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Two healthy research cats involved in a randomized, blinded prospective pharmacodynamics study evaluating midazolam continuous-rate infusion as a means to decrease sevoflurane concentrations experienced unexpectedly prolonged recoveries. Midazolam loading doses, infusion rates, and the targeted plasma midazolam concentrations at steady-state were determined by pharmacokinetic modeling based on the results of a preliminary pharmacokinetic study using a single dose of midazolam. In the pharmacodynamics study, cats remained oversedated after recovery from anesthesia, and plasma concentrations of midazolam and its primary metabolite (1-hydroxymidazolam) remained elevated. The use of flumazenil was unsuccessful in timely treatment of oversedation. Administration of intravenous lipid emulsion was used in one of the cats to facilitate recovery and appeared to be effective in both reducing the depth of midazolam-induced oversedation and significantly reducing the plasma concentration of 1-hydroxymidazolam. The effects after the administration of both treatment modalities on clinical signs and plasma drug concentrations in cats are discussed. The observations suggest that cats may eliminate 1-hydroxymidazolam more slowly than expected; consequently dose adjustments may be required when continuous infusion of midazolam is intended. In addition, intravenous lipid emulsion may facilitate recovery from midazolam oversedation, particularly in cases unresponsive to traditional treatment modalities. However, further investigations are warranted to delineate the efficacy of this modality in the treatment of midazolam oversedation.

Objectives: The main objective of this study was to compare the postoperative analgesic effects of grapiprant with those of robenacoxib in cats undergoing ovariohysterectomy (OVH). Methods: In total, 37 female cats (age range 4 months–10 years, weighing ⩾2.5 kg) were enrolled in a prospective, randomized, masked, non-inferiority (NI) clinical trial. Cats received oral robenacoxib (1 mg/kg) or grapiprant (2 mg/kg) 2 h before OVH. Analgesia was assessed via the Feline Grimace Scale (FGS), the Glasgow Composite Measure Pain Scale-Feline (CMPS-F), von Frey monofilaments (vFFs) and pressure algometry (ALG) 2 h before treatment administration, at extubation, and 2, 4, 6, 8, 18 and 24 hours after extubation. Hydromorphone (<8 h postoperatively) or buprenorphine (>18 h postoperatively) were administered to cats with scores of ⩾5/20 on CMPS-F and/or ⩾4/10 on FGS. NI margins for CMPS-F and vFFs were set at 3 and −0.2, respectively. A mixed-effect ANOVA was used for FGS scores (P <0.05). Data are reported as mean ± SEM. Results: The data from 33 cats were analyzed. The upper limit of the 95% confidence interval (CI) (0.35) was less than the NI margin of 3 for CMPS-F, and the lower limit of the 95% CI (0.055) was greater than the NI margin of −0.2 for vFFs, indicating NI of grapiprant. The FGS scores were greater than baseline at extubation for both treatments (1.65 ± 0.63; P = 0.001); however, there was no difference between treatments. There was no difference between treatments, nor treatment by time interaction, for vFFs (P <0.001). The CMPS-F scores for both treatments were higher at extubation but returned to baseline after 4 h (P <0.001). For ALG, there was no difference in treatment or treatment by time interaction. The robenacoxib group had lower pressure readings at extubation and 6 h compared with baseline. Conclusions and relevance: These results indicate that grapiprant was non-inferior to robenacoxib for mitigating postsurgical pain in cats after OVH performed via ventral celiotomy. The impact of grapiprant for analgesia in OVH via the flank is unknown. [ABSTRACT FROM AUTHOR]

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OBJECTIVE To evaluate and compare postoperative analgesic effects of grapiprant and carprofen in dogs undergoing ovariohysterectomy. ANIMALS 42 sexually intact female healthy dogs (< 35 kg and 0.5 to 7 years old) were enrolled. PROCEDURES In a masked, randomized, noninferiority clinical trial, dogs received either 2 mg/kg of grapiprant or 4.4 mg/kg of carprofen orally 2 hours prior to ovariohysterectomy. Postoperative pain was assessed using the Glasgow Composite Pain Scale-Short Form (GCPS-SF) at extubation and 2, 4, 6, 8, 18, and 24 hours postextubation and compared to baseline. After each pain scoring, mechanical nociceptive testing with von Frey monofilaments (vF) was performed to assess hyperalgesia. Hydromorphone (0.05 mg/kg, IM) was administered to any dog with a GCPS-SF of 2 5/24. The noninferiority limit (NI) for the GCPS-SF was 8 = 3. The NI for vF was & = -0.2. Following noninferiority, a mixed-effect ANOVA and post hoc comparisons were made with the Tukey correction method (P < .05). RESULTS 3 dogs required rescue analgesia and were excluded from statistical analysis, Of the remaining 39 dogs, the upper Cl for GCPS-SF was below the NI of 3 and the lower Cl for vF was greater than the NI of -0.2, indicating noninferiority of grapiprant as compared to carprofen. There was no difference between treatment (P = .89) nor treatment by time (P = .62) for GCPS-SF. There was no difference between groups at any time point or over time when vF were used. CLINICAL RELEVANCE Our study results support the use of grapiprant as an analgesic alternative to carprofen in dogs undergoing ovariohysterectomy. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the effects of propofol on the minimum alveolar concentration of sevoflurane needed to prevent motor movement (MAC(NM)) in dogs subjected to a noxious stimulus using randomized crossover design. Six, healthy, adult beagles (9.2 ± 1.3 kg) were used. Dogs were anesthetized with sevoflurane on 3 occasions, at weekly intervals, and baseline MAC(NM) (MAC(NM-B)) was determined on each occasion. Propofol treatments were administered as loading dose (LD) and constant rate infusion (CRI) as follows: Treatment 1 (T1) was 2 mg/kg body weight (BW) and 4.5 mg/kg BW per hour; T2 was 4 mg/kg BW and 9 mg/kg BW per hour; T3 was 8 mg/kg BW and 18 mg/kg BW per hour, respectively. Treatment MAC(NM) (MAC(NM-T)) determination was initiated 60 min after the start of the CRI. Two venous blood samples were collected and combined at each MAC(NM-T) determination for measurement of blood propofol concentration using high-performance liquid chromatography method (HPLC). Data were analyzed using a mixed-model ANOVA and are presented as least square means (LSM) ± standard error of means (SEM). Propofol infusions in the range of 4.5 to 18 mg/kg BW per hour resulted in mean blood concentrations between 1.3 and 4.4 μg/mL, and decreased (P < 0.05) sevoflurane MAC(NM) in a concentration-dependent manner. The percentage decrease in MAC(NM) was 20.5%, 43.0%, and 68.3%, with corresponding blood propofol concentrations of 1.3 ± 0.3 μg/mL, 2.5 ± 0.3 μg/mL, and 4.4 ± 0.3 μg/mL, for T1, T2, and T3, respectively. Venous blood propofol concentrations were strongly correlated (r = 0.855, P < 0.0001) with the decrease in MAC(NM). In dogs, propofol decreased the sevoflurane MAC(NM) in a concentration-dependent manner.

The study objective was to determine the effects of 70% nitrous oxide (N2O) and fentanyl on the end-tidal concentration of sevoflurane necessary to prevent movement (MACNM) in response to noxious stimulation in dogs. Six healthy, adult, intact male, mixed-breed dogs were used on 3 occasions in a randomized crossover design. After induction of anesthesia with sevoflurane, each of the following treatments was randomly administered: fentanyl loading dose (Ld) of 15 μg/kg and infusion of 6 μg/kg per hour [treatment 1 (T1)], 70% N2O (T2), or fentanyl (Ld of 15 μg/kg and infusion of 6 μg/kg per hour) combined with 70% N2O (T3). Each dog received each of the 3 treatments once during the 3-week period. Determination of MACNM was initiated 90 min after the start of each treatment. The values were compared using the baseline MACNM, which had been determined in a previous study on the same group of dogs. Data were analyzed using a mixed-model analysis of variance (ANOVA) and Tukey-Kramer tests, and expressed as least squares mean ± SEM. The baseline MACNM decreased by 36.6 ± 4.0%, 15.0 ± 4.0%, and 46.0 ± 4.0% for T1, T2, and T3, respectively (P < 0.05), and differed (P < 0.05) among treatments. Mean fentanyl plasma concentrations did not differ (P ≥ 0.05) between T1 (3.70 ± 0.56 ng/mL) and T3 (3.50 ± 0.56 ng/mL). The combination of fentanyl and N2O resulted in a greater sevoflurane MACNM sparing effect than either treatment alone.

Advancements in veterinary medicine have resulted in an increased number of geriatric horses being presented for medical or surgical procedures that require general anesthesia. Due to the physiological changes associated with aging and the likelihood of concurrent disease conditions, the geriatric equine is at an increased risk during anesthesia. The main physiological changes associated with aging, and their impact on anesthesia, are discussed in this review., Competing Interests: Disclosure The authors report no conflicts of interest in this work.