Pub Date : 2025-09-19DOI: 10.1016/j.vaa.2025.09.006
Matthew K. Wun , Michael H. Court , Nicolas F. Villarino , Richard Malik
Over the past 20 years, injectable non-steroidal anti-inflammatory drugs (NSAIDs) have become widely adopted to provide routine analgesia to dogs and cats, including perioperatively. This is despite growing evidence associating their use with acute kidney injury, particularly in relation to the use of meloxicam in cats. In this Perspective, we summarise the evidence obtained from pharmacovigilance agencies and the veterinary literature, examine why proponents of injectable NSAIDs appear to discard this evidence, and discuss whether injectable NSAIDs are an obligatory component of multimodal analgesia. Finally, we offer alternative analgesic drug regimens and call for further research that could be undertaken before injectable NSAIDs can be used safely in dogs and cats.
{"title":"The association between injectable non-steroidal anti-inflammatory drugs and acute kidney injury in dogs and cats","authors":"Matthew K. Wun , Michael H. Court , Nicolas F. Villarino , Richard Malik","doi":"10.1016/j.vaa.2025.09.006","DOIUrl":"10.1016/j.vaa.2025.09.006","url":null,"abstract":"<div><div>Over the past 20 years, injectable non-steroidal anti-inflammatory drugs (NSAIDs) have become widely adopted to provide routine analgesia to dogs and cats, including perioperatively. This is despite growing evidence associating their use with acute kidney injury, particularly in relation to the use of meloxicam in cats. In this Perspective, we summarise the evidence obtained from pharmacovigilance agencies and the veterinary literature, examine why proponents of injectable NSAIDs appear to discard this evidence, and discuss whether injectable NSAIDs are an obligatory component of multimodal analgesia. Finally, we offer alternative analgesic drug regimens and call for further research that could be undertaken before injectable NSAIDs can be used safely in dogs and cats.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 730-736"},"PeriodicalIF":1.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-12DOI: 10.1016/j.vaa.2025.09.004
Patricia Romero Marco , Holly M. English , Barry Nolan , Simone Ciuti , Rachel C. Bennett , Vilhelmiina Huuskonen
Objective
To compare two immobilisation protocols for the restraint of urban red foxes: medetomidine-midazolam (MM) and alfaxalone-midazolam (AM).
Study design
Prospective, randomised clinical trial.
Animals
Fourteen urban red foxes (Vulpes vulpes) captured in the Dublin metropolitan area.
Methods
Foxes were randomly assigned to receive either MM [medetomidine 0.07 mg kg-1, midazolam 0.8 mg kg-1 intramuscularly (IM)] or AM (alfaxalone 3 mg kg-1, midazolam 0.8 mg kg-1 IM). Sedation and recovery were scored. Recovery times and physiological variables [heart rate, respiratory rate (fR), oscillometric arterial blood pressure, arterial haemoglobin oxygen saturation (SpO2) and rectal temperature] were measured. Hair and blood samples were collected for cortisol analysis. Sedation was reversed with atipamezole (0.35 mg kg-1 IM) and/or flumazenil (0.01 mg kg-1 IM). Recovery ended when foxes walked with coordinated movements. Data were analysed using linear and mixed-effects models.
Results
Seven foxes were given MM and seven AM. Median sedation scores were higher in MM (14.5 versus 12.5; p = 0.048), with shorter reversal times (25 versus 54 minutes; p = 0.009). Heart rate was lower (80 versus 216 beats per minute-1; p < 0.001) and mean arterial blood pressure higher (147 versus 110 mmHg; p < 0.001) in MM. SpO2 was higher in AM (95 versus 91%; p = 0.015). Rectal temperature was higher in MM (38.6 versus 36.5 °C; p < 0.001), with a faster decrease in AM (p = 0.006). fR did not differ between groups (p = 0.492) but increased with higher ambient temperature (p = 0.04) and decreased with higher hair cortisol levels (p = 0.02).
Conclusions and clinical relevance
Both protocols provided sufficient sedation for intended procedures. MM resulted in higher sedation scores and faster recovery after antagonist administration, while AM provided higher SpO2 and heart rates and lower rectal temperature values.
{"title":"Comparison of two immobilisation protocols (medetomidine-midazolam and alfaxalone-midazolam) for restraint of urban red foxes (Vulpes vulpes) : a pilot study","authors":"Patricia Romero Marco , Holly M. English , Barry Nolan , Simone Ciuti , Rachel C. Bennett , Vilhelmiina Huuskonen","doi":"10.1016/j.vaa.2025.09.004","DOIUrl":"10.1016/j.vaa.2025.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To compare two immobilisation protocols for the restraint of urban red foxes: medetomidine-midazolam (MM) and alfaxalone-midazolam (AM).</div></div><div><h3>Study design</h3><div>Prospective, randomised clinical trial.</div></div><div><h3>Animals</h3><div>Fourteen urban red foxes (<em>Vulpes vulpes</em>) captured in the Dublin metropolitan area.</div></div><div><h3>Methods</h3><div>Foxes were randomly assigned to receive either MM [medetomidine 0.07 mg kg<sup>-1</sup>, midazolam 0.8 mg kg<sup>-1</sup> intramuscularly (IM)] or AM (alfaxalone 3 mg kg<sup>-1</sup>, midazolam 0.8 mg kg<sup>-1</sup> IM). Sedation and recovery were scored. Recovery times and physiological variables [heart rate, respiratory rate (<em>f</em><sub>R</sub>), oscillometric arterial blood pressure, arterial haemoglobin oxygen saturation (SpO<sub>2</sub>) and rectal temperature] were measured. Hair and blood samples were collected for cortisol analysis. Sedation was reversed with atipamezole (0.35 mg kg<sup>-1</sup> IM) and/or flumazenil (0.01 mg kg<sup>-1</sup> IM). Recovery ended when foxes walked with coordinated movements. Data were analysed using linear and mixed-effects models.</div></div><div><h3>Results</h3><div>Seven foxes were given MM and seven AM. Median sedation scores were higher in MM (14.5 <em>versus</em> 12.5; <em>p</em> = 0.048), with shorter reversal times (25 <em>versus</em> 54 minutes; <em>p</em> = 0.009). Heart rate was lower (80 <em>versus</em> 216 beats per minute<sup>-1</sup>; <em>p</em> < 0.001) and mean arterial blood pressure higher (147 <em>versus</em> 110 mmHg; <em>p</em> < 0.001) in MM. SpO<sub>2</sub> was higher in AM (95 <em>versus</em> 91%; <em>p</em> = 0.015). Rectal temperature was higher in MM (38.6 <em>versus</em> 36.5 °C; <em>p</em> < 0.001), with a faster decrease in AM (<em>p</em> = 0.006). <em>f</em><sub>R</sub> did not differ between groups (<em>p</em> = 0.492) but increased with higher ambient temperature (<em>p</em> = 0.04) and decreased with higher hair cortisol levels (<em>p</em> = 0.02).</div></div><div><h3>Conclusions and clinical relevance</h3><div>Both protocols provided sufficient sedation for intended procedures. MM resulted in higher sedation scores and faster recovery after antagonist administration, while AM provided higher SpO<sub>2</sub> and heart rates and lower rectal temperature values.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 737-746"},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-12DOI: 10.1016/j.vaa.2025.09.003
Henrique E. de Almeida Lupiano , Erik H. Hofmeister , Pen-Ting Liao
Objective
The purposes of this study were to document intra-rater reliability in assigning American Society of Anesthesiologists Physical Status Classification System (ASA) status, to compare Cochran–Weiss–Shanteau (CWS) scores between anesthetists with varying levels of external validation, and to document the explanations given for assigning certain ASA statuses.
Study design
Prospective case series.
Subjects
A group of 29 anesthetists.
Methods
Anesthetists were presented with 25 hypothetical cases in two stages and asked to provide an ASA status as well as an explanation. Intra-rater reliability was calculated using the single-measure averaged intraclass correlation coefficient (ICC). The CWS index was calculated and quantifies expertise by assessing discrimination and consistency, where higher scores indicate superior judgment. Explanations for assignment of ASA status were analyzed by inductive coding by two investigators.
Results
The intra-rater ICC for all raters who completed Stage 1 and 2 was 0.80 (95% confidence interval 0.76–0.83, n = 17), 0.80 (0.74–0.86, n = 6) for Diplomates, 0.76 (0.68–0.82, n = 5) for residents and 0.86 (0.81–0.90, n = 6) for veterinary technicians. CWS ranged from 2.0 to 6.1, with the same median score of 3.1 for Diplomates, residents and technicians. In cases with the lowest agreement, the themes identified included disagreement on the degree of physiological compensation (e.g. tachycardia) and the effects of mild dehydration, an asymptomatic heart murmur, patients with brachycephalic airway syndrome and hypoproteinemia.
Conclusions and clinical relevance
Intra-rater reliability was high and similar regardless of level of external validation (i.e. technician vs. resident versus Diplomate). Using the CWS for ASA status assignment did not differentiate technicians, residents and Diplomates, although some individuals had relatively higher CWS, suggesting greater expertise in ASA status assignment. Disagreements exist in classifying conditions like brachycephalic airway syndrome and asymptomatic heart murmurs.
{"title":"Intra-rater reliability, expertise and justifications for the American society of anesthesiologists physical status classification in dogs","authors":"Henrique E. de Almeida Lupiano , Erik H. Hofmeister , Pen-Ting Liao","doi":"10.1016/j.vaa.2025.09.003","DOIUrl":"10.1016/j.vaa.2025.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>The purposes of this study were to document intra-rater reliability in assigning American Society of Anesthesiologists Physical Status Classification System (ASA) status, to compare Cochran–Weiss–Shanteau (CWS) scores between anesthetists with varying levels of external validation, and to document the explanations given for assigning certain ASA statuses.</div></div><div><h3>Study design</h3><div>Prospective case series.</div></div><div><h3>Subjects</h3><div>A group of 29 anesthetists.</div></div><div><h3>Methods</h3><div>Anesthetists were presented with 25 hypothetical cases in two stages and asked to provide an ASA status as well as an explanation. Intra-rater reliability was calculated using the single-measure averaged intraclass correlation coefficient (ICC). The CWS index was calculated and quantifies expertise by assessing discrimination and consistency, where higher scores indicate superior judgment. Explanations for assignment of ASA status were analyzed by inductive coding by two investigators.</div></div><div><h3>Results</h3><div>The intra-rater ICC for all raters who completed Stage 1 and 2 was 0.80 (95% confidence interval 0.76–0.83, <em>n</em> = 17), 0.80 (0.74–0.86, <em>n</em> = 6) for Diplomates, 0.76 (0.68–0.82, <em>n</em> = 5) for residents and 0.86 (0.81–0.90, <em>n</em> = 6) for veterinary technicians. CWS ranged from 2.0 to 6.1, with the same median score of 3.1 for Diplomates, residents and technicians. In cases with the lowest agreement, the themes identified included disagreement on the degree of physiological compensation (e.g. tachycardia) and the effects of mild dehydration, an asymptomatic heart murmur, patients with brachycephalic airway syndrome and hypoproteinemia.</div></div><div><h3>Conclusions and clinical relevance</h3><div>Intra-rater reliability was high and similar regardless of level of external validation (i.e. technician vs. resident <em>versus</em> Diplomate). Using the CWS for ASA status assignment did not differentiate technicians, residents and Diplomates, although some individuals had relatively higher CWS, suggesting greater expertise in ASA status assignment. Disagreements exist in classifying conditions like brachycephalic airway syndrome and asymptomatic heart murmurs.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 747-754"},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-08DOI: 10.1016/j.vaa.2025.09.002
Carolyn L. Kerr , W Emmett Swanton , Ron J. Johnson , Maria D. Amezcua , Terri L. O’Sullivan
Objective
To determine the anesthetic and analgesic protocols and techniques used in cats undergoing elective neutering in Ontario, Canada and to obtain veterinarians’ opinions regarding their choices.
Study design
Cross-sectional survey.
Animals
Client-owned cats undergoing elective neutering in Ontario, Canada.
Methods
A confidential mixed-mode survey about anesthetic and analgesic management practices used in client-owned cats undergoing elective neutering was distributed to veterinarians (n = 2921) working in companion animal practice in Ontario. Descriptive statistics were generated. Logistic regression was used to identify associations between demographic factors and protocols. Chi-square analysis was used to compare protocols used in cats undergoing ovariohysterectomy (OVH) versus castration.
Results
Four hundred and thirty-one individuals (14.8%) completed the survey. Most respondents used a sedative before induction of anesthesia (OVH: 368/387; 95.1% and castration 360/381; 94.5%) and gave an opioid and/or a non-steroidal anti-inflammatory drug perioperatively (OVH: 379/381; 99.7% and castration: 379/382; 99.2%). Respondents placed an intravenous catheter and performed orotracheal intubation more frequently in cats undergoing OVH (catheter: 366/387; 94.6% and intubation: 379/386; 98.2%) compared with castration (catheter: 219/380; 57.6% and intubation: 166/375; 44.3%) (p < 0.001). Respondents more closely followed current anesthesia guidelines relative to their peers if they: graduated during or after 2000, were women, performed 1–10 OVHs per week, worked in an urban setting, in a companion animal practice, with three or more veterinarians or three to five registered veterinary technicians. Most respondents were very satisfied or satisfied with their current anesthetic drug protocol for cats undergoing elective OVH (396/412; 96.1%) and castration (386/413; 93.4%).
Conclusions and clinical relevance
Most veterinarians in Ontario who participated in the survey follow many of the current guidelines regarding anesthetic and analgesia management practices for cats undergoing elective neutering. Anesthetic protocols varied with respondent demographics; however, most respondents were satisfied with their choices.
{"title":"Anesthetic and analgesic management of cats undergoing elective neutering: Survey of practices and opinions of veterinarians in Ontario, Canada","authors":"Carolyn L. Kerr , W Emmett Swanton , Ron J. Johnson , Maria D. Amezcua , Terri L. O’Sullivan","doi":"10.1016/j.vaa.2025.09.002","DOIUrl":"10.1016/j.vaa.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the anesthetic and analgesic protocols and techniques used in cats undergoing elective neutering in Ontario, Canada and to obtain veterinarians’ opinions regarding their choices.</div></div><div><h3>Study design</h3><div>Cross-sectional survey.</div></div><div><h3>Animals</h3><div>Client-owned cats undergoing elective neutering in Ontario, Canada.</div></div><div><h3>Methods</h3><div>A confidential mixed-mode survey about anesthetic and analgesic management practices used in client-owned cats undergoing elective neutering was distributed to veterinarians (<em>n</em> = 2921) working in companion animal practice in Ontario. Descriptive statistics were generated. Logistic regression was used to identify associations between demographic factors and protocols. Chi-square analysis was used to compare protocols used in cats undergoing ovariohysterectomy (OVH) <em>versus</em> castration.</div></div><div><h3>Results</h3><div>Four hundred and thirty-one individuals (14.8%) completed the survey. Most respondents used a sedative before induction of anesthesia (OVH: 368/387; 95.1% and castration 360/381; 94.5%) and gave an opioid and/or a non-steroidal anti-inflammatory drug perioperatively (OVH: 379/381; 99.7% and castration: 379/382; 99.2%). Respondents placed an intravenous catheter and performed orotracheal intubation more frequently in cats undergoing OVH (catheter: 366/387; 94.6% and intubation: 379/386; 98.2%) compared with castration (catheter: 219/380; 57.6% and intubation: 166/375; 44.3%) (<em>p</em> < 0.001). Respondents more closely followed current anesthesia guidelines relative to their peers if they: graduated during or after 2000, were women, performed 1–10 OVHs per week, worked in an urban setting, in a companion animal practice, with three or more veterinarians or three to five registered veterinary technicians. Most respondents were very satisfied or satisfied with their current anesthetic drug protocol for cats undergoing elective OVH (396/412; 96.1%) and castration (386/413; 93.4%).</div></div><div><h3>Conclusions and clinical relevance</h3><div>Most veterinarians in Ontario who participated in the survey follow many of the current guidelines regarding anesthetic and analgesia management practices for cats undergoing elective neutering. Anesthetic protocols varied with respondent demographics; however, most respondents were satisfied with their choices.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 755-770"},"PeriodicalIF":1.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-23DOI: 10.1016/j.vaa.2025.08.040
Junghwa Chae, Changhoon Nam, Nahyun Kim, Jihyun Kim, Younggwang Cho, Inhyung Lee, Won-gyun Son
Objective
To characterize physiological responses to prolonged positive pressure breath holding (PPBH) in anesthetized dogs with oxygen supplementation, and to determine whether lowering initial end-tidal carbon dioxide (Pe′CO2) extends the safe duration of PPBH.
Study design
Prospective, randomized, crossover study.
Animals
A group of five healthy adult Beagle dogs (12.9 ± 1.2 kg).
Methods
Each dog underwent two PPBH trials at initial Pe′CO2 levels of 40 mmHg (5.3 kPa, control) and 30 mmHg (4.0 kPa, treatment), with 2 week interval. Anesthesia was induced and then maintained using total intravenous anesthesia with alfaxalone (3 mg kg–1, then 12 mg kg–1 hour–1) and rocuronium (1 mg kg–1, then 0.2 mg kg–1 hour–1). Mechanical ventilation with 100% oxygen was used to achieve target Pe′CO2 levels. PPBH was initiated at an end-expiratory pressure of 15 cmH2O for 10 minutes. Arterial blood gases, heart rate and arterial blood pressure were recorded every minute. Primary end points were the time to reach arterial partial pressure of carbon dioxide (PaCO2) ≥ 60 mmHg (8.0 kPa) or pH ≤ 7.2. Time-dependent changes were analyzed using linear mixed models. The duration of PPBH before reaching end points was evaluated using Kaplan–Meier survival analysis.
Results
No hypoxemia was observed. PPBH resulted in progressive increases in PaCO2 and corresponding pH reductions over time (p < 0.001). The time to reach PaCO2 ≥ 60 mmHg (8.0 kPa) was 2.4 ± 0.8 minutes at 40 mmHg (5.3 kPa) and 5.8 ± 1.6 minutes at 30 mmHg (4.0 kPa) (p = 0.006). Similarly, the time to reach pH ≤ 7.2 was significantly prolonged in the 30 mmHg (4.0 kPa) treatment (p = 0.002). Cardiovascular variables remained within reference ranges.
Conclusions and clinical relevance
The results of this study show that adjusting initial Pe′CO2 effectively delays the progression of hypercapnia and acidemia, thereby extending the clinically tolerable duration of PPBH.
{"title":"The effects of preemptive carbon dioxide reduction in prolonged positive pressure breath holding in anesthetized dogs receiving oxygen","authors":"Junghwa Chae, Changhoon Nam, Nahyun Kim, Jihyun Kim, Younggwang Cho, Inhyung Lee, Won-gyun Son","doi":"10.1016/j.vaa.2025.08.040","DOIUrl":"10.1016/j.vaa.2025.08.040","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize physiological responses to prolonged positive pressure breath holding (PPBH) in anesthetized dogs with oxygen supplementation, and to determine whether lowering initial end-tidal carbon dioxide (P<span>e′</span>CO<sub>2</sub>) extends the safe duration of PPBH.</div></div><div><h3>Study design</h3><div>Prospective, randomized, crossover study.</div></div><div><h3>Animals</h3><div>A group of five healthy adult Beagle dogs (12.9 ± 1.2 kg).</div></div><div><h3>Methods</h3><div>Each dog underwent two PPBH trials at initial P<span>e′</span>CO<sub>2</sub> levels of 40 mmHg (5.3 kPa, control) and 30 mmHg (4.0 kPa, treatment), with 2 week interval. Anesthesia was induced and then maintained using total intravenous anesthesia with alfaxalone (3 mg kg<sup>–1</sup>, then 12 mg kg<sup>–1</sup> hour<sup>–1</sup>) and rocuronium (1 mg kg<sup>–1</sup>, then 0.2 mg kg<sup>–1</sup> hour<sup>–1</sup>). Mechanical ventilation with 100% oxygen was used to achieve target P<span>e′</span>CO<sub>2</sub> levels. PPBH was initiated at an end-expiratory pressure of 15 cmH<sub>2</sub>O for 10 minutes. Arterial blood gases, heart rate and arterial blood pressure were recorded every minute. Primary end points were the time to reach arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>) ≥ 60 mmHg (8.0 kPa) or pH ≤ 7.2. Time-dependent changes were analyzed using linear mixed models. The duration of PPBH before reaching end points was evaluated using Kaplan–Meier survival analysis.</div></div><div><h3>Results</h3><div>No hypoxemia was observed. PPBH resulted in progressive increases in PaCO<sub>2</sub> and corresponding pH reductions over time (<em>p</em> < 0.001). The time to reach PaCO<sub>2</sub> ≥ 60 mmHg (8.0 kPa) was 2.4 ± 0.8 minutes at 40 mmHg (5.3 kPa) and 5.8 ± 1.6 minutes at 30 mmHg (4.0 kPa) (<em>p</em> = 0.006). Similarly, the time to reach pH ≤ 7.2 was significantly prolonged in the 30 mmHg (4.0 kPa) treatment (<em>p</em> = 0.002). Cardiovascular variables remained within reference ranges.</div></div><div><h3>Conclusions and clinical relevance</h3><div>The results of this study show that adjusting initial P<span>e′</span>CO<sub>2</sub> effectively delays the progression of hypercapnia and acidemia, thereby extending the clinically tolerable duration of PPBH.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"53 2","pages":"Article 101135"},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-22DOI: 10.1016/j.vaa.2025.08.039
Matyas Liptovszky, Marnie L Brennan, Kate White
Objective: To identify anaesthesia-related risk between common domestic species and humans by analysing peer-reviewed and other literature on anaesthesia in great apes in both human care and free-ranging settings and thereby to identify knowledge gaps.
Databases used: We conducted literature searches in the CAB Abstracts, MEDLINE and Zoological Record databases, as well as conference proceedings of the American Association of Zoo Veterinarians, the British Veterinary Zoological Society and the European Association of Zoo and Wildlife Veterinarians.
Results: Of the 142 studies reviewed, 51 were conference abstracts and 91 were peer-reviewed journal articles. There was a steady increase in the number of published papers since 1960, surpassing 30 papers per decade since 2000. Case studies and series made up 79% of included studies, and 91-94% for all species except chimpanzees. Although data for chimpanzees appeared extensive, data for bonobos, eastern gorillas, and Sumatran orangutans were notably lacking. Infant great ape anaesthesia and anaesthesia in free-ranging settings were underrepresented in the literature. Over 50 anaesthetic drugs were reported in the literature, with ketamine, tiletamine/zolazepam, midazolam, medetomidine and isoflurane being most frequently reported. There is a notable lack of reporting of anaesthesia-related adverse events (AEs), and many studies failed to report key details, which limits reproducibility. Respiratory and cardiovascular AEs were reported most frequently. The incidence of prolonged recoveries and excitation on recovery was higher than in other domestic species, and there was a notable lack of hypothermia reported as an AEs.
Conclusions and clinical relevance: This is the first evidence synthesis on general anaesthesia in great apes, and findings highlight the need for targeted research on underrepresented species and improved reporting of anaesthesia practices and AEs.
{"title":"General anaesthesia in non-human great apes: a scoping review.","authors":"Matyas Liptovszky, Marnie L Brennan, Kate White","doi":"10.1016/j.vaa.2025.08.039","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.08.039","url":null,"abstract":"<p><strong>Objective: </strong>To identify anaesthesia-related risk between common domestic species and humans by analysing peer-reviewed and other literature on anaesthesia in great apes in both human care and free-ranging settings and thereby to identify knowledge gaps.</p><p><strong>Databases used: </strong>We conducted literature searches in the CAB Abstracts, MEDLINE and Zoological Record databases, as well as conference proceedings of the American Association of Zoo Veterinarians, the British Veterinary Zoological Society and the European Association of Zoo and Wildlife Veterinarians.</p><p><strong>Results: </strong>Of the 142 studies reviewed, 51 were conference abstracts and 91 were peer-reviewed journal articles. There was a steady increase in the number of published papers since 1960, surpassing 30 papers per decade since 2000. Case studies and series made up 79% of included studies, and 91-94% for all species except chimpanzees. Although data for chimpanzees appeared extensive, data for bonobos, eastern gorillas, and Sumatran orangutans were notably lacking. Infant great ape anaesthesia and anaesthesia in free-ranging settings were underrepresented in the literature. Over 50 anaesthetic drugs were reported in the literature, with ketamine, tiletamine/zolazepam, midazolam, medetomidine and isoflurane being most frequently reported. There is a notable lack of reporting of anaesthesia-related adverse events (AEs), and many studies failed to report key details, which limits reproducibility. Respiratory and cardiovascular AEs were reported most frequently. The incidence of prolonged recoveries and excitation on recovery was higher than in other domestic species, and there was a notable lack of hypothermia reported as an AEs.</p><p><strong>Conclusions and clinical relevance: </strong>This is the first evidence synthesis on general anaesthesia in great apes, and findings highlight the need for targeted research on underrepresented species and improved reporting of anaesthesia practices and AEs.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"53 2","pages":"101134"},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-20DOI: 10.1016/j.vaa.2025.08.038
Diego A. Portela , Stuart R. McKenzie , Raiane A. Moura , Margaret Gonzalez , Pablo A. Donati , Ignacio Sandez , Joaquin Araos , Ludovica Chiavaccini , Elizabeth A. Maxwell , Pablo E. Otero
Objective
To evaluate the effect of 5 cmH2O positive end-expiratory pressure (PEEP) and end-inspiratory pause (EIP) on airway dead space (VDaw) and its resultant effects on alveolar tidal volume (VTalv) and physiological dead space-to-tidal volume ratio (VD/VT) in dorsally recumbent anesthetized dogs.
Dogs were mechanically ventilated across three 5 minute phases: 1) without PEEP (PEEPOFF); 2) with 5 cmH2O PEEP (PEEPON); and 3) with PEEPON plus an EIP (30% of inspiratory time) (PEEPON+EIP), allowing 15 minutes of stabilization between phases. During each phase, expired CO2 tension and tidal volume (VT) were measured using volumetric capnography, and arterial blood gases assessed. VDaw, VTalv and VD/VT were calculated offline and compared between phases using mixed-effect linear models. Data are presented as mean ± standard deviation (95% confidence interval) and indexed to the predicted ideal body mass when appropriate.
Results
The VT was 16.8 ± 1.7 (16.3–17.19) mL kg–1. PEEPON significantly increased VDaw [7.9 ± 1.6 (7.1–8.6) to 8.4 ± 1.8 (7.6–9.3) mL kg–1; p = 0.001] and VD/VT [0.52 ± 0.1 (0.49–0.55)% to 0.55 ± 0.1 (0.52–0.59)%; p = 0.001]. PEEPON decreased VTalv [8.9 ± 0.8 (8.6–9.4) to 8.3 ± 0.8 (7.9–8.7) mL kg–1; p = 0.001]. EIP reversed these changes, decreasing VDaw back to baseline [7.8 ± 1.6 (7.1–8.6) mL kg–1], resulting in VD/VT and VTalv returning to baseline values. Arterial PaCO2 remained stable across phases.
Conclusions and clinical relevance
Although PEEP increased VDaw and decreased VTalv, the addition of a 30% EIP mitigated these effects, suggesting that incorporating an EIP may be an effective strategy to optimize dead space and ventilation in dogs receiving mechanical ventilation with PEEP.
{"title":"The effects of positive end-expiratory pressure and end-inspiratory pause on dead space and alveolar ventilation in mechanically ventilated dogs","authors":"Diego A. Portela , Stuart R. McKenzie , Raiane A. Moura , Margaret Gonzalez , Pablo A. Donati , Ignacio Sandez , Joaquin Araos , Ludovica Chiavaccini , Elizabeth A. Maxwell , Pablo E. Otero","doi":"10.1016/j.vaa.2025.08.038","DOIUrl":"10.1016/j.vaa.2025.08.038","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of 5 cmH<sub>2</sub>O positive end-expiratory pressure (PEEP) and end-inspiratory pause (EIP) on airway dead space (V<sub>Daw</sub>) and its resultant effects on alveolar tidal volume (V<sub>Talv</sub>) and physiological dead space-to-tidal volume ratio (V<sub>D</sub>/V<sub>T</sub>) in dorsally recumbent anesthetized dogs.</div></div><div><h3>Study design</h3><div>Prospective, controlled clinical study.</div></div><div><h3>Animals</h3><div>Healthy adult dogs (<em>n</em> = 20, > 20 kg) undergoing elective surgery.</div></div><div><h3>Methods</h3><div>Dogs were mechanically ventilated across three 5 minute phases: 1) without PEEP (PEEP<sub>OFF</sub>); 2) with 5 cmH<sub>2</sub>O PEEP (PEEP<sub>ON</sub>); and 3) with PEEP<sub>ON</sub> plus an EIP (30% of inspiratory time) (PEEP<sub>ON</sub>+EIP), allowing 15 minutes of stabilization between phases. During each phase, expired CO<sub>2</sub> tension and tidal volume (V<sub>T</sub><span>)</span> were measured using volumetric capnography, and arterial blood gases assessed. V<sub>Daw</sub>, V<sub>Talv</sub> and V<sub>D</sub>/V<sub>T</sub> were calculated offline and compared between phases using mixed-effect linear models. Data are presented as mean ± standard deviation (95% confidence interval) and indexed to the predicted ideal body mass when appropriate.</div></div><div><h3>Results</h3><div>The V<sub>T</sub> was 16.8 ± 1.7 (16.3–17.19) mL kg<sup>–1</sup>. PEEP<sub>ON</sub> significantly increased V<sub>Daw</sub> [7.9 ± 1.6 (7.1–8.6) to 8.4 ± 1.8 (7.6–9.3) mL kg<sup>–1</sup>; <em>p</em> = 0.001] and V<sub>D</sub>/V<sub>T</sub> [0.52 ± 0.1 (0.49–0.55)% to 0.55 ± 0.1 (0.52–0.59)%; <em>p</em> = 0.001]. PEEP<sub>ON</sub> decreased V<sub>Talv</sub> [8.9 ± 0.8 (8.6–9.4) to 8.3 ± 0.8 (7.9–8.7) mL kg<sup>–1</sup>; <em>p</em> = 0.001]. EIP reversed these changes, decreasing V<sub>Daw</sub> back to baseline [7.8 ± 1.6 (7.1–8.6) mL kg<sup>–1</sup>], resulting in V<sub>D</sub>/V<sub>T</sub> and V<sub>Talv</sub> returning to baseline values. Arterial PaCO<sub>2</sub> remained stable across phases.</div></div><div><h3>Conclusions and clinical relevance</h3><div>Although PEEP increased V<sub>Daw</sub> and decreased V<sub>Talv</sub>, the addition of a 30% EIP mitigated these effects, suggesting that incorporating an EIP may be an effective strategy to optimize dead space and ventilation in dogs receiving mechanical ventilation with PEEP.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 771-778"},"PeriodicalIF":1.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-18DOI: 10.1016/j.vaa.2025.08.035
Rachael L. Hoh , Khursheed R. Mama , Camilo J. Morales , Daniel S. McKemie , Philip H. Kass , H.K. Knych
Objective
To assess absorption after transdermal application of buprenorphine to different sites and assess behavioral, antinociceptive and adverse effects. It was hypothesized that the dose and site of transdermal buprenorphine administration would influence absorption, plasma drug concentrations, physiological, antinociceptive and behavioral effects in horses.
Six (study 1) and eight (study 2) horses, aged 3–14 years.
Methods
In study 1, horses were administered a single dose of buprenorphine (45 μg kg–1), applied to the neck, croup and stifle. Blood samples were collected at fixed time points and a skin biopsy taken at the final time point for buprenorphine concentration analysis. In study 2, horses were administered a single transdermal dose of buprenorphine (90 μg kg–1) applied to the neck (determined in study 1). Blood samples were collected and buprenorphine concentrations determined by liquid chromatography–tandem mass spectrometry, and pharmacokinetic analysis performed. Pre- and post-drug–related behavior and physiologic responses were recorded. Response to noxious stimuli was evaluated by determining thermal threshold latency in response to the application of heat. Mixed effects analysis of variance comparisons were performed to assess differences in pharmacodynamic parameters between baseline and each time point.
Results
Plasma buprenorphine concentrations were highest after application to the neck and stifle. Transdermal application of 90 μg kg–1 to the neck significantly (p < 0.05) increased thermal nociceptive thresholds from 3 hours and up to 36 hours after application. This corresponded with plasma buprenorphine concentrations ≥ 0.1 ng mL–1. Changes in locomotor activity, heart rate and borborygmi were minimal.
Conclusions and clinical relevance
A thermal antinociceptive effect was observed after the transdermal delivery of 90 μg kg–1 of buprenorphine, applied to the neck.
{"title":"The impact of transdermal application site on pharmacokinetics and selected pharmacodynamics of buprenorphine in horses","authors":"Rachael L. Hoh , Khursheed R. Mama , Camilo J. Morales , Daniel S. McKemie , Philip H. Kass , H.K. Knych","doi":"10.1016/j.vaa.2025.08.035","DOIUrl":"10.1016/j.vaa.2025.08.035","url":null,"abstract":"<div><h3>Objective</h3><div>To assess absorption after transdermal application of buprenorphine to different sites and assess behavioral, antinociceptive and adverse effects. It was hypothesized that the dose and site of transdermal buprenorphine administration would influence absorption, plasma drug concentrations, physiological, antinociceptive and behavioral effects in horses.</div></div><div><h3>Study design</h3><div>Two-part study; prospective randomized balanced three-way crossover (study 1) and single-dose (study 2) experimental study.</div></div><div><h3>Animals</h3><div>Six (study 1) and eight (study 2) horses, aged 3–14 years.</div></div><div><h3>Methods</h3><div>In study 1, horses were administered a single dose of buprenorphine (45 μg kg<sup>–1</sup>), applied to the neck, croup and stifle. Blood samples were collected at fixed time points and a skin biopsy taken at the final time point for buprenorphine concentration analysis. In study 2, horses were administered a single transdermal dose of buprenorphine (90 μg kg<sup>–1</sup>) applied to the neck (determined in study 1). Blood samples were collected and buprenorphine concentrations determined by liquid chromatography–tandem mass spectrometry, and pharmacokinetic analysis performed. Pre- and post-drug–related behavior and physiologic responses were recorded. Response to noxious stimuli was evaluated by determining thermal threshold latency in response to the application of heat. Mixed effects analysis of variance comparisons were performed to assess differences in pharmacodynamic parameters between baseline and each time point.</div></div><div><h3>Results</h3><div>Plasma buprenorphine concentrations were highest after application to the neck and stifle. Transdermal application of 90 μg kg<sup>–1</sup> to the neck significantly (<em>p</em> < 0.05) increased thermal nociceptive thresholds from 3 hours and up to 36 hours after application. This corresponded with plasma buprenorphine concentrations ≥ 0.1 ng mL<sup>–1</sup>. Changes in locomotor activity, heart rate and borborygmi were minimal.</div></div><div><h3>Conclusions and clinical relevance</h3><div>A thermal antinociceptive effect was observed after the transdermal delivery of 90 μg kg<sup>–1</sup> of buprenorphine, applied to the neck.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 903-911"},"PeriodicalIF":1.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-12DOI: 10.1016/j.vaa.2025.08.036
Jennifer Davis
Objective
To provide the knowledge and context necessary for veterinary anaesthetists to appraise and design studies utilising biomarkers as outcome measures for acute kidney injury (AKI).
Databases used
PubMed, Medline and CAB abstracts.
Conclusions
The diagnosis of AKI in dogs currently relies upon markers of glomerular function that are delayed and not specific to the tubular structural injury present during anaesthesia-related AKI. Several urinary biomarkers of renal tubular dysfunction, notably neutrophil gelatinase-associated lipocalin, clusterin, cystatin B, cystatin C and γ-glutamyl transferase, show promise as very early markers of perioperative AKI in dogs. However, for their reliable and routine use, a larger evidence base is required in the setting of canine perioperative AKI and there is a need for standardisation of measurement and reporting methodology.
{"title":"Urinary biomarkers for early diagnosis of perioperative acute kidney injury in dogs: a narrative review","authors":"Jennifer Davis","doi":"10.1016/j.vaa.2025.08.036","DOIUrl":"10.1016/j.vaa.2025.08.036","url":null,"abstract":"<div><h3>Objective</h3><div>To provide the knowledge and context necessary for veterinary anaesthetists to appraise and design studies utilising biomarkers as outcome measures for acute kidney injury (AKI).</div></div><div><h3>Databases used</h3><div>PubMed, Medline and CAB abstracts.</div></div><div><h3>Conclusions</h3><div>The diagnosis of AKI in dogs currently relies upon markers of glomerular function that are delayed and not specific to the tubular structural injury present during anaesthesia-related AKI. Several urinary biomarkers of renal tubular dysfunction, notably neutrophil gelatinase-associated lipocalin, clusterin, cystatin B, cystatin C and γ-glutamyl transferase, show promise as very early markers of perioperative AKI in dogs. However, for their reliable and routine use, a larger evidence base is required in the setting of canine perioperative AKI and there is a need for standardisation of measurement and reporting methodology.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 707-719"},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-06DOI: 10.1016/j.vaa.2025.07.012
Anna T. Carroll , Rachel A. Reed , Michael Perlini , Amara E. Clough , Matheus Rocha , Valerie J. Moorman
Objective
To evaluate the effect of cervical epidural injection of morphine alone and morphine in combination with detomidine on recovery from anesthesia in horses.
Study design
Blinded, randomized, crossover, Latin square design.
Animals
A group of six healthy adult horses aged 9 ± 3 years and weighing 471 ± 76 kg (mean ± standard deviation).
Methods
Horses were administered each of three treatments during a 1 hour general anesthetic with a 4 day washout period. Treatments were: 1) cervical epidural injection of saline 0.011 mL kg–1 (S); 2) morphine 0.1 mg kg–1 (M); and 3) morphine 0.1 mg kg–1 with detomidine 0.01 mg kg–1 (MD). Data evaluating the quality of rope-assisted anesthetic recovery included accelerometry-based recovery score, time to first movement, time to sternal recumbency, time to standing and number of attempts to stand. Data were analyzed using a generalized linear mixed model. Significance was set at p < 0.05.
Results
Recovery scores were 24.4 ± 10.0, 23.9 ± 6.7 and 19.9 ± 7.7 for treatments S, M and MD, respectively (p = 0.463). Times for first movement, sternal recumbency and standing were 33 ± 16, 22 ± 18 and 45 ± 10 minutes; 48 ± 26, 57 ± 29 and 69 ± 25 minutes; and 55 ± 20, 61 ± 28 and 70 ± 23 minutes for treatments S, M and MD, respectively.
Conclusions
Cervical epidural injection of morphine alone and morphine with detomidine did not negatively affect recovery compared with saline.
Clinical relevance
The use of cervical epidural injection of morphine alone or morphine in combination with detomidine does not negatively affect the recovery quality of horses from general anesthesia.
{"title":"The effect of cervical epidural injection of morphine and the combination of morphine and detomidine on recovery from anesthesia in adult horses","authors":"Anna T. Carroll , Rachel A. Reed , Michael Perlini , Amara E. Clough , Matheus Rocha , Valerie J. Moorman","doi":"10.1016/j.vaa.2025.07.012","DOIUrl":"10.1016/j.vaa.2025.07.012","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of cervical epidural injection of morphine alone and morphine in combination with detomidine on recovery from anesthesia in horses.</div></div><div><h3>Study design</h3><div>Blinded, randomized, crossover, Latin square design.</div></div><div><h3>Animals</h3><div>A group of six healthy adult horses aged 9 ± 3 years and weighing 471 ± 76 kg (mean ± standard deviation).</div></div><div><h3>Methods</h3><div>Horses were administered each of three treatments during a 1 hour general anesthetic with a 4 day washout period. Treatments were: 1) cervical epidural injection of saline 0.011 mL kg<sup>–1</sup> (S); 2) morphine 0.1 mg kg<sup>–1</sup> (M); and 3) morphine 0.1 mg kg<sup>–1</sup> with detomidine 0.01 mg kg<sup>–1</sup> (MD). Data evaluating the quality of rope-assisted anesthetic recovery included accelerometry-based recovery score, time to first movement, time to sternal recumbency, time to standing and number of attempts to stand. Data were analyzed using a generalized linear mixed model. Significance was set at <em>p</em> < 0.05.</div></div><div><h3>Results</h3><div>Recovery scores were 24.4 ± 10.0, 23.9 ± 6.7 and 19.9 ± 7.7 for treatments S, M and MD, respectively (<em>p</em> = 0.463). Times for first movement, sternal recumbency and standing were 33 ± 16, 22 ± 18 and 45 ± 10 minutes; 48 ± 26, 57 ± 29 and 69 ± 25 minutes; and 55 ± 20, 61 ± 28 and 70 ± 23 minutes for treatments S, M and MD, respectively.</div></div><div><h3>Conclusions</h3><div>Cervical epidural injection of morphine alone and morphine with detomidine did not negatively affect recovery compared with saline.</div></div><div><h3>Clinical relevance</h3><div>The use of cervical epidural injection of morphine alone or morphine in combination with detomidine does not negatively affect the recovery quality of horses from general anesthesia.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 6","pages":"Pages 779-785"},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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