Javma-journal of The American Veterinary Medical Association最新文献

Objective: To estimate the time until reliable echocardiography in healthy dogs by evaluating differences in measured echocardiographic variables in dogs before sedation, during sedation with dexmedetomidine, and after reversal with atipamezole.

Methods: 13 dogs were prospectively enrolled. Two-dimensional echocardiographic measurements on left atrial and ventricular dimensions and ventricular systolic function were obtained at each time point. Dogs underwent IV sedation with 10 µg/kg of dexmedetomidine and 0.2 mg/kg of butorphanol, and dexmedetomidine was reversed with atipamezole IM. Echocardiography was performed before sedation, during sedation, and 30 to 60 minutes, 2 hours, and 6 hours after reversal. Data were analyzed with a Bayesian multivariate hierarchical model.

Results: There were effects of sedation on the mean values of all echocardiographic variables. These effects varied among dogs, with most dogs expected to remain within normal reference ranges during and after sedation for all variables except ejection fraction and fractional shortening. The effects of sedation on ejection fraction and fractional shortening were widespread and persistent, such that 88% and 79% of dogs, respectively, were expected to measure outside the normal ranges during sedation. After reversal with atipamezole, this proportion declined, with approximately 9% of dogs estimated outside the normal reference ranges after 6 hours.

Conclusions: Effects of dexmedetomidine on echocardiographic measurements were detected 6 hours after reversal with atipamezole. Accurate cardiac assessment in dogs sedated with this drug is not likely to be possible on the same day as sedation.

Clinical relevance: Dogs sedated with this protocol and that have echocardiography performed within 6 hours following reversal should have results interpreted with caution.

Objective: To describe biochemical and pathologic findings associated with meloxicam-associated nephrotoxicity in California sea lions (CSLs) with concurrent evidence of chronic domoic acid toxicosis.

Animals: Stranded free-ranging CSLs treated with meloxicam while undergoing rehabilitation in California between 2017 and 2023.

Clinical presentation: 6 adult females and 1 male pup were included in this case series due to postmortem evidence of meloxicam-associated nephrotoxicity. Five patients were in treatment for suspected domoic acid toxicosis, and 2 were in treatment for malnutrition. Three individuals showed evidence of antemortem renal impairment (azotemia, electrolyte derangements, and clinical decline), while the other 4 were diagnosed postmortem.

Results: 6 of the 7 CSLs for which serum was available before and after treatment with meloxicam developed a significant increase in serum creatinine, BUN, phosphorous, and potassium following treatment. At necropsy, renal papillary necrosis was evident on gross and histologic examination consistent with meloxicam-associated nephrotoxicity for all 7 cases. These individuals also had hippocampal atrophy supportive of chronic domoic acid toxicosis.

Clinical relevance: This is the first report of meloxicam-associated nephrotoxicity in pinnipeds. While multiple factors such as dehydration, nutrition, other medication, and/or compromised immune function may have contributed to the development of nephrotoxicity, further evaluation of renal effects of domoic acid as well as effects of NSAIDs is warranted in CSLs.