The veterinary journal
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The veterinary journal · Nov 2014
Use of systolic pressure variation to predict the cardiovascular response to mini-fluid challenge in anaesthetised dogs.
Systolic pressure variation (SPV), the maximum variation in systolic pressure values following a single positive pressure breath delivered by controlled mechanical ventilation (CMV), is highly correlated with volaemia in dogs. The aim of this study was to determine an SPV value that would indicate when fluid administration would be beneficial in clinical practice. Twenty-six client-owned dogs were anaesthetised, following which CMV with a peak inspiratory pressure (PIP) of 8 cmH2O was applied. ⋯ SPV values > 4 mmHg or >4.5% predicted haemodynamic improvement in dogs with normal cardiovascular function, with a sensitivity of 90% and a specificity of 87%. The area under the curve receiver operating characteristic value for SPV was 0.931 mmHg (95% confidence interval, CI, 0.76-0.99 mmHg) and 0.944% (95% CI 0.78-0.99%). It is proposed that SPV values > 4.5% in dogs with a normal cardiovascular function, anaesthetised with isoflurane in oxygen and air, and on CMV (PIP 8 cmH2O), can be used to predict a cardiovascular response (>10% increase in mean arterial BP and/or >10% decrease in heart rate).
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The veterinary journal · Nov 2014
Randomized Controlled TrialEffects of a constant rate infusion of medetomidine-propofol on isoflurane minimum alveolar concentrations in horses.
The aim of this investigation was to determine the isoflurane-sparing effect and impact on arterial blood pressure and anaesthetic recovery of a constant rate infusion of medetomidine-propofol in horses. In a prospective, crossover, randomised study, six healthy horses (mean ± SD age, 13.7 ± 7.7 years; weight, 433 ± 51 kg) were anaesthetised twice with isoflurane and were randomly assigned to receive one of two treatments on each occasion, at least 2 weeks apart. The first treatment was saline (CTL group) and the second a medetomidine-propofol infusion (MP group; 1.25 µg/kg/h medetomidine and 3 mg/kg/h propofol). ⋯ The recovery quality in both groups was considered fair or good and an improvement was observed using the Donaldson scale in the MP group. The administration of a medetomidine-propofol constant rate infusion reduced anaesthetic isoflurane requirements to a clinically significant extent and improved stability of arterial blood pressure together with a good quality recovery. This regime could be useful for providing balanced anaesthesia in horses.
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The veterinary journal · Nov 2014
Surgical treatment of dorsal hemivertebrae associated with kyphosis by spinal segmental stabilisation, with or without decompression.
This retrospective case series examined the effectiveness of spinal segmental stabilisation, with or without decompression, in nine dogs with neurological deficits associated with dorsal hemivertebrae. Data on signalment, preoperative neurological status, imaging findings, surgical techniques and outcome were evaluated. All cases occurred in young or adult, small-breed dogs with neurological signs ranging from progressive moderate pelvic limb ataxia to non-ambulatory paraparesis. ⋯ At 2-6 years post-surgery, four dogs were neurologically normal, three had mild residual ataxia, one had moderate ambulatory paraparesis, and one dog relapsed 3.5 years after surgery, resulting in severe paraparesis. Spinal segmental stabilisation techniques, with or without decompression, can result in satisfactory outcomes in small dogs with hemivertebrae and mild to moderate neurological signs. Further adaptations might be required to avoid implant loosening and allow continued growth in immature dogs.