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Ketamine, a noncompetitive NMDA receptor antagonist, has been shown to provide analgesia in some species. To target the NMDA receptor specifically and to potentially minimize some untoward side-effects, ketamine had been used epidurally. The objective of this study was to determine the analgesic effect of epidurally administered ketamine in dogs with chemically induced synovitis. Sixteen healthy dogs were used. Dogs were anesthetized with propofol (4 mg kg−1 IV). Synovitis was induced by injecting 1 mL of sodium urate crystal solution (10 mg mL−1) into the right stifle. Dogs were allowed to recover and the synovitis was allowed to develop for 12 hours. The dogs were then anesthetized again using propofol (4 mg kg−1 IV). Lumbosacral epidural injections were performed with each dog receiving either 2 mg kg−1 of ketamine (20 mg mL−1) or an equal volume of placebo (sterile water containing not more than 0.1 mg mL−1 benzethonium chloride). Analgesia was assessed at baseline and then at 12, 14, 16, 18, 20, and 24 hours after induction of synovitis. Ground reaction forces (peak vertical force and impulse area) and overall pain were measured using a force platform and a pain scoring system (numerical rating scale). Analysis of the data by Repeated Measures anova showed that the dogs developed a significant lameness between the baseline and 12 hours. However, no significant difference in ground reaction forces or total pain score was demonstrated between the treatment and control groups at any other time. In conclusion, ketamine administered epidurally at a dose of 2 mg kg−1 did not provide significant analgesia in dogs with chemically induced synovitis.

Objective—To evaluate nonselective computed tomographic (CT) venography for evaluating the cervical internal vertebral venous plexus (IVVP), define the diameter and area dimensions of the IVVP, and determine the relationship between dimensions of the cervical IVVP and other vertebral components in medium-sized dogs. Animals—6 healthy dogs that weighed 18 to 27 kg. Procedure—Helical CT scans were performed from C1 to C7 before and after IV injection of contrast medium (480 mg of iodine/kg) and a continuous infusion (240 mg of iodine/kg). Image data were transferred to a CT workstation, and measurements were performed on displayed transverse images. Diameter and area measurements of the vertebral canal, dural sac, IVVP, and vertebral body were obtained at C3 to C7. Results—Opacification of vertebral venous structures was achieved in all dogs with no adverse reactions. Sagittal diameters of the IVVP for C3 to C7 ranged from 0.6 to 3.2 mm. Transverse diameters ranged from 2.32 to 5.74 mm. The IVVP area represented 12.4% of the mean vertebral canal transverse area and 30.61% of the mean vertebral epidural space area. Area measurements of the IVVP were significantly correlated with vertebral canal area and dural sac area. Conclusions and Clinical Relevance—Results indicated that nonselective CT venography is a safe, sensitive method for performing morphometric assessments of the cervical IVVP in dogs. Findings support the theory that there may be a physiologic or developmental relationship between cervical vertebral canal components. (Am J Vet Res 2005;66:2039–2045)

Objective—To evaluate the hemodynamic effects of orally administered carvedilol in healthy dogs with doses that might be used to initiate treatment in dogs with congestive heart failure. Animals—24 healthy dogs. Procedure—Dogs were randomly allocated to receive carvedilol PO at a dose of 1.56, 3.125, or 12.5 mg, twice daily for 7 to 10 days; 6 dogs served as controls. Investigators were blinded to group assignment. Hemodynamic variables were recorded prior to administration of the drug on day 1 and then 2, 4, and 6 hours after the morning dose on day 1 and days 7 to 10. Change in heart rate after IV administration of 1 µg of isoproterenol/kg and change in systemic arterial blood pressure after IV administration of 8 µg of phenylephrine/kg were recorded 2 and 6 hours after administration of carvedilol. Results—Administration of carvedilol did not significantly affect resting hemodynamic variables or response to phenylephrine. The interaction of day and carvedilol dose had a significant effect on resting heart rate, but a significant main effect of carvedilol dose on resting heart rate was not detected. Increasing carvedilol dose resulted in a significant linear decrease in heart rate response to isoproterenol. Conclusions and Clinical Relevance—In healthy conscious dogs, orally administered carvedilol at mean doses from 0.08 to 0.54 mg/kg given twice daily did not affect resting hemodynamics. Over the dose range evaluated, there was a dose-dependent attenuation of the response to isoproterenol, which provided evidence of β-adrenergic receptor antagonism. (Am J Vet Res 2005;66:637–641)

The purpose of this study was to determine the analgesic efficacy of bupivacaine, morphine, or saline (control) when injected epidurally into the lumbosacral epidural space in goats after abdominal surgery. Goats received either bupivacaine (0.5%; 1.5 mg/kg in 0.9% sodium chloride solution), 0.9% sodium chloride solution (0.2 mL/kg), or preservative-free morphine (0.1 mg/kg). Total volume injected into the epidural space was 0.2 mL/kg for all groups. The variables evaluated were times to extubation, sternal recumbency, standing, and eating; heart and respiratory rates; and pain score. Only two of the goats in the bupivacaine group were able to stand on their hindlimbs before 6 hours. Time to eating was shorter for the saline group when compared with the bupivacaine group. Heart rate over all time in the saline group (137 +/- 4 beats/min, mean +/- SEM) was higher than the morphine (125 +/- 3 beats/min) and bupivacaine groups (121 +/- 3 beats/min). Respiratory rate over all time was increased in the saline group (26 +/- 1 breaths/min) compared with the bupivacaine (24 +/- 1 breaths/min) or morphine (24 +/- 1 breaths/min) groups. At 50 minutes, the pain score for the saline group was higher than the morphine group. Pain score over all time in the saline group (1.5 +/- 0.10) was higher than the morphine (1.2 +/- 0.07) and bupivacaine (1.2 +/- 0.04) groups. One goat in the saline group required two intravenous injections of flunixin meglumine for pain.

Airway obstruction and hyperreactivity are characteristics of human asthma and of "heaves," a naturally occurring respiratory disorder of horses and ponies. We measured pulmonary function and plasma immunoreactive 15-hydroxyeicosatetraenoic acid (i15-HETE) concentrations in simultaneously collected carotid artery and right ventricle blood samples in five affected ponies and their age- and gender-matched control ponies. Measurements and sampling were performed before (Period A), during (Period B), and following recovery from (Period C) acute airway obstruction precipitated by housing ponies in a barn and exposing them to hay dust. Pulmonary resistance increased significantly, and dynamic compliance and PaO2 decreased significantly in affected ponies at Period B. Plasma i15-HETE concentrations were greater in carotid artery samples compared with right ventricle samples in affected ponies at each measurement period, suggesting that the lung was a source of i15-HETE. Carotid artery i15-HETE concentrations were significantly greater in affected ponies than in control ponies and increased at Period B. There was a significant negative correlation between changes in plasma i15-HETE and changes in dynamic compliance between measurement Periods A and B. We conclude that the lung is a source of i15-HETE in ponies with heaves, that these ponies produce greater quantities of i15-HETE than control ponies, and that exposing affected ponies to a barn environment produces acute airway obstruction and increased plasma concentrations of i15-HETE.

Objective— To evaluate the efficacy of epidurally administered deracoxib to mediate the signs of a sodium urate crystal-induced stifle synovitis in dogs, and to compare the efficacy of epidural versus subcutaneously administered deracoxib. Study Design— Experimental, randomized, blinded, placebo-controlled modified cross-over design. Animals— Random source, adult, mixed breed dogs (n=24; 14 males, 10 females). Methods— Sodium urate crystals were used to create a stifle synovitis model to evaluate the efficacy of deracoxib. Dogs were divided into 4 groups: 3 mg/kg epidural deracoxib, 1.5 mg/kg epidural deracoxib, 3 mg/kg subcutaneous deracoxib, and a placebo (vehicle for deracoxib). Force plate and subjective evaluations were made at time 0, 2, 4, 8, 12, and 24 hours post-treatment. Repeated measures ANOVA with Bonferroni-corrected post hoc comparisons was used to determine significant treatment effects. Results— Peak vertical force (PVF) and vertical impulse (VI) were both significantly higher in deracoxib treated dogs compared with placebo. For 3 mg/kg epidural and subcutaneous deracoxib, PVF and VI were significantly greater than for 1.5 mg/kg epidural deracoxib. Overall pain score for all deracoxib-treated dogs was significantly lower than for placebo dogs. Conclusions— Epidural administration of deracoxib is effective at providing analgesia in an acute joint pain model; however, it does not appear to be more effective than systemic administration. Clinical Relevance— Injectable deracoxib is effective in providing analgesia in acute inflammatory conditions of synovial joints.

Objective— To compare the effects of postoperative pain after ovariohysterectomy by harmonic scalpel-assisted laparoscopy (HALO) and traditional ovariohysterectomy (OVH) in dogs. Study Design— A randomized, blinded, prospective study. Sample Population— Sixteen, purpose-bred, intact female, Beagle dogs. Methods— Dogs were divided into 2 groups: Group 1 (8 dogs), which had OVH by HALO, and Group 2 (8 dogs), which had traditional OVH. Physiologic data, abdominal nociceptive threshold scores, and University of Melbourne pain scores (UMPS) were recorded at 2, 6, 12, 24, 48, and 72 hours after surgery. Blood samples for measurement of plasma cortisol, glucose, and creatine phosphokinase (CPK) concentrations were collected at the time of the incision, and 2, 6, 12, 24, 48, and 72 hours after surgery. Results— No significant surgical complications occurred. The HALO mean surgical time was significantly longer (55.7 minutes) than traditional OVH (31.7 minutes). No significant differences were observed between groups for the pain measures of heart rate, respiratory rate, temperature, CPK, and glucose concentrations. The OVH group had significantly higher mean plasma cortisol levels at hour 2 after surgery than the HALO group (P=.0001). The mean UMPS were significantly higher in OVH than the HALO group at all postoperative times (P=.0001). The mean nociceptive threshold measurements revealed significantly higher tolerated palpation pressures in HALO than OVH at all postoperative times, except hour 72 (P=.0002). Conclusions— Dogs appeared to be in less pain with HALO than OVH. The harmonic scalpel coagulated ovarian and uterine vessels completely with minimal collateral damage to surrounding tissues. Clinical Relevance— HALO is a safe alternative to OVH and offers a minimally invasive and less painful method of surgery.

Objective To determine if epidural ketamine provides analgesia in dogs with a chemically induced synovitis. Study design Prospective randomized experimental trial. Animals Thirty-two healthy, adult mongrel dogs (13–30 kg). Methods (Part I) Synovitis was induced in the right stifle of 16 dogs and allowed to develop for 12 hours. Epidural injection at the lumbosacral space of either ketamine (2 mg kg −1 ; n = 8) or placebo ( n = 8) was performed. Limb use and pain were measured using a force platform and numerical rating scale (NRS). Assessments were performed before and at 12, 14, 16, 18, 20, and 24 hours after the induction of synovitis. (Part II) Epidural injection of either ketamine ( n = 8) or placebo ( n = 8) was performed immediately before the induction of synovitis. Analgesia was assessed as in Part I. Assessments occurred before and at 2, 4, 6, 8, and 12 hours after the induction of synovitis. Results (Part I) Vertical ground reaction forces (VGRF) significantly decreased and NRS scores of total pain significantly increased after the induction of synovitis in all dogs ( p 0.05). No significant differences in VGRF or NRS scores were measured between treatment groups at any assessment period. (Part II) Dogs that received ketamine had significantly lower NRS scores 2 hours after treatment ( p 0.05). NRS scores did not differ between groups at any other evaluation. VGRF did not differ significantly between treatment groups at any assessment period. Conclusion Epidural ketamine at a dose of 2 mg kg −1 administered after the development of synovitis does not provide significant levels of analgesia. Administration of ketamine before the induction of synovitis significantly decreased the NRS score 2 hours post-induction. Clinical relevance Administration of epidural ketamine before tissue injury may provide analgesia of short duration in dogs.

Minimally invasive surgery has been found in humans to reduce pain, incidence of infections, and duration of hospitalization. Minimally invasive procedures are also being described in veterinary medicine. Laparoscopic ovariohysterectomy (OHE) was performed on nine, healthy, intact female dogs using a Harmonic scalpel. Creatine kinase values were determined both before and 12 hours following the laparoscopic OHE; the magnitude of the difference between preoperative and postoperative creatine kinase values did not correlate with length of operative time, length of incisions, or amount of hemorrhage. Complications included one dog that had an omental herniation that was primarily repaired and one dog with seroma formation. Median surgical time for all dogs was 60 minutes (range, 35 to 100 minutes).

Objective— To assess donor-site morbidity and survival of the rectus abdominis muscle with an overlying skin graft after free tissue transfer to a medial femorotibial defect in dogs. Study Design— Experimental study. Sample Population— Phase 1:6 canine cadavers; phase 2:7 adult mixed-breed dogs. Methods— Phase 1: The rectus abdominis muscle was removed from canine cadavers, muscular and vascular dimensions were recorded, and angiography was performed. Phase 2: Muscular transfer was performed through anastomosis of the caudal epigastric artery and vein to the saphenous artery and medial saphenous vein. Transferred tissues were evaluated on postoperative days 3, 6, 10, and 13. Animals were examined daily until euthanasia between postoperative days 31 and 42. Postmortem angiograms were performed and tissues collected for histopathologic evaluation. Results— Phase 1: Appropriate vascular dimensions for microvascular anastomosis were confirmed and surgical technique perfected. Phase 2: Muscular excision produced minimal donor-site morbidity. All muscles survived after microvascular transfer and angiography confirmed vascular patency. All of the skin grafts survived, with one graft undergoing partial necrosis. Conclusions— The rectus abdominis muscle can be successfully transferred to a medial femorotibial defect and can serve as a bed for acute skin grafting. No significant donor-site morbidity is associated with its removal. Clinical Relevance— Microvascular free tissue transfer of the canine rectus abdominis muscle has not been previously described. This technique provides a new alternative for repair of appropriate wounds. Additional studies are needed to define its utility in clinical patients.

Objective— To evaluate gait, range of motion (ROM), and lameness in normal dogs after arthroscopy or arthrotomy of the cubital joint. Study Design— Experimental study. Animals— Fourteen mature, healthy dogs. Methods— Dogs were randomly assigned to treatment groups. Seven underwent arthrotomy and 7 underwent arthroscopy of the left cubital joint. Dogs were evaluated using kinetic gait assessment, subjective evaluation scores, and cubital joint ROM. Evaluations were performed before and on days 2, 4, 7, 15, 22, and 29 after surgery. Radiographs made before and after the surgical procedures were evaluated. Results— Significant differences in peak vertical force and vertical impulse force were not observed between surgery groups (P= .88 and .49, respectively). Joint ROM was not significantly different between groups (P= .09 for flexion and .91 for extension). For all dogs, joint ROM and radiographic evaluations remained normal throughout the study period. Significant differences in subjective lameness scores, weight bearing, or pain were not observed between groups (P≥ .19 for all variables). Conclusions— In this study population, significant differences between dogs undergoing arthroscopy or arthrotomy of the cubital joint with respect to postoperative pain, weight bearing, joint ROM, or temporal improvement of ground reaction forces were not observed. Clinical Relevance— The results of this study suggest that postoperative morbidity should not be a factor when making a decision to perform either arthroscopy or arthrotomy for exploration of the medial compartment of the canine cubital joint.

Objective— To assess the effects of epidural anesthesia using lidocaine on microcirculatory blood flow, volume, and velocity in free fasciocutaneous flaps in dogs. Study Design— In vivo experimental investigation. Animal Population— Ten adult dogs weighing 20 to 25 kg. Methods— A medial saphenous fasciocutaneous free flap was removed and an orthotopic transfer was performed by anastomosing the primary flap vessels back to the medial saphenous vessels. Blood flow (mLLD/min/100 g), volume (%volume or tissue hematocrit) and velocity (mm/s) in the flap were recorded throughout the procedure. After epidural anesthesia, blood flow, volume, and velocity values were again recorded. Results— Microcirculatory blood flow, volume, and velocity, as measured by a laser-Doppler flowmeter, failed to reveal any significant changes over time. Immediately after epidural anesthesia, mean arterial pressure was significantly reduced and remained depressed throughout the experimental procedure. Conclusions— Epidural anesthesia combined with general anesthesia does not improve microcirculatory flow in free flaps in the pelvic limbs of dogs. No significant change in blood flow to the medial saphenous fasciocutaneous free flap occurred after division and anastomosis of the vascular pedicle. Clinical Relevance— We recommend that epidural anesthesia with 2% lidocaine be used with caution in dogs undergoing microvascular free-flap transfer.

Objective— To evaluate the clinical, cerebrospinal fluid (CSF), and histopathologic effects of epidural ketorolac. Study Design— Blinded, randomized, placebo controlled study. Animals— Twenty-two adult mixed breed dogs with 16 treatment and 6 control dogs, weighing 14.4 to 29.8 kg. Methods— Dogs were anesthetized and epidural catheters were placed at the lumbosacral space. Catheter placement was evaluated fluoroscopically. Ketorolac (0.4 mg/kg) or placebo (5% ethanol) was administered epidurally over a 52-hour period, with 5 injections given at 12-hour intervals. At 1, 2, 4, or 8 hours after the first and last injection of ketorolac, dogs were anesthetized and CSF was obtained. Control dogs had CSF sampled 1 hour after the first and last ethanol injection. Neurologic function and pain responses were evaluated before and during the study. Selected dogs were then killed and necropsies performed. Results— None of the dogs exhibited any clinical or neurologic abnormalities during the study. No statistical difference was noted in pain response or CSF analysis between treatment and control dogs. Gross necropsy revealed gastrointestinal ulceration of varying degrees in all treatment dogs. Histopathologic analysis of the spinal cord and meninges revealed minimal focal leptomeningeal phlebitis in 2 of 8 treatment dogs and minor subdural inflammation in 1 control dog. No changes to the neural structures were noted in any dogs. Conclusions— Epidural administration of ketorolac did not cause clinical signs, alteration in CSF values, or pathologic changes to the spinal cord when used for short duration. Gastrointestinal ulceration was common when ketorolac was administered epidurally at 0.4 mg/kg every 12 hours for 5 treatments. Clinical Relevance— This study documented the neurologic safety of epidural ketorolac in dogs before an efficacy trial can be performed. Gastrointestinal ulceration may limit use to short duration or a single injection.

A fluid therapy plan for a patient is developed prior to surgery and is designed to meet each patient's needs. The volume and type of fluid are dependent on the patient's physical status; the acid-base, fluid, and electrolyte status; the surgical procedure; and the expected losses occurring during the procedure. No one fluid regimen is ideal for all patients. All fluid regimens must be continually re-evaluated. A brief minor surgical procedure in a healthy surgical candidate requires little or no fluid administration. In cases of more extensive surgical procedures involving invasion of the abdomen or chest as well as in cases with trauma and major blood loss, much more volume and a specific balanced replacement fluid are required. Depending on the severity of the surgical case, administration rates of 5 to 15 mL/kg/h or greater of crystalloid may be required to maintain perfusion. These rates are merely guidelines, and resuscitation should continue until the desired end point is reached. Balanced replacement fluids may be used to replace blood loss at a ratio of 3:1 and are added to maintenance and replacement requirements. Blood loss of 20% to 25% of the calculated blood volume or hematocrit values less than 20% are indications for colloids or blood replacement at a ratio of 1:1. The optimal fluid therapy regimen for a patient may involve a combination of crystalloids as well as natural and synthetic colloids, using each type of fluid to obtain and maintain perfusion and oxygenation to the tissues.

Failure to awaken, delayed awakening, and blunted responsiveness following anesthesia constitute a continuum which must be recognized, diagnosed accurately, and responded to appropriately. One must determine whether it is a normal recovery for this animal or a pathological delay. A delayed recovery results in continued depression of many organ systems. The possible etiologic factors, some obvious, others quite obscure, must be considered quickly to provide the patient with the best possible care. Diminished responsiveness is usually the result of a complex interaction between multiple factors. A systematic approach to treatment first begins by ensuring cardiac output, oxygenation, ventilation, and supportive care in all patients. Then consider the potential causes for prolonged recovery and either rule them out or treat them. First consider the potential causes for central nervous system depression. Several commonly encountered medical conditions enhance sensitivity to or decrease the elimination of anesthetic and sedative agents. The astute clinician will be aware of the medical condition and its impact on anesthetic drug effect and elimination to avoid prolonged recoveries.

Effects of positioning on systemic blood pressure were evaluated in six full-term pregnant golden retriever bitches during general anesthesia. Two positions (dorsal and left lateral recumbency) were examined. Anesthesia was induced with thiamylal sodium and maintained with halothane in oxygen. Direct arterial blood pressures were recorded from the bitches in each position. Effects of positioning for each bitch during general anesthesia were reexamined after the bitch weaned its pups; thus, each bitch served as its own control. Maternal posture had no significant effect (p greater than 0.05) on systemic blood pressure. Pregnancy had no significant effect (p greater than 0.05) on systemic blood pressure. Supine hypotension did not occur in anesthetized large, full-term pregnant bitches. Dorsal recumbency was an acceptable position for cesarean sections performed with the patient under general anesthesia.