Avaliação clínica e laboratorial de cão com osteoartrose tratado com formulação de meloxicam em spray oral. Relato de caso / Clinical and laboratory evaluation of a dog with osteoarthritis treated with oral spray meloxicam formulation. Case report / Avaliación clínica y de laboratorio de un perro con osteoartrosis tratado con formulación de meloxicam en spray oral. Reporte de caso

O presente relato de caso avaliou o meloxicam solução oral spray com o sistema de absorção transmucosa no tratamento de um cão tripedal acometido por osteoartrose em joelho e coluna. Além da avaliação ortopédica, foram realizados questionários de avaliação de dor, baropodometria, termografia e monitoramento de atividade.

The present case report evaluated the meloxicam oral solution spray with the transmucosal absorption system in the treatment of a three-legged dog affected by osteoarthritis in the knee and spine. In addition to the orthopedic evaluation, assessments of pain, baropodometry, thermography, and activity monitoring were carried out.

El presente informe de caso evaluó el spray de solución oral de meloxicam con el sistema de absorción transmucosa en el tratamiento de un perro de tres patas afectado por osteoartritis en la rodilla y columna. Además de la evaluación ortopédica, se realizaron cuestionarios de evaluación del dolor, baropodometría, termografía y monitoreo de la actividad.

Evaluation of 3D-Printed Dog Teeth for Pre-clinical Training of Endodontic Therapy in Veterinary Dentistry.

Artificial teeth in dental training have become a valuable tool for students to gain hands-on experience in a safe and controlled environment. This training method allows students to practice various dental procedures and develop their skills without putting patients at risk. Artificial teeth can be used to simulate dental conditions, allowing students to gain experience in dealing with various situations and techniques. Although previous studies in human dentistry have demonstrated the feasibility of using 3D-printed teeth for teaching endodontic procedures such as root canal therapy, similar research has yet to be conducted in the veterinary field. This study aimed to assess the feasibility of creating 3D-printed teeth from an adult dog skull and validate their use as an alternative training tool for root canal therapy in this species. For this, cone beam computed tomography images from a medium-sized dog skull were used to replicate its teeth using a digital 3D printing system. Then, artificial mandibular first molar teeth and a 24-question survey were sent to specialized veterinary dentistry practitioners in Brazil to assess their perception of the model's characteristics during endodontic treatment. In conclusion, it was feasible to create 3D-printed models of dog teeth with high accuracy for the endodontic system. Despite the differences in the properties of the two materials between natural and artificial teeth, it was possible to use the artificial tooth as a training device for conventional endodontic treatment in dogs. The reliability level for the survey was reported as good, displaying a reliability coefficient above 0.86.

Location of Trigger Points in a Group of Police Working Dogs: A Preliminary Study.

This study examined the percentage and location of trigger points in police working dogs. Twelve dogs housed at a military police kennel were selected through convenience sampling. Only active dogs with no comorbidities or radiographic changes doing 6 hours of intense physical activity per day were included. After orthopedic and neurological examination, dogs were palpated for the detection of trigger points (TPs), carried out by two independent examiners, with criteria of palpations previously standardized. TPs were recorded using an anatomy reference image according to the corresponding anatomical location. The percentage of TPs was highest in the lumbar portion of the longissimus dorsi muscle (42%), followed by the latissimus dorsi, pectineus, quadriceps femoris, and sartorius (33%) muscles. Most TPs were located on the right side of the body. This study's percentage of TPs in police working dogs was higher in spinal and hind limb muscles, especially on the right side. The major criteria for identifying TPs in dogs were the pain responses to palpation and contractile local response. The findings of this study could be used to refine myofascial pain prevention to reduce early retirement due to musculoskeletal pain and draw attention to this kind of problem that can also affect dogs.

Evaluation of an onco-diet on body composition and inflammatory status of dogs with mammary tumor-Pilot study.

A high-protein hypercaloric diet enriched with glutamine and omega-3 polyunsaturated fatty acids was called an onco-diet. The goal was to verify the modulation of the inflammatory response and body composition of female dogs with mammary tumor after mastectomy, during onco-diet consumption, using a randomized, double-blinded, clinical trial. Six bitches (average age of 8.6 years) were allocated into Control Group-diet without glutamine, EPA and DHA supplementation; and six bitches (10.0 years) were allocated into Test-diet enriched with glutamine and omega-3. Serum measurements of TNF-α, IL-6, IL-10, IGF-1, C-reactive protein and determination of body composition were performed at pre- and post-surgical times. Statistical tests were used to compare the nutrient intake and dietary effects on inflammatory variables between the diets. No differences in concentrations of different cytokines (p>0.05) and C-reactive protein (CRP) (p = 0.51) were observed between the groups. The test group had a higher concentration of IGF-1 (p<0.05), higher percentage of muscle mass (p<0.01) and lower body fat (p<0.01), but the difference was present from initial and throughout the study. Onco-diet, enriched with glutamine and omega-3, in the amounts evaluated in this study, was not sufficient to modulate the inflammation and body composition of female dogs with mammary tumors submitted to unilateral mastectomy.

Comparison of Hemodynamic Effects of Dobutamine and Ephedrine Infusions in Isoflurane-Anesthetized Horses.

The objective of this study was to compare the hemodynamic effects of dobutamine and ephedrine during the management of anesthesia-related hypotension in healthy horses. Thirteen horses underwent general anesthesia with isoflurane and were randomly divided into two different groups, one of which received a dobutamine constant rate infusion (CRI) (1 µg/kg bwt/min) and the other received an ephedrine CRI (20 µg/kg bwt/min) when hypotension (<60 mmHg) was identified, following up to 15 min after the blood pressure reached 70 mmHg. All horses were equipped with a pulmonary artery catheter and a peripheral artery catheter, and multiparameter monitoring commenced as soon as they were under mechanical ventilation. Hemodynamic parameters were recorded, while tissue perfusion markers (peripheral oxygen saturation, arterial oxygen partial pressure, arterial carbon dioxide partial pressure, arterial pH, arterial plasma bicarbonate concentration, arterial oxygen saturation, mixed venous oxygen saturation, mixed venous oxygen content, arterial oxygen content, arteriovenous oxygen difference, oxygen delivery index, oxygen consumption index, and oxygen extraction ratio), serum lactate concentration, and troponin I concentrations were analyzed before the start of infusions (T0), when the blood pressure reached 70 mmHg (T1), and 15 min after T1 (T2). The time to restore the arterial pressure was similar in both groups (p > 0.05); however, the heart rate was higher in the ephedrine group (p = 0.0098), and sinus bradyarrhythmia occurred in the dobutamine group. Furthermore, both experimental protocols increased cardiac output (p = 0.0012), cardiac index (p = 0.0013), systemic vascular resistance (p = 0.008), systemic vascular resistance index (p < 0.001), and ameliorated perfusion markers. In the dobutamine group, the pulmonary artery wedge pressure (p < 0.001) and systolic index (p = 0.003) were elevated, while the arteriovenous oxygen difference was reduced in the ephedrine group (p = 0.02). Troponin I was used as a myocardial injury indicator, and did not differ between moments or between groups (p > 0.05). We concluded that both drugs were effective and safe to treat anesthetic hypotension under the conditions of this study.

Sildenafil in endotoxin-induced pulmonary hypertension: an experimental study.

BACKGROUND: Sepsis and septic shock still represent great challenges in critical care medicine. Sildenafil has been largely used in the treatment of pulmonary arterial hypertension, but its effects in sepsis are unknown. The aim of this study was to investigate the hypothesis that sildenafil can attenuate endotoxin-induced pulmonary hypertension in a porcine model of endotoxemia. METHODS: Twenty pigs were randomly assigned to Control group (n.ß=.ß10), which received saline solution; or to Sildenafil group (n.ß=.ß10), which received sildenafil orally (100.ßmg). After 30.ßminutes, both groups were submitted to endotoxemia with intravenous bacterial lipopolysaccharide endotoxin (LPS) infusion (4.ß..g.kg-1.h-1) for 180.ßminutes. We evaluated hemodynamic and oxygenation functions, and also lung histology and plasma cytokine (TNF.., IL-1.., IL6, and IL10) and troponin I response. RESULTS: Significant hemodynamic alterations were observed after 30.ßminutes of LPS continuous infusion, mainly in pulmonary arterial pressure (from Baseline 19.ß...ß2.ßmmHg to LPS30 52.ß...ß4.ßmmHg, p.ß<.ß0.05). There was also a significant decrease in PaO2/FiO2 (from Baseline 411.ß...ß29 to LPS180 334.ß...ß49, p.ß<.ß0.05). Pulmonary arterial pressure was significantly lower in the Sildenafil group (35.ß...ß4.ßmmHg at LPS30, p.ß<.ß0.05). The Sildenafil group also presented lower values of systemic arterial pressure. Sildenafil maintained oxygenation with higher PaO2/FiO2 and lower oxygen extraction rate than Control group but had no effect on intrapulmonary shunt. All cytokines and troponin increased after LPS infusion in both groups similarly. CONCLUSION: Sildenafil attenuated endotoxin-induced pulmonary hypertension preserving the correct heart function without improving lung lesions or inflammation.

Effects of a stepwise alveolar recruitment maneuver on lung volume distribution in dogs assessed by computed tomography.

Background: Pulmonary atelectasis is a commonly occurs during anesthesia. In these cases, mechanical ventilation (MV) associated with alveolar recruitment maneuvers (ARMs) and positive end-expiratory pressure (PEEP) is indicated to reverse the condition, ensure adequate gas exchange and improve oxygenation. ARMs can trigger volutrauma, barotrauma, and atelectrauma. Therefore, computed tomography (CT) is the gold-standard method for monitoring lung aeration after ARM. Objective: To evaluate lung volume distribution after stepwise ARMs using computed tomography (CT). Methods: Twelve dogs weighing 24.0 ± 6.0 kg, aged 3 ± 1 years, of both sexes and different breeds, underwent orchiectomy or ovariohysterectomy. The animals were anesthetized and ventilated in volume-controlled mode. ARMs were then initiated by positive end-expiratory pressure (PEEP) titration (5, 10, 15, and 20 cmH2O). CT scans, cardiovascular parameters, and ventilatory mechanics were evaluated at all time points. Data were assessed for normality using the Shapiro-Wilk test and a two-way analysis of variance, followed by a post-hoc Bonferroni test to identify differences between time points. Statistical significance was attributed to a value of p of <0.05. Results: CT demonstrated that the ARMs increased ventilation throughout the lung, including the dependent regions, with volumes that increased and decreased proportionally with PEEP titration. When they reached PEEP 10 and 5 cmH2O descending (d), they remained significantly higher than those in PEEP 0 cmH2O (baseline). Static compliance improved about 40% at PEEP 10d and PEEP 5d compared to baseline. There was an increase in heart rate (HR) from PEEP 15 increasing (i) (74.5%) to PEEP 10d (54.8%) compared to baseline. Mean arterial blood pressure (MABP) decreased approximately 9% from PEEP 15i to PEEP 15d compared to baseline. Conclusion: Lung attenuation and regional and global volumes assessed by CT showed that maximum pulmonary aeration distribution followed by PEEP titration occurred at PEEP 20 cmH2O, maintaining the lungs normoaerated and without hyperaeration.

Sildenafil in endotoxin-induced pulmonary hypertension: an experimental study

Abstract Background Sepsis and septic shock still represent great challenges in critical care medicine. Sildenafil has been largely used in the treatment of pulmonary arterial hypertension, but its effects in sepsis are unknown. The aim of this study was to investigate the hypothesis that sildenafil can attenuate endotoxin-induced pulmonary hypertension in a porcine model of endotoxemia. Methods Twenty pigs were randomly assigned to Control group (n = 10), which received saline solution; or to Sildenafil group (n = 10), which received sildenafil orally (100 mg). After 30 minutes, both groups were submitted to endotoxemia with intravenous bacterial lipopolysaccharide endotoxin (LPS) infusion (4 µg.kg-1.h-1) for 180 minutes. We evaluated hemodynamic and oxygenation functions, and also lung histology and plasma cytokine (TNFα, IL-1β, IL6, and IL10) and troponin I response. Results Significant hemodynamic alterations were observed after 30 minutes of LPS continuous infusion, mainly in pulmonary arterial pressure (from Baseline 19 ± 2 mmHg to LPS30 52 ± 4 mmHg, p< 0.05). There was also a significant decrease in PaO2/FiO2 (from Baseline 411 ± 29 to LPS180 334 ± 49, p< 0.05). Pulmonary arterial pressure was significantly lower in the Sildenafil group (35 ± 4 mmHg at LPS30, p< 0.05). The Sildenafil group also presented lower values of systemic arterial pressure. Sildenafil maintained oxygenation with higher PaO2/FiO2 and lower oxygen extraction rate than Control group but had no effect on intrapulmonary shunt. All cytokines and troponin increased after LPS infusion in both groups similarly. Conclusion Sildenafil attenuated endotoxin-induced pulmonary hypertension preserving the correct heart function without improving lung lesions or inflammation.

Corrigendum: Intraoperative protective mechanical ventilation in dogs: A randomized clinical trial.

[This corrects the article DOI: 10.3389/fvets.2022.842613.].

The optimal PEEP after alveolar recruitment maneuver assessed by electrical impedance tomography in healthy horses.

Background: Electrical impedance tomography (EIT) has been an essential tool for assessing pulmonary ventilation in several situations, such as the alveolar recruitment maneuver (ARM) in PEEP titration to maintain the lungs open after atelectasis reversion. In the same way as in humans and dogs, in horses, this tool has been widely used to assess pulmonary aeration undergoing anesthesia, mechanical ventilation, recruitment maneuver, standing horses, or specific procedures. Objectives: The present study aimed to evaluate the distribution of regional ventilation during ARM based on lung monitoring assessment by EIT, with a focus on better recruitment associated with less or no overdistention. Methods: Fourteen horses of 306 ± 21 kg undergoing isoflurane anesthesia in dorsal recumbency were used. The animals were mechanically ventilated with a tidal volume of 14 ml kg-1 and a respiratory rate of 7-9. An alveolar recruitment maneuver was instituted, increasing the PEEP by five cmH2O every 5 min until 32 cmH2O and decreasing it by five cmH2O every 5 min to 7 cmH2O. At each step of PEEP, arterial blood samples were collected for blood gas analysis, EIT images, hemodynamic, and respiratory mechanics. Results: Associated with the CoV-DV increase, there was a significant decrease in the DSS during the ARM and a significant increase in the NSS when PEEP was applied above 12 cmH2O compared to baseline. The ComplROI showed a significant increase in the dependent area and a significant decrease in the non-dependent area during ARM, and both were compared to their baseline values. The driving pressure decreased significantly during the ARM, and Cst, PaO2, and PaO2/FiO2 ratio increased significantly. The VD/VT decreased significantly at DEPEEP17 and DEPEEP12. There was an HR increase at INPEEP27, INPEEP 32, and DEPEEP17 (p < 0.0001; p < 0.0001; and p < 0.05, respectively), those values being above the normal reference range for the species. The SAP, MAP, DAP, CI, and DO2I significantly decreased INPEEP32 (p < 0.05). Conclusion: The ARM by PEEP titration applied in the present study showed better ventilation distribution associated with better aeration in the dependent lung areas, with minimal overdistention between PEEP 17 and 12 cmH2O decreasing step. Those changes were also followed by improvements in static and regional compliance associated with increased oxygenation and pulmonary ventilation. ARM promoted a transitory decrease in arterial blood pressure and depression in CI with a concomitant drop in oxygen delivery, which should be best investigated before its routine use in clinical cases.

Effects of dexmedetomidine on hemodynamic, oxygenation, microcirculation, and inflammatory markers in a porcine model of sepsis.

PURPOSE: To determine whether dexmedetomidine aggravates hemodynamic, metabolic variables, inflammatory markers, and microcirculation in experimental septic shock. METHODS: Twenty-four pigs randomized into: Sham group (n = 8), received saline; Shock group (n = 8), received an intravenous infusion of Escherichia coli O55 (3 × 109 cells/mL, 0.75 mL/kg, 1 hour); Dex-Shock group (n = 8), received bacteria and intravenous dexmedetomidine (bolus 0.5 mcg/kg followed by 0.7 mcg/kg/h). Fluid therapy and/ornorepinephrine were administered to maintain a mean arterial pressure > 65 mmHg. Hemodynamic, metabolic, oxygenation, inflammatory markers, and microcirculation were assessed at baseline, at the end of bacterial infusion, and after 60, 120, 180, and 240 minutes. RESULTS: Compared to Shock group, Dex-Shock group presented a significantly increased oxygen extraction ratio at T180 (23.1 ± 9.7 vs. 32.5 ± 9.2%, P = 0.0220), decreased central venous pressure at T120 (11.6 ± 1 vs. 9.61 ± 1.2 mmHg, P = 0.0214), mixed-venous oxygen saturation at T180 (72.9 ± 9.6 vs. 63.5 ± 9.2%, P = 0.026), and increased plasma lactate (3.7 ± 0.5 vs. 5.5 ± 1 mmol/L, P = 0.003). Despite the Dex-Shock group having a better sublingual vessel density at T240 (12.5 ± 0.4 vs. 14.4 ± 0.3 mL/m2; P = 0.0003), sublingual blood flow was not different from that in the Shock group (2.4 ± 0.2 vs. 2.4 ± 0.1 mL/kg, P = 0.4418). CONCLUSIONS: Dexmedetomidine did not worsen the hemodynamic, metabolic, inflammatory, or sublingual blood flow disorders resulting from septic shock. Despite inducing a better sublingual vessel density, dexmedetomidine initially and transitorily increased the mismatch between oxygen supply and demand.

Analgesic efficacy of ultrasound-guided transversus abdominis plane block in dogs undergoing ovariectomy.

Background: In medicine, the transversus abdominis plane (TAP) block has been shown as an effective method of analgesia in several surgical procedures. In this context, this prospective, randomized, blinded study aimed to evaluate the analgesic efficacy of TAP block, guided by ultrasound in female dogs submitted to ovariectomy. Methods: Therefore, 32 animals randomly assigned in two groups (n = 16) were used. Groups consisted of TAP block control (TBC) which received water injection (0.2 ml kg-1 point), and TAP block bupivacaine (TBB) which received bupivacaine (0.2 ml kg-1 point at 0.25%); both groups were submitted to four-point approach. Animals were pre-medicated with acepromazine (0.03 mg kg-1) and meperidine (2 mg kg-1) IM, propofol was used as anesthetic induction (3-5 mg kg-1) IV, and isoflurane was used to maintain. To standardize groups, the animals received a continuous infusion of remifentanil (0.2µg kg-1 min) and rocuronium (0.6 mg kg-1) IV in the intraoperative period. Variables measured were the heart and respiratory rates, blood pressure, temperature, peripheral oxyhemoglobin saturation, exhaled carbon dioxide concentration, exhaled isoflurane concentration, serum cortisol, analgesia, and sedation. Before the pre-anesthetic medication (Baseline) and 1, 2, 4, 6, and 8 h after extubation, pain and sedation were assessed using a numeric rating scale (NRS), Glasgow composite measure pain scale (GCMPS-SF), and sedation scale. Moreover, serum cortisol was measured at different moments. Results: The results show that in the intraoperative period, there was no significant difference between groups. After surgery, in TBC, 13 out of 16 animals required analgesic rescue, whereas, in TBB, this occurred only in one animal. Regarding the measurement of serum cortisol, the TBC group showed a significant difference when compared to the baseline time in the traction of the first ovary (p < 0.0001), 2 h (p = 0.0441), and 8 h (p = 0.0384) after extubation. In TBB, cortisol showed a significant increase only in the traction of the first ovary and 2 h after extubation (p < 0.0001). Conclusion: The technique using ultrasound-guided TAP block in two points approach by hemiabdomen with 0.2 ml kg-1 bupivacaine 0.25% was effective in providing post-operative analgesia in dogs undergoing ovariectomy.

Microcirculation assessment of dexmedetomidine constant rate infusion during anesthesia of dogs with sepsis from pyometra: a randomized clinical study.

OBJECTIVE: To compare dexmedetomidine and fentanyl constant rate infusions in anesthetic protocols for septic dogs with pyometra, using microcirculatory, hemodynamic and metabolic variables. STUDY DESIGN: Randomized clinical study. ANIMALS: A total of 33 dogs with pyometra with two or more systemic inflammatory response syndrome variables undergoing ovariohysterectomy. METHODS: Dogs were randomized into two groups: group DG, dexmedetomidine (3 µg kg-1 hour-1; 17 dogs) and group FG, fentanyl (5 µg kg-1 hour-1; 16 dogs) infused during isoflurane anesthesia and mechanical ventilation. Microcirculation flow index (MFI), total vessel density and De Backer score were assessed using orthogonal polarization spectral imaging at the sublingual site. Heart rate, invasive blood pressure, temperature, arterial blood gas analysis and lactate concentration were obtained at various time points. Variables were recorded at baseline (BL), immediately before (T0), 30 (T30) and 60 (T60) minutes after infusion, and 60 minutes after surgery. Data were analyzed using the Shapiro-Wilk test. To compare variables between groups, the unpaired Student t test was used. Comparison between evaluation time points was performed with two-way anova for repeated measures. Where statistical significance was detected, the Bonferroni post hoc test was used. RESULTS: MFI was significantly higher in group FG at T30. Mean arterial pressure at T30 was higher in group DG (89 ± 15 mmHg) than in group FG (72 ± 13 mmHg). Lactate concentrations were not significantly different between groups at each time point. Both groups had similar clinical outcomes (mortality, extubation time and occurrence of hypotension and bradyarrhythmias). CONCLUSIONS AND CLINICAL RELEVANCE: Dexmedetomidine (3 µg kg-1 hour-1) without a loading dose can be included in the maintenance of anesthesia in dogs with pyometra and sepsis without compromising microcirculation and hemodynamic values when compared with fentanyl (5 µg kg-1 hour-1).

Computed Tomography Assessment of Tidal Lung Overinflation in Domestic Cats Undergoing Pressure-Controlled Mechanical Ventilation During General Anesthesia.

Objective: This study aimed to evaluate lung overinflation at different airway inspiratory pressure levels using computed tomography in cats undergoing general anesthesia. Study Design: Prospective laboratory study. Animals: A group of 17 healthy male cats, aged 1.9-4.5 years and weighing 3.5 ± 0.5 kg. Methods: Seventeen adult male cats were ventilated in pressure-controlled mode with airway pressure stepwise increased from 5 to 15 cmH2O in 2 cmH2O steps every 5 min and then stepwise decreased. The respiratory rate was set at 15 movements per min and end-expiratory pressure at zero (ZEEP). After 5 min in each inspiratory pressure step, a 4 s inspiratory pause was performed to obtain a thoracic juxta-diaphragmatic single slice helical CT image and to collect respiratory mechanics data and an arterial blood sample. Lung parenchyma aeration was defined as overinflated, normally-aerated, poorly-aerated, and non-aerated according to the CT attenuation number (-1,000 to -900 HU, -900 to -500 HU, -500 to -100 HU, and -100 to +100 HU, respectively). Result: At 5 cmH2O airway pressure, tidal volume was 6.7± 2.2 ml kg-1, 2.1% (0.3-6.3%) of the pulmonary parenchyma was overinflated and 84.9% (77.6%-87.6%) was normally inflated. Increases in airway pressure were associated with progressive distention of the lung parenchyma. At 15 cmH2O airway pressure, tidal volume increased to 31.5± 9.9 ml kg-1 (p < 0.001), overinflated pulmonary parenchyma increased to 28.4% (21.2-30.6%) (p < 0.001), while normally inflated parenchyma decreased 57.9% (53.4-62.8%) (p < 0.001). Tidal volume and overinflated lung fraction returned to baseline when airway pressure was decreased. A progressive decrease was observed in arterial carbon dioxide partial pressure (PaCO2) and end-tidal carbon dioxide (ETCO2) when the airway pressures were increased above 9 cmH2O (p < 0.001). The increase in airway pressure promoted an elevation in pH (p < 0.001). Conclusions and Clinical Relevance: Ventilation with 5 and 7 cmH2O of airway pressure prevents overinflation in healthy cats with highly compliant chest walls, despite presenting acidemia by respiratory acidosis. This fact can be controlled by increasing or decreasing respiratory rate and inspiratory time.

Intraoperative Protective Mechanical Ventilation in Dogs: A Randomized Clinical Trial.

Objective: To evaluate gas exchange, respiratory mechanics, and hemodynamic impact of mechanical ventilation with low tidal volume (VT) in dogs with the use of positive end-expiratory pressure (PEEP) or preceded by alveolar recruitment maneuver (ARM). Study Design: Prospective randomized clinical trial. Animals: Twenty-one healthy client-owned mesocephalic healthy dogs, 1-7 years old, weighing 10-20 kg, and body condition scores 4-6/9 admitted for periodontal treatment. Methods: Isoflurane-anesthetized dogs in dorsal recumbency were ventilated until 1 h with a volume-controlled ventilation mode using 8 mL kg-1 of VT. The dogs were distributed in 2 groups: in the ARM group, PEEP starts in 0 cmH2O, increasing gradually 5 cmH2O every 3 min, until reach 15 cmH2O and decreasing in the same steps until 5 cmH2O, maintaining this value until the end; and PEEP group, in which the pressure 5 cmH2O was instituted from the beginning of anesthesia and maintained the same level up to the end of the anesthesia. Cardiopulmonary, metabolic, oxygenation parameters, and respiratory mechanics were recorded after the anesthesia induction (baseline-BL), 15, 45, and 75 min after BL and during the recovery. Results: The ARM increased the static compliance (Cst) (15 min after baseline) when compared with baseline moment (24.9 ± 5.8 mL cmH20-1 vs. 20.7 ± 5.4 mL cmH20-1-p = 0.0364), oxygenation index (PaO2/FIO2) (505.6 ± 59.2 mmHg vs. 461.2 ± 41.0 mmHg-p = 0.0453) and reduced the shunt fraction (3.4 ± 2.4% vs. 5.5 ± 1.6%-p = 0.062). In the PEEP group, no statistical differences were observed concerning the variables evaluated. At the beginning of the evaluation, the driving pressure (DP) before ARM was significantly greater than all other evaluation time points (6.9 ± 1.8 cmH20). Conclusions and Clinical Relevance: The use of 8 mL kg-1 of VT and 5 cmH20 PEEP without ARM maintain adequate oxygenation and mechanical ventilation in dental surgeries for up to 1 h. The use of ARM slightly improved compliance and oxygenation during the maneuver.

Effects of dexmedetomidine on hemodynamic, oxygenation, microcirculation, and inflammatory markers in a porcine model of sepsis

Purpose: To determine whether dexmedetomidine aggravates hemodynamic, metabolic variables, inflammatory markers, and microcirculation in experimental septic shock. Methods: Twenty-four pigs randomized into: Sham group (n = 8), received saline; Shock group (n = 8), received an intravenous infusion of Escherichia coli O55 (3 × 109 cells/mL, 0.75 mL/kg, 1 hour); Dex-Shock group (n = 8), received bacteria and intravenous dexmedetomidine (bolus 0.5 mcg/kg followed by 0.7 mcg/kg/h). Fluid therapy and/ornorepinephrine were administered to maintain a mean arterial pressure > 65 mmHg. Hemodynamic, metabolic, oxygenation, inflammatory markers, and microcirculation were assessed at baseline, at the end of bacterial infusion, and after 60, 120, 180, and 240 minutes. Results: Compared to Shock group, Dex-Shock group presented a significantly increased oxygen extraction ratio at T180 (23.1 ± 9.7 vs. 32.5 ± 9.2%, P = 0.0220), decreased central venous pressure at T120 (11.6 ± 1 vs. 9.61 ± 1.2 mmHg, P = 0.0214), mixed-venous oxygen saturation at T180 (72.9 ± 9.6 vs. 63.5 ± 9.2%, P = 0.026), and increased plasma lactate (3.7 ± 0.5 vs. 5.5 ± 1 mmol/L, P = 0.003). Despite the Dex-Shock group having a better sublingual vessel density at T240 (12.5 ± 0.4 vs. 14.4 ± 0.3 mL/m2; P = 0.0003), sublingual blood flow was not different from that in the Shock group (2.4 ± 0.2 vs. 2.4 ± 0.1 mL/kg, P = 0.4418). Conclusions: Dexmedetomidine did not worsen the hemodynamic, metabolic, inflammatory, or sublingual blood flow disorders resulting from septic shock. Despite inducing a better sublingual vessel density, dexmedetomidine initially and transitorily increased the mismatch between oxygen supply and demand.

Ozone Therapy in the Prevention of Dental Plaque Formation in Dogs.

This study aims to assess ozonized mineral oil ointment application as an antiplaque therapy for dogs. Domestic healthy dogs received dental scaling and polishing under general anesthesia. Under standard feeding and homecare during 7 days, 20 dogs were randomly placed into 2 different groups for dental treatment. The control group (CG) was given a single placebo application and the ozone group (O3G) received daily ozonized ointment application. The average age (CG = 4.4; O3G = 5.7 years old), body weight (CG = 15.7; O3G = 15.3 kg) and the gingivitis index obtained on the first day (D0) allowed initial homogeneity between the groups. The dental plaque index, including clinical and computerized analysis on the seventh day, was obtained from the buccal aspect of specific dental locations. Both analyses revealed significant statistical association between daily application of ozone and antiplaque effect. There was no evidence of toxicity during the study. These results suggest that ozone therapy may be an efficient adjuvant to conventional periodontal treatment in decreasing initial dental plaque formation.

Cyclooxygenases 1 and 2 inhibition and analgesic efficacy of dipyrone at different doses or meloxicam in cats after ovariohysterectomy.

OBJECTIVE: To evaluate the cyclooxygenases (COX) inhibition, adverse effects and analgesic efficacy of dipyrone or meloxicam in cats undergoing elective ovariohysterectomy. STUDY DESIGN: Prospective, blinded, randomized, clinical study. ANIMALS: A total of 30 healthy young cats. METHODS: The cats were randomly assigned to three postoperative groups: D25 (dipyrone 25 mg kg-1 every 24 hours), D12.5 (dipyrone 12.5 mg kg-1 every 12 hours) and M (meloxicam 0.1 mg kg-1 every 24 hours). In the first 24 hours, the drugs were administered intravenously (IV), and then orally for 6 (dipyrone) or 3 days (meloxicam). Prostanoids thromboxane B2 and prostaglandin E2 concentrations served as indicators of COX activity and, with physiological variables and pain and sedation scores, were measured for 24 hours after first analgesic administration. Rescue analgesia (tramadol, 2 mg kg-1 IV) was provided if Glasgow feline composite measure pain scale (CMPS-Feline) ≥5. Laboratory tests included symmetric dimethylarginine and adverse effects were evaluated regularly up to 7 and 10 days after surgery, respectively. Parametric and nonparametric data were analyzed with two-way anova and Kruskal-Wallis tests, respectively (p < 0.05). RESULTS: In the first half hour after analgesic administration, COX-1 activity was close to zero and remained significantly lower than before drug administration for 24 hours in all groups. The inhibition of COX-2 activity was significant for 30 minutes in all groups and up to 4 hours in group M. No alterations in laboratory tests or significant adverse effects were observed. Pain scores and need for rescue analgesia did not differ statistically among groups. CONCLUSIONS: Dipyrone at both doses and meloxicam provided a nonselective inhibition of COX-1 and -2 activities and effective analgesia without causing significant adverse effects or laboratory tests alterations. CLINICAL RELEVANCE: Dipyrone at both doses provides equally effective analgesia without causing adverse effects in cats undergoing ovariohysterectomy.