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Objective: To evaluate the effect of epidural morphine on gastrointestinal (GI) motility in horses., Study Design: Randomly ordered crossover design., Animals: Six healthy adult horses weighing 585± 48 kg (mean±SD)., Methods: Horses were randomly assigned to receive either 0.2 mg kg(-1) morphine or an equal volume (0.04 mL kg(-1)) of saline epidurally (the first inter coccygeal space) with 2 weeks between treatments. The horses were stabled, fed a standardized diet and allowed water ad libitum throughout the duration of the study. Radiopaque spheres were administered by stomach tube. Xylazine 0.2 mg kg(-1) intravenously was administered prior to epidural injection. Heart rate, respiratory rate, GI sounds score and behavior score were recorded before drug administration and after epidural injection at 4, 8, 12, 18, 24 hours and every 12 hours thereafter for 6 days. Feces were weighed, radiographed and the number of spheres counted. Data were analyzed using a mixed effect model., Results: At no time did horses exhibit signs of colic or show significant differences between treatments regarding heart rate, respiratory rate, GI sounds score, behavior score, or cumulative number of spheres. The concentration of spheres per kg of feces was significantly lower (p<0.05) for the morphine group at 18 and 24 hours. Using the centroid of the curves (spheres kg(-1) plotted versus time) the average transit time after saline epidural was 38 hours and after morphine it was 43 hours. The weight of feces hour(-1) was significantly lower (p<0.05) at only 4 and 8 hours after morphine., Conclusions and Clinical Relevance: Epidural morphine, at a dose of 0.2 mg kg(-1) , temporarily reduced GI motility but did not cause ileus or colic in this small group of healthy unfasted horses. Care should be taken when extrapolating these data to situations in which other factors may also affect GI motility., (© 2011 The Authors. Veterinary Anaesthesia and Analgesia © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)

Objective: To assess whether recovery from general anesthesia, in an illuminated or a darkened stall, has an effect on time to first movement, time to standing, and recovery score., Study Design: Prospective randomized clinical study., Animals: Twenty-nine healthy, 2- to 5-year-old horses undergoing surgical correction of dorsal displacement of the soft palate., Methods: Each horse was assigned randomly to recover in either an illuminated (n = 15) or a darkened stall (n = 14). For pre-anesthetic medication, all horses received intravenous (IV) xylazine (0.4 mg kg(-1)) and butorphanol (0.02 mg kg(-1)). Anesthesia was induced with midazolam (0.1 mg kg(-1)) and ketamine (2.2 mg kg(-1)) IV and maintained on isoflurane in oxygen. Vital parameters, end-tidal CO(2) and isoflurane were recorded at 5-minute intervals. At the conclusion of anesthesia, horses were placed in either an illuminated or a darkened stall and xylazine (0.2 mg kg(-1)) IV was administered at extubation. Video cameras were used to record the horses while they were allowed to recover undisturbed. Video recordings were later viewed and recoveries were evaluated on a 100-point scale by three graders., Results: Horses in illuminated and darkened recovery stalls were evaluated on total anesthesia time, minimum alveolar concentration hours of isoflurane, time to first movement, time to standing, and total recovery score. There were no significant differences between the two groups in any of the measured parameters., Conclusion: Recovering horses in a darkened versus an illuminated recovery stall may provide no benefit., Clinical Relevance: Darkening the recovery stalls for horses recovering from general anesthesia may be unnecessary.

Objective: To compare acceleromyography (AMG) with visual assessment of train-of-four (TOF) for monitoring neuromuscular blockade and detecting residual muscle paralysis in horses receiving atracurium., Study Design: Prospective, controlled clinical study., Animals: Nine adult, client-owned horses weighing 577 (436, 727) kg (median, minimum, maximum) and ASA physical status I-II, admitted for surgery., Methods: An electrical nerve stimulator was used to stimulate the peroneal nerve with TOFs at 1 minute intervals. Before and after atracurium administration (0.15 mg kg(-1), IV), the number of twitches observed (TOF count, or TOFc) was assessed visually. When four twitches were seen (i.e., TOFc = 4) presence or absence of fade by visual assessment was recorded. Simultaneously, the response to each TOF was assessed by AMG; this measured TOFc, and twitch fade using TOF ratio (TOFR; ratio of fourth to first twitch). The anesthetist performing the visual evaluation was blinded to the AMG readings. Recovery from neuromuscular blockade was defined as the absence of fade by visual inspection or a TOFR > or =90% by AMG., Results: During onset of action of the drug, fade was first detected 4 (1, 8) minutes earlier by AMG (p = 0.008). Maximal blockade started at 6 (3, 17) minutes by visual assessment and 9 (3, 25) minutes by AMG (not significantly different). Only four horses achieved complete neuromuscular blockade (TOFc of zero by both methods); in those four horses AMG did not detect the start of the return of neuromuscular transmission before visual assessment. Visual assessment indicated the return of four twitches with no fade 12 (8, 42) minutes before AMG gave a TOFR of > or =90% (p = 0.004)., Conclusion and Clinical Relevance: There was no substantial advantage for AMG in detecting the onset of atracurium-induced neuromuscular blockade. However, AMG detected residual blockade when visual assessment of TOF did not. Application of AMG is likely to reduce the incidence of residual blockade.

Objective: To compare cardiac output measured in the pulmonary artery and a carotid artery by use of thermal and electrical impedance dilution. Animals-7 fit, clinically normal Standardbreds between 2 and 5 years of age., Procedure: Transient changes in electrical impedance and temperature of blood were induced by bolus injections of ice-cold saline hypertonic (6% and 9% NaCl) solutions. Cardiac output was calculated by applying Stewart-Hamilton principles to the indicator dilution transients. Measurements were made during sequential exercise episodes on a level treadmill over approximately an 8-fold range of cardiac output values., Results: We detected agreement between cardiac output determined by use of electrical impedance dilution at the pulmonary artery and carotid artery. Cardiac output from thermal dilution measured at the carotid artery exceeded that measured at the pulmonary artery. Cardiac output from the thermal dilution technique exceeded cardiac output from the electrical impedance dilution technique at both locations., Conclusions and Clinical Relevance: The electrical impedance indicator is conserved on first transit; therefore cardiac output measured by electrical impedance dilution at the carotid artery is reliable over a large range of values. Thermal dilution provides a larger estimate of cardiac output, compared with the electrical impedance dilution technique, probably because of a loss of indicator. The transpulmonary electrical impedance dilution technique may have potential for clinical application, particularly in animals in which catheterization of the pulmonary artery is not appropriate or blood loss must be minimized.

Objective: To determine accuracy and precision of a point-of-care hemoglobinometer for measuring hemoglobin concentration and estimating PCV in horses., Design: Prospective trial., Animals: 55 horses., Procedure: Blood samples were obtained from 43 horses examined at a veterinary teaching hospital. Hemoglobin concentration was measured with the hemoglobinometer and by means of the standard cyanmethemoglobin method; PCV was measured by centrifugation. Blood samples were also obtained from 12 healthy horses, and PCV of aliquots of these samples was altered to approximately 5 to 80% by removing or adding plasma. Hemoglobin concentration and PCV were then measured., Results: For samples from the clinic patients, hemoglobin concentrations obtained with the hemoglobinometer were less than concentrations obtained with the cyanmethemoglobin method; however, there was a linear relationship between concentrations obtained with the 2 methods. Breed, sex, body weight, and duration of sample storage did not significantly affect the difference between hemoglobin concentrations obtained with the 2 methods. There was a significant linear relationship between PCV and hemoglobinometer hemoglobin concentration (PCV = [2.83 x hemoglobin concentration] - 0.62). For samples from the healthy horses, a substantial negative bias was evident with the hemoglobinometer when hemoglobin concentration exceeded 16 g/dL., Conclusions and Clinical Relevance: Results suggest that this hemoglobinometer is reasonably accurate and precise when used to measure hemoglobin concentration in blood samples from horses with a hemoglobin concentration < 16 g/dL.

OBJECTIVE To compare the quality of recovery in horses emerging from general anesthesia with or without the assistance of a novel device (recovery-enhancing device [RED]) designed to minimize high-energy falls. ANIMALS 20 mixed-breed horses, between July 1, 2023, and January 24, 2024. METHODS A computer-controlled belay system designed to slow the acceleration of a horse during a fall was evaluated in this study. Horses were randomly assigned to 1 of 2 treatment groups: RED (belay, assisted) or FREE (unassisted). An inertia-measuring unit was fitted to all horses and data were live streamed and recorded onto a computer for further analysis. Recoveries were scored using the composite grading scale (CGS; 0 to 100) by 3 independent observers. Two additional unitless recovery scores (RS and RS’), based on accelerometry values (high accelerations, less desirable), were calculated for each recovery. All the recovery scores were compared between the 2 treatment groups. RESULTS Composite grading scale scores were 26 ± 10 and 46 ± 13 in the RED and FREE groups, respectively (P = .001). The RS was 120 ± 79 and 198 ± 34 for the RED and FREE treatment groups, respectively (P = .015). The RS’ was 32 (7 to 50) and 46 (28 to 44) for the RED and FREE treatment groups, respectively (P = .038). CLINICAL RELEVANCE The RED improves the recovery scores compared with unassisted recoveries. This device may lead to a potential reduction in the number and severity of injuries in horses and personnel involved during the recovery period. [ABSTRACT FROM AUTHOR]

Several factors affect the quality of recovery from general anesthesia in horses. These can increase the likelihood of injury. Body and limb position during recovery may correlate with successful standing. The objective of this study was to identify the prevalence of and the factors associated with successful standing at the first attempt in horses undergoing general anesthesia. Retrospective study. Video of recovery and anesthetic records from 221 equine patients were reviewed by six veterinary students. Cases with poor video quality or incomplete anesthetic records were excluded. Demographic variables, type of procedure, perioperative drugs administered, assistance during recovery and body and limb positions during the first attempt to stand were recorded. Association between putative variables (including specific descriptors for body and limb position) and success for standing were analyzed using backward logistic regression; significance was set at 0.05. A decision tree for a successful attempt was created to predict the outcome of a recovery attempt based on these variables. Extension of the carpal joints, head and neck alignment with the thoracic limbs, greater time in lateral recumbency, coordination during sternal recumbency, longer time to first attempt to stand and pelvic limb position were associated with successful standing at the first attempt. The association between extension of the carpal joints with wide base positioning of the pelvic limbs provided the best success rate for standing, whereas the association of flexed carpal joints and head and neck orientation different from the thoracic limbs resulted in a worse success rate. Results suggest that certain limb and body positions displayed by horses during recovery may be associated with the likelihood of successful standing at the first attempt. These variables may be useful for assessing recovery quality in future research. [ABSTRACT FROM AUTHOR]

To collect data about the current practice of recovering horses from general anesthesia and recovery personnel safety. Online survey. An online questionnaire, including questions on general demographic data, recovery drugs, modality and characteristics of equine recovery and morbidity and mortality, was designed and distributed via e-mail to equine practitioners worldwide. Practitioners from 22 countries completed 373 questionnaires; 53% of the participants were board-certified equine surgeons, and the remainder were board-certified anesthesiologists (18%), large animal residents (8%), general practitioners (7%), large animal interns (6%), anesthesia residents (4.5%) and veterinary technicians (1.6%). Respondents were employed by academia (58%) or private practice (42%). Of the respondents employed at a university, 93% had a board-certified anesthesiologist on staff compared with 7% of respondents employed at a private practice. Most of the respondents assist horses during recovery, with 23% assisting every recovery and 44% assisting recovery in the majority of cases. Reasons for choosing to assist horses during recovery were: orthopedic procedures (57%), neurological deficits (49%), bad health (47%), history of poor recovery (44%), foals (42%), draft breeds (30%), magnetic resonance imaging (17%) and computed tomography (16%). Unacceptable recoveries were reported by 77% of participants. Commonly reported complications during recovery with any method were: orthopedic injury (66%), myopathy (54%), skin abrasion (53%) and airway obstruction (37%). The incidences of unacceptable quality of recovery (p = 0.09) or personnel injury (p = 0.56) were not different between assisted and nonassisted recoveries; however, more equine fatalities were reported for assisted recoveries (p < 0.006). Practitioners in academia reported more unacceptable recoveries (p < 0.0007) and personnel injuries (p < 0.002) compared with those in private practice. The method of recovery differs among hospitals. Recovery personnel injuries associated with assisting horses during recovery are an important and previously unreported finding. [ABSTRACT FROM AUTHOR]

Objective To evaluate the potency and duration of three subparalyzing doses of vecuronium (VEC) in isoflurane-anesthetized horses. Study design Prospective experimental study. Animals Thirteen healthy adult horses undergoing arthroscopic surgery. Methods During isoflurane anesthesia, horses received one of three doses of vecuronium (25, 50, or 100 μg kg−1). Neuromuscular transmission was monitored with acceleromyography (AMG) with train-of-four (TOF) stimulation of the radial nerve. Maximal depression of the first twitch (T1), and onset time were recorded for each dose. Recovery time to a TOF ratio >90% was also evaluated. Results Vecuronium 25 μg kg−1 produced no observable T1 depression in four horses. VEC 50 μg kg−1 ( n = 5) produced a maximal T1 depression of [median (min, max)] 41 (20, 71) % in four horses, and no neuromuscular block was seen in the fifth. VEC 100 μg kg−1 was given to four horses and produced a T1 depression of 73 (64, 78) %. Of the four horses in which VEC 50 μg kg−1 produced a measurable neuromuscular block, three recovered spontaneously 43 (40, 52) minutes after VEC administration; a fourth subject received edrophonium to reverse residual block at the end of the surgery. Spontaneous recovery after VEC 100 μg kg−1 occurred by 112 minutes in one horse, and had to be facilitated by edrophonium in the remaining three horses, more than 2 hours after VEC had been given. Conclusions and clinical relevance A dose of 100 μg kg−1 VEC in isoflurane anesthetized horses failed to produce complete paralysis. The partial neuromuscular block lasted at least 2 hours after this dose had been administered. Edrophonium was required to reverse the neuromuscular block in three of four horses. It is likely that more than 100 μg kg−1 VEC would be necessary for complete neuromuscular blockade in horses, and that this dose will last >2 hours. [ABSTRACT FROM AUTHOR]