Ana Cristina Pacheco de Araújo

Retrospective Study of Anesthesias in Dogs and Cats Underwent to Neurosurgery

Background: The goal of anesthesia in patients with neurological diseases is to maintain the homeostasis of the central nervous system, focusing on intracranial pressure and pain during the intraoperative period. The purpose of this study was to evaluate the anesthesia performed between January 2010 and January 2016 at the Veterinary Clinical Hospital at the Federal University of Rio Grande do Sul and correlate the types of surgeries, drugs used in the pre-anesthetic medication, induction, pain control, and the development of complications during the procedure. Materials, Methods & Results: The medical records of 242 patients, who presented with neurological signs of spinal cord compression or traumatic brain injury, were assessed. Only 70 patients who underwent surgery had properly documented and detailed anesthesia records. Of these 70, there were 32 male and 38 female animals, with one feline and 69 canines. Their weights on the day of surgery ranged between 1.5 kg and 38 kg and their ages ranged from six months up to 13 years. We evaluated 74 surgeries because four patients underwent two separate surgeries. There were 38 hemilaminectomies, 14 ventral slots, seven vertebral stabilizations (one atlantoaxial instability and six vertebral fractures), six dorsal laminectomies, four pediculectomies, two fenestrations with hemilaminectomy, one durotomy with hemilaminectomy, one minihemilaminectomy, and one tumor removal. The complications observed were bradycardia (25/74), systemic hypotension (49/74), systemic hypertension, (21/74) and death (4/74). There was a great variation in the pre-anesthetic medication; either combinations of two or more drugs, one drug, or no medication was used. The most common drug used for induction of the patient was propofol, which was used in 46 cases as single agent and in 26 cases in combination with other drugs. In 43 patients, the majority of nociception control during the intraoperative period was achieved with continuous infusions of fentanyl combined with lidocaine, while some used ketamine. Pain control for the remaining 15 patients was accomplished with drug boluses. In two cases, the choice of opioid in the pre-anesthetic medication was repeated. Fourteen patients had remained without analgesia during surgery. No correlation was observed between the frequency of complications and the type of surgery performed, the medications used for induction of the patient, or the method of control of nociceptive stimuli during surgery. Continuous infusions were used frequently for pain control during surgery, however no significant correlation with complications was observed. Discussion: The high prevalence of neurological diseases that affect the spinal cord makes spinal surgery one of the most frequent neurosurgeries. The risk of complications in spinal surgery is affected by hemodynamics of the patient and may lead to death during the procedure. The most frequent complications are bradycardia, hypotension, cardiac electrophysiological changes, apnea, hemorrhage, and death. The survey identified bradycardia, hypotension, hypertension, and death as the major complications. The most frequent method of intraoperative analgesia was a continuous infusion, due to its benefits when compared to other methods of analgesia. When compared to previous studies, the present study showed similar complications that had no correlation wtih the type of surgery or anesthesia protocol.

A Retrospective Study of Small Animal Poisoning at the Veterinary Medical Teaching Hospital from South Region of Brazil

Background : Poisoning cases are a challenge for the veterinary practitioner, since many agents can be involved. The incomplete patient history associated with advanced poisoning stage often leads to death. Since lacking information is common, it is essential to be aware of principal poisoning agents and their associated symptomatology. The aim of this study is to describe the major agents involved in small animal poisoning, the causative agent, poisoning route, time to search veterinary care, clinical signs and ancillary tests of canine and feline patients treated at the Veterinary Medical Teaching Hospital from January 2010 to June 2016. Materials, Methods & Results : Forty-four medical records with poisoning history were found and reviewed, but only 30 medical records had complete data to be evaluated. There were 24 dogs and 6 cats, 17 female and 13 male. Six females were spayed. Poisoning agent identification was possible in 29 cases and was food, molluscicide, cleaning product, ornamental plants, medication, rodenticide and antiparasitic drugs. Fourteen poisonings were caused by the owner and 16 were accidental. There was a higher poisoning incidence in dogs than cats. Most of the patients were young and unneutered/unspayed. Discussion : In this study there was a higher poisoning prevalence in dogs than cats, as occurred in other studies published in Europe, Belgium, France, Greece, Italy, Spain, Austria and other Brazilian regions. Most of the patients were young, which is in agreement with previous studies in which young animals were more affected. Domestic antiparasitic drugs were the most common poisoning agents (33%), as reported in studies from France and Spain. In southern Brazil, the most common poisoning agent was medication, whereas in southeast Brazil, organophosphates were the most prevalent poisoning agent. Considering this, the geographic localisation seems to influence the poisoning agent. It is known that many owners give unprescribed medication to their pets and this also happened in this study, as 46% of the poisoning cases were caused by the owner. The most common clinical signs were gastrointestinal (76%, emesis and anorexia) and neurological (63%, depression). This is in agreement with another study that showed a high number of patients poisoned by medications leading to severe gastrointestinal clinical signs. Despite a history of eating spiced food, our food-poisoned patient did not show clinical signs compatible with pepper poisoning. In fact, clinical signs were more compatible with salt or onion and garlic poisoning, but there was no history to support that our patient had eaten these foods. The patient who ate fern and busy Lizzie ( Impatiens walleriana ) did not show clinical signs compatible with these agents but showed gastrointestinal clinical signs that could have occurred due to plant indigestion. This fact emphasises the need for more studies in this area. One dog with rodenticide poisoning presented with normal blood test results, but the blood sample was collected a few hours after exposure. This can occur after brodifacoum poisoning, which has a longer half-life than warfarin. In brodifacoum poisoning cases, clinical signs can appear days after exposure. In one dog, it was not possible to indentify the poisoning agent and this specific patient case exemplifies the challenge to diagnose the exact poisoning agent and concomitant diseases when the history is incomplete. This retrospective study shows the heterogeneity of the causative agents and the associated symptomatology, which highlights the need for further studies in this area. In this study, antiparasitic drugs were the most common poisoning agents, especially pyrethroids. Dogs were more affected than cats. Most of the patients were young and unneutered/unsprayed, indicating these characteristics could be a risk factor in this study.