Direct colloid osmometry in healthy New World camelids.

BACKGROUND: Direct colloid osmometry provides an objective assessment of the oncotic effects of crystalloid or colloidal fluid therapy, which is especially useful in monitoring fluid therapy of critically ill camelids due to their tendency toward nonspecific hypoproteinemia with increased risk of developing edema and ascites. OBJECTIVES: The aims of this study were to measure colloid osmotic pressure (COP) of alpacas and llamas, determine its correlation with concentrations of total protein (TP) and total solids (TS), as well as both albumin (A) and globulin (G) concentrations in the same model (A+G), and evaluate the effects of sample type and storage conditions on COP. METHODS: Blood was collected from clinically healthy alpacas (n=23) and llamas (n=22) into heparin tubes. COP of fresh whole blood (COP(FB) ) and plasma (COP(FP) ) was determined using a membrane osmometer. For 20 alpacas, COP of refrigerated whole blood (COP(RB) ) and frozen plasma (COP(FrP) ) was also measured. Correlations between COP(FB) and TS, TP, and A+G concentrations were assessed by simple and multiple regression analysis to model potential predictors. RESULTS: Median COP(FB) from alpacas (24.6 mmHg, range 19.3-28.1) was not significantly different from that of llamas (25.3 mmHg, range 22.5-33.7). Sample type or storage conditions did not affect COP. Measured COP had a strong positive linear correlation with TS, TP, and A+G concentrations in alpacas (r(2) =.7, .74, and .88, respectively). In llamas, COP correlated best with TS concentration (r(2) =.59), whereas correlation with TP and A+G concentrations was poor (r(2) =.19 and .25, respectively). CONCLUSION: COP can be measured using heparinized whole blood or plasma, either fresh or stored. Direct measurement is recommended whenever quantitative knowledge of COP is required in clinical or research setting. Further studies are needed to verify if the poor association of COP with TP found in this study can be generalized to llamas.

Evaluation of the effect of hetastarch and lactated Ringer's solution on plasma colloid osmotic pressure in healthy llamas.

OBJECTIVE: To compare the effects of hetastarch and lactated Ringer's solution (LRS) on plasma colloid osmotic pressure (pCOP) and other hematologic variables in healthy llamas. DESIGN: Prospective crossover study. ANIMALS: 6 healthy female llamas. Procedures-Llamas were administered LRS (45 mL/kg [20.5 mL/lb]) and, after a 3-day washout period, hetastarch (15 mL/kg [6.8 mL/lb]) during 60-minute IV infusions. Serum total protein, serum albumin, and hemoglobin concentrations and Hct were measured before each infusion (baseline), immediately after each infusion was completed (0 hours), and at 2, 4, 8, and 12 hours. The pCOP was measured at baseline and at 0, 2, 4, 8, 12, 24, 36, and 48 hours after each infusion was completed; additional measurements of pCOP were obtained 72 and 96 hours after hetastarch infusion. RESULTS: Hetastarch administration significantly increased mean ± SEM pCOP from 23.5 ± 0.3 mm Hg (baseline) to a peak of 28.4 ± 0.6 mm Hg (12 hours); significant increases in pCOP persisted at 96 hours after hetastarch administration. Administration of LRS significantly decreased albumin and total protein concentrations; in addition, mean ± SEM pCOP decreased from 24.1 ± 0.4 mm Hg (baseline) to 18.0 ± 0.3 mm Hg (0 hours). Hetastarch administration caused more pronounced decreases in Hct (0 hours) and concentrations of hemoglobin (0 hours), albumin (all time points), and total protein (all time points) than did LRS administration. CONCLUSIONS AND CLINICAL RELEVANCE: Hetastarch administration increased pCOP in healthy llamas for 96 hours with no clinically important complications.

Anesthetic potency of sevoflurane with and without nitrous oxide in mechanically ventilated Dumeril monitors.

OBJECTIVE: To determine the minimum alveolar concentration (MAC) of sevoflurane and assess the sevoflurane-sparing effect of coadministration of nitrous oxide in mechanically ventilated Dumeril monitors (Varanus dumerili). DESIGN: Prospective crossover study. ANIMALS: 10 healthy adult Dumeril monitors. PROCEDURE: Anesthesia was induced with sevoflurane in 100% oxygen or sevoflurane in 66% nitrous oxide (N2O) with 34% oxygen, delivered through a face mask. Monitors were endotracheally intubated, and end-tidal and inspired isoflurane concentrations were measured continuously; MAC was determined by use of a standard bracketing technique. An electrical stimulus (50 Hz, 50 V) was delivered to the ventral aspect of the tail as the supramaximal stimulus. A blood sample for blood gas analyses was collected from the ventral coccygeal vessels at the beginning and end of the anesthetic period. An interval of at least 7 days was allowed to elapse between treatments. RESULTS: The MAC +/- SDs of sevoflurane in oxygen and with N2O were 2.51 +/- 0.46% and 1.83 +/- 0.33%, respectively. There was a significant difference between the 2 treatments, and the mean MAC-reducing effect of N2O was 26.4 +/- 11.4%. Assuming simple linear additivity of sevoflurane and N2O, the MAC for N2O was estimated to be 244%. No significant differences in blood gas values--with the predictable exception of oxygen pressure--were detected between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of sevoflurane in Dumeril monitors is similar to that reported for other species. The addition of N2O significantly decreased the MAC of sevoflurane in this species.

Minimum alveolar concentration of isoflurane in mechanically ventilated Dumeril monitors.

OBJECTIVE: To determine minimum alveolar concentration (MAC) of isoflurane in mechanically ventilated Dumeril monitors (Varanus dumerili). DESIGN: Prospective study. ANIMALS: 10 healthy adult Dumeril monitors. PROCEDURE: Anesthesia was induced with isoflurane in oxygen delivered through a face mask. Monitors were endotracheally intubated, and end-tidal and inspired isoflurane concentrations were continuously measured. After equilibration at an end-tidal-to-inspired isoflurane concentration ratio of >0.9 for 20 minutes, an electrical stimulus (50 Hz, 50 V) was delivered to the ventral aspect of the tail for up to 1 minute and the monitor was observed for purposeful movement. End-tidal isoflurane concentration was then decreased by 10%, and equilibration and stimulation were repeated. The MAC was calculated as the mean of the lowest end-tidal isoflurane concentration that prevented positive response and the highest concentration that allowed response. A blood sample for blood gas analysis was collected from the tail vein at the beginning and end of the anesthetic period. RESULTS: Mean +/- SD MAC of isoflurane was 1.54 +/- 0.17%. Mean heart rates at the upper and lower MAC values were 32.4 +/- 3 beats/min and 34 +/- 4.5 beats/min, respectively. During the experiment, PaCo2 decreased significantly from 43.1 mm Hg to 279 mm Hg and blood pH and HCO3 concentration increased significantly from 7.33 to 7.64 and from 25.3 to 32.9 mmol/L, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of isoflurane in Dumeril monitors was similar to that reported in mammals but lower than values reported in other reptiles. This difference may be reflective of the more advanced cardiovascular physiologic features of monitor lizards.

The cardiovascular dose-response effects of isoflurane alone and combined with butorphanol in the green iguana (Iguana iguana).

OBJECTIVE: To assess the cardiovascular effects (arterial blood pressure, heart rate, and metabolic acid-base status) of three doses (MAC multiples) of isoflurane alone and combined with butorphanol in the green iguana (Iguana iguana). STUDY DESIGN: Prospective randomized double-blind, two-period cross-over trial. ANIMALS: Six mature healthy green iguanas (Iguana iguana). METHODS: The iguanas received each of two treatments, saline 0.1 mL kg(-1) (SAL) and butorphanol 1.0 mg kg(-1) (BUT) during isoflurane anesthesia. Treatments were separated by at least 1 week. The iguanas were exposed to each of the three minimum alveolar concentration (MAC) multiples (1.0, 1.5, and 2.0) in random order. Anesthesia was induced with isoflurane and maintained using controlled ventilation. Instrumentation included use of an ECG, airway gas monitor, cloacal thermometer, esophageal pulse oximeter, and the placement of a femoral arterial catheter. Body temperature was stabilized and maintained at 32 degrees C. The treatment was administered, and the animals were equilibrated for 20 minutes at each MAC multiple. At each concentration, the heart rate, blood pressure (systolic, mean, diastolic), end-tidal CO2, and SpO2 were measured. At 1.0 and 2.0 MAC, simultaneous blood samples were drawn from the tail vein/artery complex and femoral catheter for blood gas analysis. Data were analyzed using a two-way analysis of variance for repeated measures looking for differences between treatments and among MAC multiples. RESULTS: There were no significant differences in any of the cardiovascular variables between the treatments. Significant differences among isoflurane MAC multiples were observed for HR, mean, diastolic, and systolic blood pressures. Blood pressure and heart rate decreased with an increasing dose of anesthetic. There were no significant differences between treatments or MAC multiples for any of the blood gas variables. The blood pH, PCO2, HCO3-, and hemoglobin saturation differed significantly between sites. Pulse oximetry values measured from the carotid complex did not correlate with and were significantly different from the calculated hemoglobin saturation values determined using the gas analyzer. CONCLUSION AND CLINICAL RELEVANCE: Cardiovascular depression associated with isoflurane anesthesia in the green iguana is dose dependent. The degree of cardiovascular depression was not significantly different when isoflurane was combined with butorphanol. This finding suggests that the pre-emptive or intraoperative use of butorphanol is unlikely to be detrimental to cardiovascular function. Butorphanol may be a useful anesthetic adjunct to isoflurane anesthesia in the green iguana.

Minimum alveolar concentration of isoflurane in green iguanas and the effect of butorphanol on minimum alveolar concentration.

OBJECTIVE: To determine minimum alveolar concentration (MAC) of isoflurane in green iguanas and effects of butorphanol on MAC. DESIGN: Prospective randomized trial. ANIMALS: 10 healthy mature iguanas. PROCEDURE: in each iguana, MAC was measured 3 times: twice after induction of anesthesia with isoflurane and once after induction of anesthesia with isoflurane and IM administration of butorphanol (1 mg/kg [0.45 mg/lb]). A blood sample was collected from the tail vein for blood-gas analysis at the beginning and end of the anesthetic period. The MAC was determined with a standard bracketing technique; an electrical current was used as the supramaximal stimulus. Animals were artificially ventilated with a ventilator set to deliver a tidal volume of 30 mL/kg (14 mL/lb) at a rate of 4 breaths/min. RESULTS: Mean +/- SD MAC values during the 3 trials (2 without and 1 with butorphanol) were 2.0 +/- 0.6, 2.1 +/- 0.6, and 1.7 +/- 0.7%, respectively, which were not significantly different from each other. Heart rate and end-tidal partial pressure of CO2 were also not significantly different among the 3 trials. Mean +/- SD heart rate was 48 +/- 10 beats/min; mean end-tidal partial pressure of CO2 was 22 +/- 10 mm Hg. There were no significant differences in blood-gas values for samples obtained at the beginning versus the end of the anesthetic period. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the MAC of isoflurane in green iguanas is 2.1% and that butorphanol does not have any significant isoflurane-sparing effects.

The cardiac anesthetic index of isoflurane in green iguanas.

OBJECTIVE: To determine the cardiac anesthetic index (CAI) of isoflurane in green iguanas and whether butorphanol affected the CAI. DESIGN: Prospective randomized controlled trial. ANIMALS: 7 healthy mature iguanas. PROCEDURE: In 5 iguanas, CAI was determined after induction of anesthesia with isoflurane alone, and in 5 iguanas, CAI was determined after induction of anesthesia with isoflurane and IM administration of butorphanol (1 mg/kg [0.45 mg/lb]). Three iguanas underwent both treatments. Animals were equilibrated for 20 minutes at 1.5 times the minimum alveolar concentration (MAC) of isoflurane and observed for evidence of cardiovascular arrest. If there was no evidence of cardiovascular arrest, end-tidal isoflurane concentration was increased by 20%, and animals were allowed to equilibrate for another 20 minutes. This process was repeated until cardiovascular arrest occurred or vaporizer output could no longer be consistently increased. The CAI was calculated by dividing the highest end-tidal isoflurane concentration by the MAC. RESULTS: None of the iguanas developed cardiovascular arrest and all survived. Mean +/- SD highest end-tidal isoflurane concentration during anesthesia with isoflurane alone (9.2 +/- 0.60%) was not significantly different from mean concentration during anesthesia with isoflurane and butorphanol (9.0 +/- 0.43%). The CAI was > 4.32. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the CAI of isoflurane in green iguanas is > 4.32 and not affected by administration of butorphanol. Isoflurane appears to be a safe anesthetic in green iguanas.