S. Zaki

Clinical evaluation of Alfaxan-CD® as an intravenous anaesthetic in young cats.

OBJECTIVE To describe and evaluate the use of Alfaxan-CD as an intravenous anaesthetic in young cats. DESIGN Thirty-five Domestic Short-hair cats aged from 3 to 12 months were admitted into the University Veterinary Teaching Hospital-Sydney for elective surgery. Anaesthesia was induced with Alfaxan-CD and maintained with isoflurane: 22 cats received no premedication and 13 cats received acepromazine (0.03 mg/kg) and butorphanol (0.3 mg/kg) subcutaneously 30 min prior to induction. Qualitative and quantitative data for induction and recovery were recorded. Physiological parameters were recorded at 0, 2 and 5 min post induction, and every 5 min thereafter until the end of the procedure. RESULTS Intravenous injection of Alfaxan-CD resulted in rapid induction of anaesthesia with a mean time to intubation of 122 s. The mean dose of Alfaxan-CD used was 4.2 mg/kg in unpremedicated cats and 2.7 mg/kg in premedicated cats. All cats maintained a heart rate above 95 beats/min. No cat developed hypoxaemia. Hypercapnoea was detected in 4 cats and hypotension was observed in 18 cats. Time to extubation ranged from 1 to 9 min. The mean time to sternal recumbency for premedicated cats was 11 min; 77% of premedicated cats and 23% of unpremedicated cats had a recovery score of 1 or 2. CONCLUSION Alfaxan-CD is an effective anaesthetic agent in young healthy cats, providing a smooth induction and rapid recovery. Cats that were premedicated with acepromazine and butorphanol prior to induction with Alfaxan-CD had better recovery scores than those that were not premedicated.

Depletion of Protease-Activated Receptor 2 but Not Protease-Activated Receptor 1 May Confer Protection Against Osteoarthritis in Mice Through Extracartilaginous Mechanisms

To explore the involvement of protease‐activated receptor 1 (PAR‐1) and PAR‐2 in the pathologic processes of osteoarthritis (OA) and to identify the cells/tissues primarily affected by ablation of PAR‐1 or PAR‐2 in mice.

Hepatic cysts incarcerated in a peritoneopericardial diaphragmatic hernia

Peritoneopericardial diaphragmatic hernia is a common incidental finding in cats and is rarely symptomatic. The case report described herein presented with dyspnoea secondary to incarceration of hepatic cysts within the pericardial space of a cat with a peritoneopericardial diaphragmatic hernia.

The use of sevoflurane in a 2:1 mixture of nitrous oxide and oxygen for rapid mask induction of anaesthesia in the cat

An inhalational technique for rapid induction of anaesthesia in unsedated cats using sevoflurane and nitrous oxide is described. Using a pliable, tight-fitting, face mask, sevoflurane (7.5–8%) was delivered from an out-of-circuit precision vaporiser connected to a coaxial non-rebreathing system using a fresh gas flow of 1 l oxygen and 2 l nitrous oxide per min. Cats were restrained with gentle but firm pressure applied by scruffing the dorsal cervical skin until the righting reflex was lost and the patient could be positioned in lateral recumbency. Typically, cats could be positioned on their side in a light plane of anaesthesia within 1 min of applying the mask, at which time the sevoflurane concentration was reduced to 5% or less. A similar protocol, using a lower initial concentration of sevoflurane, is recommended for old or debilitated patients. Maintenance of light sevoflurane (2–4%) anaesthesia by mask permitted minor interventions to be performed readily, including blood collection, intravenous chemotherapy, abdominal palpation, radiography and ultrasonography. More painful procedures, such as bone marrow aspiration, required a deeper plane of anaesthesia. Cats were sufficiently deep to be intubated, if this was required, about 3 min after commencing the induction. Recovery from sevoflurane/nitrous oxide anaesthesia was smooth and rapid, with most cats being able to right within 5 min of discontinuing the agents. This protocol for rapid inhalational induction and recovery is particularly suited to feline practice, where rendering an uncooperative patient unconscious greatly facilitates the completion of many minor diagnostic and therapeutic procedures, especially when these must be performed on successive days or when peripheral vascular access is limited. For longer procedures, isoflurane may be substituted for sevoflurane for maintenance of anaesthesia in order to minimise cost.

An evaluation of fresh gas flow rates for spontaneously breathing cats and small dogs on the Humphrey ADE semi‐closed breathing system

OBJECTIVE To evaluate the fresh gas flow (FGF) rate requirements for the Humphrey ADE semi-closed breathing system in the Mapleson A mode; to determine the FGF at which rebreathing occurs, and compare the efficiency of this system to the Bain (Mapleson D) system in spontaneously breathing cats and small dogs. STUDY DESIGN Prospective clinical study. ANIMALS Twenty-five healthy (ASA score I or II) client-owned cats and dogs (mean ± SD age 4.7 ± 5.0 years, and body weight 5.64 ± 3.26 kg) undergoing elective surgery or minor procedures. METHODS Anaesthesia was maintained with isoflurane delivered via the Humphrey ADE system in the A mode using an oxygen FGF of 100 mL kg(-1) minute(-1). The FGF was then reduced incrementally by 5-10 mL kg(-1) minute(-1) at approximately five-minute intervals, until rebreathing (inspired CO(2) >5 mmHg (0.7 kPa)) was observed, after which flow rates were increased. In six animals, once the minimum FGF at which rebreathing occurred was found, the breathing system was changed to the Bain, and the effects of this FGF delivery examined, before FGF was increased. RESULTS Rebreathing did not occur at the FGF recommended by the manufacturer for the ADE. The mean ± SD FGF that resulted in rebreathing was 60 ± 20 mL kg(-1) minute(-1). The mean minimum FGF at which rebreathing did not occur with the ADE was 87 ± 39 mL kg(-1) minute(-1). This FGF resulted in significant rebreathing (inspired CO(2) 8.8 ± 2.6 mmHg (1.2 ± 0.3 kPa)) on the Bain system. CONCLUSIONS The FGF rates recommended for the Humphrey ADE are adequate to prevent rebreathing in spontaneously breathing cats and dogs <15 kg. CLINICAL RELEVANCE The Humphrey ADE system used in the A mode is a more efficient alternative to the Bain system, for maintenance of gaseous anaesthesia in spontaneously breathing cats and small dogs.

Use of continuous positive airway pressure in the acute management of laryngeal paralysis in a cat.

Continuous positive airway pressure (CPAP) has been is used widely in humans to manage obstructive sleep apnoea syndrome, but it has not been widely used in animals. A brachycephalic cat, with previously undiagnosed laryngeal paralysis, that developed acute upper respiratory tract obstruction on recovery from anaesthesia, is presented. The condition was managed by CPAP, delivered via a facial mask.

Bradyarrhythmia in an anaesthetised, elderly, hypertensive cat

A 14-year-old neutered male domestic shorthaired cat was presented to the University Veterinary Centre Sydney for evaluation and treatment of dental disease. This cat developed an unusual bradyarrhythmia under anaesthesia. The possible causes and treatment of the dysrythmia are discussed.

One health in our backyard: Design and evaluation of an experiential learning experience for veterinary medical students

Background New educational approaches are needed to improve student understanding of the wider sociological and ecological determinants of health as well as professional responsibilities in related areas. Field trips allow students to observe interaction between plant, animal and human communities, making them an ideal tool for teaching One Health concepts. Methods Veterinary medical students participated in a field trip to a local parklands area, frequented by humans, dogs, horses, and wildlife. Students rotated through 5 learning activities (‘stations’) that focused on: (1) response to exotic animal disease incursion (equine influenza); (2) impact of cultures and belief systems on professional practice; (3) management of dangerous dogs; (4) land use change, biodiversity and emerging infectious disease; and (5) management of environmentally-acquired zoonoses (botulism). Intended learning outcomes were for students to: evaluate the various roles and responsibilities of veterinarians in society; compare the benefits and risks associated with human-animal and animal-animal interactions; and evaluate the contributions made by various professionals in safeguarding the health and welfare of animals, humans and the environment. Following the field trip, students participated in a debrief exercise and completed an online survey on their experiences. Results Feedback from students collected in 2016/2017 (n = 211) was overwhelmingly positive. The learning experience at each station was rated as 4 (‘Good’) or 5 (‘Very Good’) out of 5 by 82–96% of students. Responses to closed- and open-ended questions − as well as outputs generated in the debrief session − indicated that students achieved the learning outcomes. Overall, 94% of students agreed or strongly agreed that they had a better understanding of One Health because of the field trip. Conclusions Field trips to local parklands are effective in promoting learning about One Health and can be incorporated into the core curriculum to maximize student exposure at relatively low cost.

Resilience in Veterinary Students and the Predictive Role of Mindfulness and Self-Compassion

Resilience is a dynamic and multifaceted process in which individuals draw on personal and contextual resources. In difficult situations, resilient people use specific strategies to learn from the situation without being overcome by it. As stressors are inherent to veterinary work, including long work hours, ethical dilemmas, and challenging interactions with clients, resilience is an important component of professional quality of life. However, while resilience in other health professionals has received attention, it has received little in the veterinary field. In this cross-sectional study, veterinary students from six veterinary schools in Australia completed an online survey, with 193 responses (23%). Very few veterinary students (6%) reached the threshold to be considered highly resilient using the Brief Resilience Scale, and approximately one third classified as having low levels of resilience. In the final linear multiple regression model, predictors of resilience included nonjudgmental and nonreactive mindfulness (Five Facet Mindfulness Questionnaire) and self-compassion (Neff Self-Compassion Scale). Students with higher nonjudgmental and nonreactive mindfulness and self-compassion had higher resilience scores. These findings indicate that fostering these qualities of mindfulness and self-compassion may be aligned with strengthening veterinary student resilience. Importantly, if the factors that help veterinary students develop a capacity for resilience can be identified, intervention programs can be targeted to educate future veterinary professionals with a high quality of life, both professional and personal.