Successful use of lipid emulsion to resuscitate a foal after intravenous lidocaine induced cardiovascular collapse.

BACKGROUND: Lipid emulsion has been reported to be effective for the treatment of local anaesthetic overdoses in rats, dogs and man. OBJECTIVES: To describe the successful treatment of cardiovascular lidocaine toxicity in a foal with intravenous lipid administration. STUDY DESIGN: Observational study: case report. METHODS: An 8-month-old Arabian cross foal was anaesthetised for removal of the right alar fold and nasal plate. Anaesthesia was maintained with isoflurane in oxygen and lidocaine administered with a loading dose followed by a continuous rate infusion (CRI). The anaesthetic period was uneventful and 30 min before expected termination of the procedure lidocaine infusion was stopped. A sudden drop in mean arterial blood pressure was then observed. The ECG signal was lost, the end tidal CO2 tension dropped from 40 to 10 mmHg, corneal reflex was absent and asystole diagnosed. Cardiopulmonary resuscitation manoeuvres were immediately initiated, but epinephrine and atropine were unsuccessfully administered. Lipid emulsion was administered and the heart rate and arterial blood pressure gradually returned to normal. RESULTS: The foal recovered consciousness 3 h later, regained its sternal position, was responsive and 20 h later was able to stand up alone. MAIN LIMITATIONS: It will be necessary to evaluate a greater number of cases to determine the effectiveness of lipids in foals intoxicated with lidocaine. CONCLUSION: Intravenous lipid emulsion may be helpful in the treatment of potentially lethal cardiotoxicity attributable to lidocaine overdose in the foal.

Development of a technique for standing hand-assisted laparoscopic splenectomy in five horses.

OBJECTIVES: To develop an experimental standing hand-assisted laparoscopic splenectomy (HALS) technique, report the associated peri-operative complications and document the short-term surgical outcomes. METHODS AND RESULTS: Five healthy 300-470 kg horses that underwent standing HALS. Spleens of different weights (2.25-7.0 kg) were removed using this technique. The main complication during surgery was difficulty sectioning the gastrosplenic ligament. The postoperative complications included adhesions of the colon to the nephrosplenic ligament stump and incisional discharge in two horses. CONCLUSIONS: Standing HALS is a feasible experimental procedure for medium-sized horses, which avoids rib excision and general anaesthesia, but requires further development.

Intra and postoperative assessment of re-sterilised Ligasure Atlas for orchidectomies in horses: clinical study.

Horses (n=35) underwent orchidectomy in a single institution with a re-sterilised LSA as sole means of haemostasis. During the surgery, the gross quality of the seal, the stickiness of the forceps to the tissues, bleeding/oozing from the stump and the need for a subsequent application in already severed spermatic cord were assessed for haemostasis quality. After surgery, physical parameters (appearance of the mucous membranes, quality of the peripheral pulse, heart rate, respiratory rate, rectal temperature and blood dripping from the incisions), haematology or packed cell volume and total protein were monitored to assess signs of bleeding or any other condition. For cleanliness and asepsis assessment, signs of surgical infection were recorded. Complications during surgery were mild degree of sticking of the LSA forceps to the tissues and dulling of the blade. There was no need to reapply LSA a second time except in one horse. This means a haemostasis complication rate of 2.85 per cent of the horses. No postoperative bleeding was detected. Only two horses with fever had associated signs of surgical site infection. This means an infection rate of 5.71 per cent of the horses.

Endometrial adenocarcinoma and mucometra in a 6-year-old Alaska Malamute dog.

A 6-year-old female Alaska Malamute dog was presented for evaluation of abdominal enlargement referred by a local veterinarian. On the history, the owner complained of chronic abdominal enlargement initiated more than 4 months ago, reduced appetite, occasional vomiting and general dullness. He also complained of greenish mucous intermittent vaginal discharge starting 10 days ago. The bitch was chronically treated with medroxiprogesterone acetate. A laparatomy was performed and fluid in the abdomen was found and aspirated during the surgery. Also a very fluid-filled distended uterus and a mass in the distal part of the left uterine horn were found. The mass was encapsulated by the omentum, but areas of necrosis and calcification were identified. Histopathological diagnosis was endometrial adenocarcinoma.