Evaluation of pulse oximetry in horses surgically treated for colic.

All 43 horses anaesthetised for colic surgery were premedicated with xylazine or diazepam. Anaesthesia was induced with guaifenesin and ketamine, horses were placed in dorsal recumbency and anaesthesia was maintained with isoflurane in oxygen and mechanical ventilation. Haemoglobin saturation readings (SpO2) were taken with a pulse oximeter and compared with computed haemoglobin saturation (SaO2) from arterial blood samples. Readings were taken over a range of SaO2 of 78-100%, mean arterial blood pressure ranged from 24 to 108 mmHg and PaO2 ranged from 53 to 490 mmHg. Analysis of 107 readings showed that SpO2 values predicted SaO2 but time, blood pressure and individual horse did not. Correlation coefficients between SpO2 and SaO2 were 0.85 for all values and 0.88 for values at 30 min. Values for bias and precision were calculated for all SpO2 values and for readings separated into 3 saturation groups: normal, low normal, and abnormal. The pulse oximeter tended to underestimate SaO2 at all times, and was less precise as the saturation decreased.

Effects of atropine on the arrhythmogenic dose of dobutamine in xylazine-thiamylal-halothane-anesthetized horses.

We investigated the influence of parasympathetic tone on the arrhythmogenic dose of dobutamine in horses premedicated with xylazine, anesthetized with guaifenesin and thiamylal, and maintained on halothane in oxygen. Six horses were used in 12 randomized trials. In each trial, after end-tidal halothane concentration was stabilized at 1.1% (1.25 times minimum alveolar concentration [MAC]) in oxygen, either saline solution (0.02 ml/kg of body weight) or atropine (0.04 mg/kg) was administered IV. Five minutes later, dobutamine infusion was started at dosage of 2.5 micrograms/kg/min, IV. The dobutamine infusion was continued for 10 minutes, or until 4 or more premature ventricular complexes occurred within 15 seconds, or sustained narrow-complex tachyarrhythmia clearly not sinus in nature occurred. If the criteria for termination were not met, dobutamine infusion was increased by 2.5 micrograms/kg/min, after the hemodynamic variables had returned to baseline. The horses were allowed to recover, and were rested for at least 1 week before the second trial. The arrhythmogenic dose of dobutamine was calculated by multiplying the infusion rate by the elapsed time into infusion when arrhythmia occurred. There was significant difference between the arrhythmogenic dose of dobutamine (ADD) in saline-treated horses (mean +/- SEM, ADD = 105.6 +/- 16.3 micrograms/kg) and atropinized horses (ADD = 36.2 +/- 8.7 micrograms/kg). There were no differences in the prearrhythmia or immediate postarrhythmia ventricular heart rate (HR) or systolic (SAP), diastolic (DAP), or mean (MAP) arterial pressures between treated and control groups. The change in hemodynamic variables from prearrhythmia to immediate postarrhythmia formation was not different between the 2 groups. (ABSTRACT TRUNCATED AT 250 WORDS)

Surgical treatment of egg retention in emus.

We developed a surgical technique for management of retained eggs in emus. Clinical signs associated with egg retention include cessation of laying activity or failure to lay eggs, lethargy, anorexia, straining, and passing egg material, and diagnosis can be made by external palpation, abdominal radiography, and ultrasonography. The retained eggs were removed through a paramedian abdominal incision in all birds. One bird was euthanatized at surgery because of severe peritonitis resulting from uterine rupture at the site of obstruction by the retained egg. Three birds survived and were discharged from the hospital to the owners. Egg peritonitis resulting from eggs or egg remnants in the abdominal cavity was evident in the birds that survived surgery. Surgery and administration of antimicrobials were successful in resolving the peritonitis.

Repetitive injectable anesthesia in a 27-year-old horse.

A 27-year-old horse was anesthetized 3 times a week for 4 weeks, to facilitate cobalt therapy of a squamous cell carcinoma in the left paranasal sinus. Limitations of facilities required transport of the anesthetized horse to and from the cobalt therapy room, therefore, injectable anesthesia was used. Initially, the horse was preanesthetized with xylazine (at 1.1 mg/kg IV) and butorphanol (0.04 mg/kg IV). After 3 anesthetic episodes, the xylazine dose was reduced to 0.4 mg/kg IV and the butorphanol was deleted from the regimen. Tiletamine-zolazepam (1.1 mg/kg IV) was used for induction and maintenance of anesthesia (although on 2 occasions a bolus of ketamine was used to maintain immobility). The length of the procedure varied from 10-45 minutes, and the recovery times to sternal and standing varied from 23-76 and 55-105 minutes respectively. Although numerous complications might be expected given the age of this horse and the physiologic and metabolic demands of repetitive injectable anesthetics, none were observed.

Small intestinal incarceration through the lateral ligament of the urinary bladder in a horse.

Small intestinal incarceration through the lateral ligament of the urinary bladder was diagnosed in a 14-year-old, 569-kg, castrated Quarter Horse. The incarceration was corrected by ventral midline celiotomy. Approximately 70 cm of the middle portion of the jejunum was resected and end-to-end, single-layer anastomosis was performed. After surgery, the horse developed signs of adynamic ileus and lameness in the right forelimb. The horse developed laminitis in all 4 feet within 24 hours of surgery. The horse was euthanatized because of poor prognosis for survival. At necropsy, a 4.5-cm rent was found in the left lateral ligament of the urinary bladder. The cause of the rent in the ligament of this horse was not determined.

Parasympathetic influence on the arrhythmogenicity of graded dobutamine infusions in halothane-anesthetized horses.

We investigated the influence of parasympathetic tone on the arrhythmogenicity of graded dobutamine infusions in horses anesthetized under clinical conditions. Six horses were used in 9 trials. Two consecutive series of graded dobutamine infusions were given IV; each continuous graded dobutamine infusion was administered for 20 minutes. The dobutamine infusion dosage (5, 10, 15, and 20 micrograms/kg of body weight/min) was increased at 5-minute intervals. Isovolumetric saline solution vehicle (v) or atropine (A; 0.04 mg/kg) was administered IV, or bilateral vagotomy (VG) was performed as a treatment before the second series of dobutamine infusions. Treatment was not administered prior to the first dobutamine infusion. Significant interaction between treatment and dosage of dobutamine infusion existed for differences from baseline for mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, heart rate, and cardiac index at dosages of 5 and 10 micrograms of dobutamine/kg/min, given IV and for heart rate at dosage of 15 micrograms of dobutamine/kg/min, given IV. Results for group-V horses were different from those for group-A and group-VG horses, but were not different between group-A and group-VG horses in all aforementioned cases, except for heart rate and cardiac index at dosage of 5 micrograms of dobutamine/kg/min, given IV. Normal sinus rhythm, second-degree atrioventricular block, and bradyarrhythmias predominated during low dobutamine infusion rates during the first infusion series (nontreated horses) and in group-V horses during the second infusion series. Only tachyarrhythmias were observed during the second infusion series in the horses of the A and VG groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Dynamic baroreflex sensitivity in anesthetized horses, maintained at 1.25 to 1.3 minimal alveolar concentration of halothane.

Dynamic baroreflex sensitivity for increasing arterial pressure (DBSI) was used to quantitatively assess the effects of anesthesia on the heart rate/arterial pressure relationship during rapid (less than or equal to 2 minutes) pressure changes in the horse. Anesthesia was induced with IV administration of xylazine and ketamine and maintained with halothane at a constant end-tidal concentration of 1.1 to 1.2% (1.25 to 1.3 minimal alveolar concentration). Systolic arterial pressure (SAP) was increased a minimum of 30 mm of Hg in response to an IV bolus injection of phenylephrine HCl. Linear regression was used to determine the slope of the R-R interval/SAP relationship. During dynamic increases in SAP, a significant correlation between R-R interval and SAP was observed in 8 of 8 halothane-anesthetized horses. Correlation coefficients between R-R interval and SAP were greater than 0.80 in 5 of 8 horses. Mean (+/- SD) DBSI was 4.8 +/- 3.4 ms/mm of Hg in anesthetized horses. A significant correlation between R-R interval and SAP was observed in only 3 of 6 awake horses during dynamic increases in SAP. Lack of correlation between R-R interval and SAP in 3 of 6 awake horses indicated that rapidly increasing SAP with an IV phenylephrine bolus is a poor method to evaluate baroreceptor-mediated heart rate changes in awake horses. Reflex slowing of heart rate in response to a rising arterial pressure appeared to have been overridden by the effects of excitement. Mean (+/- SD) DBSI (3 horses) was 7.3 +/- 3.3 ms/mm of Hg in awake horses.

Growth and development in children receiving hemodialysis.

Five children, aged 12 to 18 years, received intermittent hemodialysis for as long as 60 months. Linear growth and development progressed in all children. Growth rate was 60% to 260% of the expected increment. Four of the children developed secondary sexual characteristics. Prolonged hemodialysis combined with good nutrition may promote maximal growth before renal homotransplantation in children with end-stage renal disease.