Lexmaulová L., R. Novotná, P. Raušer, A. Nečas: Complications Related to Surgical Treatment of Intervertebral Disc Disease in Dogs. Acta Vet. Brno 2008, 77: 269-276. After intervertebral disk surgery we often have to deal with various complications (seizures, gastrointestinal tract (GIT) ulcerations, cystitis, and surgical wound healing problems). These complications may lead to the death of the patient. We performed clinical and laboratory investigations in 161 dogs with an intervertebral disc disease. After that, we performed a cranial (n = 31), caudal (n = 125) or both (n = 5) types of myelography at the same time, and surgery -ventral slot decompression (SLOT) (n = 18) or hemilaminectomy (n = 143). During the postsurgical period we observed seizures, GIT complications, cystitis, and surgical wound healing problems or even death of the patients. These complications appeared to be related to the lesion site, the degree of clinical signs and the type of surgical procedure. In our study we found a higher incidence of seizures after cranial myelography, higher incidence of gastrointestinal (GI) complications particularly in paraplegic dogs, and a higher risk of death in patients after the SLOT surgery. The occurrence of cystitis was not significant (p = 0.5524, p = 0.1655, respectively). We consider seizures, GI ulcerations, and death the most frequent complications after intervertebral disc surgery. Their incidence depends on the lesion site and the degree of neurologic symptoms.
Gastric dilatation-volvulus (GDV) or gastric dilatation (GD), were diagnosed in 173 dogs during the period from 1997 to 2001. Risk factors possibly associated with higher mortality in cases of GDV were evaluated. Variables suitable for quantitative evaluation were examined by the Student's t-test with regard to the risk of death. We characterised groups of dogs with potential risk factors (age, body weight, time lapsed from the last feeding until presentation, time lapsed from the onset of clinical signs until presentation, time lapsed from the last feeding until the onset of clinical signs), and compared the groups with regard to the risk of death, using the χ 2 -test. There were no differences between the dying and surviving patients as to their age, body weight and time lapsed from the last feeding until the onset of clinical signs. The time lapsed from the onset of clinical signs until presentation at the clinic was a significant factor associated with a lower survival rate. Mortality in dogs with GDV was 26.3% (36/137). Significantly higher mortality (p < 0.01) was found in dogs with gastric necrosis. Gastric necrosis in dogs with GDV is responsible for a 6.5 times higher risk of death compared to patients without gastric necrosis. There was also higher mortality in dogs after splenectomy (p < 0.05). Results of our study suggest that the most important prognostic factor is a timely treatment following the onset of clinical signs of GDV. Dog, retrospective study, gastric necrosis, splenectomy, risk factors, feedingGastric dilatation-volvulus (GDV) is a very serious, life-threatening syndrome typically affecting large and giant breeds of dogs. For example, in the United States of America this syndrome affects about 60 000 dogs a year (Burrows and Ignaszewski 1990). The risk of this syndrome in some dog breeds is very high. In the Great Dane it amounts to more than 40% (Glickman et al. 2000). Despite its recognition more than 90 years ago (Cadeac 1906) and considerable advances in diagnosis and treatment, mortality associated with GDV still remains high. Various studies report mortality varying from 10 to 60% (Betts et al. 1974;Muir 1982;Walshaw and Johnson 1976;Matthiesen 1983;Frankquist and Obel 1979; Winfgield et al. 1975;Glickman et al. 1994;Brockman et al. 1995;Brourman 1996;Van Sluijs 1991;Glickman et al. 1998;Eggertsdóttir and Moe 1995;Nagel and Neumann 1992). It is, however, difficult to compare individual results because of differences in the definition of mortality and different therapeutic procedures within individual studies.On the basis of our current knowledge, therapy of the syndrome consists of three important parts:1) immediate and aggressive patient stabilisation including gastric decompression and treatment of shock; 2) surgical correction of volvulus including gastropexy to prevent recurrence; and 3) post-operative monitoring and intensive care (Matthiesen 1983;Aronson et al.
Arterial occlusion due to thrombosis caused by ruptured atherosclerotic plaques (Baba et al., 1975) has been recognized as a major cause of morbidity and mortality in western populations. Thrombosis may occur in various sections of arterial circulation, peripheral arteries of the limbs, coronary arteries, brain arteries, or both major and minor vessels within the abdominal cavity. The ultimate consequence is varying degrees of organ failure, mostly of ischemic origin. Arterial thrombosis represents a continuous problem, debilitating patients and decreasing their quality of life. Moreover, along with chronic heart failure, it can significantly decrease patient life expectancy. Arterial thrombosis results in ischemia, with serious systemic consequences, such as metabolic breakdown. The major goal of treatment remains fast and efficient recanalization -surgical, interventional or thrombolytic. To be able to prevent acute reocclusion with severe consequences (rhabdomyolysis, compartment syndrome, excessive tissue necrosis leading to limb amputation, etc.), several adjunctive treatment regimens have been advocated. Among others, thrombin inhibitors and platelet inhibitors have been widely used for both prophylaxis and adjunctive treatment. Direct thrombin inhibitors and antithrombin stimulators have been recognized as typical antithrombotic drugs. Direct (antithrombin-independent) thrombin inhibitors can be divided into two main categories: monovalent, active site inhibitors (argatroban, efegatran, inovastan, melagatran) and bivalent (hirudin, hirugen, hirulog, bivalirudin), while antithrombin stimulators represent standard (unfractionated) heparin (UFH) and its depolymerizing products -low molecular weight heparins (LMWH's). Recently, a clear change in the main use of heparin, as well as low-molecular weight heparins has been advocated representing a shift from treatment and prophylaxis of deep vein thrombosis to prophylaxis of thromboembolic disease following vascular, cardiovascular or orthopedic surgery, treatment of unstable angina and prevention of acute myocardial infarction. The main effect of heparins lies in their anticoagulant activity. Heparins are involved in different pathways of the coagulation cascade with anticoagulant, antithrombotic, profibrinolytic, anti-aggregative, as well as anti-inflammatory effects. Moreover, there is a little doubt about their anti-proliferative and anti-ischemic activity (Penka and Bulikova, 2006). Unlike standard heparin, low-molecular weight heparins do not affect the patient's general coagulation profile. Obviously, the difference in molecular weight results in different pharmacokinetic and pharmacodynamic properties of the agents.Key words: coagulation; arterial thrombosis; standard heparin; low-molecular weight heparins List of abbreviations ABI = axillary/...index, t-PA = tissue-type plasminogen activator, ADP = adenosin diphosphate, AG = angiography, AMI = acute myocardial infarction, APSAC = acylated plasminogen streptokinase activator complex, APTT = acti...
Objective -To compare the incidence of seizures in dogs with intervertebral disk disease after iopamidol or iomeprol myelography, and to assess whether the incidence of seizures differed between the 2 agents when severity of neurological deficits, location of cord compression, duration of anesthesia, site of myelogram, volume of contrast, and concentration of contrast were evaluated. Design -Retrospective study. Setting -Veterinary teaching hospital. Animals -One hundred and sixty-one client-owned dogs with intervertebral disk disease. Interventions -Subarachnoid injection of contrast medium. Measurements and Main Results -One hundred and sixty-one dogs with intervertebral disk disease were subjected to myelography using iopamidol (n 5 74) or iomeprol (n 5 87). Cranial myelography was performed in 31 dogs, caudal myelography in 125 and both cranial and caudal myelography in 5. Seizures occurred in 23 of 161 (14%) dogs. There was no significant difference overall between iopamidol and iomeprol myelography. However, in dogs with thoracolumbar disk extrusion and paraplegia, seizures occurred more frequently after caudal myelography using iopamidol compared with iomeprol. Conclusions -Both iomeprol and iopamidol are suitable for myelography in dogs. Iomeprol is recommended for caudal myelography in paraplegic dogs with thoracolumbar disk extrusion due to the higher incidence of seizures in this group when iopamidol was used.
Rau‰er P., J. Zatloukal, A. Neãas, J. Lorenzová, L. Lexmaulová: Combined Medetomidine and Ketamine for Short-term Anaesthesia in Ferrets -a Clinical Study. Acta Vet. Brno 2002, 71: 243-248.In a clinical study we evaluated the quality of anaesthesia by a combination of medetomidine and ketamine given at two different doses to perform standard surgical procedures in the ferret (e.g., anal sac removal, castration or ovariohysterectomy). Ferrets were intramuscularly administered medetomidine (60 µg/kg) in a combination with ketamine given at two different doses (5 mg/kg in group A and 8 mg/kg in group B). Within several minutes all animals took up lateral recumbency, lost bottle the palpebral reflex and deep sensation except for three individuals receiving the lower ketamine dose, in which there was no deep sensation loss observed. Lower ketamin dose resulted in later loss of all evaluated parameters. It also reduced the time of their recovery (especially deep sensation). The loss of deep sensation after the higher ketamine dose was nearly twice as long as after the lower dose. Heart rate values were comparable in both groups and showed a decreasing tendency as well as the respiratory rate, which, however, differed in both groups from the 30 th min of anaesthesia. The combination of medetomidine and ketamine is very effective for the anaesthesia in ferrets regarding the duration, myorelaxation and analgesia. Prolongation of this anaesthesia is possible with half ketamine doses. α-adrenergic drugs; dissociative anesthetics
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