Lidocaine infusions dose dependently decreased the MAC of Sevo, did not induce clinically significant changes in HR or arterial blood pressure, but vomiting was common during recovery in HCRI.
OBJECTIVE To evaluate pain intensity and kinetic variables in dogs with hip dysplasia (HD) treated with acupuncture, carprofen, or a placebo. DESIGN Randomized, controlled clinical study. ANIMALS 54 HD-affected dogs and 16 healthy dogs. PROCEDURES Seven HD-affected dogs were removed from the study. Dogs with HD were treated in a blinded manner for 30 days with acupuncture (once weekly for 5 sessions; n = 15), carprofen (4.4 mg/kg [2.0 mg/lb], PO, q 24 h; n = 16), or placebo capsules containing lactose (1 mg/kg [0.45 mg/lb], PO, q 24 h; n = 16). Dogs were evaluated 2 weeks and immediately before (baseline) and 2, 4, and 6 weeks after the onset of treatment. Owners evaluated the dogs' pain intensity with 2 validated questionnaires and a visual analogue scale (VAS) for pain and evaluated degree of lameness with a VAS for locomotion. Kinetics of the hind limbs were also evaluated. Sixteen HD-free dogs were used to assess the evaluation protocol. RESULTS Owners' assessments revealed that outcomes of the 3 treatments did not differ significantly. The Canine Brief Pain Inventory and VAS pain intensity assessments were decreased from baseline at weeks 4 and 6, respectively, but only in acupuncture-treated dogs. The locomotion VAS values were decreased at week 4 in acupuncture-treated and carprofen-treated dogs. Kinetic evaluation findings did not differ among the groups or over time. CONCLUSIONS AND CLINICAL RELEVANCE Neither acupuncture nor carprofen was significantly different from placebo. Acupuncture and carprofen reduced the degree of subjectively evaluated lameness, and acupuncture was associated with a decrease in validated chronic pain scores.
RESUMOO manejo adequado da dor depende de métodos de avaliação acurados. O objetivo deste estudo foi avaliar a validade e a responsividade de uma escala multidimensional para avaliação de dor pós-operatória em gatas submetidas à ovário-histerectomia. Trinta gatas foram filmadas no período perioperatório em quatro momentos predeterminados: pré-operatório, pós-operatório antes e depois da analgesia de resgate e às 24 horas após o término da cirurgia. Cinco observadores não cientes dos momentos de avaliação e um observador considerado padrão-ouro (pesquisador que desenvolveu a escala) avaliaram os vídeos em ordem aleatória e determinaram os escores de dor dos animais, utilizando a escala a ser validada. A responsividade e a validade de conteúdo e constructo foram estabelecidas pelo aumento e pela redução significativa nos escores de dor, em resposta ao procedimento cirúrgico e à administração de analgesia de resgate, respectivamente, avaliados pelo teste de Wilcoxon (P<0,001). A validade de critério foi atestada pela concordância alta entre as avaliações do padrão-ouro com os demais observadores, analisada pela porcentagem de absoluta concordância e coeficiente Kappa ponderado. Os resultados suportam a validade e a responsividade de uma escala multidimensional para avaliação de dor aguda pós-operatória em gatas submetidas à ovário-histerectomia, quando utilizada por veterinários formados e com experiência clínica.
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Avaliou-se a confiabilidade e determinou-se a pontuação mínima relacionada à necessidade de intervenção analgésica de uma escala multidimensional para avaliação de dor pós-operatória em gatas submetidas à ovário-histerectomia. Trinta gatas foram filmadas em quatro momentos predeterminados: pré-operatório, pós-operatório antes e depois da analgesia de resgate e às 24 horas após a cirurgia. Quatro observadores, não cientes dos momentos de avaliação, e um observador, considerado padrão-ouro - pesquisador que desenvolveu a escala - , avaliaram os vídeos em ordem aleatória, a partir da aplicação da escala, e determinaram a suficiência ou não de analgesia, baseando-se na experiência clínica. Os vídeos foram reavaliados dois meses após a primeira análise. O grau de concordância entre as avaliações dos diferentes observadores e das avaliações feitas pelo mesmo observador em diferentes ocasiões foi verificado pelo coeficiente de correlação intraclasse, que variou entre bom e muito bom para todos os itens da escala, exceto atividade, atitude e miscelânea de comportamentos que apresentaram confiabilidade moderada. O ponto de corte ótimo (> 7) foi selecionado pela análise descritiva e da curva Receiver Operating Characteristic. Os resultados suportam a confiabilidade em termos de reprodutibilidade e estabilidade e indicam que a terapia analgésica deve ser considerada em pontuações >8.
Remifentanil decreased ISO(MAC) in a dose-related fashion; the reduction in ISO(MAC) was stable over the course of a prolonged CRI (6 hours). A dose of 0.30 microg of remifentanil/kg/min resulted in nearly maximal isoflurane-sparing effect in dogs; a ceiling effect was observed at higher infusion rates.
ABSTRACT:A spayed crossbred female dog was presented due to progressive weight loss, emesis and anorexia over the preceding month. A complete blood count, urinalysis, serum biochemical panel, and ultrasound were initially performed. Computed tomography urography was performed as a complementary exam. Based on ultrasound and CT findings an exploratory celiotomy was performed to remove hyperdense structures that could be the cause of the hydronephrosis and hydroureter in both kidneys. An extensive granulomatous reaction was found near the caudal pole to the left kidney. A nylon cable tie adhering firmly to this tissue was removed during surgical excision. On the dorsal surface of the bladder an extensive granulomatous reaction that had entrapped the right ureter was also noted. Another nylon cable tie was removed and the ureter was released. Eight months postoperatively, the dog was in good general physical condition, showing appetite and vigour. Abdominal ultrasonography showed improvement of the hydronephrosis in both kidneys. The urea ratio was normal, but the creatinine level was slightly elevated, suggesting a guarded prognosis. Thus, bilateral hydronephrosis as observed in the present study should be considered as a major complication after elective ovariohysterectomy.
OBJECTIVE--To compare ultrasonographic, CT, and surgical findings in dogs infested with giant kidney worms (Dioctophyme renale). DESIGN--Case series. ANIMALS--15 crossbred dogs infected with D renale. PROCEDURES--Immediately after ultrasonography was performed with dogs in dorsal recumbency, sequential transverse images of the abdomen were acquired with a helical CT scanner. After plain CT, contrast CT was performed with a nonionic iodinated contrast agent. Subsequently, exploratory celiotomy was performed. RESULTS--In the corticomedullary area of the right kidney of 12 dogs, ultrasonography revealed several ring-like structures with an echogenic wall and anechoic central area in the transverse plane and arrayed as bands in the longitudinal plane. Similar structures were observed in the abdominal cavity of 10 dogs. In 13 dogs, CT revealed loss of corticomedullary differentiation in the right kidney, with discrete uptake of contrast material in the periphery of the kidney, and several ring-like or elongated structures with a hyperdense wall and hypodense center. In 11 dogs, the same structures were observed free in the abdominal cavity. Surgery revealed that 13 dogs had a damaged right kidney that required nephrectomy. Parasites were found free in the abdominal cavity of 7 dogs. CONCLUSIONS AND CLINICAL RELEVANCE--Ultrasonography and CT were effective imaging methods for detecting D renale in the kidney and less effective for detecting parasites in the abdominal cavity. Care should be taken to avoid erroneously interpreting normal structures as parasites, especially in the abdominal cavity.
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