Revealing the diversity of internal body temperature and panting response for feedlot cattle under environmental thermal stress.

Core body temperature (CBT) regulation is crucial for mammalian wellbeing and survival. Cattle pant to dissipate excess heat to regulate CBT when ambient conditions exceed thermoneutral zones. However, to date, neither the variability in cattle heat response, the lagged response of CBT to thermal indices, nor the diurnal patterns of thermal indices, CBT and panting have been reported in the literature. We decomposed thermal indices, CBT and panting time-series data for 99 feedlot heifers across three discrete heat events into diurnal, trend and residual components. Both raw and decomposed data were analysed to explore the lagged CBT and panting responses and the association between series. We show ambient thermal conditions impact CBT with a 1-h lag despite a lag of between 1.5 to 3 h from raw data. Average individual panting scores were used to identify heat-susceptible and heat-tolerant cattle. Heat-susceptible cattle showed greater CBT (P < 0.01) between 8:00 and 23:00 and greater panting duration (P < 0.05) between 10:00 and 18:00 than heat-tolerant cattle under the same thermal conditions and these variations followed a similar pattern despite differences in cattle breed. This new information enables targeted amelioration and selection of individuals against heat susceptibility.

Timing of eating during transition impacts feedlot cattle diet and liveweight gain.

The timing of eating, relative to when feed is offered, is affected by the social rank of feedlot cattle due to limited feed bunk space. As cattle can select feed based on dietary preference, the timing of eating for cattle in feedlot may be associated with the ingested diet composition. Our objectives were to determine the nutritive value and timing of feed ingested by 100 feedlot cattle during transition and the association of timing of eating with feeding behaviours and average daily gain (ADG). Cattle behaviour and timing of eating were determined on 100 feedlot cattle using accelerometer-based ear tag sensors from days 3 to 6 post feedlot induction (observation period), and the ongoing impact of this period on ADG was determined for the full feed period (75 days). To determine eating patterns at the time of feed offer, cattle were grouped according to the number of days they were recorded as eating within 1 h of feed being offered across 4 observation days, G0: not present across 4 days, G1: present for 1 day, G2: 2 days, G3: 3 days and G4: present for each of the 4 days. Total mixed ration (TMR) samples were collected for nutritive value analysis from four locations along the feed bunk from the time feed was offered and at hourly intervals thereafter for 7 h each day during the observation period. The composition of feed in the bunk changed across the 7 h of measurement (P < 0.05). The DM and CP of feed increased from 65 to 70% and 15 to 16%, respectively, and the NDF decreased from 36 to 32%. Thus, the preferred TMR feed component was the fibrous dietary fraction. However, the overall composition of the ingested diet for 7 h post feeding was similar between groups. Cattle in G0 had reduced eating time (0.7 vs 4.8%; P < 0.001), rumination time (4.5 vs 19.5%; P < 0.001) and ADG (1.0 vs 1.3 kg/d; P < 0.05) across the study, as compared with cattle in G4. Offering a more fibrous ration during feedlot transition, and customised cattle segregation and/or customised feeding regimes based on sensor derived feeding behaviour profiles during acclimation to feedlot can optimise ADG, animal welfare and feedlot profit.

Effects of topical anaesthetic and buccal meloxicam on average daily gain, behaviour and inflammation of unweaned beef calves following surgical castration.

Although the pain caused by castration of calves is a significant animal welfare issue for the beef industry, analgesia is not always used for this procedure, largely because of practical limitations associated with injectable forms of pain relief. Novel analgesic formulations have now been developed for livestock to allow topical and buccal administration, offering practical options to improve cattle welfare if shown to be effective. To assess the effects of topical anaesthetic (TA) and buccal meloxicam (BM) on average daily gain (ADG), behaviour and inflammation following surgical castration of beef calves, a total of 50 unweaned bull calves were randomly allocated to: (1) sham castration (SHAM, n=10); (2) surgical castration (C, n=10); (3) surgical castration with pre-operative buccal meloxicam (CBM, n=10); (4) surgical castration with post-operative topical anaesthetic (CTA, n=10); and (5) surgical castration with pre-operative buccal meloxicam and post-operative topical anaesthetic (CBMTA, n=10). Calves were recorded on video for 5 h following treatment and the frequency and duration of specific behaviours displayed by each animal was later observed for 5 min every hour (total of 25 min). Average daily gain was calculated 1, 2 and 6 days following treatment. Scrotal diameter measurements and photographs of wounds were collected from all castrated calves 1, 2 and 6 days following treatment to evaluate inflammation and wound healing. Infrared photographs were used to identify maximum scrotal temperature. Digital photographs were used to visually score wounds on a numerical rating scale of 1 to 5, with signs of inflammation increasing and signs of healing decreasing with progressive scores. Sham castration calves displayed significantly less, and C calves displayed significantly more foot stamps than all other calves (P=0.005). Observations on the duration of time that calves displayed a hypometric 'stiff gait' locomotion, indicated that SHAM calves tended to spend no time, C calves tended to spend the greatest time and all other calves tended to spend an intermediate time displaying this behaviour (P=0.06). Maximum scrotal temperatures were lower in CBM and CBMTA calves than C and CTA calves 2 days following treatment (P=0.004). There was no significant effect of treatment on ADG (P=0.7), scrotal diameter (P=0.09) or wound morphology score (P=0.5). These results suggest that TA and BM, alone or in combination, reduced pain and BM reduced inflammation following surgical castration of calves.

Effect of a topical anaesthetic formulation on the cortisol response to surgical castration of unweaned beef calves.

Impracticality and cost of existing pain management strategies during surgical castration of beef cattle have limited their widespread implementation on-farm. A farmer-applied topical anaesthetic formulation, originally developed and used commercially to mitigate the pain of mulesing in lambs, was investigated for its potential use for managing pain in surgically castrated calves. This formulation contained lidocaine, bupivacaine, adrenalin and cetrimide. In this study, 24 Angus bull calves were randomly allocated to (1) surgical castration (C, n=8), (2) surgical castration with the post-operative application of topical anaesthetic (CTA, n=8) and (3) sham castration/control (CON, n=8). The experiment was conducted over 2 days, with treatment groups evenly represented across each day. Calves were habituated to handling before the experiment and blood samples were collected for plasma cortisol measurement at defined time periods before, at and post treatment, (at -0.5, 0 h, then +0.5, 1, 1.5, 2, 4 and 6 h). There was a significant effect of time on cortisol concentrations across all treatment groups (P<0.01), with lowest concentrations at -0.5 and 6 h and peak concentration at 0.5 h being significantly higher than the cortisol response at 0 h. The effect of treatment was not significant (P=0.077), however, there was a trend for CON calves to display lower cortisol concentrations than C and CTA calves and CTA calves to display lower cortisol concentrations than C calves. The mean area under the curve (AUC) of CON calves was significantly lower than those of C and CTA calves (P=0.04), however, there was no significant difference between the AUCs of CTA and C calves. Immediate application of topical anaesthetic after surgical castration did not significantly reduce plasma cortisol concentrations. However, the trend for CTA calves to display lower cortisol concentrations than C calves warrants further investigation into the use of TA for pain relief of surgically castrated beef calves.

Topical anesthesia mitigates the pain of castration in beef calves.

Castration involves the removal of the testes and is performed to improve product quality and management of male calves. The procedure has been proven to cause significant pain and stress, and despite several attempts to reduce the impact of castration on animal welfare, there has yet to be a practical and affordable option made available for farmer application. To address this issue, we conducted 2 trials (n = 18 and 27) to examine the efficacy of topical anesthetic Tri-Solfen (TA) to alleviate the pain of surgical castration. Angus bull calves (135.8 ± 5.7 kg) aged 3 to 4 mo were randomly allocated to 3 treatment groups, including surgical castration, castration in combination with TA, and uncastrated controls. In Trial 1, pain-related behavior was assessed using a customized numerical rating scale (NRS) over 4 h. In Trial 2, pre- and postoperative skin sensitivity of the wound and periwound areas was assessed using an electronic von Frey anesthesiometer (IITC Life Sciences, Woodland Hills, CA) and von Frey monofilaments (300 g). Sampling was repeated at 1 min and 2, 4, 6, and 24 h after castration. Pain threshold was measured as maximum pressure (g) exerted by the electronic anesthesiometer to invoke animal reflex, and responses to the von Frey monofilaments were scored from 0 to 3 using a NRS on the basis of local and central motor reflexes. Calves treated with TA displayed significantly less pain-related behaviors up to 3.5 h after castration than untreated calves (P < 0.001) and did not differ from uncastrated controls. Topical anesthetic-treated calves also exhibited significantly greater pain threshold of the wound (559.2 ± 14.3 g) and surrounding skin (602.8 ± 16.5 g) than untreated calves (446.0 ± 18.9 and 515.3 ± 20.4 g, respectively; P < 0.001). Control and TA-treated calves had significantly lower mean response scores to von Frey stimulation than untreated calves (0.333, 0.978, and 4.289, respectively; P < 0.001). Results indicate that TA effects rapid and prolonged pain alleviation in calves up to 24 h after castration. Topical anesthesia may present a cost-effective, practical, on-farm approach to pain alleviation and is proposed as a potential tool for reducing the welfare impact on the beef animal in routine husbandry procedures.

The effect of a topical anesthetic on the sensitivity of calf dehorning wounds.

The objective was to determine the effect of a topical local anesthetic on the sensitivity of dehorning wounds in calves. Thirty 2-mo-old Holstein-Friesian calves were randomly allocated to sham dehorning control (CON), scoop dehorning without treatment with topical anesthetic (SnoTA), or scoop dehorning with an application of a topical anesthetic (STA). Sensitivity was measured by providing mechanical stimulation to the dehorned wound and peri-wound area using von Frey monofilaments calibrated at 10 and 300 g. Calf responses were categorized as absent, minor, moderate, or severe. Sensitivity measurements were performed before treatment and at various time points up to 24h posttreatment. Sham dehorned calves displayed unchanging absent or minor responses to stimulation. Regardless of whether topical anesthetic was applied, scoop dehorned calves were more likely to display minor, moderate, or severe responses than sham dehorned control calves, and responses tended to be most extreme at 4h postdehorning. Calves in the STA group tended to be less likely to display minor, moderate, or severe responses than calves in the SnoTA group at most time points (exception at 4h postdehorning). Responses were significantly more likely to be less severe in STA calves than in SnoTA calves at 40 min and 1.5h following dehorning. Thus, the use of the topical anesthetic for calves reduced the short-term sensitivity of scoop dehorning wounds.

Duration of action of a topical anaesthetic formulation for pain management of mulesing in sheep.

OBJECTIVE: To investigate the effect of topical anaesthesia on 'mothering up' of lambs after mulesing and marking, and for pain alleviation over a 24-h period. DESIGN: Two separate trials were performed on Merino lambs undergoing the mules procedure for flystrike prevention, to assess the efficacy of immediate postoperative topical anaesthetic wound dressing containing lignocaine (hydrochloride) 40.6 g/L, bupivacaine (hydrochloride) 4.5 g/L, adrenaline (tartrate) 24.8 mg/L and cetrimide 5.0 g/L in a gel base (Bayer Animal Health, Gordon, NSW, Australia). METHODS: In both trials, lambs were assigned to one of three treatment regimens: control, mules procedure with topical anaesthetic (0.5 mL/kg) and mules procedure without topical anaesthetic treatment. Parameters measured included body weight, assessment of skin and wound sensitivity to light touch and pain stimulation, behavioural responses and time to mother up and to feed. RESULTS: In both trials there was rapid (1 min) and prolonged (up to 24 h) wound analgesia as shown by lower scores for light touch (P<0.001) and pain responses (P<0.001), with absent or significantly diminished primary and secondary hyperalgesia (P≤0.05) and significant reduction in pain-related behaviours (P<0.001) in treated versus untreated lambs. CONCLUSION: Significant pain alleviation and improved recovery can be achieved in lambs for at least 24 h after mulesing through the use of topical anaesthesia. It is suggested that the haemostatic action of adrenalin, together with inhibition of the inflammatory cascade and the barrier effect of the gel within the product, may explain the prolonged anaesthesia up to 24 h observed in the present study. These results suggest that topical anaesthesia has the capacity to dramatically improve the welfare of lambs undergoing mulesing.

Use of sugammadex in a 'can't intubate, can't ventilate' situation.

A 78-yr-old woman presented for a panendoscopy to investigate dysphonia and dysphagia. Intubation was anticipated to be difficult but possible, and mask ventilation was anticipated to be possible. After induction of anaesthesia and after three attempts at intubation, a 'can't intubate, can ventilate' situation deteriorated to a 'can't intubate, can't ventilate' (CICV) situation. Rocuronium-induced neuromuscular block was successfully reversed with sugammadex, as evidenced by the restoration of diaphragmatic movement, the ability of the patient to move her limbs, and the presence of a train-of-four nerve stimulation with no fade; however, ventilation was still not possible. A cricothyroid puncture using a Ravussin needle was performed successfully to provide emergency oxygenation. A tracheostomy was performed to allow the panendoscopy. CICV situations are rare anaesthetic emergencies. While sugammadex can be relied upon to reverse rocuronium-induced neuromuscular block, it should not be relied upon to rescue all CICV events, especially where airway instrumentation has led to airway swelling. The availability of sugammadex does not obviate the need for emergency tracheal access in the event of failed oxygenation. The presence of head and neck pathology should lead to the consideration of securing the airway awake.

Nasotracheal fibreoptic intubation: a randomised controlled trial comparing the GlideRite® (Parker-Flex® Tip) nasal tracheal tube with a standard pre-rotated nasal RAE™ tracheal tube.

In a randomised controlled study, we compared the ease of railroading a GlideRite® nasal tracheal tube over a fibrescope with that of a pre-rotated RAE™ nasal tracheal tube. We studied 110 anaesthetised patients with no known airway difficulties undergoing elective dental or maxillofacial surgery. Impingement was more common with the GlideRite tubes (11/55 (20%)) compared with the pre-rotated RAE tubes (3/55 (5%); p=0.02). The median (IQR [range]) time to intubation (GlideRite 7.6 (4.7-10.8 [3.0-46.2]) s; RAE 8.0 (6.2-10.7 [2.4-30.0]) s) and postoperative sore throat numerical ratings (GlideRite 2 (0-3 [0-10]); RAE 2 (0-5 [0-8])) were similar. A 90° anticlockwise pre-rotation of a standard nasal RAE tube has a higher initial rate of successful railroading at first attempt and is therefore superior to a GlideRite nasotracheal tube during nasal fibreoptic intubation.

Topical anaesthesia alleviates short-term pain of castration and tail docking in lambs.

OBJECTIVE: To investigate the effect of a topical anaesthetic formulation on pain alleviation, wound healing and systemic levels of local anaesthetic actives in lambs undergoing castration and tail docking. DESIGN: Three placebo-controlled and/or randomised experiments were conducted using three groups of Merino lambs (n = 62, 68 and 19) undergoing routine castration and tail docking. PROCEDURE: Surgical castration, with either surgical or hot-iron tail docking, was performed with and without the application of topical anaesthetic (Tri-Solfen) or placebo. The effects of this procedure were compared with those of rubber ring castration and tail docking, and of the handled but unmarked controls. Wound pain was assessed using calibrated Von-Frey monofilaments over a 4-h period, pain-related behaviour was assessed over 5 h, wound healing was assessed at 14 and 28 days, and the plasma levels of lignocaine and bupivacaine were determined. RESULTS: Rapid and up to 4 h primary hyperalgesia developed following surgical castration and tail docking in the untreated and placebo-treated lambs. It was absent in the castration wounds, and significantly reduced in the tail-docking wounds, of the treated lambs. Hot-iron docking was associated with mild and transient secondary hyperalgesia, which was abolished by the topical anaesthesia. There was a significant reduction in pain-related behaviours in treated lambs, which were not significantly different in their behaviour to the sham-operation handled controls. Plasma lignocaine and bupivacaine levels were below the toxic thresholds in all tested lambs. CONCLUSION: Topical anaesthesia alleviates wound pain and significantly reduces pain-related behaviours in lambs undergoing surgical castration plus surgical or hot-iron tail docking, without a negative effect on wound healing or a risk of systemic toxicity.

Clinical effectiveness of a brief educational intervention in Type 1 diabetes: results from the BITES (Brief Intervention in Type 1 diabetes, Education for Self-efficacy) trial.

AIMS: Intensive 5-day educational interventions for people with Type 1 diabetes have shown improved outcomes in a number of European studies. The aim was to assess the effectiveness of a brief (2.5 days) psycho-educational intervention. METHODS: Our randomized trial in a secondary-care setting had 54 and 60 participants allocated to intervention and control groups, respectively. Primary outcomes were HbA1c and severe hypoglycaemia. Secondary outcomes were blood pressure, weight, height, lipids and psychometric profile. RESULTS: HbA1c showed no statistically significant change at 3 months [difference = 0.01, 95% confidence interval (CI) -0.23, 0.26, P = 0.92], 6 months (difference = -0.06, 95% CI -0.32, 0.20, P = 0.67) and 12 months (difference = 0.01, 95% CI -0.30, 0.32, P = 0.94). Incidence of severe hypoglycaemia (per patient per year) in the intervention group (0.41) and control group (0.48) was not statistically different. Treatment satisfaction improved at 3 months (difference = 9.4, 95% CI 5.2, 13.6, P = 0.0005), 6 months (difference = 10.4, 95% CI 6.0, 14.8, P = 0.0005) and 12 months (difference = 7.1, 95% CI 2.1, 12.1, P = 0.006). The 'Managing psychological aspects' and 'Setting and achieving goals' dimensions of the Diabetes Empowerment Scale also showed significant improvement at 3, 6 and 12 months. Diabetes Knowledge Test, Illness Perception Questionnaire, Hypoglycaemia Fear Scale and Short Form 36 showed no significant change. CONCLUSIONS: This brief intervention had no significant impact on HbA(1c) or severe hypoglycaemia, but improved diabetes treatment satisfaction and patient empowerment. Current Controlled Trials ISRCTN75807800.

Impact of topical anaesthesia on pain alleviation and wound healing in lambs after mulesing.

OBJECTIVE: To investigate the impact of using the topical anaesthetic preparation Tri-Solfen on pain alleviation and wound healing in lambs undergoing mulesing. DESIGN: Three separate trials, placebo controlled and/or randomised, were carried out over a 5 month period on three mobs of between 60 and 263 merino lambs undergoing routine mulesing. PROCEDURE: Wound pain was assessed using 10 and 75 g calibrated Von-Frey monofilaments to determine sensitivity to light touch and pain stimulation over a 4 to 8 h period. Pain-related behaviour was documented by trained, blinded observers using a numerical rating scale. Wound healing rates were determined using scaled digital photography and image analysis software to calculate contraction in wound surface area 2 and 4 weeks after mulesing. RESULTS: There was rapid (3 min) and prolonged (up to 8 h) wound analgesia as shown by pain response scores (P < or = 0.01), with absent or significantly diminished primary and secondary hyperalgesia (P < or = 0.01) and significant reduction in pain-related behaviour (P < 0.001) in treated versus untreated lambs. In addition there was improved wound healing in the treated lambs (P < or = 0.05). CONCLUSION: Tri-Solfen effects rapid and prolonged wound analgesia, reduction in pain-related behaviour and improved wound healing in lambs undergoing routine mulesing, providing effective alleviation of pain associated with routine mulesing in sheep.

Unusually early onset of post-dural puncture headache after spinal anaesthesia using a 27G Whittacre needle.

We present a case of a post-dural puncture headache occurring 20 min after spinal anaesthesia using a 27-Gauge Whittacre needle. The unusually early occurrence of this complication is thought to be the first of its kind reported in the literature and highlights the novelty of this case.