Silvia Renata Gaido Cortopassi

Changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization at admission to ICU and the relation to outcome

OBJECTIVE To evaluate the changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization in the ICU and their relation to outcome. DESIGN Prospective observational study. SETTING ICU of a veterinary university medical center. ANIMALS Thirty dogs with severe sepsis or septic shock caused by pyometra who underwent surgery and were admitted to the ICU. MEASUREMENTS AND MAIN RESULTS Severe sepsis was defined as the presence of sepsis and sepsis-induced dysfunction of one or more organs. Septic shock was defined as the presence of severe sepsis plus hypotension not reversed with fluid resuscitation. After the presumptive diagnosis of sepsis secondary to pyometra, blood samples were collected and clinical findings were recorded. Volume resuscitation with 0.9% saline solution and antimicrobial therapy were initiated. Following abdominal ultrasonography and confirmation of increased uterine volume, dogs underwent corrective surgery. After surgery, the animals were admitted to the ICU, where resuscitation was guided by the clinical parameters, central venous oxygen saturation (ScvO(2)), lactate, and base deficit. Between survivors and nonsurvivors it was observed that the ScvO(2), lactate, and base deficit on ICU admission were each related independently to death (P = 0.001, P = 0.030, and P < 0.001, respectively). ScvO(2) and base deficit were found to be the best discriminators between survivors and nonsurvivors as assessed via receiver operator characteristic curve analysis. CONCLUSION Our study suggests that ScvO(2) and base deficit are useful in predicting the prognosis of dogs with severe sepsis and septic shock; animals with a higher ScvO(2) and lower base deficit at admission to the ICU have a lower probability of death.

A new brachial plexus block technique in dogs

OBJECTIVE To evaluate the feasibility and efficacy of a new technique of brachial plexus anesthesia in dogs. STUDY DESIGN Prospective, experimental study. ANIMALS Twelve adult mongrel dogs, six males and six females weighing 14.8 ± 1.75 kg. METHODS The animals were sedated with acepromazine 0.05 mg kg-1 and anesthetized with propofol (6 mg kg-1, IV bolus) followed by an infusion of 212 μg kg-1 minute-1. The brachial plexus block technique was performed utilizing the brachial artery as an anatomic landmark, the needle was inserted from the axilla and a nerve stimulator was used to ensure the accuracy of needle placement. Bupivacaine (0.375% with 5 μg mL-1 epinephrine) was used at a dose rate of 4 mg kg-1. Dogs underwent mid-diaphyseal osteotomies of the humerus followed by intramedullary pin fixation. RESULTS Onset time to motor and sensory block were 9.70 ± 5.52 and 26.20 ± 8.86 minutes, respectively. Analgesia lasted for 11.11 ± 0.47 hours. The block was effective in 91.6% of the animals, being verified by anesthesia of the whole front limb distal to the shoulder. One animal became hypotensive after the block and did not undergo the surgery at that time. In the remaining 10 animals the heart and respiratory rates, blood pressure, blood gas parameters and plasma bicarbonate concentration did not show any statistically significant alterations during the surgical procedure. CONCLUSIONS This brachial plexus block technique is effective in most cases to provide surgical analgesia for the front limb distal to the shoulder. CLINICAL RELEVANCE Various surgical procedures in the front limb can be performed with a regional anesthetic technique without the use and concomitant risks of general anesthesia in dogs. Long-lasting analgesia associated with this technique may also provide a valuable tool for the management of pain in the forelimb.

Electro-acupuncture and Chinese herbs for treatment of cervical intervertebral disk disease in a dog

A non-ambulatory dog with tetraparesis following a pain episode that had evolved over 2 months was submitted for medical treatment and diagnosed with intervertebral disk disease at C3-C4 and dorsal extradural compression at C1-C2 and C3-C4 using myelography and computed tomography. The dog experienced ambulation recovery after 15 days of treatment with only electroacupuncture and Chinese herbal medicine, with marked improvement occurring after only 10 treatments. Six months of follow-up demonstrated that the dog was stable and had no recurrence of symptoms. Therefore, it was concluded that the combination of electroacupuncture and Chinese herbal medicine was responsible for motor rehabilitation.

Efeitos do jejum alimentar pré-cirúrgico sobre a glicemia e o período de recuperação anestésica em cães

O objetivo do presente estudo foi avaliar o efeito de diferentes periodos de jejum alimentar pre-cirurgico sobre a concentracao serica de glicose em caes sadios, bem como sobre o periodo de completa recuperacao anestesica destes animais. Os animais foram distribuidos em grupos, de acordo com o periodo de jejum alimentar: Grupo I: 6 a 8 horas; Grupo II: 12 a 14 horas e Grupo III: acima de 16 horas. Nos tres grupos preconizou-se jejum hidrico de no minimo 2 horas. Todos os animais foram submetidos ao mesmo protocolo anestesico e a procedimentos cirurgicos eletivos. As coletas de amostra para a glicemia foram realizadas imediatamente antes da aplicacao da medicacao pre-anestesica e apos a completa recuperacao anestesica do animal. Nao se observaram diferencas entre os grupos em relacao a glicemia pre e pos-anestesica, assim como em relacao ao periodo de recuperacao destes animais.

Anestesia geral com propofol em cäes pré-tratados com acepromazina e alfentanil

Medico Veterinario, Professor, Doutor, Aposentado, FMVZ, USP.RESUMOForam utilizados 30 caes, sem raca definida,adultos, (10 machos e 20 femeas), com peso medio de 14,44 ±2,72kg, distribuidos em tres grupos. O grupo I (GI) recebeu aassociacao de 0,1 mg/kg de acepromazina, 0,05mg/kg dealfentanil e 6,0mg/kg de propofol; o grupo H (GII) O,1 mg/kg deacepromazina, O,1ml/kg de solucao fisiologica e 6,0mg/kg depropofol; e o grupo III (GIII) recebeu 0,05 ml/kg de solucaofisiologica, 0,05mg/kg de alfentanil e 6,0mg/kg de propofol.Todos os farmacos foram administrados atraves da viaintravenosa. Houve bradicardia intensa e de curta duracao nosanimais dos grupos I e III apos a administracao do alfentanil,tendo a frequencia cardiaca se restabelecido apos a inducao daanestesia. No atinente a pressao arterial, os animais dos grupos le II apresentaram hipotensao acentuada, havendo recuperacaodos indices pressoricos apenas do GII. As tres associacoesanestesicas promoveram alteracoes dos valores obtidos nahemogasometria arterial, verificando-se aumento da PaCO

Comparison of Racemic Ketamine Versus (S+) Ketamine When Combined with Midazolam for Anesthesia of Callithrix jacchus and Callithrix penicillata

Abstract Ten common marmosets (Callithrix jacchus) and 10 black-tufted marmosets (Callithrix penicillata) were immobilized to compare the anesthetic effects of racemic ketamine and (S+) ketamine in combination with midazolam. The animals were distributed into four groups: five common marmosets (group CJR) and five black-tufted marmosets (group CPR) received 9.8 ± 1.4 mg/kg of racemic ketamine, and five common marmosets (group CJS) and five black-tufted marmosets (group CPS) received 10.4 ± 1.6 mg/kg of (S+) ketamine. All groups received similar dosages of midazolam (1.0 ± 0.15 mg/kg). During immobilization, heart rates, respiratory rates, rectal temperatures, and muscle relaxation scores were recorded at 5, 10, and 20 min after initial injection. Quality of induction and quality of recovery were evaluated in each marmoset by recording physical reactions including withdrawal reflexes, involuntary movements, salivation, compulsive licking, catalepsy, and ataxia. There were no significant differences in the induction, immobilization, and recovery times between the four groups. Similarly, there were no significant differences between groups in heart rates, respiratory rates, or body temperatures, although there was a significant decrease in respiratory rates over time in group CPR. In addition, the CJR and CPS groups showed significant decreases over time in rectal temperature. Muscle relaxation was more profound in the CPR group than in the other groups. Compulsive licking, involuntary movements, salivation, and withdrawal reflexes were observed more frequently in animals given S(+) ketamine; but in general, racemic ketamine and S(+) ketamine had similar effects in all callitrichines. Further studies are required to confirm that S(+) ketamine has different potency in these species.

Nova técnica de bloqueio do plexo braquial em cães

The aim of this study was to evaluate the viability and efficacy of a new technique of brachial plexus block in dogs. Eleven mongrel dogs of different ages and weight, both male and female were used. Animals were pre-medicated with acepromazine and induction of anesthesia was performed with propofol. The brachial plexus block was achieved with the combination of the following techniques: multiple injections, nerve stimulator and the axilary artery pulse to locate the nerves. Bupivacaine was the local anesthetic employed at a total dose of 4mg/kg. This dose was divided in 4, that were administered in 30 seconds each, to achieve more nerves as possible. The time spent to perform the whole procedure was 11.30 ± 4.54 minutes; onset time for motor and sensitive block were 9.70 ± 5.52 and 26.20 ± 8.86 respectively. Duration of analgesia was 11.0 ± 0.45 hours. The block was effective in 90% of animals what was assessed through complete anesthesia of the front limb distally to the shoulder joint. Hypotension in one animal was the sole complication observed. With the results obtained we can suggest the use of this technique for front limb surgery performed distally to the shoulder joint as well as a pos-operative analgesic approach in dogs.

Avaliação comparativa entre acepromazina, detomidina e romifidina em eqüinos

Farmaceutica, Tecnica de Nivel Superior, FMVZ, USP.RESUMOOs efeitos da acepromazina, detomidina e romifidi-na em equinos foram comparados, objetivando-se determinarqual o agente mais seguro e efetivo para a referida especieanimal. Foram utilizados 15 equinos higidos, de ambos os sexos,idades e racas variadas e encaminhados ao setor de Cirurgia doHospital Veterinario da FMVZ - USP. Os animais foram distri-buidos em tres grupos: grupo I, recebeu 0,1mg/kg de aceproma-zina; grupo II recebeu 20mcg/kg de detomidina e grupo III, oqual recebeu 80mcg/kg de romifidina, sendo todos os agentesadministrados atraves da via intravenosa. Previamente a admi-nistracao dos farmacos e aos 15, 30, 60 e 90 minutos, apos suaaplicacao, foram avaliadas a frequencia e ritmo cardiacos,frequencia respiratoria, pressao arterial sistolica e diastolica,assim como foram coletadas amostras de sangue arterial paraverificacao do pH, pressao parcial de oxigenio e pressao parcialde dioxido de carbono. Os resultados foram submetidos a analiseestatistica atraves do teste de analise de variância (ANOVA),seguido do teste de Tukey. Nao foi observada nenhuma alteracaoda frequencia respiratoria nos grupos estudados. Verificou-sediminuicao significativa dos valores da FC nos animais tratadoscom os agentes α-2 agonistas quando comparados com os valo-res obtidos no grupo I. Apos a administracao da acepromazina,observou-se diminuicao significativa das pressoes sistolica ediastolica em relacao aos valores controle. Os animais do grupoI apresentaram valores pressoricos estatisticamente inferiores emrelacao aos valores obtidos nos grupos II e III. Os animais dogrupo II demonstraram incremento da pressao arterial sistolicaapos 15 minutos da aplicacao do agente, com subsequente redu-cao destes valores. O mesmo ocorreu no grupo III, porem, semvalor estatistico significativo. Com estes resultados, pode-seconcluir que a romifidina e a detomidina promoveram alteracoesparametricas de menor intensidade e duracao quando compara-das a acepromazina.Palavras-chave: acepromazina, romifidina, detomidina, equinos.SUMMARYThe effects of acepromazine, detomidine andromifidine were compared in horses in the present study, aimingto determine which agent is safer and more effective for thereferred species of animal. Fifteen healthy horses of the same sex,age and breed varying, were sent to the Surgical Division of theVeterinarian Hospital of FMVZ-USP. The animals weredistributed in three groups; group I - GI - received 0.1mg/kg ofacepromazine; group II - GII - received 20µg/kg of detomidine;group III - GIII received 80µg/kg of romifidine, all agentsdelivered intravenously. Prior to administration of the agents andat 15, 30, 60 and 90 minutes after their application, the followingparameters were evaluated: heart rate, respiratory rate, systolicand diastolic arterial pressure. Arterial blood samples werecollected to verify pH, partial oxygen pressure and partial carbondioxide pressure. The results were submitted to statisticalanalysis using the analysis of variance (ANOVA) followed by theTukey test. No significant alteration was observed in respiratoryrate of the studied groups. The heart rate significantly decreasedin the animals treated with the alpha-2 agonist agents whencompared to the values obtained in the GI. Followingadministration of acepromazine a significant decrease n systolicand diastolic blood pressures was observed in relation to controlvalues. The animals of GI presented pressure values that werestatistically inferior in relation to the values obtained for groupsII and III. The animals in GII showed an increase in systolic

Avaliação radiográfica e de função de vôo após fixação de osteotomias distais do úmero em pombas (Columba livia), com modelo de fixador externo articulado

The treatment of distal humeral fractures in birds is very difficult, technically and for consolidation and maintenance of normal function of the wing, because theses bones are pneumatic, and its cortices very thin. The ankylosis of the humerus-radius-ulnar joint with external fixator is unviable for birds intended for rehabilitation and release. In all animals, the experimental fixator was placed over the humerus, with its articulation over the humerus-radial-ulnar joint e the extension of the fixator was placed over the ulna. The animals were divided in two groups: bilateral surgeries with ankylosis in one wing (static wing) and maintenance of the joint function in the other (dynamic wing) (Group 1), and unilateral surgery, with maintenance of the joint function (dynamic wing) (Group 2). The bonny callus was evaluated with radiographs: post-surgical, at 3, 6 and 9 weeks. The birds in Group 2 were evaluated as of their flight abilities between 11 and 15 weeks after surgery. The wing amplitude and humeral length was evaluated in all animals, after euthanasia. At 6 weeks, all the animals in Group 2, that underwent unilateral surgery, without ankylosis, and four animals in Group 1, that underwent bilateral surgeries: ankylosis of one elbow (static wing) and not of the other (dynamic wing), presented radiographic and clinical consolidation of the fractures. Two animals in Group 1 only presented consolidation of the dynamic wing at 9 weeks and of the static wing at 12 weeks. All the animals in Group 2 presented adequate flight capacity, in at least 13 weeks after surgery. There are few published papers on bird osteosynthesis, and therefore we studied the use of articulated external fixator for the stabilization of distal humeral fractures, avoiding ankylosis of the elbow joint, and, therefore keeping flight function viable, using as a model, rock pigeons (Columba livia). The proposed method of maintenance of wing function in the dynamic wing, demonstrated being effective in maintaining the length of the bone, the amplitude of the wing as well as viability of muscles and tendons, guaranteeing flight capacity of the studied birds, being a good method for the repair of distal humeral fractures of birds, when rehabilitation and release are intended.

Total intravenous anaesthesia with propofol-racemic ketamine and propofol-S-ketamine: a comparative study and haemodynamic evaluation in dogs undergoing ovariohysterectomy

Intelisano T.R., Kitahara F.R., Otsuki D.A., Fantoni D.T., Auler Jr J.O.C. & Cortopassi S.R.G. 2008. Total intravenous anaesthesia with propofol-racemic ketamine and propofol-S-ketamine: A comparative study and haemodynamic evaluation in dogs undergoing ovariohysterectomy. Pesquisa Veterinaria Brasileira 28(4):216-222.