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OBJECTIVE Use a referral dental clinic model to study how to calculate accurate 95% upper confidence limits for probabilities of workloads (total case duration, including turnover time) exceeding allocated times. ANIMALS Dogs and cats undergoing dental treatments. METHODS Managerial data (procedure date and duration) collected over 44 consecutive operative workdays were used to calculate the daily anesthetist workload. Workloads were compared with a normal distribution using the Shapiro-Wilk test, serial correlation was examined by runs test, and comparisons among weekdays were made using the KruskalWallis test. The 95% confidence limits for normally distributed workloads exceeding allocated times were estimated with a generalized pivotal quantity. The impact of a number of procedures was assessed with scatterplots, Pearson linear correlation coefficients, and multivariable linear regression. RESULTS Mean anesthetist’s workload was normally distributed (Shapiro-Wilk P = .25), without serial correlation (P = .45), and without significant differences among weekdays (P = .52). Daily workload, mean 9.39 hours and SD 3.06 hours, had 95% upper confidence limit of 4.47% for the probability that exceeding 16 hours (ie, 8 hours per each of 2 tables). There was a strong positive correlation between daily workload and the end of the workday (r = .85), significantly larger than the correlation between the end of the workday and the number of procedures (r = .64, P < .0001). CLINICAL RELEVANCE There are multiple managerial applications in veterinary anesthesia wherein the problem is to estimate risks of exceeding thresholds of workload, including the costs of hiring a locum, scheduling unplanned add-on cases, planning for late discharge of surgical patients to owners, and coordinating anesthetist breaks. [ABSTRACT FROM AUTHOR]

Objectives The primary study objective was to assess two injectable anesthetic protocols, given to facilitate castration surgery in cats, for equivalence in terms of postoperative analgesia. A secondary objective was to evaluate postoperative eating behavior. Methods Male cats presented to a local clinic were randomly assigned to receive either intramuscular ketamine (5 mg/kg, n = 26; KetHD) or alfaxalone (2 mg/kg, n = 24; AlfHD) in combination with dexmedetomidine (25 μg/kg) and hydromorphone (0.05 mg/kg). All cats received meloxicam (0.3 mg/kg SC) and intratesticular lidocaine (2 mg/kg). Species-specific pain and sedation scales were applied at baseline, 1, 2 and 4 h postoperatively. Time taken to achieve sternal recumbency and begin eating were also recorded postoperatively. Results Pain scale scores were low and showed equivalence between the treatment groups at all time points (1 h, P = 0.38, 95% confidence interval [CI] of the difference between group scores 0–0; 2 h, P = 0.71, 95% CI 0–0; 4 h, P = 0.97, 95% CI 0–0). Four cats crossed the threshold for rescue analgesia (KetHD, n = 1; AlfHD, n = 3). At 1 h, more cats in the KetHD (65%) group than in the AlfHD (42%) group were sedated, but statistical significance was not detected (P = 0.15, 95% CI −1 to 0). Most AlfHD cats (88%) began eating by 1 h vs 65% of KetHD cats (P = 0.039). Time to recover sternal recumbency did not differ between groups (P = 0.86, 95% CI −14.1 to 11.8). Conclusions and relevance These results show that AlfHD and KetHD provide equivalent analgesia as part of a multimodal injectable anesthetic protocol. Alfaxalone is associated with an earlier return to eating. [ABSTRACT FROM AUTHOR]

Background: The Canadian Council on Animal Care and American Veterinary Medical Association classify intraperitoneal (IP) pentobarbital as an acceptable euthanasia method in rats. However, national guidelines do not exist for a recommended dose or volume and IP euthanasia has been described as unreliable, with misinjections leading to variable success in ensuring a timely death. The aims of this study were to assess and improve efficacy and consistency of IP euthanasia. In a randomized, blinded study, 51 adult female Sprague-Dawley rats (170-495 g) received one of four treatments: low-dose low-volume (LL) IP pentobarbital (n = 13, 200 mg/kg pentobarbital), low-dose high-volume (LH) IP pentobarbital (n = 14, 200 mg/kg diluted 1:3 with phosphate buffered saline), high-dose high-volume (HH, n = 14, 800 mg/kg pentobarbital), or saline. Times to loss of righting reflex (LORR) and cessation of heartbeat (CHB) were recorded. To identify misinjections, necropsy examinations were performed on all rats. Video recordings of LL and HH groups were analyzed for pain-associated behaviors. Between-group comparisons were performed with 1-way ANOVA and Games-Howell post hoc tests. Variability in CHB was assessed by calculating the coefficient of variation (CV). Results: The fastest euthanasia method (CHB) was HH (283.7 ± 38.0 s), compared with LL (485.8 ± 140.7 s, p = 0.002) and LH (347.7 ± 72.0 s, p = 0.039). Values for CV were: HH, 13.4%; LH, 20.7%; LL, 29.0%. LORR time was longest in LL (139.5 ± 29.6 s), compared with HH (111.6 ± 19.7 s, p = 0.046) and LH (104.2 ± 19.3 s, p = 0.01). Misinjections occurred in 17.0% (7/41) of euthanasia attempts. Pain-associated behavior incidence ranged from 36% (4/11, LL) to 46% (5/11, HH). Conclusions: These data illustrate refinement of the IP pentobarbital euthanasia technique. Both dose and volume contribute to speed of death, with a dose of 800 mg/kg (HH) being the most effective method. An increase in volume alone does not significantly reduce variability. The proportion of misinjections was similar to that of previous studies. [ABSTRACT FROM AUTHOR]

Objectives The objective of this study was to compare the effects of ketamine and alfaxalone on the application of a validated feline-specific multidimensional composite pain scale (UNESP-Botucatu MCPS). Methods In a prospective, randomized, blinded, crossover trial, 11 adult cats (weight 4.4 ± 0.6 kg) were given dexmedetomidine (15 μg/kg) and hydromorphone (0.05 mg/kg) with either alfaxalone (2 mg/kg) or ketamine (5 mg/kg) as a single intramuscular injection for the induction of general anesthesia. After orotracheal intubation, general anesthesia (without surgery) was maintained for 32 mins with isoflurane, followed by atipamezole. The following parameters were recorded at baseline, 1–8 h and 24 h post-extubation: pain (pain expression and psychomotor subscales) and sedation scale scores. Alfaxalone treatment injection sites were examined for inflammation at baseline, postinjection, and 8 h and 24 h post-extubation. Results Psychomotor scores were higher with ketamine at hours 1 (3.5 [0–5.0], P <0.0001), 2 (2.5 [0–4.0], P <0.0001) and 3 (0.5 [0–4.0], P = 0.009) post-extubation compared with alfaxalone (hour 1, 0 [0–2]; hour 2, 0 [0–0]; hour 3, 0 [0–0]). Six cats in the ketamine group crossed the analgesic intervention threshold. In contrast, pain expression scores did not differ significantly between treatments at any time (P >0.05); one cat from each group crossed the analgesic intervention threshold. Sedation was greater with ketamine (1 [0–3], P = 0.02) than alfaxalone (0 [0–1]) 1 h post-extubation. No cats had visible inflammation at the injection sites at any time. Conclusions and relevance Ketamine has a confounding effect on the psychomotor subscale of the pain scale studied, which may lead to erroneous administration of rescue analgesia. In contrast, alfaxalone was not associated with significant increases in either pain subscale. These effects of ketamine should be considered when evaluating acute postoperative pain in cats. [ABSTRACT FROM AUTHOR]

Objective To compare the effects of alfaxalone and propofol on intraocular ( IOP) pressure in the canine eye. Animals studied Twenty-three healthy adult dogs. Procedures Dogs were randomized to receive intravenous propofol ( n = 11) or alfaxalone ( n = 12) until loss of jaw tone, 20 min after intravenous premedication (acepromazine 0.02-0.03 mg/kg and hydromorphone 0.05-0.1 mg/kg). IOP was measured at baseline ( BL), 20 min postpremedication (postpremed), loss of jaw tone (postinduct), and immediately following orotracheal intubation (postintub). Between- and within-treatment effects were analyzed with two-way and one-way repeated measures ANOVA with Bonferroni's post hoc test, respectively. P < 0.05 was considered significant. Results No significant IOP differences were detected between alfaxalone or propofol groups at any time point ( P > 0.05). Propofol: IOP did not change between BL (15.5 ± 2.7 mmHg) and postpremed (16.2 ± 3.6 mmHg, P > 0.05), or postinduct (19.1 ± 5.2 mmHg) and postintub (21.0 ± 4.6 mmHg, P > 0.05), but differed significantly between BL and postinduct ( P < 0.0001), and postintub ( P < 0.0001). Alfaxalone: IOP did not change between BL (15.7 ± 2.8 mmHg) and postpremed (15.3 ± 4.1 mmHg, P > 0.05), or postinduct (19.2 ± 4.9 mmHg) and postintub (20.5 ± 4.5 mmHg, P > 0.05), but differed significantly between BL and postinduct ( P < 0.01), and postintub ( P < 0.0001). Conclusions These data show a potentially clinically significant increase in IOP following induction with propofol or alfaxalone, but no difference between agents. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the reporting of key items associated with risk of bias and weak study design over a 10‐year period. Design: Literature survey. Setting: Not applicable. Animals: Not applicable. Interventions: Papers published in the Journal of Veterinary Emergency and Critical Care between 2009 and 2019 were screened for inclusion. Inclusion criteria consisted of prospective experimental studies describing in vivo or ex vivo research (or both), containing at least 2 comparison groups. Identified papers had identifying information (publication date, volume and issue, authors, affiliations) redacted by an individual not involved with paper selection or review. Two reviewers independently reviewed all papers and applied an operationalized checklist to categorize item reporting as fully reported, partially reported, not reported, or not applicable. Items assessed included randomization, blinding, data handling (inclusions and exclusions), and sample size estimation. Differences in assessment between reviewers were resolved by consensus with a third reviewer. A secondary aim was to document availability of data used to generate study results. Papers were screened for links to access data in the text and supporting information. Measurements and Main Results: After screening, 109 papers were included. Eleven papers were excluded during full‐text review, with 98 papers included in the final analysis. Randomization was fully reported in 31.6% of papers (31/98). Blinding was fully reported in 31.6% of papers (31/98). Inclusion criteria were fully reported in all papers. Exclusion criteria were fully reported in 60.2% of papers (59/98). Sample size estimation was fully reported in 8.0% of papers (6/75). No papers (0/99) made data freely available without a requirement to contact study authors. Conclusions: There is substantial room for improvement in reporting of randomization, blinding, data exclusions, and sample size estimations. Evaluation of study quality by readers is limited by the low reporting levels identified, and the risk of bias present indicates a potential for inflated effect sizes. [ABSTRACT FROM AUTHOR]

To assess sedation following intramuscular (IM) administration of medetomidine versus medetomidine–vatinoxan in bearded dragons. Prospective, randomized, experimental, crossover study. A group of 10 (five males and five females) bearded dragons (mean mass ± standard deviation 172 ± 28 g). All animals were administered both medetomidine (0.2 mg kg–1) (MED) and medetomidine (0.2 mg kg–1)-vatinoxan (4 mg kg–1) (MED-VAT) IM, with a 14–16 day washout period between treatments. Sedation was assessed using an adapted version of a sedation scale for bearded dragons (scale range 0–12) before (T0), and every 5 minutes from 10 to 45 minutes after treatment administration (T10–T45). Sedation scores were compared: 1) between time points (within treatments) using a Friedman test and Dunn's post hoc test; and 2) between treatments at each time point using a Wilcoxon paired test. Heart rate and respiratory rate (f R) were analyzed descriptively. At T45, atipamezole was administered IM. Compared with T0, sedation scores were significantly higher at most time points for both treatments. Highest median (range) scores occurred at T30 for MED [T0, 0 (0–0); T30, 2.5 (1–5); p = 0.0001] and at T35 and T40 for MED-VAT [T0, 0 (0–0); T35, 2 (1–5); p = 0.002; T40, 2 (1–5); p = 0.001]. No significant differences in sedation scores were identified between treatments at any time point. The two protocols caused bradycardia and reduction in f R. All animals were active and ate 1 hour after reversal administration. Both medetomidine and medetomidine–vatinoxan caused similar mild sedation in bearded dragons (median < 3/12). Inclusion of vatinoxan did not enhance sedation in this species. [ABSTRACT FROM AUTHOR]