Traditional Chinese veterinary medicine: the mechanism and management of acupuncture for chronic pain.

Complementary and alternative medicine can be defined as the diagnosis, treatment, and/or prevention that complements mainstream medicine, satisfying a demand not met by orthodoxy and diversifying the conceptual framework of medicine. Acupuncture is being used much more commonly now as a sole or integrative modality in veterinary medicine and can play a large role in management of inflammation and chronic pain. Western medical etiology, pathophysiology, diagnosis, and treatment should be considered before applying acupuncture. This article describes the evolving biomedical basis of acupuncture analgesia and gives the practitioner an overview of how acupuncture can be performed in a medical setting.

Diagnosis and treatment of presumptive postobstructive pulmonary edema in a Florida panther (Puma concolor coryi).

A free-ranging, adult male Florida panther (Puma concolor coryi) was immobilized and evaluated for hematuria following routine capture. Prior to anesthetic recovery, the panther was fitted with a telemetry collar. After an initially quiet recovery, the panther began thrashing in the transport cage, and was again immobilized. Pink foam was evident from the nostrils, and crackles were ausculted over the chest, indicating pulmonary edema. Postobstructive pulmonary edema was diagnosed based on history, clinical signs, radiographic evaluation, and blood gas analysis. The animal was treated intensively for several hours with diuretics, oxygen, and manual ventilation. The panther responded rapidly to therapy and was released back into the wild 48 hr after presentation. Postobstructive pulmonary edema, also called negative-pressure pulmonary edema, may be underrecognized in veterinary medicine. In this case, the telemetry collar, in conjunction with anesthetic recovery in a small transport crate, may have contributed to tracheal obstruction. Wildlife veterinarians and biologists should be aware of the risk of airway obstruction when placing tracking collars, and animals should be continuously monitored during anesthetic recovery to ensure the presence of a patent airway.

Effects of acepromazine on the incidence of vomiting associated with opioid administration in dogs.

OBJECTIVE: To evaluate the anti-emetic properties of acepromazine in dogs receiving opioids as pre-anesthetic medication. STUDY DESIGN: Randomized prospective clinical study. ANIMALS: One hundred and sixteen dogs (ASA I or II), admitted for elective surgical procedures. The dogs were a mixed population of males and females, purebreds and mixed breeds, 0.25-13.4 years of age, weighing 1.8-57.7 kg. METHODS: A prospective clinical trial in which the dogs were randomly assigned to one of three groups. All groups received acepromazine (0.05 mg kg(-1) intramuscularly (i.m.)). Group I received acepromazine 15 minutes prior to opioid administration. Group II received acepromazine in combination with the opioid. Group III received acepromazine 15 minutes after opioid administration. One of three different opioids was administered i.m. to each dog: morphine sulfate at 0.5 mg kg(-1); hydromorphone hydrochloride at 0.1 mg kg(-1); or oxymorphone hydrochloride at 0.075 mg kg(-1). RESULTS: Dogs receiving acepromazine before the opioid (group I) had a significantly lower incidence of vomiting (18%) than dogs in groups II (45%) and III (55%). The degree of sedation was significantly lower in the dogs receiving the combination of acepromazine and the opioid (group II) than in dogs receiving the opioid as the first drug (group III). CONCLUSIONS AND CLINICAL RELEVANCE: Acepromazine administered 15 minutes before the opioid lowers the incidence of vomiting induced by opioids.

Effects of theophylline on tracheal mucociliary clearance rates in healthy cats.

OBJECTIVE: To determine tracheal mucociliary clearance rate (TMCCR) by use of a standard protocol in healthy anesthetized cats and to determine the effect of theophylline on TMCCR in healthy anesthetized cats. ANIMALS: 6 healthy cats. PROCEDURE: Cats were anesthetized with propofol, and a droplet of the radiopharmaceutical technetium Tc 99m macroaggregated albumin was placed endoscopically at the carina. Dynamic acquisition scintigraphic imaging was performed, using the larynx as the end point. The TMCCR was determined by measuring the distance the droplet traveled by frame rate. Each cat was imaged 6 times as follows: 3 times following placebo administration and 3 times following the administration of sustained release theophylline (25 mg/kg, PO). Serum theophylline concentrations were assessed during imaging to ensure therapeutic concentrations. RESULTS: The TMCCR in healthy adult cats anesthetized with propofol was 22.2 +/- 2.8 mm/min. Tracheal mucociliary clearance rate in cats receiving theophylline was 21.8 +/- 3.5 mm/min. Theophylline administration did not significantly alterTMCCR. CONCLUSIONS AND CLINICAL RELEVANCE: Theophylline has been shown to increase TMCCR in humans and dogs. In our study, we determined TMCCR in healthy anesthetized cats and found that it was not accelerated by the administration of theophylline.

Using the human patient simulator to educate students of veterinary medicine.

INTRODUCTION: The human patient simulator has proved to be an effective educational device for teaching physicians and paramedical personnel. METHODOLOGY: To determine whether veterinary medicine students would benefit from similar educational sessions, 90 students each took a turn being the patient's clinician as real-life scenarios were played out on the simulator. The students induced and maintained anesthesia on their patient and monitored vital signs. Several critical events were presented for the students to diagnose and treat as they occurred. All students submitted a written evaluation of the course upon completion. The last 40 students were randomly divided into two groups of 20 students each. The students in Group I experienced the simulator before their clerkship examination, and those in Group II took the examination before their simulator experience. RESULTS: The students rapidly gained confidence in treating their simulated patient. This carried over to the clinical setting, where they appeared to be more confident when anesthetizing live patients. The simulator experience brought together much of the previous didactic material that they had been exposed to so they could appreciate its clinical relevance. The overwhelming response to the simulator experience was positive. The students in Group I had a significantly higher score on the clerkship examination dealing with concepts reviewed by simulation than those in Group II, who engaged in self-study instead of the simulation exercise (p < 0.001). CONCLUSION: We conclude that the human patient simulator was a valuable learning tool for students of veterinary medicine. It was exciting for the students to work with, made them deal with "real-life" scenarios, permitted them to learn without subjecting live patients to complications, enabled them to retrace their steps when their therapy did not correct the simulated patient's problems, and facilitated correlation of their basic science knowledge with clinical data, thus accelerating their ability to handle complex clinical problems in healthy and diseased patients.