Evaluation of a resilience training program for college student-athletes: A pilot study.

Objective: To determine if a resilience training program improved knowledge of and intention to use adaptive coping strategies among college student-athletes; and explore college student-athletes' experiences and satisfaction with program components. Participants: Division I college student-athletes. Methods: Pretest-posttest design with surveys completed at baseline and immediately post-program. Results: A total of 79 participants were included (n = 43 [54.4%] females; n = 36 [45.6%] males; Mage = 20.94, [SD = 1.05]). Overall intention to use adaptive coping strategies significantly increased from baseline (M = 29.05, SD = 4.50) to post-program (M = 32.38, SD = 5.62) (p = 0.0004), as did intentions to use the coping strategies seeking social support (p = 0.0037) and self-controlling (p = 0.0007). We found no statistically significant differences in knowledge scores from baseline to post-program. Conclusions: Resilience training may increase college student-athletes' likelihood of using adaptive coping strategies to manage academic and sport-related stressors.

Intravenous Acetaminophen Does Not Provide Adequate Postoperative Analgesia in Dogs Following Ovariohysterectomy.

(1) Objective: To investigate the analgesic effects of intravenous acetaminophen after intravenous administration in dogs presenting for ovariohysterectomy. (2) Methods: 14 ASA I client-owned female entire dogs. In this randomized, blinded, clinical study, dogs were given meperidine and acepromazine intramuscularly before induction of anesthesia with intravenous propofol. Anesthesia was maintained with isoflurane in oxygen. Intravenous acetaminophen 20 mg/kg or 0.9% NaCl was administered postoperatively. Pain assessments were conducted using the Glasgow Pain Scale short form before premedication and at 10, 20, 60, 120, and 180 min post-extubation or until rescue analgesia was given. The pain scores, times, and incidences of rescue analgesia between the groups was compared. Blood was collected before and 2, 5, 10, 20, 40, and 80 min after acetaminophen administration. Acetaminophen plasma concentration was quantified by liquid chromatography-mass spectrometry. The acetaminophen plasma concentration at the time of each pain score evaluation was subsequently calculated. (3) Results: There was no significant difference in pain scores at 10 min, highest pain scores, or time of rescue analgesia between groups. In each group, 3 dogs (43%) received rescue analgesia within 20 min. (4) Conclusions: Following ovariohysterectomy in dogs, there was no detectable analgesic effect of a 20 mg/kg dosage of intravenous acetaminophen administered at the end of surgery.

Two-point ultrasound-guided transversus abdominis plane injection in canine cadavers - a pilot study.

OBJECTIVE: This study evaluated the spread of a two-point transversus abdominis plane (TAP) injection in canine cadavers. Compared with previous techniques, the two-point TAP injection was developed to increase the consistency of local anaesthetic spread to the nerve segments T11, T12, L1, L2 and L3. STUDY DESIGN: Prospective experimental trial. ANIMALS: Five fresh canine cadavers. METHODS: Two-point TAP injections were performed under ultrasound guidance by a single trained individual in canine cadavers (15.7-43.0 kg). Each hemi-abdomen was infiltrated and evaluated independently for a total of 10 evaluations of the technique. The first injection was performed at the level of the costo-chondral junction of the thirteenth rib, and the second injection was performed cranial to the tuber coxae. Each injection comprised 0.3 mL kg-1 methylene blue solution (0.0015 mg mL-1). Ten minutes after the injections, abdominal wall dissection was performed, and any nerves stained for a minimum of 10 mm along their long axis were identified and recorded. RESULTS: During all injections, separation of the internal oblique and transversus abdominis muscles was observed on ultrasound. On dissection, branches of T12, T13, L1, L2 and L3 were adequately stained in 30%, 100%, 100%, 90% and 90% of injections, respectively. No staining of branches of T11 occurred in any of the cadavers. In one hemi-abdomen, branches of L1 and L3, but not L2, were stained. CONCLUSIONS AND CLINICAL RELEVANCE: This study indicates that the two-point TAP injection delivers consistent dye dispersion to adequately stain branches of T13, L1, L2 and L3, with no coverage of T11 and poor coverage of T12, in fresh canine cadavers. An in vivo study using local anaesthetic should be performed to evaluate the analgesic efficacy of this technique in mid to caudal abdominal surgeries.

Content validation of a Critical Appraisal Tool for Reviewing Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain.

INTRODUCTION: This article reports the content validation of a Critical Appraisal Tool designed to Review the quality of Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain and provide guidance as to the strengths and weakness of findings. The CATRAS quality items encompass 3 domains: level of evidence, methodological soundness, and grading of the pain assessment tool. OBJECTIVES: To validate a critical appraisal tool for reviewing analgesia studies involving subjects incapable of self-reporting pain. METHODS: Content validation was achieved using Delphi methodology through panel consensus. A panel of 6 experts reviewed the CATRAS in 3 rounds and quantitatively rated the relevance of the instrument and each of its quality items to their respective domains. RESULTS: Content validation was achieved for each item of the CATRAS and the tool as a whole. Item-level content validity index and kappa coefficient were at least greater than 0.83 and 0.81, respectively, for all items except for one item in domain 2 that was later removed. Scale-level content validity index was 97% (excellent content validity). CONCLUSIONS: This 67-item critical appraisal tool may enable critical and quantitative assessment of the quality of individual analgesia trials involving subjects incapable of self-reporting pain for use in systematic reviews and meta-analysis studies.

Effect of rate of administration of propofol or alfaxalone on induction dose requirements and occurrence of apnea in dogs.

OBJECTIVE: To evaluate the effect of rate of administration of propofol or alfaxalone on induction dose requirements and incidence of postinduction apnea (PIA) in dogs following premedication with methadone and dexmedetomidine. STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: Thirty-two healthy American Society of Anesthesiologists class I client-owned dogs (seven females, 25 males), aged between 5 and 54 months, weighing between 2.0 and 48.2 kg. METHODS: Dogs were premedicated intramuscularly with 0.5 mg kg-1 methadone and 5 µg kg-1 dexmedetomidine. Thirty minutes after premedication, dogs were preoxygenated for 5 minutes before the induction agent was administered intravenously via a syringe driver until orotracheal intubation was achieved. Dogs were randomized to receive alfaxalone 0.5 mg kg-1 minute-1 (A-Slow), alfaxalone 2 mg kg-1 minute-1 (A-Fast), propofol 1 mg kg-1 minute-1 (P-Slow), or propofol 4 mg kg-1 minute-1 (P-Fast). Oxygen saturation of hemoglobin (SpO2), end-tidal carbon dioxide and respiratory rate were monitored. If PIA (≥30 seconds without a breath) occurred, the time to the first spontaneous breath was measured. If SpO2 decreased below 90%, the experiment was stopped and manual ventilation initiated. RESULTS: The mean±standard deviation induction doses of alfaxalone and propofol were lower in the A-Slow [A-Slow 0.9±0.3 mg kg-1, A-Fast 2.2±0.5 mg kg-1 (p≤0.001)] and P-Slow [P-Slow 1.8±0.6 mg kg-1, P-Fast 4.1±0.7 mg kg-1 (p≤0.001)] groups, respectively. The incidence of PIA was 25% for the A-Slow and P-Slow groups and 100% for the A-Fast and P-Fast groups (p = 0.007). CONCLUSIONS AND CLINICAL RELEVANCE: Both propofol and alfaxalone following methadone and dexmedetomidine premedication caused PIA. Induction dose requirement and incidence of PIA were affected by the rate of administration of both drugs. When possible, propofol and alfaxalone doses should be reduced and administered slowly to reduce PIA.

Postinduction apnoea in dogs premedicated with acepromazine or dexmedetomidine and anaesthetized with alfaxalone or propofol.

OBJECTIVE: To compare incidence and duration of postinduction apnoea in dogs after premedication with methadone and acepromazine (MA) or methadone and dexmedetomidine (MD) followed by induction with propofol (P) or alfaxalone (A). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 32 American Society of Anesthesiologists class I dogs (15 females, 17 males), aged between 4 months and 4 years, weighing between 3 and 46 kg. METHODS: Dogs were randomly allocated to be administered MA+P, MA+A, MD+P or MD+A (methadone 0.5 mg kg-1 and acepromazine 0.05 mg kg-1 or dexmedetomidine 5 µg kg-1). Induction agents were administered intravenously via syringe driver (P at 4 mg kg-1 minute-1 or A at 2 mg kg-1 minute-1) until successful endotracheal intubation and the endotracheal tube connected to a circle system with oxygen flow at 2 L minute-1. Oxygen saturation of haemoglobin (SpO2), end tidal partial pressure of carbon dioxide and respiratory rate were monitored continuously. If apnoea (≥ 30 seconds without breathing) occurred, the duration until first spontaneous breath was measured. If SpO2 decreased below 90% the experiment was stopped and manual ventilation initiated. Data were analysed with general linear models with significance set at p ≤ 0.05. RESULTS: There was no statistical difference in the incidence (11 of 16 dogs in A groups and 12 of 16 dogs in P groups), or mean ± standard deviation duration (A groups 125 ± 113 seconds, P groups 119 ± 109 seconds) of apnoea. The SpO2 of one dog in the MD+P group decreased below 90% during the apnoeic period. CONCLUSIONS AND CLINICAL RELEVANCE: Propofol and alfaxalone both cause postinduction apnoea and the incidence and duration of apnoea is not influenced by the use of acepromazine or dexmedetomidine in premedication. Monitoring of respiration is recommended when using these premedication and induction agent combinations.

The use of alfaxalone for premedication, induction and maintenance of anaesthesia in pigs: a pilot study.

OBJECTIVE: The evaluation of alfaxalone as a premedication agent and intravenous anaesthetic in pigs. STUDY DESIGN: Prospective, clinical trial. ANIMALS: Nine healthy, 6-8-week-old female Landrace pigs weighing 22.2 ± 1.0 kg, undergoing epidural catheter placement. METHODS: All pigs were premedicated with 4 mg kg-1 alfaxalone, 40 µg kg-1 medetomidine and 0.4 mg kg-1 butorphanol administered in the cervical musculature. Sedation was subjectively scored by the same observer from 1 (no sedation) to 10 (profound sedation) prior to induction of anaesthesia with alfaxalone intravenously to effect. All pigs were maintained on alfaxalone infusions with the rate of administration adjusted to maintain appropriate anaesthetic depth. Quality of induction was scored from 1 (poor) to 3 (smooth) and basic cardiorespiratory variables were recorded every 5 minutes during anaesthesia. Results are reported as mean ± standard deviation or median (range) as appropriate. RESULTS: Sedation scores were 9 (7-10). Inductions were smooth in all pigs and cardiovascular variables remained within normal limits for the duration of anaesthesia. The induction dose of alfaxalone was 0.9 (0.0-2.3) mg kg-1. Three pigs did not require additional alfaxalone after premedication to facilitate intubation. CONCLUSIONS AND CLINICAL RELEVANCE: Intramuscular alfaxalone in combination with medetomidine and butorphanol produced moderate to deep sedation in pigs. Alfaxalone produced satisfactory induction and maintenance of anaesthesia with minimal cardiovascular side effects. Appropriate monitoring of pigs premedicated with this protocol is required as some pigs may become anaesthetized after intramuscular administration of this combination of drugs.

Assessment of agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scoring the recovery of horses from anesthesia by use of subjective grading scales and development of a system for evaluation of the recovery of horses from anesthesia by use of accelerometry.

OBJECTIVE To evaluate agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scores determined by use of a simple descriptive scale (SDS) or a composite grading scale (CGS) for quality of recovery of horses from anesthesia and to investigate use of 3-axis accelerometry (3AA) for objective evaluation of recovery. ANIMALS 12 healthy adult horses. PROCEDURES Horses were fitted with a 3AA device and then were anesthetized. Eight diplomates evaluated recovery by use of an SDS, and 7 other diplomates evaluated recovery by use of a CGS. Agreement was tested with κ and AC1 statistics for the SDS and an ANOVA for the CGS. A library of mathematical models was used to map 3AA data against CGS scores. RESULTS Agreement among diplomates using the SDS was slight (κ = 0.19; AC1 = 0.22). The CGS scores differed significantly among diplomates. Best fit of 3AA data against CGS scores yielded the following equation: RS = 9.998 × SG0.633 × ∑UG0.174, where RS is a horse's recovery score determined with 3AA, SG is acceleration of the successful attempt to stand, and ∑UG is the sum of accelerations of unsuccessful attempts to stand. CONCLUSIONS AND CLINICAL RELEVANCE Subjective scoring of recovery of horses from anesthesia resulted in poor agreement among diplomates. Subjective scoring may lead to differences in conclusions about recovery quality; thus, there is a need for an objective scoring method. The 3AA system removed subjective bias in evaluations of recovery of horses and warrants further study.

The Effect of Heart Disease on Anesthetic Complications During Routine Dental Procedures in Dogs.

Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital. Medical records were reviewed to evaluate the occurrence of anesthetic complications. No dogs died in either group, and no significant differences were found between the groups in any of the anesthetic complications evaluated, although dogs in the heart disease group were significantly older with higher American Society of Anesthesiologists scores. Midazolam and etomidate were used more frequently, and alpha-2 agonists used less frequently, in the heart disease group compared to controls. This study suggests dogs with heart disease, when anesthetized by trained personnel and carefully monitored during routine dental procedures, are not at significantly increased risk for anesthetic complications.

Influence of two administration rates of propofol at induction of anaesthesia on its relative potency in cats: a pilot study.

Objectives This was a randomised, blinded trial to investigate the influence of administration rate on the dose of propofol required for the orotracheal intubation of cats. Methods Twenty-four female domestic cats undergoing ovariohysterectomy were premedicated with oral tramadol (6 mg/kg) or intramuscular tramadol (4 mg/kg), and intramuscular dexmedetomidine (0.007 mg/kg). Oral or intramuscular (IM) tramadol was administered 60 or 30 mins prior to induction of anaesthesia, respectively. Dexmedetomidine was administered 30 mins prior to anaesthetic induction. Sedation scores were established prior to anaesthesia induction with propofol intravenously at 4 mg/kg/min (fast) or 1 mg/kg/min (slow) to effect until orotracheal intubation was achieved without coughing. If coughing occurred, the intubation process was paused for 15 s. Four groups were determined: IM tramadol/propofol fast (GIMF, n = 6); IM tramadol/propofol slow (GIMS, n = 6); oral tramadol/propofol fast (GOF, n = 6); oral tramadol/propofol slow (GOS, n = 6). The Shapiro-Wilk test was used to evaluate for normality of residuals. Sedation scores and propofol anaesthetic induction doses were compared between GIMF and GIMS groups, and between GOF and GOS groups using the Mann-Whitney test and the t-test, respectively ( P = 0.05). The presence of hypotension (mean arterial blood pressure <60 mmHg) or apnoea (no breathing for 30 s or more) within the first 15 mins postintubation was recorded. Results The median sedation scores for GIMF and GOF were not significantly different compared with those for GIMS ( P = 0.94) and GOS ( P = 0.70). However, the mean ± SD propofol anaesthetic induction doses were higher in GIMF (9.1 ± 1.8 mg/kg) and GOF (7.9 ± 1.7 mg/kg) than in GIMS (5.1 ± 1.5 mg/kg; P <0.01) and GOS (5.4 ± 0.3 mg/kg; P <0.01). No hypotension or apnoea were detected. Conclusions and relevance Using the slower anaesthetic induction rate resulted in an increase in propofol relative potency.

Influence of two administration rates of alfaxalone at induction on its relative potency in cats: a pilot study.

Objectives The aim of the study was to evaluate, in a controlled, randomised, masked clinical trial, the influence of administration rate of alfaxalone at induction on its relative potency in cats and to report the incidence of cardiorespiratory adverse effects. Methods Twelve healthy female domestic cats admitted for ovariohysterectomy were premedicated with buprenorphine 20 µg/kg intramuscularly and alfaxalone 3.0 mg/kg subcutaneously. Sedation scores were established (using a published scale ranging from 1 [no sedation] to 5 [profound sedation]) prior to anaesthesia induction with alfaxalone intravenously at 2 mg/kg/min (group A2; n = 6) or 0.5 mg/kg/min (group A0.5; n = 6) to effect until orotracheal intubation was achieved. Sedation scores and alfaxalone induction doses were compared between the groups, using a Mann-Whitney exact test. Results are reported as median and range. Presence of apnoea (no breathing for more than 30 s) or hypotension (mean arterial blood pressure <60 mmHg) within 5 mins postintubation was also reported. Results Although sedation scores (1.5 [range 1.0-3.0] and 2.5 [range 1.0-3.0] for A2 and A0.5, respectively) were not significantly different ( P = 0.32), cats in group A2 required significantly more alfaxalone (4.3 mg/kg [range 3.4-7.0 mg/kg]) than group A0.5 (2.1 mg/kg [range 1.5-2.5 mg/kg]) ( P = 0.002). Two cats in each group presented postinduction apnoea, and two cats in group A2 and three cats in group A0.5 presented postinduction hypotension. Conclusions and relevance The use of a slower induction infusion rate resulted in an increase in the alfaxalone relative potency without obvious cardiorespiratory benefit.

Use of Propofol for Induction and Maintenance of Anesthesia in a King Penguin ( Aptenodytes patagonicus ) Undergoing Magnetic Resonance Imaging.

Anesthesia protocols for patients with intracranial lesions need to provide hemodynamic stability, preserve cerebrovascular autoregulation, avoid increases in intracranial pressure, and facilitate a rapid recovery. Propofol total intravenous anesthesia (TIVA) maintains cerebral blood flow autoregulation and is considered superior to inhalant agents as an anesthetic protocol for patients with intracranial lesions. A propofol-based TIVA subsequent to premedication with medetomidine and diazepam was used in a king penguin ( Aptenodytes patagonicus ) undergoing magnetic resonance imaging of the brain after a new onset of seizures. This protocol provided a rapid and smooth induction and calm recovery in the penguin. When ventilation control is possible, propofol TIVA may be a superior choice to inhalant agents for anesthesia of birds with potential intracranial lesions.

Evaluation of the influence of atipamezole on the postoperative analgesic effect of buprenorphine in cats undergoing a surgical ovariohysterectomy.

OBJECTIVE: To evaluate the influence of atipamezole on postoperative pain scores in cats. STUDY DESIGN: Controlled, randomized, masked clinical trial. ANIMALS: Twelve healthy female domestic cats. METHODS: Cats admitted for ovariohysterectomy (OVH) surgery were randomly allocated to group atipamezole (n = 6) or group saline (n = 6) and were premedicated with buprenorphine 20 µg kg(-1) intramuscularly (IM) and alfaxalone 3.0 mg kg(-1) subcutaneously (SC). Anaesthesia was induced with alfaxalone intravenously (IV) to effect and maintained with isoflurane in oxygen. Ten minutes after extubation, cats from group atipamezole received IM atipamezole (0.0375 mg kg(-1) ) whereas group saline received an equivalent volume [0.0075 mL kg(-1) (0.003 mL kg(-1) IM)] of 0.9% saline. A validated multidimensional composite scale was used to assess pain prior to premedication and postoperatively (20 minutes after extubation). If postoperative pain scores dictated, rescue analgesia consisting of buprenorphine and meloxicam were administered. Pain score comparisons were made between the two groups using a Mann-Whitney exact test. Results are reported as the median and range. RESULTS: Preoperatively, all cats scored 0. At the postoperative pain evaluation, the pain scores from group atipamezole [16 (range, 12-20)] were not significantly different from group saline [18 (range, 15-23)] (p = 0.28). All cats required rescue analgesia post-operatively. CONCLUSIONS AND CLINICAL RELEVANCE: Atipamezole (0.0375 mg kg(-1) IM) administration did not significantly affect the postoperative pain scores in cats after OVH. Preoperative administration of buprenorphine (20 µg kg(-1) IM) did not provide adequate postoperative analgesia for feline OVH.

Accidental alfaxalone overdose in a mature cat undergoing anaesthesia for magnetic resonance imaging.

Case summary This case report describes the clinical signs and treatment of an alfaxalone 10 times overdose in a 12-year-old cat undergoing anaesthesia for MRI. The cat was discharged from hospital following a prolonged recovery including obtunded mentation and cardiorespiratory depression for several hours following cessation of anaesthesia. The cat received supportive therapy that included supplemental oxygen via a face mask, intravenous crystalloid fluids and active rewarming. The benefits of using alfaxalone for maintenance of anaesthesia, its pharmacokinetics and previously reported lethal doses are discussed. Strategies for reducing the incidence of medication errors are presented. Relevance and novel information An unintentional overdose of alfaxalone by continuous rate infusion has not been reported previously in a cat. Treatment is supportive and directed towards maintenance of the cardiorespiratory systems. Whenever possible, smart pumps that have been designed to reduce human error should be used to help prevent medication errors associated with continuous rate infusions.

Psychosocial predictors of drive for muscularity in male collegiate athletes.

The purpose of this study was to examine the simultaneous relation of general and sport-specific pressures about body weight and shape, negative affect, and body satisfaction to drive for muscularity (DM) in male collegiate athletes. Participants were 183 male athletes who were drawn from three NCAA Division I institutions and represented 17 different sports. As hypothesized, after controlling for BMI and sport type, sport-specific pressures, negative affect, and body satisfaction were significant predictors, and accounted for 15-34% of the variance in muscularity-oriented body image and muscularity behaviors; general pressures however were not significantly related. These findings offer insight into the personal and social antecedents of DM in male athletes, and serve as a starting point for future research on DM in this population.

A review of the pharmacology and clinical application of alfaxalone in cats.

Alfaxalone-2-hydroxpropyl-ß-cyclodextrin (alfaxalone-HPCD) was first marketed for veterinary use in Australia in 2001 and has since progressively became available throughout the world, including the USA, where in 2012 Food and Drug Administration (FDA) registration was granted. Despite the growing body of published works and increasing global availability of alfaxalone-HPCD, the accumulating evidence for its use in cats has not been thoroughly reviewed. The purpose of this review is: (1) to detail the pharmacokinetic properties of alfaxalone-HPCD in cats; (2) to assess the pharmacodynamic properties of alfaxalone-HPCD, including its cardiovascular, respiratory, central nervous system, neuromuscular, hepatic, renal, haematological, blood-biochemical, analgesic and endocrine effects; and (3) to consider the clinical application of alfaxalone-HPCD for sedation, induction and maintenance of anaesthesia in cats. Based on the published literature, alfaxalone-HPCD provides a good alternative to the existing intravenous anaesthetic options for healthy cats.

Evaluation of the perioperative analgesic efficacy of buprenorphine, compared with butorphanol, in cats.

OBJECTIVE: To compare the analgesic effects of buprenorphine and butorphanol in domestic cats. DESIGN: 2-phase positive-controlled randomized masked clinical trial. ANIMALS: 39 healthy female cats (10 in phase 1 and 29 in phase 2). PROCEDURES: Cats admitted for ovariohysterectomy received buprenorphine (4 in phase 1; 14 in phase 2) or butorphanol (6 in phase 1; 15 in phase 2). In phase 1, cats were premedicated with buprenorphine (0.02 mg/kg [0.009 mg/lb], IM) or butorphanol (0.4 mg/kg [0.18 mg/lb], IM), in combination with medetomidine. Anesthesia was induced with propofol (IV) and maintained with isoflurane in oxygen. After extubation, medetomidine was antagonized with atipamezole. A validated multidimensional composite scale was used to assess signs of pain after surgery starting 20 minutes after extubation and continuing for up to 360 minutes, and pain score comparisons were made between the 2 groups. Phase 2 proceeded similar to phase 1 with the following addition: during wound closure, cats from the butorphanol and buprenorphine groups received butorphanol (0.4 mg/kg, IM) or buprenorphine (0.02 mg/kg, IM), respectively. RESULTS: Phase 1 of the study was stopped after 10 cats were ovariohysterectomized because 9 of 10 cats required rescue analgesia at the first evaluation. In phase 2, at the first pain evaluation, pain scores from the buprenorphine group were lower, and all cats from the butorphanol group required rescue analgesia. None of the cats from the buprenorphine group required rescue analgesia at any time. CONCLUSIONS AND CLINICAL RELEVANCE: Buprenorphine (0.02 mg/kg, IM) given before surgery and during wound closure provided adequate analgesia for 6 hours following ovariohysterectomy in cats, whereas butorphanol did not.

Onset and quality of sedation after intramuscular administration of dexmedetomidine and hydromorphone in various muscle groups in dogs.

OBJECTIVE: To compare onset time and quality of sedation achieved by IM injection of hydromorphone and dexmedetomidine into either the semimembranosus, cervical, gluteal, or lumbar muscle groups in dogs. DESIGN: Prospective, randomized, crossover study. ANIMALS: 7 dogs. PROCEDURES: Each dog was assigned to receive each treatment in random order, and at least 1 week elapsed between treatments. Dogs were sedated with dexmedetomidine and hydromorphone combined and injected IM into the assigned muscle group. An observer unaware of group assignments assessed physiologic variables every 5 minutes for 30 minutes, and a videographic recording was obtained. Recordings were evaluated by 16 individuals who were unaware of group assignments; these reviewers assessed time to onset of sedation and assigned a sedation score to each dog every 5 minutes. RESULTS: Resting pulse and respiratory rates did not differ among injection site groups. The semimembranosus site had a significantly higher sedation score than all other sites, and the cervical site had a significantly higher sedation score than the lumbar and gluteal sites. The semimembranosus and cervical sites had significantly shorter time to onset of sedation than did the gluteal and lumbar sites. CONCLUSIONS AND CLINICAL RELEVANCE: When the combination of dexmedetomidine and hydromorphone was used to induce sedation in dogs, rapid and profound sedation was achieved with IM injection into the semimembranosus muscle.

Anaphylactoid reaction in a heartworm-infected dog undergoing lung lobectomy.

CASE DESCRIPTION: A 7-year-old 23-kg (50.6-lb) spayed female Border Collie with a history of heartworm disease was evaluated for respiratory distress. CLINICAL FINDINGS: Computed tomography of the thorax revealed possible pulmonary bullae or blebs, and on the basis of these findings, a tentative diagnosis of bullous emphysema was made. TREATMENT AND OUTCOME: Exploratory median sternotomy revealed gross pathological lesions in the right caudal lung lobe; the most peripheral portion appeared discolored (pale pink), and a clear line of demarcation was observed. Upon excision of the affected lung lobe, a worm segment was noticed both on the remaining stump of the lung lobe in the dog and in the removed lobe. At this time, the dog had an anaphylactoid reaction. The reaction was successfully treated with fluid therapy, antihistamines, and corticosteroids. Lung lobectomy of the right caudal lobe resulted in clinical resolution of the bilateral pneumothorax. However, during the postoperative period, the dog developed a hemothorax and was returned to surgery. As no obvious cause for the hemothorax was seen at the second surgery, the dog was treated for a potential coagulopathy with fresh frozen plasma, which provided clinical resolution of the hemothorax. Parasitological examination of the worm segment confirmed a Dirofilaria immitis infection. The dog was discharged 5 days after surgery and treated with doxycycline for 30 days and monthly administration of heartworm preventative was prescribed. CLINICAL RELEVANCE: Heartworm infection should be a differential diagnosis in dogs with spontaneous pneumothorax. Anaphylactoid reactions associated with accidental dissection of adult heartworms should be managed with treatment aimed at cardiovascular stabilization.