The gallbladder is routinely evaluated during ultrasonographic examinations in dogs. However, published studies describing the effects of sedative agents on gallbladder wall thickness are currently lacking. The aims of this prospective, blinded, randomized crossover pilot study were to test hypotheses that IV morphine would result in gallbladder wall thickening, that morphine administration would increase plasma histamine concentrations, and that combining IV morphine with dexmedetomidine would potentiate gallbladder wall thickening. Six healthy Beagle dogs were sedated with intravenous (IV) morphine 0.4 mg/kg (group M), dexmedetomidine 7 μg/kg (group D), or a combination of the two (group MD). Physiologic parameters were measured at baseline and at regular intervals until the last ultrasonographic scan. Ultrasonographic scans were performed at baseline, 90 s, and at 5, 15, 30, 45, 60, 90, and 120 min. Plasma histamine samples were taken at baseline, 90 s, and 5 and 60 min. Cochran's Q‐test was used to compare gallbladder wall thickening between groups, while the association between histamine plasma concentration and gallbladder wall thickness was compared with a mixed‐effects model. Baseline gallbladder wall thickness was not significantly different between groups. Six of 18 treatments/dogs (33%) developed gallbladder thickening, with no difference between groups. There was no significant difference in baseline plasma histamine concentrations between groups, and no association between plasma histamine concentration and gallbladder wall thickness. Gallbladder wall thickening was observed in at least one dog in each group, therefore caution is recommended for gallbladder wall thickness ultrasonographic interpretation in dogs when these drugs have been administered.
A 1-year-old, 9.8-kg (21.6-lb), female, spayed Pembroke Welsh corgi dog was presented for evaluation of previously diagnosed patent ductus arteriosus and severe pulmonary hypertension. In the veterinary literature, there is relatively little information related to the anaesthetic management of patients with patent ductus arteriosus and severe pulmonary hypertension (or in those with Eisenmenger pathophysiology). In this case report, we consider haemodynamic concerns related to anaesthesia in this clinical setting, while describing the successful management of this case and related complications.
e11544 Background: Fertility loss is a main side effect of adjuvant CT in young women with BC. AMH was evaluated as a potential marker of residual ovarian function after CT. Method: AMH (ng/mL), FSH (mIU/mL), E2 (pg/mL) and menstrual activity were evaluated before CT and every 3 months after CT in pre-menopausal BC patients ( pts ) enrolled in a phase III study evaluating the role of triptorelin in the prevention of CT-induced early menopause. Means were compared with Student t test for paired data, anova or ancova. The effect of age, CT regimen, FSH and AMH on time to menstrual resumption was investigated by means of the Cox's proportional hazards model. Results: Among 26 evaluable pts at baseline, mean age was 39 years (range 27-45). Baseline mean values were: FSH 5.67 (SD 4.88), E2 151.81 (SD 134.9), AMH 2.67 (SD 1.85). Levels of AMH were significantly lower (1.26) in old pts ( ≥ 41 yrs) as compared to younger ones (2.97 and 3.63 in 25–36 yrs and 37–40 yrs old women, respectively) (p=0.018). After CT, mean value of AMH significantly decreased from 2.04 ( SD 1.44 ) to 0.59 ( SD 0.59 ) (p=0.0003 ); FSH value increased, from of 8.64 (SD 12.99) to 23.13 (SD 25.80) (p=0.017) and E2 values decreased from 159.71 (SD 147.03) to 73.29 (SD 129.53) (p=0.02). The mean decrease of AMH levels was not affected by the type of CT regimens: -1.50, -1.52 and -1.33 after FEC ⋄ Paclitaxel, FEC ⋄ Taxotere and FEC/CMF, respectively (p=0.97). Among 10 pts with both early (0–5 months) and delayed (6–11 months) post-CT evaluations, no change in AMH values was observed with longer follow up: mean values were 1.49, 0.35 and 0.36, at baseline, after 0–5 months and after 6–11 months, respectively. Menstrual activity resumption occurred in 48% of patients. At multivariate analysis factors significantly associated with the lower probability of menstrual activity resumption after CT were: old age (p=0.05) and chemotherapy with FEC ⋄ docetaxel ( p=0.05 ). In this preliminary analysis baseline and after CT values of AMH were not significantly associated with menstrual resumption. Conclusions: Adjuvant CT significantly affects the levels of AMH in young women with BC. Further studies are needed to assess the role of AMH as a surrogate of ovarian toxicity induced by CT. No significant financial relationships to disclose.
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