of 3D models in in vitro preliminary evaluation.

Background: Transdermal delivery of highly lipophilic molecules is challenging due to the strong barrier function of the skin. Vesicles with penetration enhancers are safe and efficient systems that could improve the transdermal delivery of non-psychoactive cannabinoids such as cannabidiol and desoxy-cannabidiol. In the last decades, research interest in desoxy-cannabidiol as a potent drug with anti-nociceptive properties has risen. Still, its scarce market availability poses a limit for both research and clinical applications. Therefore, it is necessary to improve the synthesis to produce sufficient amounts of desoxy-cannabidiol. Moreover, also the formulation aspects for this drug are challenging and require to be addressed to meet an efficient delivery to the patients., Objective: This work aimed to develop innovative phospholipid-based vesicles with propylene glycol (PG), oleic acid (OA), or limonene as edge activators, for the transdermal delivery of highly lipophilic drugs such as non-psychoactive cannabinoids. In particular, desoxy-cannabidiol was selected thanks to its anti-nociceptive activity, and its synthesis was improved enhancing the stereoselectivity of its synthon's production., Methods: Desoxy-cannabidiol was synthesized by Lewis acid-mediated condensation of p-mentha-2,8-dien- 1-ol and m-pentylphenol, improving the stereoselectivity of the first synthon's production. Transethosomes containing 20-50% w/w PG, 0.4-0.8% w/w OA, or 0.1-1% w/w limonene were optimized and loaded with cannabidiol or desoxy-cannabidiol (0.07-0.8% w/w, 0.6-7.0 mg/mL). Ex-vivo studies were performed to assess both the skin permeation and accumulation of the cannabinoids, as well as the penetration depth of fluorescein- loaded systems used as models., Results: An enantioselective bromination was added to the pathway, thus raising the production yield of pmentha- 2,8-dien-1-ol to 81% against 35%, and the overall yield of desoxy-cannabidiol synthesis from 12% to 48%. Optimized transethosomes containing 0.6 mg/mL cannabinoids were prepared with 1:10 PG:lipid weight ratio, 0.54 OA:lipid molar ratio, and 0.3 limonene:lipid molar ratio, showing good nanometric size (208 ± 20.8 nm - 321 ± 26.3 nm) and entrapment efficiency (> 80%). Ex-vivo tests showed both improved skin permeation rates of cannabinoids (up to 21.32 ± 4.27 μg/cm2 cannabidiol), and skin penetration (depth of fluorescein up to 240 μm, with PG)., Conclusion: Desoxy-cannabidiol was successfully produced at high yields, and formulated into transethosomes optimized for transdermal delivery. Loaded vesicles showed improved skin penetration of desoxy-cannabidiol, cannabidiol and a lipophilic probe. These results suggest the potential of these carriers for the transdermal delivery of highly lipophilic drugs., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: To compare the analgesic effect of a bilateral ultrasound-guided erector spinae plane block (ESPB) in dogs undergoing hemilaminectomy using either a low-volume high-concentration (LV-HC) or a high-volume low-concentration (HV-LC) local anaesthetic solution., Study Design: Retrospective observational equivalence trial., Animals: A total of 391 client-owned dogs undergoing hemilaminectomy., Methods: Dogs were assigned to group LV-HC or HV-LC depending on whether 0.2-0.25% levobupivacaine (0.4-0.5 mL kg -1 ) or 0.125-0.15% levobupivacaine (0.8-1 mL kg -1 ) was used to perform the ESPB, respectively. The number of dogs in which intraoperative rescue fentanyl boluses were administered, the total dose of fentanyl administered, the overall methadone consumption during the first 24 hours postoperatively and anaesthetic complications were recorded. Univariate and multivariate statistical analyses were performed considering p < 0.05 significant., Results: A total of 248 and 143 dogs were assigned to groups LV-HC and HV-LC, respectively. In group HV-LC, the number of dogs requiring fentanyl intraoperatively (64.3%) was higher (p = 0.0001) than that in group LV-HC (43.5%). The overall intraoperative fentanyl consumption was higher in group HV-LC between the first skin incision and the end of the lamina drilling (p = 0.028). According to the regression analysis, the group allocation was the best variable to predict the intraoperative fentanyl consumption (p < 0.001). Antimuscarinic drugs were administered more frequently in group LV-HC (p < 0.02). However, the prevalence of hypotension and other pharmacological cardiovascular interventions did not differ between groups. No differences in methadone consumption during the first 24 hours postoperatively were found between the groups., Conclusionsand Clinical Relevance: When performing a bilateral ESPB in dogs undergoing hemilaminectomy, compared with HV-LC, the use of LV-HC local anaesthetic solution reduces the intraoperative fentanyl consumption without affecting the postoperative methadone requirement., (Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

The aim of the present study consists of the evaluation of the biodistribution of a novel 68 Ga-labeled radiopharmaceutical, [ 68 Ga]Ga-NODAGA-Z360, injected into Balb/c nude mice through histopathological analysis on bioptic samples and radiomics analysis of positron emission tomography/computed tomography (PET/CT) images. The 68 Ga-labeled radiopharmaceutical was designed to specifically bind to the cholecystokinin receptor (CCK2R). This receptor, naturally present in healthy tissues such as the stomach, is a biomarker for numerous tumors when overexpressed. In this experiment, Balb/c nude mice were xenografted with a human epidermoid carcinoma A431 cell line (A431 WT) and overexpressing CCK2R (A431 CCK2R+), while controls received a wild-type cell line. PET images were processed, segmented after atlas-based co-registration and, consequently, 112 radiomics features were extracted for each investigated organ / tissue. To confirm the histopathology at the tissue level and correlate it with the degree of PET uptake, the studies were supported by digital pathology. As a result of the analyses, the differences in radiomics features in different body districts confirmed the correct targeting of the radiopharmaceutical. In preclinical imaging, the methodology confirms the importance of a decision-support system based on artificial intelligence algorithms for the assessment of radiopharmaceutical biodistribution.

This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic‐pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio‐respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of intravenous (IV) fentanyl on cough reflex and quality of endotracheal intubation (ETI) in cats., Study Design: Randomized, blinded, negative controlled clinical trial., Animals: A total of 30 client-owned cats undergoing general anaesthesia for diagnostic or surgical procedures., Methods: Cats were sedated with dexmedetomidine (2 μg kg -1 IV), and 5 minutes later either fentanyl (3 μg kg -1 , group F) or saline (group C) was administered IV. After alfaxalone (1.5 mg kg -1 IV) administration and 2% lidocaine application to the larynx, ETI was attempted. If unsuccessful, alfaxalone (1 mg kg -1 IV) was administered and ETI re-attempted. This process was repeated until successful ETI. Sedation scores, total number of ETI attempts, cough reflex, laryngeal response and quality of ETI were scored. Postinduction apnoea was recorded. Heart rate (HR) was continuously recorded and oscillometric arterial blood pressure (ABP) was measured every minute. Changes (Δ) in HR and ABP between pre-intubation and intubation were calculated. Groups were compared using univariate analysis. Statistical significance was set as p < 0.05., Results: The median and 95% confidence interval of alfaxalone dose was 1.5 (1.5-1.5) and 2.5 (1.5-2.5) mg kg -1 in groups F and C, respectively (p = 0.001). The cough reflex was 2.10 (1.10-4.41) times more likely to occur in group C. The overall quality of ETI was superior in group F (p = 0.001), with lower laryngeal response to ETI (p < 0.0001) and ETI attempts (p = 0.045). No differences in HR, ABP and postinduction apnoea were found., Conclusions and Clinical Relevance: In cats sedated with dexmedetomidine, fentanyl could be considered to reduce the alfaxalone induction dose, cough reflex and laryngeal response to ETI and to improve the overall quality of ETI., (Copyright © 2023 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Background: Erector spinae plane block (ESPB) is an ultrasound-guided interfascial plane block used to provide analgesia in dogs undergoing hemilaminectomy. The aim of this study is to compare the analgesic efficacy of a bilateral ESPB with a fentanyl constant rate infusion (CRI) in dogs undergoing hemilaminectomy., Methods: This is a retrospective cohort study. Anaesthetic records of client-owned dogs undergoing hemilaminectomy (June 2019-August 2020), and in which a bilateral ESPB was performed (group ESPB), were retrieved and compared to a cohort of 39 dogs that underwent hemilaminectomy (September 2014 - June 2017) and in which a fentanyl CRI (2 μg/kg bolus followed by 5 μg/kg/hour) was used as a primary intraoperative analgesia (group CRI). The prevalence of dogs in which intraoperative rescue fentanyl boluses were administered, the total dose of rescue fentanyl boluses administered, the postoperative methadone requirement and anaesthetic complications during the first 24 postoperative hours were evaluated. Univariate statistical analysis was used., Results: Group ESPB comprised of 93 dogs. The bilateral ESPB was performed using a median (range) levobupivacaine volume of 1 (0.5-1.7) mL/kg per side, at a concentration of 0.125% (0.12-0.25). At least one rescue fentanyl bolus was administered in 54.8% and in 56.4% of dogs in group ESPB and CRI, respectively (p > 0.99). The number of rescue fentanyl boluses was higher in group CRI (p = 0.006), especially during lumbar hemilaminectomy. Rescue fentanyl boluses were more frequently administered from skin incision to end of vertebral lamina drilling in group CRI (p = 0.001), and from end of vertebral lamina drilling to end of surgery in group ESPB (p = 0.0002). During the first 6 (p = 0.0035) and 6-12 (p = 0.0005) postoperative hours, the number of dogs that required at least one dose of methadone was higher in group CRI. In group ESPB, dogs were more likely to become hypothermic (p = 0.04). One dog, not included in the study, developed sinus arrest after performing a caudal thoracic ESPB., Conclusions: Under the conditions of this study, a bilateral ESPB was associated with a lower number of rescue fentanyl boluses administered in dogs undergoing hemilaminectomy, especially between skin incision to end of vertebral lamina drilling. Despite ESPB being associated with a reduced opioid consumption during the first 12 hours postoperatively, differences in the postoperative management precluded any firm conclusion regarding its postoperative effect., (© 2022. The Author(s).)

Background: To describe the use of a bilateral thoracic (T5 - T9) ultrasound-guided erector spinae plane block (UG-ESPB) in dogs undergoing sternotomy anaesthetised with propofol and dexmedetomidine continuous infusions., Methods: Demographic information, perioperative anaesthetic and analgesic drugs, the prevalence of hypotension and nociceptive events, and their treatment, were recorded and analysed. Local anaesthetic injection point, volume and concentration were reported for each dog. In attempt to differentiate somatic nociception from visceral nociception, the surgery was divided into three timeframes: from the skin incision to the thoracic cavity opening; from the latter to the beginning of its closure; from thoracic cavity closure to the end of surgery., Results: Overall, 10 dogs were included and four experienced nociception: somatic nociception was recorded in one dog, whereas visceral nociception was recorded in four dogs. The overall fentanyl consumption to control nociception was 0.3 µg/kg/h. No adverse events associated with the UG-ESPB were reported., Conclusion: The bilateral UG-ESPB could be used as a part of a multimodal analgesic technique in dogs undergoing sternotomies. However, more clinical studies are warranted to assess its safety and effects., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Objectives: To assess the effects of extradural anaesthesia-analgesia (EAA) in dogs undergoing cholecystectomy., Materials and Methods: Medical records of dogs undergoing cholecystectomy between 2011 and 2019 were retrieved and allocated to two groups depending if analgesia was provided systemically (group SA) or extradurally (EAA). Preoperative data, intraoperative antinociceptive medications, postoperative analgesia, perioperative complications, and food intake were compared., Results: Overall 41 medical records were included in the study: 19 and 22 dogs were allocated to groups SA and EAA, respectively. In group EAA, an extradural catheter was placed preoperatively in 8 dogs; in the remaining, it was placed postoperatively but an extradural injection was performed preoperatively. The extradural catheter tip was between the 4th lumbar and the 10th thoracic vertebrae. Intraoperatively, nociception was more likely to occur in group SA [OR 55.42 (2.97-1,035.06)]. During the first 24 and 48 h postoperatively, more dogs in group SA required methadone [OR 24 (2.81-268.4) and OR 11.56 (2.37-45.06), respectively] and additional analgesic drugs [OR 25 (3.47-281.9) and OR 35.29 (1.86-668.2), respectively] compared to group EAA. Voluntary postoperative food intake was also significantly higher in group EAA., Clinical Significance: Compared to systemic analgesia, the use of extradural anaesthesia-analgesia reduced perioperative analgesic requirement and promoted postoperative food intake in dogs undergoing cholecystectomy., Competing Interests: Authors BS, CD, RH, and EV were employed by Linnaeus Veterinary Limited., (Copyright © 2022 Sambugaro, De Gennaro, Hattersley and Vettorato.)

Background: The usefulness of routine follow-up Magnetic Resonance Imaging (MRI-2) in asymptomatic dogs treated for discospondylitis is unknown., Methods: This cross-sectional retrospective study investigated the features of MRI-2 in a heterogeneous group of dogs treated for discospondylitis, and if these were associated with the presence or absence of clinical signs. After comparing initial MRI (MRI-1) and MRI-2, an observer, blinded to the dog's clinical signs, described the MRI-2 findings. The study population was then divided into symptomatic or asymptomatic at the time of MRI-2. Two separate observers subjectively classified the discospondylitis as active or inactive. Repeatability and interobserver agreement were evaluated., Results: A total of 25 dogs were included. At the time of MRI-2 16 (64%) dogs were asymptomatic and 9 (36%) were symptomatic. Based on MRI-2, 20 (80%) and 18 (72%) out of 25 dogs were considered to have active discospondylitis by the first and second observers, respectively. Interobserver agreement was moderate. No MRI-2 features were associated with the clinical status. The subjective classification of inactive discospondylitis was significantly associated with asymptomatic clinical status, but the classification of active discospondylitis was evenly distributed between groups., Conclusion: This study did not identify a meaningful association between the clinical status of dogs treated for presumptive discospondylitis and MRI-2 results. There were no specific MRI-2 features which were associated with the clinical status., Competing Interests: All authors were employed by company Dick White Referrals, part of Linnaeus Veterinary Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 de Freitas, Vettorato, Scarpante, Cherubini and Caine.)

Objective:  The aim of this study was to retrospectively evaluate the success rate and perioperative complications of lumbosacral extradural anaesthesia in dogs undergoing total hip replacement., Study Design:  Records of dogs undergoing total hip replacement in which lumbosacral extradural anaesthesia with 0.5% levo- or bupivacaine combined with either morphine or buprenorphine were retrieved. Success rate was defined as intraoperative fentanyl consumption <1 μg/kg/h with no intravenous infusion of other analgesic drugs and no additional morphine/methadone within the first 3 hours from premedication. Prevalence of intraoperative anaesthetic and postoperative surgical complications was calculated., Results:  Overall, 206 dogs were included in the study. Success rate was 88.7%. Hypercapnia (75.2%), hypotension (46.1%), hypothermia (27.7%) and regurgitation (6.3%) were recorded during anaesthesia. Within 24 hours post-surgery, urinary retention (17.8%), vomiting/regurgitation/diarrhea (8.2%) and sciatic neurapraxia of the operated limb (5.8%) were recorded. Luxation of the operated hip occurred at 48 and 72 hours after surgery in two dogs and one dog respectively. One dog had cardiopulmonary arrest at 52 hours after surgery., Conclusion:  While hypercapnia, hypotension and hypothermia might develop intraoperatively, the high success rate and the relatively low prevalence of postoperative surgical complications directly associated with lumbosacral extradural anaesthesia justify its use in dogs undergoing total hip replacement., Competing Interests: None declared., (Thieme. All rights reserved.)

This retrospective study assessed the effect of an intraoral bilateral maxillary nerve block in dogs undergoing surgery for brachycephalic obstructive airway syndrome (BOAS). Records of dogs that underwent BOAS surgery were retrieved. Cases were assigned to Group B or C if a preoperative bilateral maxillary nerve block was performed or not. Type and dose of local anesthetic, inhalant anesthetic minimum alveolar concentration multiples, intraoperative fentanyl and injectable anesthetic use, prevalence of intraoperative hypotension or bradycardia, and postoperative opioids administration, were compared between groups. Sixty-seven cases met the inclusion criteria: 33 were assigned to Group B and 34 to Group C. In Group C, 18 dogs required intraoperative fentanyl ( P = 0.005), and 12 needed injectable anesthetic top-ups ( P = 0.006). Hypotension, or bradycardia, were not different between groups. Bilateral maxillary nerve block reduces intraoperative fentanyl and injectable anesthetic requirement in dogs undergoing BOAS surgery., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Introduction: The supratemporal retrobulbar block (RB) has not been comprehensively described in cats. Materials and methods: Cadaveric study : a modified supratemporal retrobulbar injection of 0.1 ml/kg of iomeprole and saline (1:3) was executed using a Tuohy needle in recently deceased cats. Cadavers underwent computed tomography before and following injections. Injectate distribution within the intraconal space was evaluated. Extraconal injections were considered a failure. Clinical study : cats undergoing corneal/intraocular surgery were included. After intramuscular premedication with methadone 0.3 mg/kg, dexmedetomidine 3 mcg/kg and alfaxalone 2 mg/kg and induction with intravenous (IV) alfaxalone to effect, isoflurane anesthesia was maintained with a target end-expired fraction of 1.1%. Cats were randomly allocated in the retrobulbar group [RG, receiving a modified supratemporal RB with 0.1 ml/kg of a mixture of 2% lidocaine (5.5 ml) and 0.75% ropivacaine (2 ml)] or control group (CG). When heart rate or mean arterial pressure increased above 20% of the pre-incisional values, fentanyl (1 mcg/kg IV) was administered. Alfaxalone (0.5 mg/kg IV) was injected when anesthesia was deemed too light. After a total of 3 interventions regardless the type of drugs (fentanyl/alfaxalone), a constant rate infusion of fentanyl (5 mcg/kg/h IV) was started. Anesthetist interventions, quality of recovery (blindly assessed using a descriptive score scale), postoperative eye rubbing, complications were studied. Results: In the cadaveric study 8 eyes were included (success rate = 87%). The contrast agent spread was scored "moderate-to-large" or "large" in 85.7% of cases and a median 360° (180–360) distribution around the optic nerve was reported. In the clinical study 12 cats were included (6 in RG, 6 in CG). The median time to perform the RB was 35 s (20–50). Only the controls required anesthetist interventions [total amount of 6 (p = 0.0276): fentanyl (3/6) and alfaxalone (2/6)]. The RG had a significantly better recovery score (p = 0.0012) than CG. Only controls showed eye rubbing (3/6). Conclusions: The modified supratemporal RB is an achievable and rapidly performed technique. In this study it reduced intraoperative drug administration and improved recovery quality in cats undergoing corneal or intraocular surgery. [ABSTRACT FROM AUTHOR]

Skin diseases are a common health problem affecting millions of people worldwide. Effective treatment often depends on the precise delivery of drugs to the affected areas. One promising approach is currently the transdermal drug delivery system (TDDS), whose significant challenge is the poor penetration of many compounds into the skin due to the stratum corneum (SC), which acts as a formidable barrier. To overcome this limitation, nanocarriers have emerged as a highly effective alternative. This review discusses the use of liposomes and ethosomes for transdermal drug delivery. Liposomes are micro- or nanostructures consisting of a lipid bilayer surrounding an aqueous core. They facilitate transdermal drug penetration and may be advantageous for site-specific targeting. Some methods of treating skin diseases involve incorporating drugs such as acyclovir, dithranol, and tretinoin or bioactive compounds such as fluconazole, melanin, glycolic acid, kojic acid, and CoQ10 into nanocarriers. The inability of liposomes to pass through the narrowed intercellular channels of the stratum corneum led to the invention of lipid-based vesicular systems such as ethosomes. They are structurally similar to conventional liposomes, as they are prepared from phospholipids, but they contain a high ethanol concentration. Ethosomes are noninvasive carriers that allow drugs to reach the deep layers of the skin. Examples of commonly used substances and drugs combined with ethosomes in cosmetics include methotrexate, ascorbic acid, vitamin A and E, and colchicine. A significant development in this area is the use of rutin-loaded ethosomes. Encapsulating rutin in ethosomes significantly improves its stability and enhances skin penetration, allowing more efficient delivery to deeper skin layers. In cosmetics, rutin–ethosome formulations are used to protect the skin from oxidative stress, reduce redness, and improve capillary strength, making it a valuable formulation in anti-aging and anti-inflammatory products. The results of the first clinical trial of the acyclovir–ethosome formulation confirm that ethosomes require further investigation. The work provides an update on recent advances in pharmaceutical and cosmetic applications, mentioning the essential points of commercially available formulations, clinical trials, and patents in the recent past. [ABSTRACT FROM AUTHOR]

Simple Summary: Visceral pain due to abdominal malignancies or pancreatitis is common in both people and animals. In human medicine, the celiac plexus block or neurolysis are performed in subjects with intractable visceral pain. Ultrasonographic-guided percutaneous techniques for block and/or neurolysis have been described in people. The aim of this study is to describe a percutaneous ultrasound-guided technique to localize the celiac plexus in a pig cadaveric model. The described technique was effective in localizing the celiac plexus in all subjects. Following anatomical and clinical studies, its role in veterinary analgesia should be assessed. Celiac plexus (CP) block (CPB) and neurolysis (CPN) are interventional techniques employed in human analgesia to control visceral pain originating from the upper abdomen. Visceral pain is common in animals and its treatment is challenging. A percutaneous ultrasound (US)-guided approach to the CP has been reported in people but not in veterinary species. The objective of this study is to describe a US-guided percutaneous approach to the CP in a porcine cadaveric model. Cadavers were positioned in right lateral recumbency. The vertebral body of the last thoracic vertebra (T15) was identified (in transverse view) with a left cranial abdominal US scan. Under US guidance, an 18 G Tuohy needle was inserted parallel and ventral to the transverse process of T15. The transducer was gently slid and tilted to have an in-plane view while introducing the needle through the epaxial muscle layer. Once the T15 body was contacted, the needle was advanced towards the ventral surface of the vertebra, and if loss of resistance was present, 2 mL of dye (China Ink) was injected. A laparotomy was performed, and the dyed tissue dissected for histological preparation from 14 cadavers. In all samples submitted for histological study, tissue belonging to the CP was found. The percutaneous ultrasound-guided approach to the CP was effective in localizing the CP in all subjects. Future studies are warranted to identify the clinical utility of this technique in veterinary species. [ABSTRACT FROM AUTHOR]

Simple Summary: The mortality rate in horses undergoing general anaesthesia (GA) is 1%, which is higher than in small animals. This mortality rate is impacted by complications that occur during the recovery period, making it the riskiest phase in equine anaesthesia. It has been shown that using a postanaesthetic intravenous bolus dose of an α2-agonist improves recovery quality and increases its time. However, recovery time should not be prolonged as complications such as neuro/myopathy or hypoxaemia can occur. The objective of this study was to compare the recovery quality and time after administering two different doses of medetomidine at the end of the anaesthesia (0.5 or 1 µg/kg IV). There were no significant differences between the groups for recovery quality, recovery time, or the number of attempts to return to the standing position. It can be concluded that the low dose medetomidine postanaesthetic bolus (0.5 µg/kg IV) did not decrease the recovery time but maintained recovery quality when compared to the high dose medetomidine (1 µg/kg IV). Further research is necessary to optimise the quality–time ratio of recovery. A 50% reduction in the post-anaesthetic bolus dose of medetomidine was not enough to reduce the recovery time. Further studies using lower doses to reduce the time and maintain quality could be postulated. Recovery from general anaesthesia is risky in horses. Alpha2-agonist administration after anaesthesia enhances the quality of recovery but may prolong this phase. Recovery time and quality were investigated after medetomidine administration at the end of general anaesthesia in a prospective, randomised, masked and clinical study. Horses underwent medetomidine–isoflurane partial intravenous anaesthesia. Medetomidine (0.5 or 1 µg/kg) IV was administered just after isoflurane was discontinued. The duration of different recovery phases and the number of attempts were recorded. A composite scale (from 1—excellent to 6—accident) was used for quality assessment. Mann—Whitney U-test was performed (p < 0.05). Twenty-seven horses per group were included. Results for 0.5 and 1 µg/kg groups were as follows: lateral recumbency time: 35 (24–45) and 43 (35–55) minutes; sternal recumbency time: 6 (3–15) and 5 (2–15) minutes; total recovery time: 47 (40–59) and 49 (42–62) minutes; number of attempts to sternal: 1 (1–1) and 1 (1–2) and to standing: 1 (1–3) and 1 (1–2); and, quality: 2 (1–2) and 2 (1–2), respectively. No significant differences between the groups were found. Medetomidine 0.5 µg/kg dose did not decrease the recovery time but maintained the recovery quality. [ABSTRACT FROM AUTHOR]

Objective: To assess the use of adrenaline (0.00198%) in a bilateral maxillary nerve block to reduce intraoperative hemorrhage in dogs undergoing staphylectomy for the treatment of brachycephalic obstructive airway syndrome (BOAS)., Study Design: Prospective, randomized, double-blinded controlled study., Sample Population: A total of 32 client owned, clinically affected dogs undergoing a cut and sew sharp staphylectomy for treatment of BOAS. A total of 16 dogs randomly assigned to adrenaline (A) group and 16 to no-adrenaline (NA) group., Methods: A bilateral maxillary nerve block was performed in all dogs prior to staphylectomy using lidocaine alone (group NA) or a combination of lidocaine and adrenaline (group A). Total hemorrhage was measured by weighing cotton-tipped applicators and swabs used on precision scales. In addition, a semi-quantitative hemorrhage score (1-5) was determined. Dogs were monitored for intraoperative hemodynamic stability during the procedure., Results: Total hemorrhage was significantly (p = .013) lower in group A compared with group NA. The median semi-quantitative hemorrhage score was significantly lower for group A (p = .029) compared with group NA. No significant adverse effects were noted due to adrenaline usage., Conclusion: This study demonstrated that the use of adrenaline in a bilateral maxillary nerve block results in significantly lower intraoperative hemorrhage during cut and sew sharp staphylectomy and appeared safe to use., Clinical Significance: Potential clinical advantages include improved visualization, prevention of unnecessary blood loss and reduction in risk of blood aspiration., (© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

This anesthetic case study outlines the rationale behind and describes the successful use of butorphanol as a premedicant and as an intraoperative analgesic in a dog undergoing unilateral arytenoid lateralization. Given the antiemetic, sedative, and analgesic effects of butorphanol, it may be the opioid of choice in certain veterinary surgeries (especially those where anxiolysis, sedation, antiemesis, and moderate analgesia are beneficial). [ABSTRACT FROM AUTHOR]

Simple Summary: In human medicine, catheter implantation for local anesthetic administration in the quadratus lumborum (QL) inter-fascial plane (IFP) has been reported to extend the duration of a single-shot block's effect in the postoperative period of patients undergoing abdominal surgeries. In the first phase of this study, we described an ultrasound-guided technique for placing catheters in the QL IFP in canine cadavers and assessed the spread of 0.3 versus 0.6 mL kg−1 per side of contrast media solution injected through the catheters using computed tomography (CT). The second phase described the outcomes of five dogs undergoing open cholecystectomy or adrenalectomy, in which QL catheters were used for postoperative pain management. CT scan images showed that using a higher volume of injectate resulted in a significantly higher number of vertebral bodies stained by the contrast solution between the QL and psoas minor muscles. Results of the second phase of the study suggest that ropivacaine 0.5% injected uni- or bilaterally every eight hours through QL catheters could be safely implemented in a multimodal analgesic approach during the postoperative period in dogs subjected to abdominal surgeries. This study aimed to describe an ultrasound-guided technique for implanting catheters for local anesthetic administration into the quadratus lumborum (QL) inter-fascial plane in canine cadavers and assessing the spread along the vertebral bodies (VBs) by computed tomography (CT). Phase 1: eight canine cadavers received one catheter per hemiabdomen, followed by injection of contrast media solution [low volume (LV) 0.3 mL kg−1 or high volume (HV) 0.6 mL kg−1]. Phase 2: postoperative pain of five dogs was managed by injecting 0.3 mL kg−1 of ropivacaine 0.5% through QL catheters every eight hours, up to 72 h after abdominal surgery. Pain was assessed using the Short Form of the Glasgow Composite Measure Pain Scale, and methadone 0.2 mg kg−1 was administered intravenously when the pain score was ≥6. The number of VBs stained by the contrast solution between the QL and psoas minor muscles was significantly higher in group HV than group LV. The catheter tip was visualized in the retroperitoneal space in 1/16 and 2/10 hemiabdomens in phases 1 and 2, respectively. Rescue analgesia was required in 3/5 dogs during the postoperative period. The QL catheter placement technique appears feasible and may be included in a multimodal analgesic approach for dogs undergoing abdominal surgeries. [ABSTRACT FROM AUTHOR]

This randomized prospective clinical study aimed to compare the hemodynamic effects of propofol and alfaxalone for the induction of anesthesia in dogs. Thirty-one healthy dogs undergoing various procedures in a private referral center were premedicated with intramuscular acepromazine (0.015 mg/kg) and methadone (0.15 mg/kg). They then received 5 mg/kg of propofol over 30 s for induction, followed by a maintenance dose of 25 mg/kg/h (Group P), or 2 mg/kg of alfaxalone over 30 s for induction, followed by a continuous rate infusion of 10 mg/kg/h (Group A). Heart rate (HR), mean arterial pressure (MAP), and the velocity time integral (VTI) of the aortic blood flow using transthoracic echocardiography were measured before anesthetic induction and every 15 s for 180 s. Dogs not adequately anaesthetized for intubation were excluded from the hemodynamic evaluation. Events of hypotension (any MAP value lower than 60 mmHg) were also recorded. Statistical analyses utilized ANOVA for repeated measures, two-way repeated measures ANOVA, paired t-tests, or Wilcoxon signed rank-test as appropriate. Significance was set at p < 0.05. Two dogs in Group P (2/14) and 3 in Group A (3/17) were excluded from the study because the anesthesia plane was too light to allow intubation. Treatment P resulted in a significant decrease in MAP between 45 and 75 s during the induction period, with no significant variation in HR, VTI, and VTI*HR. In treatment A, HR increases between 60 and 105 s, VTI decreases at 150-180 s. Analysis between groups did not show any difference in MAP (p = 0.12), HR (p = 0.10), VTI (p = 0.22) and VTI*HR (p = 0.74). During induction, hypotension was detected in 3/12 (25%) dogs in Group P and 1/14 (8%) in Group A. In healthy premedicated dogs, propofol and alfaxalone induction produce similar hemodynamic variations. Propofol induction results in a short-term reduction in MAP, whereas alfaxalone induction preserves MAP and cardiac output by significantly increasing heart rate. [ABSTRACT FROM AUTHOR]

Simple Summary: Advances in pain research challenge the concept that animals lack pain senses, showing that they have similar neural pathways to humans and experience pain similarly. Understanding brain circuits for effective pain control is crucial for adjusting pain control to individual patient responses and conditions. Pain management in oncological patients aims to lessen the impact of tumor cell development and its consequences on the immune system. Researchers have focused on improving algological approaches to better respond to patient needs, which requires a deeper understanding of how analgesics work, interact with other drugs, and affect patients' conditions. Opioids, although linked to tumor progression, remain the mainstay for managing oncologic pain. Advancements in understanding pain physiopathology have historically challenged animals' absence of pain senses. Studies have demonstrated that animals have comparable neural pain pathways, suggesting that cats and dogs likely experience pain similarly to humans. Understanding brain circuits for effective pain control has been crucial to adjusting pain management to the patient's individual responses and current condition. The refinement of analgesic strategies is necessary to better cater to the patient's demands. Cancer pain management searches to ascertain analgesic protocols that enhance patient well-being by minimizing or abolishing pain and reducing its impact on the immune system and cancer cells. Due to their ability to reduce nerve sensitivity, opioids are the mainstay for managing moderate and severe acute pain; however, despite their association with tumor progression, specific opioid agents have immune-protective properties and are considered safe alternatives to analgesia for cancer patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Pain scoring in dogs can be challenging, particularly in a busy clinical setting and when staff with diverse training and veterinary students are involved. Consequently, concerns about dogs receiving inadequate analgesia were raised at this institution. This study was performed to investigate if veterinary students, veterinary nurses, veterinary surgeons with no specific training in anaesthesia, and diplomates in veterinary anaesthesia and analgesia perform pain scoring using the short form of the canine Glasgow Composite Measure Pain Scale (CMPS-SF) in a similar manner. The results obtained indicated good to excellent pain assessment agreement between groups. Nevertheless, the overall agreement amongst all assessors was poor and the intra-group agreement was poor to moderate, suggesting significant individual differences when pain scoring dogs. Veterinary students tend to pain score higher than more experienced assessors. Several pain scoring systems have been validated to measure pain in dogs. However, pain may not be adequately assessed since these tools are associated with high-level inter-observer variation. The aim of this study is to evaluate the agreement of pain assessment using the CMPS-SF between veterinary students, veterinary nurses, veterinary surgeons, and European College of Veterinary Anaesthesia and Analgesia (ECVAA) diplomates. Forty-five client-owned dogs presented to a teaching hospital were enrolled in this prospective, observational study. All dogs were pain-scored in vivo, while a video of the assessment was recorded and subsequently evaluated by twenty assessors, with five per group. Mean scores between groups were compared, and agreement within groups and agreement of the average scores between groups were assessed by calculating the intraclass correlation coefficient (ICC). The intervention point at which dogs were deemed to require additional analgesia was also evaluated. Overall agreement of pain assessment was poor (ICC = 0.494). Nurses had the best inter-observer agreement (ICC = 0.656), followed by ECVAA diplomates (ICC = 0.540), veterinary surgeons (ICC = 0.478), and veterinary students (ICC = 0.432). The best inter-group agreement was between veterinary surgeons and nurses (ICC = 0.951) and between ECVAA diplomates and nurses (ICC = 0.951). Students were more likely to determine that additional analgesia was required compared to other groups. Pain assessment is key for animal welfare, and training in this area should be reinforced to improve consistency. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigated how dexmedetomidine, a sedative, works when given to healthy cats via intramuscular injection at a dose of 10 μg/kg. Nine adult cats were observed before and after receiving the drug, with blood samples taken at various times to measure drug levels. Dexmedetomidine acted quickly, causing sedation that lasted for at least an hour, with peak effects between 20 and 30 min and a half-life of about 70 min. Significant decreases in heart rate, respiratory rate, and blood pressure were observed in the first hour, along with an increase in blood sugar levels after 60 min. Overall, dexmedetomidine proved to be effective and safe for sedation in healthy cats, providing valuable information for veterinarians to ensure its safe and effective use in feline patients. This study investigated the pharmacokinetic profile of and pharmacodynamic response to dexmedetomidine administered intramuscularly (IM) at a dose of 10 μg/kg in healthy cats. Nine adult cats were evaluated before and after administration of the drug, with serial collections of plasma samples. Dexmedetomidine induced deep sedation, with a rapid onset of action and a duration of one hour, reaching a peak between 20 and 30 min after administration. The half-life (T½) was 70.2 ± 48 min, with a maximum concentration (Cmax) of 2.2 ± 1.9 ng/mL and time to reach maximum concentration (Tmax) of 26.4 ± 19.8 min. The area under the curve (AUC) was 167.1 ± 149.1 ng/mL*min, with a volume of distribution (Vd) of 2159.9 ± 3237.8 mL/kg and clearance (Cl) of 25.8 ± 33.0 mL/min/kg. There was a reduction in heart rate (HR) and respiratory rate (RR) in relation to the baseline, with a slight decrease in systolic (SBP), diastolic (DBP), and mean (MAP) blood pressure in the first hour. Blood glucose increased after 60 min. Dexmedetomidine proved to be effective and safe, with rapid absorption, metabolization, and elimination, promoting good sedation with minimal adverse effects after IM administration in healthy cats. [ABSTRACT FROM AUTHOR]

Introduction: Refractory status epilepticus (RSE) is defined as seizure activity that is minimally responsive to first- or second-line antiseizure medications. Constant rate infusion (CRI) intravenous propofol (PPF) is commonly used to treat RSE in dogs and cats. The antiseizure activity of alfaxalone (ALF) in RSE has been demonstrated in various experimental studies. This study compared the clinical efficacy and safety of intramuscular administration followed by CRI infusion of ALF with intravenous administration followed by CRI infusion of PPF to treat canine RSE. Materials and methods: This was a multicenter, prospective, randomized clinical trial of client-owned dogs referred for status epilepticus that did not respond to first- and second-line drugs. Animals with suspected or confirmed idiopathic or structural epilepsy were included. The dogs were randomly assigned to either the PPF or ALF treatment groups and each group received drug CRI infusions for 6 h. Drug dosages were progressively reduced by 25% every hour from the third hour until suspension after 6 h. Patients were classified as responders or nonresponders based on the relapse of epileptic seizures during the 24 h therapy infusion or within 24 h of drug suspension. Univariate statistical analyses were performed. Results: Twenty dogs were enrolled in the study. Ten (10/20) dogs were randomly allocated to the PPF group and 10 (10/20) to the ALF group. Successful outcomes were obtained in six (6/10) patients in the PPF group and five (5/10) patients in the ALF group. Adverse effects were recorded in six (6/10) and three (3/10) animals in the PPF and ALF groups, respectively. No statistically significant differences in outcomes or the presence of adverse effects were observed between the groups. Discussion: The results of this preliminary study suggest that ALF can be considered a valid and safe alternative to PPF for the treatment of RSE in dogs, with the additional advantage of intramuscular administration. However, caution should be exercised when using these drugs to provide airway and hemodynamic support. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to prospectively evaluate the feasibility of an opioid-free anesthesia protocol and describe the quality of recovery and management of postoperative analgesia in dogs after a tibial plateau leveling osteotomy (TPLO). Methods: In total, 20 dogs presented for TPLO were included. After premedication with intravenous (IV) medetomidine (0.005-0.007 mg/kg) and midazolam (0.2 mg/kg), the dogs were anesthetized using ketamine (2 mg/kg) and propofol and maintained with isoflurane and ketamine CRI (0.6 mg/kg/h). Sciatic and femoral nerve blocks were performed with bupivacaine 0.5% (0.087 +/- 0.01 and 0.09 +/- 0.02 mL/kg, respectively). Meloxicam (0.2 mg/kg IV) was administered intraoperatively, after osteotomy. Fentanyl (0.002 mg/kg IV) was administered intraoperatively, as rescue analgesia in the case of sustained increase in cardiorespiratory variables. Two pain scores (French 4A-VET and Glasgow short form) were performed at conscious sternal recumbency and 2, 4, 6, 8, 12, and 20 h after extubation and compared to baseline using a Friedman test followed by a Nemenyi post-hoc test. The time taken for the first food intake and urination was reported. Results: Intraoperative opioid-free anesthesia was feasible in 11 dogs, whereas 9 dogs received fentanyl once during arthrotomy. No opioid postoperative rescue analgesia was required. Food intake occurred within 6 h, and all dogs were discharged after 24 h without any complication. Conclusion: Total opioid-free postoperative analgesia was achieved in all dogs, with adequate recoveries. Although opioid-free anesthesia was feasible in 55% of the population, a single dose of fentanyl was necessary in 45% of the dogs during arthrotomy. [ABSTRACT FROM AUTHOR]

Introduction: French bulldogs can be affected by several neurological diseases, with myelopathies representing the most frequent cause of neurological signs. Studies focusing on the epidemiology of cervical diseases in this breed are lacking. This study aims to describe the prevalence of neurological pathologies responsible for cervical pain and/or signs of cervical myelopathy, assuming that intervertebral disc herniation represents the most common disease; a second aim was to evaluate how often different pathologies coexist in this spinal region in French bulldogs. Materials and methods: A retrospective analysis of medical records from the database of a single referral center (AniCura I Portoni Rossi Veterinary Hospital--Zola Predosa, Bologna, Italy) was performed, including French bulldogs presented for neck pain and/or neurological deficits consistent with cervical myelopathy. Clinical and imaging data were reviewed and used as inclusion criteria. Based on the number of MRI-diagnosed diseases, the eligible dogs were divided into three groups. Results: One hundred five French bulldogs met the inclusion criteria. The most commonly diagnosed condition was an intervertebral disc herniation (66.9%), followed by C2 idiopathic hypertrophic ganglioneuritis (15.1%), cervical syringomyelia (11.5%), congenital osseous malformations (1.4%), spinal arachnoid diverticula (1.4%), neoplasms (1.4%), steroid-responsive meningitis-arteritis (0.7%), traumatic vertebral fractures (0.7%), and other (0.7%). For the vast majority of dogs (75/105) a single pathology was diagnosed, with intervertebral disc herniations accounting for 86.7% of cases, involving C3-C4 IVD most commonly. In the remaining 30 dogs, two or three different and concurrent diseases were detected. Among these 30 dogs, intervertebral disc herniations still remained the most diagnosed condition, in combination with C2 idiopathic hypertrophic ganglioneuritis and syringomyelia in 19 and seven cases, respectively. Conclusion: The results of this study highlight that different pathologies can affect the cervical spinal cord in French bulldogs, with intervertebral disc herniations representing the most frequent condition, as previously described in the veterinary literature. In almost a third of cases, different pathologies can coexist at the cervical level. However, for cases in which different pathologies are present at the same time, it is not always possible to clearly establish their clinical significance. [ABSTRACT FROM AUTHOR]

Introduction: Various early warning score tools have been developed to identify clinical deterioration in patients. This study assessed the predictive capacity of the National Early Warning Score 2 (NEWS-2) in the prehospital setting to predict death within 24 hours and 30-day intensive care unit admission. Methods: A single-center observational retrospective study was conducted in the emergency medical services (EMS) of King Abdulaziz Medical City, Riyadh, Saudi Arabia. We included adult patients (> 18 years) who attended the emergency medical service. The primary outcome was 24-hour death and 30-day intensive care unit admission. Sensitivity, specificity, and negative/positive predictive values (NPV/PPV) were determined. Results: The study comprised 1,343 eligible patients. NEWS-2 exhibited a sensitivity of 20% and a specificity of 80% for predicting 24-hour death and a sensitivity of 10% and a specificity of 80% for predicting 30-day intensive care unit admission. The area under the curve for predicting death was 0.529, and for intensive care unit admission was 0.456. Conclusion: Our study underscores the limited utility of NEWS-2 as a predictor of 24-hour death and 30-day intensive care unit admission in adult patients utilizing the emergency medical service. Further extensive studies are warranted to corroborate this study's findings. [ABSTRACT FROM AUTHOR]

Simple Summary: The GIN-TONIC block is an interfascial ultrasound-guided regional anesthesia technique that desensitizes the lumbosacral plexus and provides analgesia to the pelvic limb. Different methods have been attempted previously, such as blocking specific plexuses (e.g., lumbar and sacral plexuses) and nerves (e.g., femoral and sciatic). However, these approaches either resulted in excessive motor block or failed to encompass all the required areas for surgery. This study assessed the efficacy of the GIN-TONIC block in dogs premedicated with either acepromazine or dexmedetomidine for surgeries on the hip and stifles. It also checked how well the dogs could move after the surgery. The results showed that the GIN-TONIC block provided adequate perioperative analgesia, independently of the drug used in premedication. During recovery, dogs showed minimal motor block, suggesting that GIN-TONIC block provides a motor-protective analgesic effect. However, more research is needed to fully understand how effective the GIN-TONIC block is during surgery. This study assessed the analgesic and motor effects of the GIN-TONIC block, a combination of the greater ischiatic notch plane block and the caudal lateral quadratus lumborum block, in 24 dogs undergoing pelvic limb surgery. Dogs were randomly divided into two equal groups: GA received acepromazine [(20 µg kg−1 intravenously (IV)] as premedication, and GD received dexmedetomidine (2 µg kg−1 IV). General anesthesia was maintained with isoflurane, and both groups received a GIN-TONIC block using 2% lidocaine. Nociception during surgery and postoperative pain [assessed using the Glasgow Composite Measure Pain Score (GCMPS-SF)] were assessed. Fentanyl (2 µg kg−1 IV) was administered if nociception was noted and morphine (0.5 mg kg−1 IV) was administered during recovery if the pain scores exceeded the predefined threshold. Motor function was assessed during the recovery period using descriptors previously reported. All dogs received analgesics at the 4 h mark before being discharged. Three and two dogs in GD and GA required fentanyl once. Postoperative pain scores remained ≤4/20 for all dogs except one. Dogs achieved non-ataxic ambulation within 38.9 ± 10.3 and 35.1 ± 11.1 min after extubation in GD and GA, respectively. This study highlighted the potential of the GIN-TONIC block as a feasible regional anesthesia method for delivering perioperative analgesia in dogs undergoing pelvic limb orthopedic surgery. [ABSTRACT FROM AUTHOR]

Simple Summary: Periorbital surgeries are painful procedures that require effective pain management, and regional anaesthesia is an essential tool used to achieve it. To desensitise the area of the head involved, blockade of the branches of the trigeminal nerve (ophthalmic, maxillary, and mandibular nerves) is warranted. This technique is well described and employed in human medicine, but the literature on veterinary medicine (dogs) is scarce. This study aims to assess and compare two ultrasound-guided approaches for trigeminal nerve block. Thirteen dog heads were utilised, and following a preliminary anatomical assessment, procedures were conducted using temporal and coronoid approaches. The needle was advanced under ultrasonographic guidance from the dorsal aspect of the temporal area or ventral to the zygomatic arch, respectively. A computed tomography scan was performed with the needles in place and repeated after injection of a contrast medium/tissue dye mixture. Dissection of the heads was immediately performed thereafter. Needle position, contrast distribution, and nerve staining were evaluated and compared between the two techniques. Results indicate no significant difference between both techniques. Both methods demonstrate adequate distribution, with minimal intracranial spread of the injectate. Both techniques are promising, although further studies in live animals are required. The trigeminal nerve is responsible for innervating the periorbita. Ultrasound-guided trigeminal block is employed in humans for trigeminal neuralgia or periorbital surgery. There are no studies evaluating this block in dogs. This study aims to evaluate and compare two approaches (coronoid and temporal) of the trigeminal nerve block. We hypothesised superior staining with the coronoid approach. Thirteen dog heads were used. After a preliminary anatomical study, two ultrasound-guided injections per head (right and left, coronoid and temporal approach, randomly assigned), with an injectate volume of 0.15 mL cm−1 of cranial length, were performed (iodinated contrast and tissue dye mixture). The ultrasound probe was placed over the temporal region, visualising the pterygopalatine fossa. For the temporal approach, the needle was advanced from the medial aspect of the temporal region in a dorsoventral direction. For the coronoid approach, it was advanced ventral to the zygomatic arch in a lateromedial direction. CT scans and dissections were conducted to assess and compare the position of the needle, the spread of the injectate, and nerve staining. No significant differences were found. Both approaches demonstrated the effective interfascial distribution of the injectate, with some minimal intracranial spread. Although the coronoid approach did not yield superior staining as hypothesised, it presents a viable alternative to the temporal approach. Studies in live animals are warranted to evaluate clinical efficacy and safety. [ABSTRACT FROM AUTHOR]

Simple Summary: The celiac plexus (CP) is a dense network of ganglia and sensitive fibres receiving nociceptive inputs from most abdominal viscera. In human medicine, the CP is a therapeutic target to control pain originating from pancreatic tumours and chronic pancreatitis. The fluoroscopic-guided block and neurolysis of the CP are commonly used in human analgesia but they have not been described in animals. We describe a fluoroscopically guided transcutaneous approach to the CP in swine cadavers to assess the feasibility of the technique in veterinary species. This technique is shown to be feasible, and its application in veterinary subjects suffering abdominal pain should be assessed. Celiac plexus block (CPB) and neurolysis (CPN) are used for pain management in people suffering from abdominal tumours or chronic pancreatitis. The fluoroscopically guided approach common in human medicine has not been described in veterinary settings. The aim of this study was to describe a fluoroscopic approach to the celiac plexus (CP) in fresh pig cadavers. Twelve animals were included in the procedure. Cadavers were positioned in sternal position and, under fluoroscopic guidance, a Chiba needle was inserted parasagittal at 6 cm from the spinal midline at the level of the last thoracic vertebra. From the left side, the needle was directed medio-ventrally with a 45° angle towards the T15 vertebral body; once the vertebral body was contacted, the needle was advanced 1 cm ventrally towards the midline. Iodinated contrast was injected to confirm the location. Following this, 2 mL of dye (China ink) was injected. A laparotomy was performed, and dyed tissue was dissected and prepared for both histochemical and immunohistochemical techniques. In 10 out of 12 samples submitted for histological evaluation, nervous tissue belonging to CP was observed. Fluoroscopy guidance allows for feasible access to the CP in swine cadavers in this study. Further studies are warranted to determine the efficacy of this technique in swine and other veterinary species. [ABSTRACT FROM AUTHOR]

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Simple Summary: Dexmedetomidine is a frequently used sedative; however, in some cases, its administration may prove insufficient; therefore, an additional dose or another drug is required to achieve the desired sedative outcome. The present study investigated the sedative effects of commonly used anaesthetics when administered after an inadequate initial dose of dexmedetomidine. Six healthy adult cats were included in the study, and each cat participated seven times. The initial dose of dexmedetomidine was followed by the administration of a second dose of dexmedetomidine, butorphanol, buprenorphine, tramadol, ketamine, midazolam, or saline NS 0.9%. Additionally, atipamezole was administered to all animals to elicit recovery. To assess the sedative effect of each treatment, a sedation scale was used, and recovery quality was evaluated using two recovery scales. The results suggested that the two consecutive doses of dexmedetomidine produced deeper sedation compared to the administration of a single dose of dexmedetomidine. Sedation levels were also enhanced by the administration of dexmedetomidine, butorphanol, or ketamine following the administration of an initial dose of dexmedetomidine, and the recovery quality was good. On the contrary, administration of midazolam following dexmedetomidine administration resulted in inferior sedation and recovery quality. Dexmedetomidine is an a2-agonist commonly used in veterinary practice. Occasionally, the administered dose of dexmedetomidine may result in insufficient sedation, and an additional dose or drug may be required. The sedative effects of seven different drugs administered at subsequent time points after an initial, insufficient dose of dexmedetomidine were evaluated. Seven adult cats participated in this crossover, blind, randomised study. The groups consisted of two consecutive doses of dexmedetomidine (15 + 10 μg/kg) (DD) or a dose of dexmedetomidine (15 μg/kg) followed by either NS 0.9% (DC-control group), tramadol 2 mg/kg (DT), butorphanol 0.2 mg/kg (DBT), buprenorphine 20 μg/kg (DBP), ketamine 2 mg/kg (DK), or midazolam 0.1 mg/kg (DM). Sedation was evaluated using the Grint sedation scale. In all groups, atipamezole was administered at the end of the evaluation, and recovery was assessed using the Lozano and Sams recovery scales. The DC and DM groups exhibited minimal sedative effects. The maximum sedative effect was observed in the DD and DK groups, while sedation in the DD and DK groups was significantly higher compared to the DC group. Recovery in all groups was uneventful, except in the DM group, where it was prolonged and difficult, although no statistically significant difference was detected. Therefore, insufficient sedation with dexmedetomidine can be enhanced by a subsequent dose of dexmedetomidine, ketamine, or butorphanol, whereas the addition of midazolam reduces sedation and prolongs recovery. [ABSTRACT FROM AUTHOR]

Simple Summary: Oxidative stress is a metabolic state in which the organism possesses more oxidative compounds than antioxidant ones. This imbalance contributes to the formation of multiple pathologies and can be caused by different methods of drug administration, surgery, and anesthesia. The aim of the current study was to evaluate the effect of two different anesthetic protocols on oxidative stress and vital parameters. Ten dogs were randomly assigned into two groups and received different anesthetic agents during anesthesia for female spaying procedures. It was noted and concluded that the administration of medetomidine–butorphanol contributed to higher values of oxidative stress markers during different time frames when compared to the medetomidine–buprenorphine group. Even though the cardiorespiratory parameters were stable throughout the study in all dogs, the medetomidine–butorphanol group experienced greater alterations in vital parameters during anesthesia. Therefore, this study suggests that medetomidine–buprenorphine might be a superior anesthetic combination in comparison to medetomidine–butorphanol. Oxidative stress (OS) is caused by an imbalance between the production of oxygen-containing free radicals and their elimination. General anesthesia increases the production of reactive oxygen species (ROS) and therefore causes oxidative stress. Our objective was to determine the effects of medetomidine–butorphanol (MEDBUT) and medetomidine–buprenorphine (MEDBUP) on oxidative stress and cardiorespiratory parameters in dogs undergoing ovariohysterectomy (OHE). Ten healthy female dogs were randomly assigned to two groups: the MEDBUT group (n = 5) received medetomidine and butorphanol, while the MEDBUP group (n = 5) received medetomidine and buprenorphine. OS was evaluated by measuring total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) during five different time points (from the administration of anesthetic drugs to 2 h after surgery). The observed vital cardiorespiratory parameters included heart rate (HR), respiratory rate (fR), noninvasive systolic (SAP) and diastolic (DAP) arterial blood pressures, oxygen saturation (SpO2), end-tidal CO2 (EtCO2), and body temperature (BT). Cardiorespiratory parameters were altered at a significantly greater degree in animals sedated with MEDBUT (p < 0.05). The administration of medetomidine–butorphanol was more likely to increase OS parameters, while medetomidine–buprenorphine showed decreased levels of oxidative stress throughout the study. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to analyse the potential benefit of the epidural application of steroids on time to ambulation in non-ambulatory dogs affected by intervertebral disc disease (IVDD) treated with decompressive surgery., Methods: This prospective, randomised, blinded control trial involved 41 dogs with thoracolumbar disc extrusion, which were randomly allocated into two groups. In the control group, saline was locally applied after surgical decompression of the spinal cord (n = 23). In the treatment group (n = 18), local epidural application of methylprednisolone acetate (1 mg/kg) was used. Ambulation time was the primary outcome measure, defined as the ability to take 10 independent steps., Results: The median number of days to ambulation was 7 days (range: 1‒17 days) for the control group and 3 days (range: 1‒8 days) for the treatment group. One dog from the treatment group developed discospondylitis and abscess formation., Limitations: The study's heterogeneity in dog breeds, ages and pre-existing health conditions could affect the generalisability of the findings., Conclusion: Epidural methylprednisolone acetate applied locally at the time of surgery may accelerate recovery in dogs following IVDD surgery., (© 2024 The Author(s). Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)