Elizabeth M. Hardie

Behavior after ovariohysterectomy in the dog: what's normal?

Abstract The purpose of this study was to establish the post-operative behavior of caged dogs after ovariohysterectomy. Twenty dogs in the Control Group were anesthetized, but did not undergo surgery. Twenty-two dogs in the Surgery Group underwent laparotomy and ovariohysterectomy. Dogs in the Control and Surgery Groups were further assigned on a random basis to either the Oxymorphone or Placebo Groups (Group O or P). Dogs in Group O received oxymorphone (2.5 mg m −2 intramuscularly) as a pre-anesthetic and 6, 12 and 18 h later, while dogs in Group P received isovolumetric doses of sterile saline. The dogs were videotaped for 24 h after anesthesia, during which time a handler interacted with the dog once each hour. At each interaction the handler recorded a sedation and a pain score, using a numerical scoring system. Interactive and non-interactive behavior was observed and quantitated by a single observer using the videotapes. Surgery resulted in an increase in pain score, sedation score and time spent sleeping. During interactions with caregivers, greeting behaviors were decreased after surgery. Differences between Surgery Group dogs given analgesics and those given placebo drugs were readily measured using quantitative behavioral measurements, but were not apparent using the numerical scoring system.

Comparison of transdermal fentanyl and intramuscular oxymorphone on post-operative behaviour after ovariohysterectomy in dogs

The effects of transdermal fentanyl and i.m. oxymorphone on behavioural and physiological responses, after ovariohysterectomy in dogs, were investigated. The study involved three groups of 10 dogs: fentanyl/surgery (FS), oxymorphone/surgery (OS), fentanyl/control (FC). A transdermal fentanyl delivery system (50 microg hour(-1)) (FS and FC) was applied 20 hours before surgery, or i.m. oxymorphone (OS) was administered. After ovariohysterectomy (FS and OS) or anaesthesia alone (FC), dogs were continuously videotaped for 24 hours and a standardised hourly interaction with a handler performed. The videotapes were analysed, and interactive and non-interactive behaviours evaluated. In addition, pain and sedation scores, pulse and respiratory rates, rectal temperature, arterial blood pressure, plasma cortisol and plasma fentanyl concentrations were measured. This study showed that transdermal fentanyl and i.m. oxymorphone (0.05 mg kg(-1)) produced comparable analgesic effects over a 24 hour recording period. I.m. oxymorphone produced significantly more sedation and lower rectal temperatures than transdermal fentanyl. There were no significant differences between groups in respiratory and heart rates, and arterial blood pressures.

Item generation and design testing of a questionnaire to assess degenerative joint disease-associated pain in cats

OBJECTIVE To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)-associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners. ANIMALS 100 randomly selected client-owned cats from 6 months to 20 years old. PROCEDURES Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs. RESULTS 22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats. CONCLUSIONS AND CLINICAL RELEVANCE Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.

Physiological measurements after ovariohysterectomy in dogs: what's normal?

Abstract Twenty-two pet dogs presented to the North Carolina State University Veterinary Teaching Hospital for elective ovariohysterectomy were treated with oxymorphone 2.5 mg m −2 (Surgery-O group, n = 11) or placebo (Surgery-P group, n = 11) immediately before the induction of anesthesia and 6, 12 and 18 h later. Seventeen random source dogs assigned to a control group that underwent anesthesia alone for 2 h received identical treatment with oxymorphone (Control-O group, n = 9) or placebo (Control-P group, n = 8). The heart rate, respiratory rate, temperature and blood pressure were measured preoperatively, at the time of skin incision (or 1 h after anesthetic induction of controls), at extubation and at hours 1, 3, 6, 12 and 24 after extubation. Plasma cortisol concentration was measured preoperatively, at extubation and at hours 3, 6 and 12. Treatment with oxymorphone reduced the heart rate and body temperature in both the Surgery-O and Control-O groups, but no differences in physical findings suggesting an analgesic effect of the drug were identified. Elevated plasma cortisol concentrations were found at hours 3 and 6 in both surgery groups, whereas the plasma cortisol concentration in the control groups did not change. The plasma cortisol concentration was reduced in the Surgery-O group compared to the Surgery-P group at hours 3–12, suggesting an analgesic effect of the drug. We conclude that routinely monitored physiological signs are not sensitive indicators of a stress response to ovariohysterectomy, or of an analgesic effect of oxymorphone.

Reliability and discriminatory testing of a client-based metrology instrument, feline musculoskeletal pain index (FMPI) for the evaluation of degenerative joint disease-associated pain in cats

The objective of this study was to test the readability, reliability, repeatability and discriminatory ability of an owner-completed instrument to assess feline degenerative joint disease (DJD)-associated pain (feline musculoskeletal pain index, FMPI). Readability was explored using four different formulas (Flesch, Fry, SMOG and FOG) and the final FMPI instrument was produced. To assess the instrument, client-owned cats that were defined as normal (normal group) or as having DJD-associated pain and mobility impairment (pain-DJD group) were recruited. A total of 32 client-owned cats were enrolled in the study (normal, n=13; pain-DJD, n=19). Owners completed the FMPI on two occasions, 14days apart. Internal consistency (reliability) and repeatability (test-retest) were explored using Cronbachs α and weighted κ statistic, respectively. Data from the two groups were compared using analysis of covariance (controlling for age) to evaluate discriminatory ability. The FMPI was constructed with 21 questions covering activity, pain intensity and overall quality of life. It had a 6th grade readability score. Reliability of the FMPI was excellent (Cronbachs α>0.8 for all groupings of questions in normal and pain-DJD cats) and repeatability was good (weighted κ statistic >0.74) for normal and pain-DJD cats. All components of the FMPI were able to distinguish between normal cats and cats with DJD (P<0.001 for all components). This initial evaluation of the FMPI suggests that this instrument is worthy of continued investigation.

Acute Nontraumatic Hemoabdomen in the Dog: A Retrospective Analysis of 39 Cases (1987–2001)

The medical records of 39 dogs with acute nontraumatic hemoabdomen were identified and reviewed. Anemia and hypoalbuminemia were identified in 36/37 (97%) and 25/33 (76%) dogs, respectively. Coagulopathies were identified in 26/31 (84%) dogs. When a definitive diagnosis was obtained, malignant neoplasia was diagnosed most frequently and occurred in 24/30 (80%) dogs. Hemangiosarcoma accounted for 21/30 (70%) diagnoses. Sixteen dogs underwent exploratory laparotomy, of which seven (44%) survived the perioperative period. Of the dogs that did not undergo surgery, 9/23 (39%) survived to be discharged from the hospital.

Feline Musculoskeletal Pain Index: Responsiveness and Testing of Criterion Validity

BACKGROUND Progress in establishing if therapies provide relief to cats with degenerative joint disease (DJD)-associated pain is hampered by a lack of validated owner-administered assessment methods. HYPOTHESIS That an appropriately developed subjective owner-completed instrument (Feline Musculoskeletal Pain Index-FMPI) to assess DJD-associated impairment would have responsiveness and criterion validity. ANIMALS Twenty-five client-owned cats with DJD-associated pain. METHODS FMPI responsiveness (ability to detect the effect of an analgesic treatment) and validity (correlation with an objective measure) were explored through a stratified, randomized, double blinded, placebo-controlled, crossover 10-week clinical study. Meloxicam was administered to effect pain relief. A linear mixed model, backward stepwise regression, and Pearson correlations were used to assess responsiveness and criterion validity with the assumption that the NSAID would increase activity. RESULTS Positive responses of cats to placebo (P = .0001) and meloxicam treatment (P = .0004) were detected; however, the instrument did not detect any difference between placebo and meloxicam (linear mixed model), even for the high impairment cases. Percent meloxicam target dose administered, temperament, and total baseline FMPI score were covariates that most affected FMPI scores. Controlling for significant covariates, most positive effects were seen for placebo treatment. Positive treatment effects on activity were detected, but only for the cases designated as most highly impaired. CONCLUSIONS AND CLINICAL IMPORTANCE Neither responsiveness nor criterion validity were detected by the inclusion criteria for cases in this study. The data suggest that further work is indicated to understand factors affecting activity in cats to optimize inclusion criteria.

Management of Osteoarthritis in Cats

OA is a disease of the geriatric cat. Clinical signs include weight loss, anorexia, depression, urinating outside the litter box, poor grooming, and lameness. Radiographs, synovial fluid analysis, and synovial biopsy are used to distinguish this disease from the various forms of inflammatory arthritis that affect the cat. Management consists mainly of environmental manipulation. Aspirin, butorphanol, corticosteroids, and nutritional supplements are used for chronic treatment of painful OA in cats.

Aural Cholesteatoma in Twenty Dogs

OBJECTIVE To determine the clinical course in dogs with aural cholesteatoma. STUDY DESIGN Case series. ANIMALS Dogs (n=20) with aural cholesteatoma. METHODS Case review (1998-2007). RESULTS Twenty dogs were identified. Clinical signs other than those of chronic otitis externa included head tilt (6 dogs), unilateral facial palsy (4), pain on opening or inability to open the mouth (4), and ataxia (3). Computed tomography (CT) was performed in 19 dogs, abnormalities included osteoproliferation (13 dogs), lysis of the bulla (12), expansion of the bulla (11), bone lysis in the squamous or petrosal portion of the temporal bone (4) and enlargement of associated lymph nodes (7). Nineteen dogs had total ear canal ablation-lateral bulla osteotomy or ventral bulla osteotomy with the intent to cure; 9 dogs had no further signs of middle ear disease whereas 10 had persistent or recurrent clinical signs. Risk factors for recurrence after surgery were inability to open the mouth or neurologic signs on admission and lysis of any portion of the temporal bone on CT imaging. Dogs admitted with neurologic signs or inability to open the mouth had a median survival of 16 months. CONCLUSIONS Early surgical treatment of aural cholesteatoma may be curative. Recurrence after surgery is associated with advanced disease, typically indicated by inability to open the jaw, neurologic disease, or bone lysis on CT imaging. CLINICAL RELEVANCE Presence of aural cholesteatoma may affect the prognosis for successful surgical treatment of middle ear disease.

Outcome of permanent tracheostomy for treatment of upper airway obstruction in cats: 21 cases (1990–2007)

OBJECTIVE To determine clinical outcome of permanent tracheostomy in cats with upper airway obstruction. DESIGN Retrospective case series. ANIMALS 21 cats. PROCEDURES Medical records were reviewed for information on history, signalment, clinical signs, results of preoperative clinicopathologic testing, cause of upper airway obstruction, surgical procedure, postoperative complications, and outcome. RESULTS Causes of upper airway obstruction included neoplasia (squamous cell carcinoma [n = 6] or malignant lymphoma [2]), inflammatory laryngeal disease (5), laryngeal paralysis (4), trauma (3), and a laryngeal mass of unknown cause (1). Fourteen cats had dyspnea in the immediate postoperative period; dyspnea most often resulted from mucous plugs at the stoma or elsewhere in the respiratory tract. Eleven cats died, including 6 cats that died while hospitalized after surgery and 5 cats that died after discharge; 7 cats were euthanatized, most often because of progression of neoplasia; and 2 were still alive at the time of the study. The remaining cat was lost to follow-up after discharge from the hospital. Overall, median survival time for the 20 cats for which information was available was 20.5 days (range, 1 day to 5 years). Cats that underwent permanent tracheostomy because of inflammatory laryngeal disease were 6.61 times as likely to die as cats that underwent permanent tracheostomy for any other reason. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that permanent tracheostomy was an uncommon procedure in cats with upper airway obstruction that was associated with high complication and mortality rates.