Görel Nyman

Physiologic Evaluation of Capture and Anesthesia with Medetomidine–Zolazepam–Tiletamine in Brown Bears (Ursus arctos)

Abstract Physiologic variables during anesthesia with medetomidine–zolazepam–tiletamine were evaluated in 52 free-ranging brown bears (Ursus arctos) darted from a helicopter and in six captive brown bears darted at a zoo. During anesthesia, rectal temperature, respiratory rate, heart rate, and pulse oximetry derived hemoglobin oxygen saturation were recorded. Arterial blood samples were collected and immediately analyzed for evaluation of pulmonary gas exchange, acid–base status, and selected hematologic and plasma variables. At the end of anesthesia, atipamezole was administered intramuscularly at five times the medetomidine dose. Capture-induced hyperthermia and lactic acidemia were documented in free-ranging bears. Hypoxemia during anesthesia was documented in both free-ranging and captive bears. In free-ranging bears, rectal temperature, heart rate, lactate, hematocrit, and hemoglobin decreased significantly during anesthesia, whereas partial pressure of arterial carbon dioxide, pH, potassium, and glucose increased. Yearlings had a significantly higher heart rate, pH, base excess, bicarbonate, and glucose, and had a significantly lower rectal temperature, sodium, hematocrit, and hemoglobin when compared with subadult and adult brown bears. In conclusion, alterations in pulmonary gas exchange and acid–base status in brown bears during anesthesia with medetomidine–zolazepam–tiletamine with the doses and capture methods used in this study were identified. Oxygen supplementation is recommended to counteract hypoxemia during anesthesia.

Effect of local anaesthesia and/or analgesia on pain responses induced by piglet castration

BackgroundSurgical castration in male piglets is painful and methods that reduce this pain are requested. This study evaluated the effect of local anaesthesia and analgesia on vocal, physiological and behavioural responses during and after castration. A second purpose was to evaluate if herdsmen can effectively administer anaesthesia.MethodsFour male piglets in each of 141 litters in five herds were randomly assigned to one of four treatments: castration without local anaesthesia or analgesia (C, controls), analgesia (M, meloxicam), local anaesthesia (L, lidocaine), or both local anaesthesia and analgesia (LM). Lidocaine (L, LM) was injected at least three minutes before castration and meloxicam (M, LM) was injected after castration. During castration, vocalisation was measured and resistance movements judged. Behaviour observations were carried out on the castration day and the following day. The day after castration, castration wounds were ranked, ear and skin temperature was measured, and blood samples were collected for analysis of acute phase protein Serum Amyloid A concentration (SAA). Piglets were weighed on the castration day and at three weeks of age. Sickness treatments and mortality were recorded until three weeks of age.ResultsPiglets castrated with lidocaine produced calls with lower intensity (p < 0.001) and less resistance movements (p < 0.001) during castration. Piglets that were given meloxicam displayed less pain-related behaviour (huddled up, spasms, rump-scratching, stiffness and prostrated) on both the castration day (p = 0.06, n.s.) and the following day (p = 0.02). Controls had less swollen wounds compared to piglets assigned to treatments M, L and LM (p < 0.001). The proportion of piglets with high SAA concentration (over threshold values 200, 400 mg/l) was higher (p = 0.005; p = 0.05) for C + L compared to M + LM. Ear temperature was higher (p < 0.01) for controls compared to L and LM. There were no significant treatment effects for skin temperature, weight gain, sickness treatments or mortality.ConclusionsThe study concludes that lidocaine reduced pain during castration and that meloxicam reduced pain after castration. The study also concludes that the herdsmen were able to administer local anaesthesia effectively.

Effects of epidural morphine and transdermal fentanyl analgesia on physiology and behaviour after abdominal surgery in pigs.

The objective of this work was to evaluate the physiological and behavioural effects of opioid analgesic treatment in pigs subjected to abdominal surgery. Ten Swedish Landrace × Yorkshire pigs (20 ± 4 kg b.w.) were submitted for intestinal cannulation. The pigs were allocated into two groups during one preoperative, one surgical and two postoperative days. All pigs were anaesthetized with medetomidine, tiletamine and zolazepam. One group was treated with epidural morphine (0.1 mg/kg) preoperatively, and transdermal fentanyl patches (50 μg/kg/h) were applied behind the ear immediately after surgery. The other group received epidural saline (equivalent volume) and placebo patches. All pigs were regularly weighed and clinically examined and repeated blood samples were analysed for serum concentrations of cortisol, β-endorphin and fentanyl. Pre- and postoperative behaviours were evaluated by a swine specialist blinded to the treatment, three times a day, and were also videotape recorded for a total of 84 h per pig. No differences in behaviour were noted by the observer. During the first postoperative 12 h, treated pigs did not differ in activity compared with preoperative recordings, while untreated pigs were found to be less active. The treated group started to show interest in eating immediately after anaesthesia recovery, whereas the placebo group did not. During the 12–60 h postoperative period, the treated group had lower activity levels compared with the preoperative levels, which were similar to those in the placebo group. Treated pigs gained 0.5 ± 0.2 kg during the subsequent two postoperative days, whereas the untreated pigs lost weight throughout the experiment. Cortisol concentration differed immediately after the surgery: Group P had 325 ± 120 nmol/L and Group M 159 ± 49 nmol/L. β-endorphin concentration did not differ between groups. The highest serum fentanyl concentration (0.37 ± 0.3 ng/mL) was measured 24 h postoperatively. Preoperative epidural morphine in combination with postoperative transdermal fentanyl resulted in earlier return to normal activity levels and an immediate weight gain after surgery.

Effect of sedation with detomidine and butorphanol on pulmonary gas exchange in the horse

BackgroundSedation with α2-agonists in the horse is reported to be accompanied by impairment of arterial oxygenation. The present study was undertaken to investigate pulmonary gas exchange using the Multiple Inert Gas Elimination Technique (MIGET), during sedation with the α2-agonist detomidine alone and in combination with the opioid butorphanol.MethodsSeven Standardbred trotter horses aged 3–7 years and weighing 380–520 kg, were studied. The protocol consisted of three consecutive measurements; in the unsedated horse, after intravenous administration of detomidine (0.02 mg/kg) and after subsequent butorphanol administration (0.025 mg/kg). Pulmonary function and haemodynamic effects were investigated. The distribution of ventilation-perfusion ratios (VA/Q) was estimated with MIGET.ResultsDuring detomidine sedation, arterial oxygen tension (PaO2) decreased (12.8 ± 0.7 to 10.8 ± 1.2 kPa) and arterial carbon dioxide tension (PaCO2) increased (5.9 ± 0.3 to 6.1 ± 0.2 kPa) compared to measurements in the unsedated horse. Mismatch between ventilation and perfusion in the lungs was evident, but no increase in intrapulmonary shunt could be detected. Respiratory rate and minute ventilation did not change. Heart rate and cardiac output decreased, while pulmonary and systemic blood pressure and vascular resistance increased. Addition of butorphanol resulted in a significant decrease in ventilation and increase in PaCO2. Alveolar-arterial oxygen content difference P(A-a)O2 remained impaired after butorphanol administration, the VA/Q distribution improved as the decreased ventilation and persistent low blood flow was well matched. Also after subsequent butorphanol no increase in intrapulmonary shunt was evident.ConclusionThe results of the present study suggest that both pulmonary and cardiovascular factors contribute to the impaired pulmonary gas exchange during detomidine and butorphanol sedation in the horse.

Pulsed delivery of nitric oxide counteracts hypoxaemia in the anaesthetized horse

OBJECTIVE To study the effect of the pulsed delivery of nitric oxide (NO) on pulmonary gas exchange in the anaesthetized horses. Design  Prospective, controlled randomized. ANIMALS Five healthy Standardbred trotters, three geldings and two mares. METHODS The horses were anaesthetized with thiopentone and isoflurane and positioned in dorsal recumbency. Nitric oxide was added as a pulse to the inspired gas during the first half of each inspiration. In three horses the effect of NO on the ventilation-perfusion distribution was also investigated using the multiple inert gas elimination technique. Data were analysed with repeated measures ANOVA. RESULTS During spontaneous breathing, arterial oxygen tension (PaO2) increased with NO inhalation, from 14 ± 2 to 29 ± 3 kPa (105 ± 15 to 218 ± 23 mm Hg) (p < 0.001). Arterial oxygen tension also increased, from 17 ± 3 to 31 ± 5 kPa (128 ± 23 to 233 ± 38 mm Hg) (p < 0.05) during intermittent positive pressure ventilation. The increase in PaO2 was mainly due to a reduced right to left vascular shunt, but ventilation and perfusion matching also improved. The beneficial effect of NO inhalation was lost within 5 minutes of its discontinuation. CONCLUSION Delivery of NO as a pulse during inspiration is an effective method for counteracting impaired gas exchange caused by anaesthesia in horses. Pulsation has to be continuous because of the transience of NOs therapeutic effect. CLINICAL RELEVANCE Horses with impaired pulmonary gas exchange during anaesthesia can be treated with pulsed NO inhalation.

Treatment of Hypoxemia During Anesthesia of Brown Bears (Ursus arctos)

Abstract This study assessed whether arterial oxygenation could be increased by treatment with intranasal oxygen supplementation in brown bears (Ursus arctos) with hypoxemia during anesthesia with medetomidine-zolazepam-tiletamine. Arterial blood samples were collected anaerobically from the femoral artery before and during oxygen supplementation. An oxygen flow rate of 2–5 L/min administered intranasally to brown bears weighing 12–120 kg markedly increased arterial oxygenation. Intranasal oxygen supplementation proved to be a simple and efficient method for treatment of hypoxemia in anesthetized bears.

The relationship of muscle perfusion and metabolism with cardiovascular variables before and after detomidine injection during propofol–ketamine anaesthesia in horses

OBJECTIVES To study in horses (1) the relationship between cardiovascular variables and muscle perfusion during propofol-ketamine anaesthesia, (2) the physiological effects of a single intravenous (IV) detomidine injection, (3) the metabolic response of muscle to anaesthesia, and (4) the effects of propofol-ketamine infusion on respiratory function. STUDY DESIGN Prospective experimental study. ANIMALS Seven standardbred trotters, 5-12 years old, 416-581 kg. METHODS Anaesthesia was induced with intravenous (IV) guaifenesin and propofol (2 mg kg-1) and maintained with a continuous IV infusion of propofol (0.15 mg kg-1 minute-1) and ketamine (0.05 mg kg-1 minute-1) with horses positioned in left lateral recumbency. After 1 hour, detomidine (0.01 mg kg-1) was administered IV and 40-50 minutes later anaesthesia was discontinued. Cardiovascular and respiratory variables (heart rate, cardiac output, systemic and pulmonary artery blood pressures, respiratory rate, tidal volume, and inspiratory and expiratory O2 and CO2) and muscle temperature were measured at pre-determined times. Peripheral perfusion was measured continuously in the gluteal muscles and skin using laser Doppler flowmetry (LDF). Muscle biopsy samples from the left and right gluteal muscles were analysed for glycogen, creatine phosphate, creatine, adenine nucleotides, inosine monophosphate and lactate. Arterial blood was analysed for PO2, PCO2, pH, oxygen saturation and HCO3. Mixed venous blood was analysed for PO2, PCO2, pH, oxygen saturation, HCO3, cortisol, lactate, uric acid, hypoxanthine, xanthine, creatine kinase, creatinine, aspartate aminotransferase, electrolytes, total protein, haemoglobin, haematocrit and white blood cell count. RESULTS Circulatory function was preserved during propofol-ketamine anaesthesia. Detomidine caused profound hypertension and bradycardia and decreased cardiac output and muscle perfusion. Ten minutes after detomidine injection muscle perfusion had recovered to pre-injection levels, although heart rate and cardiac output had not. No difference in indices of muscle metabolism was found between dependent and independent muscles. Anaerobic muscle metabolism, indicated by decreased muscle and creatine phosphate levels was evident after anaesthesia. CONCLUSION Muscle perfusion was closely related to cardiac output but not arterial blood pressure. Total intravenous anaesthesia with propofol-ketamine deserves further study despite its respiratory depression effects, as the combination preserves cardiovascular function. Decreases in high-energy phosphate stores during recovery show that muscle is vulnerable after anaesthesia. Continued research is required to clarify the course of muscle metabolic events during recovery.

CAPTURE AND MEDETOMIDINE-KETAMINE ANESTHESIA OF FREE- RANGING WOLVERINES (GULO GULO)

Capture and anesthesia with medetomidine-ketamine were evaluated in free-ranging wolverines (Gulo gulo) immobilized for marking with radiocollars or intraperitoneal radiotransmitters in Norrbotten, Sweden, during early June 2004 and 2005. Twelve juvenile wolverines were captured by hand and injected with 0.14±0.03 mg/kg (mean±SD) medetomidine and 7.5±2.0 mg/kg ketamine. Twelve adult wolverines were darted from a helicopter or the ground, or captured by hand. Adults received 0.37±0.06 mg/kg medetomidine and 9.4±1.4 mg/kg ketamine. Arterial blood samples were collected between 15 min and 30 min and between 45 min and 60 min after drug administration and immediately analyzed for selected hematologic and plasma variables. Hyperthermia was recorded initially in one juvenile wolverine and 11 adults. Rectal temperature, heart rate, and lactate decreased significantly during anesthesia, whereas hemoglobin oxygen saturation, pH, partial pressure of arterial carbon dioxide, and base excess increased. Adult wolverines darted from a helicopter had a significantly higher rectal temperature, higher glucose and hematocrit values, and a lower heart rate than juveniles captured by hand. Impaired arterial oxygenation was evident in all wolverines. This study provides baseline data on physiologic variables in adult and juvenile wolverines captured with different methods and anesthetized with medetomidine-ketamine.

Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden

BackgroundThe first outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010.MethodThis descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by spa-typing and pulsed-field gel electrophoresis (PFGE) were performed.ResultsInterventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months.Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA spa-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases.ConclusionsCollaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the dedication of staff were essential for the development and implementation of new, improved routines. Demonstration of the outbreak strain in the environment was useful for interventions such as improvement of cleaning routines and interior design, and increased compliance with basic hygienic precautions. The interventions led to a reduction in MRSA-positive samples and the outbreak was considered curbed as no new cases occurred for over a year.

Dissociative Anaesthesia During Field and Hospital Conditions for Castration of Colts

The principal aim of this study was to evaluate dissociative anaesthesia for castration of colts during field conditions. Three dissociative anaesthetic protocols were evaluated during castration of colts in an animal hospital. The protocol considered to be the most suitable was thereafter evaluated during castration of colts under field conditions. Respiratory and haemodynamic parameters and the response to surgery were determined during anaesthesia. All horses breathed air spontaneously during anaesthesia. Under hospital conditions 26 colts were randomised to receive one of three anaesthetic protocols: Romifidine and tiletamine-zolazepam (RZ); acepromazine, romifidine and tiletamine-zolazepam (ARZ); or acepromazine, romifidine, butorphanol and tiletamine-zolazepam (ARBZ). The surgeon was blinded to the anaesthetic protocol used and decided whether supplemental anaesthesia was needed to complete surgery. Under field conditions 31 colts were castrated during anaesthesia with the ARBZ protocol. All inductions, anaesthesia and recoveries were calm and without excitation under both hospital and field conditions. Surgery was performed within 5–20 minutes after the horses had assumed lateral recumbency during both hospital and field castrations. Under hospital conditions some horses needed supplemental anaesthesia with all three anaesthetic protocols to complete surgery. Interestingly, none of the horses castrated with protocol ARBZ under field conditions needed additional anaesthesia. Cardiorespiratory changes were within acceptable limits in these clinically healthy colts.SammanfattningDissociativ anestesi för kastration av hingst på klinik och i fält.Huvudmålet med denna undersökning var att utvärdera dissociativ anestesi för kastration av hingst under fältmässiga förhållanden. Tre olika dissociativa anestesiprotokoll utvärderades vid kastration av hingst på djursjukhus. Protokollet som ansågs lämpligast användes därefter vid kastration av hingst under fältförhållanden. Under djursjukhusförhållanden fördelades 26 hingstar slumpmässigt till ett av följande tre anestesiprotokoll: RZ = romifidin och tiletamin- zolazepam, ARZ = acepromazin, romifidin och tiletamin-zolazepam, ARBZ = acepromazin, romifidin, butorfanol och tiletamin-zolazepam. Trettioen hingstar kastrerades under fältförhållande med protokoll ARBZ. Hästarna spontanandades luft under anestesin. Respiratoriska och hemodynamiska parametrar samt responsen på kirurgi utvärderades. Kirurgen, som var ovetande om vilket anestesiprotokoll som använts, bedömde om ytterligare anestetika behövde ges för att genomföra kirurgin. Alla induktioner, anestesier och resningar var lugna utan excitation både på djursjukhus och i fält. Kirurgin utfördes mellan 5-20 minuter efter det att hästen lagt sig i sidoläge. Under djursjukhusförhållanden behövde ytterligare anestesi ges till vissa hästar från alla tre grupperna för att kunna genomföra kastrationen. Det mest intressanta fyndet var att ingen häst som kastrerades i fält behövde ytterligare anestesimedel för kirurgins genomförande. Variationer i cirkulation och respiration var acceptabla hos dessa kliniskt friska hästar.