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Objective  To determine, in mildly hypercapnic horses under isoflurane–medetomidine balanced anaesthesia, whether there is a difference in cardiovascular function between spontaneous ventilation (SV) and intermittent positive pressure ventilation (IPPV). Study design  Prospective randomized clinical study. Animals  Sixty horses, undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. Methods  Horses were sedated with medetomidine and anaesthesia was induced with ketamine and diazepam. Anaesthesia was maintained with isoflurane and a constant rate infusion of medetomidine. Horses were assigned to either SV or IPPV for the duration of anaesthesia. Horses in group IPPV were maintained mildly hypercapnic (arterial partial pressure of carbon dioxide (PaCO2) 50–60 mmHg, 6.7–8 kPa). Mean arterial blood pressure (MAP) was maintained above 70 mmHg by an infusion of dobutamine administered to effect. Heart rate (HR), respiratory rate (fR), arterial blood pressure and inspiratory and expiratory gases were monitored continuously. A bolus of ketamine was administered when horses showed nystagmus. Cardiac output was measured using lithium dilution. Arterial blood‐gas analysis was performed regularly. Recovery time was noted and recovery quality scored. Results  There were no differences between groups concerning age, weight, body position during anaesthesia and anaesthetic duration. Respiratory rate was significantly higher in group IPPV. Significantly more horses in group IPPV received supplemental ketamine. There were no other significant differences between groups. All horses recovered from anaesthesia without complications. Conclusions  There was no difference in cardiovascular function in horses undergoing elective surgery during isoflurane–medetomidine anaesthesia with SV in comparison with IPPV, provided the horses are maintained slightly hypercapnic. Clinical relevance  In horses with health status ASA I and II, cardiovascular function under general anaesthesia is equal with or without IPPV if the PaCO2 is maintained at 50–60 mmHg.

SummaryA new anesthetic protocol for horses was evaluated in 300 clinical patients. Particular attention was paid to cardiopulmonary function and recovery, as poor recoveries and bad cardiovascular function represent the main causes for the high mortality rate associated with equine anesthesia. 300 equidae of mixed breed, mean age of 8 years and mean weight of 486 kg were anaesthetised. Horses were premedicated with acepromazine IM. Following sedation with medetomidine IV, anaesthesia was induced with ketamine and diazepam IV. Anesthesia was maintained with isoflurane in oxygen and constant rate infusion of medetomidine. Horses were allowed to breathe spontaneously, unless apnea necessitated artificial ventilation. Heart rates, respiratory rates, arterial blood pressure, and composition of inhaled and exhaled gases were monitored continuously. Arterial blood gases were measured regularly. Incremental boli of ketamine or thiopentone were noted. Morphine and medetomidine were administered for recovery. Recovery time was recorded and recovery quality was scored on a 1-5 scale (1=best, 5= worst). Mean duration of anaesthesia was 149 minutes. Hypotension or hypoxemia occurred in a small number of horses. Both resolved when either additional fluids and sympathomimetics or a higher concentration of inspiratory oxygen was administered. 146 horses received supplemental ketamine and 29 thiopentone respectively. Recovery was scored excellent or good in 299 horses, poor in one horse. Mean duration of recovery was 50 minutes. Results suggest that the described anesthetic protocol is suitable to maintain anesthesia in horses for various procedures of considerable duration. Cardiopulmonary function was well maintained and recoveries were of exceptionally good quality. Keywords: Horse, anaesthesia, medetomidine, cardiopulmonary functionKlinische Anwendung von Isofluran/Medetomidin-Anästhesie bei 300 Equiden Die Mortaliätsrate in der Pferdeanästhesie ist mit 1 % sehr hoch. Im Vergleich dazu liegt sie in der Kleintieranästhesie bei lediglich 0.15 % und in der Humananästhesie bei 0.002 %. Die drei häufigsten perioperativen Todesursachen beim Pferd sind Herzkreislaufstillstand zu Beginn der Anästhesie, sowie Frakturen und Myopathien während der Aufwachphase. Für längere operative Eingriffe sind heutzutage Inhalationsanästhetika Mittel der Wahl. Diese führen zu einer Beeinträchtigung der Kreislauffunktion und dadurch zu einer verminderten muskulären Durchblutung. Dies fördert die Entstehung oben genannter Myopathien. Eine neue Möglichkeit Pferde sicherer zu anästhesieren bietet der kombinierte Einsatz von Inhalationsanästhetika und Analgetika oder Sedativa. Ein Sedativum mit hervorragenden analgetischen Eigenschaften ist Medetomidin, der zurzeit potenteste und spezifischste α 2 -Agonist. Medetomidin kann aufgrund seiner pharmakokinetischen Eigenschaften beim Pferd während einer Inhalationsanästhesie kontinuierlich infundiert werden. Dies resultiert in einer Verminderung des Bedarfes an Inhalationsanästhetika, stabiler Herzkreislauff...

ALPS offers a reliable alternative for fracture treatment and some other orthopedic conditions in small animals.

Our goal was to investigate the effect of contrast medium injection duration on pulmonary artery peak enhancement and time to peak enhancement. Fourteen dogs were allocated into one of seven predefined weight categories, each category contained two dogs. Dogs in each weight category were assigned to group A or B. Animals in each group received a different contrast medium injection protocol. In group A, a fixed injection rate of 5 ml/s was used. In group B, the contrast injection rate was calculated as follows: flow rate= contrast volume/scan duration + 10s. Time to peak enhancement and peak enhancement of the main left and right pulmonary arteries were measured on single-level, dynamic CT images for a fixed time of 30s. Rank correlation (Spearman's) coefficients between injection duration and time to peak enhancement and between body weight and peak enhancement were calculated. For group A, there was a significant negative correlation between peak enhancement and weight (r = -0.94; P = 0.005), while for group B, there was no significant correlation (r = -0.64 and P = 0.18). There was a significant correlation between time to peak enhancement and injection duration in both groups (group A: r = 0.99; P = 0.006 and group B: r = 0.85; P = 0.02). In conclusion, injection duration is a key feature in a CT angiography injection protocol. A protocol with an injection duration adjusted to the scan duration seems to be particularly suitable for veterinary applications where a population with great weight variability is studied.

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