Partial right ventriculectomy using the incised patch technique to treat double chambered right ventricle and chylothorax in a cat.

OBJECTIVE: To report successful surgical treatment of double chambered right ventricle (DCRV) in a cat. STUDY DESIGN: Clinical report. ANIMALS: Cat with DCRV. METHODS: DCRV was diagnosed in a 5-month-old male Maine Coon cat using echocardiography and angiocardiography. At 2 years, despite medical therapy, chylothorax developed. A section of the right ventricular free wall that spanned the fibromuscular obstruction was excised under total venous inflow occlusion (TVIO) using the incised pericardial patch technique. RESULTS: Short-term recovery was complicated by return of chylothorax but this resolved after thoracocentesis and diuretic therapy. Three years after surgery, the cat is free of clinical signs and no longer on any medical therapy. CONCLUSIONS: Partial right ventriculectomy can be performed under TVIO through an incised pericardial patch. CLINICAL RELEVANCE: DCRV in cat can be successfully treated by partial right ventriculectomy performed under TVIO through an incised pericardial patch.

A comparison of the duration and quality of recovery from isoflurane, sevoflurane and desflurane anaesthesia in dogs undergoing magnetic resonance imaging.

OBJECTIVE: To compare the recovery after anaesthesia with isoflurane, sevoflurane and desflurane in dogs undergoing magnetic resonance imaging (MRI) of the brain. STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: Thirty-eight dogs weighing 23.7 +/- 12.6 kg. METHODS: Following pre-medication with meperidine, 3 mg kg(-1) administered intramuscularly, anaesthesia was induced intravenously with propofol (mean dose 4.26 +/- 1.3 mg kg(-1)), the trachea was intubated, and an inhalational anaesthetic agent was administered in oxygen. The dogs were randomly allocated to one of three groups: group I (n = 13) received isoflurane, group S (n = 12) received sevoflurane and group D (n = 13) received desflurane. Parameters recorded included cardiopulmonary data, body temperature, end-tidal anaesthetic concentration, duration of anaesthesia, and recovery times and quality. Qualitative data were compared using chi-squared and Fisher's exact tests and quantitative data with anova and Kruskal-Wallis test. Post-hoc comparisons for quantitative data were undertaken with the Mann-Whitney U-test. RESULTS: The duration of anaesthesia [mean and standard deviation (SD)] in group I was: 105.3 (27.48) minutes, group S: 120.67 (19.4) minutes, and group D: 113.69 (26.68) minutes (p = 0.32). Times to extubation [group I: 8 minutes, (interquartile range 6-9.5), group S: 7 minutes (IQR 5-7), group D: 5 minutes (IQR 3.5-7), p = 0.017] and to sternal recumbency [group I: 11 minutes (IQR 9.5-13.5), group S: 9.5 minutes (IQR 7.25-11.75), group D: 7 minutes (range 3.5-11.5), p = 0.048] were significantly different, as were times to standing. One dog, following sevoflurane, had an unacceptable quality of recovery, but most other recoveries were calm, with no significant difference between groups. CONCLUSIONS AND CLINICAL RELEVANCE: All three agents appeared suitable for use. Dogs' tracheas were extubated and the dogs recovered to sternal recumbency most rapidly after desflurane. This may be advantageous for animals with some neurological diseases and for day case procedures.

The effect of hyoscine on dobutamine requirement in spontaneously breathing horses anaesthetized with halothane.

OBJECTIVE: To determine whether hyoscine has a sparing effect on the volume of dobutamine required to maintain mean arterial pressure (MAP) at 70 mmHg in horses anaesthetized with halothane. STUDY DESIGN: Prospective, randomized, controlled clinical trial. ANIMALS: Twenty adult horses weighing 507 +/- 97 kg (mean +/- SD), aged 10 +/- 5 years. MATERIALS AND METHODS: Pre-anaesthetic medication in all horses was intramuscular (IM) acepromazine (40 mug kg(-1)) and intravenous (IV) detomidine (0.02 mg kg(-1)). Anaesthesia was induced with ketamine (2.2 mg kg(-1) IV) and diazepam (0.02 mg kg(-1) IV), and maintained with halothane in oxygen. Horses breathed spontaneously. Flunixin (1.1 mg kg(-1) IV) was given to provide analgesia. Heart rate, ECG, invasive arterial pressure, respiratory rate, percentage end-tidal carbon dioxide, percentage end-tidal halothane and partial pressure of oxygen and carbon dioxide in arterial blood and blood pH were monitored. Dobutamine was infused by an infusion pump to maintain MAP at 70 mmHg. Horses were randomly assigned to receive saline or hyoscine (0.1 mg kg(-1)) IV 30 minutes after induction. The heart rate, MAP and volume of dobutamine infused over 30-minute periods were measured and analysed statistically using a one-way anova. RESULTS: After administration of hyoscine, heart rate increased for 10 minutes (p < 0.01) and MAP for 5 minutes (p < 0.01). There was no difference in the volume of dobutamine infused over 30 minutes between horses given hyoscine or saline, although there was a wide individual variation in dobutamine requirements. No side effects of hyoscine were seen. CONCLUSIONS: The increase in heart rate and blood pressure that occurs after 0.1 mg kg(-1) hyoscine is given IV in anaesthetized horses, is of short duration and does not significantly alter the amount of dobutamine required to maintain arterial pressure over the next 30 minutes. Clinical relevance The short duration of action of 0.1 mg kg(-1) hyoscine IV may limit its usefulness for correction of hypotension in horses anaesthetized with halothane. Further work is necessary to investigate the effects of higher or repeated doses or constant rate infusions of hyoscine.

Pulmonary oedema associated with anaesthesia for colic surgery in a horse.

A 506 kg Warmblood horse with colic was anaesthetized for exploratory celiotomy. Anaesthesia was complicated by arterial hypoxaemia which persisted throughout surgery from the induction of anaesthesia. After endotracheal extubation in the recovery box, a degree of airway obstruction probably occurred during a brief delay in naso-tracheal intubation. Signs of pulmonary oedema were seen shortly afterwards. Furosemide and oxygen were given. Arterial hypoxaemia was present [PaO2: 6.5 kPa (49 mmHg)] when FIO2 was an estimated 0.3. The horse recovered and stood after 45 minutes. It was re-anaesthetized 3 days later when arterial blood gas analysis did not reveal hypoxaemia. The horse was killed on this occasion; post-mortem examination revealed the presence of pulmonary oedema, which probably resulted from multiple causes.