Total intravenous anesthesia with midazolam, ketamine, and xylazine or detomidine following induction with tiletamine, zolazepam, and xylazine in red deer (Cervus elaphus hippelaphus) undergoing surgery.

Sixteen captive female red deer were successfully anesthetized to surgically implant a telemetry system. The deer were immobilized with (mean±SD) 1.79±0.29 mg/kg xylazine and 1.79±0.29 mg/kg tiletamine/zolazepam given intramuscularly with a dart gun. Anesthesia was maintained for 69±2 min using a total intravenous protocol with a catheter placed in the jugular vein. Group X received xylazine (0.5±0.055 mg/kg/hr) and group D, detomidine (2±0.22 µg/kg/hr), both in combination with ketamine (2±0.02 mg/kg/hr) and midazolam (0.03±0.0033 mg/kg/hr), as a constant rate infusion. Anesthesia was reversed with 0.09±0.01 mg/kg atipamezole and 8.7±1.21 µg/kg sarmazenil given intravenously in both groups. These drug combinations provided smooth induction, stable anesthesia for surgery, and rapid recovery. Respiratory depression and mild hypoxemia were seen, and we, therefore, recommend using supplemental intranasal oxygen.

A novel simulation model for minimally invasive spine surgery.

OBJECTIVE: Minimally invasive spine surgery (MISS) is among the fastest growing technologies in general neurosurgical practice. In addition, great demand exists to teach these skills to neurosurgery residents. With newly enforced work hour restrictions, opportunities to acquire these skills are limited, necessitating development of alternative strategies of education. We describe a novel simulation model for MISS supplemented by resident self-assessment analysis and evaluation. METHODS: The simulator was constructed using a nontransparent Plexiglas frame supplemented with a modified halo frame on which to affix spine specimens. Interchangeable copper tubing was affixed to a 360-degree pivot system to replicate a working portal. Deer skulls and spines were then collected and prepared accordingly. Laboratory exercises were based on the resident's level of training with emphasis on proper drilling techniques. Eight neurosurgery residents were asked to complete the exercises and complete a self-assessment survey regarding their competence level on a scale of 0 to 5, both before and after completing the skill sets. Additionally, they were asked to complete an exit survey that was used to assess the simulation exercises. RESULTS: All exercises were completed successfully with the exception of placing 2 separate pedicle screws through the same portal, which posed difficulty on some specimens because of the of lack of lordosis of the specimens, leading to unfavorable trajectories using a free-hand technique. With regard to the resident self-assessment analysis, the mean confidence rating for performing an MISS laminectomy improved by a difference of 1.25 points (n = 8; 95% confidence interval, 0.66-1.84; P = 0.0015), from 2.50 to 3.75 before and after simulation exercises, respectively, and reached statistical significance. For the senior-level residents, the mean confidence rating for performing MISS placement of pedicle screws using a free-hand technique improved by a difference of 1.00 (n = 3; 95% confidence interval, -1.48-3.48; P = 0.225), from 3.33 to 4.33 before and after simulation exercises, respectively. Results of the exit survey were encouraging. CONCLUSION: The MISS simulator is a feasible, inexpensive, and reproducible adjunct to neurosurgery resident training and provides a new teaching method for spine surgery. Further investigation of this technology is warranted, although multicenter, randomized, controlled trials assessing its validity may not be practical because of ethical constraints with regard to patient safety.

Carotid artery exteriorization in brown brocket deer (Mazama gouazoubira) for an experimental study of anesthesia.

This report evaluates the carotid artery exteriorization technique to allow repeated percutaneous artery catheterization in six brown brocket deer (Mazama gouazoubira). Repeated percutaneous catheterization of the carotid artery was possible for periods of 3 mo to obtain arterial blood and monitor arterial blood pressure of deer without risk of arterial rupture. The artery pulse was easily palpable for periods up to 15 mo. Postoperative complication and/or arterial damage was not observed.

Assessment of the production of analgesia induced by application of a rubber ring or local anaesthetic to the antler pedicle of yearling stags.

AIMS: To compare two methods of applying rubber rings to the pedicles of yearling stags to induce analgesia in the antler prior to removal. To compare the application of a rubber ring with that of a lignocaine ring block of the antler pedicle on the efficacy and time course of the analgesia produced in yearling stags. METHODS: Rubber rings were applied to the pedicles of 36 yearling stags that required velvet antler removal. The standard method, a doubled-over ring expanded and lowered down from the distal end of the antler and released midway down the pedicle, was compared with a cable-tie method on the other pedicle, where a ring was pulled around the pedicle by an electrical cable tie threaded through the ring. Brief electrical stimulation (train-of-four mode) was applied proximal and distal to the ring before, and at regular intervals for 1 hour after, application of the ring to a level that produced an auriculopalpebral reflex response. In a second experiment, each pair of antlers per yearling stag (n=36) was allocated to one of three pairs of treatments, viz no treatment (control) and the cable-tie method as described above, control and local anaesthesia (a ring block of 2 ml 2% lignocaine per cm pedicle circumference), or the cable-tie method and local anaesthesia. Electrical stimulation (tetanic mode) was applied to each antler approximately 25 mm distal to the pedicle/antler junction before, and at intervals up to 1 hour after, application of treatments at a level required to produce a head/neck avoidance behavioural response. In a third experiment, the two electrical stimulation protocols used above were directly compared by measuring the response of stags (n=8) to one protocol on each pedicle/antler prior to, and at intervals for 1 hour after, application of a rubber ring. At the end of each treatment in all three experiments, analgesia of the antler was established as a nil behavioural response of the stag to a saw cut to the antler (the 'nick test'). RESULTS: For both methods of application of a ring the minimum electrical stimulation required distal to the ring to elicit a reflex response increased from around 16 to 55 mA by 60 minutes. In contrast, the electrical stimulation required proximal to the ring remained low (approximately 17.0 mA) throughout. No stag subjected to either of the methods of application responded to the nick test 60 minutes after application of the ring. The electrical stimulation required to produce a behavioural response increased very rapidly in stags treated with local anaesthetic and at a slower rate in those treated with the cable-tie method but showed no significant increase in control stags. After 4 and 30 minutes, for local anaesthesia and the cable-tie method, respectively, 95% of stags were not responding to 80 mA. A significantly greater proportion of stags with antlers treated with local anaesthetic and the cable-tie method did not respond to the nick test than controls, and there was no significant difference in the frequency of the response between stags with treated antlers. The minimum current required to produce a response proximal to a rubber ring was slightly higher on average for train-of-four electrical stimulus (mean 18.1 (SD 2.6) mA) than for the tetanic mode (mean 11.9 (SD 2.5) mA). The increase in minimum current required to produce the respective response to stimulation distal to the ring was similar for both methods, although the maximum predicted value (67.4 mA) was lower for train-of-four than for the tetanic mode (84.5 mA). No stag responded to the nick test > or = 60 minutes after application of the ring. CONCLUSIONS: The cable-tie method was no different from the standard method as a procedure for producing analgesia in the antlers of yearling stags and should be accepted as an appropriate procedure for applying analgesic rings to yearling stags. The analgesia produced in the antlers of yearling stags by rubber rings applied by the cable-tie method to the pedicle was similar to that of a lignocaine ring block, but the time course for the development of analgesia was markedly different. Given that a lignocaine ring block is accepted as an adequate method of pain relief for antler removal, the application of rubber rings followed by a period of > or = 30 minutes after application can be advocated as a viable alternative for pain relief.

Surgical technique for tubal ligation in white-tailed deer (Odocoileus virginianus).

Surgical tubal ligation was used to sterilize urban free-ranging white-tailed deer (Odocoileus virginianus) as a methodology of a larger study investigating the influences of intact, sterile females on population dynamics and behavior. Deer were either trapped in clover traps (n = 55) and induced with an i.m. injection of xylazine and tiletamine/zolazepam or induced by a similar protocol by dart (n = 12), then intubated and maintained on isoflurane in oxygen. Over 3 yr, individual female deer (n = 103) were captured in Highland Park, Illinois, with a subset of females sterilized using tubal ligation by ventral laparotomy (n = 63). Other sterilization procedures included tubal transection by ventral (n = 1) or right lateral (n = 2) laparoscopy and ovariohysterectomy by ventral laparotomy (n = 1). One mortality (1/ 67, 1.5%) of a doe with an advanced pregnancy was attributed to a lengthy right lateral laparoscopic surgery that was converted to a right lateral laparotomy. The initial surgical modality of laparoscopy was altered in favor of a ventral laparotomy for simplification of the project and improved surgical access in late-term gravid does. Laparotomy techniques included oviductal ligation and transection (n = 14), application of an oviductal mechanical clip (n = 9), ligation and partial salpingectomy (n = 40), and ovariohysterectomy (n = 1). As of 2 yr poststerilization, no surgical does were observed with fawns, indicating that these procedures provide sterilization with low mortality in urban white-tailed deer.

Anesthesia of male axis deer (Axis axis): evaluation of thiafentanil, medetomidine, and ketamine versus medetomidine and ketamine.

Thiafentanil oxalate, previously known as A-3080, is a synthetic opioid used for chemical immobilization of a variety of nondomestic hoofstock species. This study compared the combination of thiafentanil oxalate, medetomidine, and ketamine (TMK; 0.09 +/- 0.02 mg/kg, 0.01 +/- 0.003 mg/kg, and 1.36 +/- 0.33 mg/kg, respectively) with the combination of medetomidine and ketamine (MK; 0.09 +/- 0.02 mg/kg and 3.48 +/- 0.55 mg/kg, respectively) for anesthetization of 17 captive male axis deer (Axis axis) for vasectomy. Nine deer received TMK and eight deer received MK via projectile syringe during the months of January and February, 2005. Mean induction and arousal times, vital signs, and arterial blood gas values were monitored and compared. All animals received supplemental oxygen during the surgical procedure. Animals receiving TMK were reversed with naltrexone (100 mg/mg thiafentanil) and atipamazole (5 mg/mg medetomidine). Animals receiving MK were reversed with atipamazole (5 mg/mg medetomidine). Two MK animals and three TMK animals required supplementation with ketamine i.v. immediately upon handling. Six of the nine animals immobilized with TMK required intubation for positive-pressure ventilation. Two of these six animals also required isoflurane to maintain anesthesia. Mean induction time was 3.5 +/- 2.0 min in the TMK group, and 9.8 +/- 6.7 min in the MK group. Despite shorter mean induction times, animals anesthetized with TMK experienced unpredictable inductions, apnea, muscle rigidity, limb movement, and significant respiratory and metabolic lactic acidosis. MK resulted in smoother inductions, better respiratory function, and less adverse metabolic disturbances, and thus was considered superior to TMK for anesthesia in captive axis deer at the dosages tested.

Comparison of analgesic techniques for antler removal in halothane-anaesthetized red deer (Cervus elaphus): electroencephalographic responses.

OBJECTIVE: To provide evidence for an analgesic effect of antler pedicle compression or lidocaine 'ring block' by comparing changes in median and spectral edge frequencies and total electroencephalographic (EEG) power during the application of each technique followed by antler removal. ANIMALS: Twenty-nine 2-year-old red deer (Cervus elaphus) stags weighing 106-131 kg each were used in this study. Stags were carrying immature growing antler suitable for commercial harvest. MATERIALS AND METHODS: Anaesthesia was induced using propofol (8.25 +/- 1.28 mg kg(-1)) and ketamine (2.18 +/- 0.15 mg kg(-1)) and maintained with halothane in oxygen. End-tidal halothane (Fe'HAL), expired CO(2) tension (Pe'CO(2)), SpO(2), EEG, ECG, and direct arterial blood pressures were recorded continuously. Respiratory rate and somatic responses were recorded at specific time points. After stabilization of anaesthesia (Fe'HAL was approximately 0.8%) baseline data were recorded. Stags were randomly allocated to one of three treatment groups; control, local anaesthesia, or compression band. One antler was removed 4 minutes after the application of treatment. Electroencephalographic responses to application of treatment and antler removal were analysed using area under the curve (AUC) analysis. Mean AUC was compared between groups using anova, and when significant differences were found, groups were compared post hoc with two-tailed t-tests. Significance levels were set at p

Comparison of analgesic techniques for antler removal in halothane-anaesthetized red deer (Cervus elaphus): cardiovascular and somatic responses.

OBJECTIVE: To compare changes in heart rate and arterial pressures resulting from compression of the antler pedicle or lidocaine 'ring block' and during subsequent antler removal during minimal halothane anaesthesia. ANIMALS: Twenty-nine 2-year-old red deer (Cervus elaphus) stags, weighing 106-131 kg and carrying immature growing antler suitable for commercial harvest were studied. MATERIALS AND METHODS: Anaesthesia was induced using intravenous propofol (median dose 8.0 mg kg(-1), range 5.2-11.0) and ketamine (median dose 2.2 mg kg(-1), range 1.9-2.4) and maintained using halothane in oxygen. End-tidal halothane concentration (Fe'HAL) end-tidal CO(2) tension (Pe'CO(2)), SpO(2), EEG, ECG, and direct systolic (SAP) mean (MAP) and diastolic (DAP) arterial pressures were recorded continuously. Respiratory rate and somatic responses were recorded. Baseline data were recorded once anaesthesia (Fe'HAL approximately 0.8%) was stable. Stags were randomly allocated to control, lidocaine 'ring block' or compression band treatment groups. One antler was removed 4 minutes after treatment. Cardiovascular responses to the application of analgesia and antler removal were analysed using a general estimates equation for repeated measures or area under the curve (AUC) analysis. Mean AUC was compared between groups using anova, and when significant differences were found, groups were compared post hoc with two-tailed t-tests. Somatic response data were compared with Fisher's exact chi-square test. A value of p < 0.05 was considered significant. RESULTS: Heart rate fell during observations in all groups with no significant differences between groups. Arterial pressures in the control and lidocaine groups during treatment and removal were not different from baseline values or from each other. Compression group pressures were significantly higher than baseline during both treatment and removal. Compression group DAP and MAP were significantly higher after antler removal than during treatment. In control and lidocaine groups, the AUC for SAP, DAP, and MAP over the combined baseline, treatment, and removal period did not differ. The compression group AUC for DAP and MAP were significantly greater over the experimental period than both the lidocaine group and control groups. Somatic responses occurred in one animal at lidocaine injection and three at compression application. Somatic responses occurred in eight control animals and two in the compression group at antler removal. More animals responded to antler removal in the control group than in the compression (p = 0.015) or lidocaine (p < 0.001) groups. CONCLUSIONS: Compression of the antler pedicle appears to be noxious. Pedicular compression is a less effective analgesic technique for antler removal compared to 'ring blocks' with lidocaine. CLINICAL RELEVANCE: This study suggests that lidocaine 'ring blocks' are the current technique of choice for antler removal in deer.

Acid-base, blood gas, and physiologic parameters during laparoscopy in the head-down position in white-tailed deer (Odocoileus virginianus).

The objective of this project was to evaluate the acid-base, blood gas, and physiologic parameters of white-tailed deer (Odocoileus virginianus) during laparoscopy in the head-down position. Eleven white-tailed does were captured and then immobilized with xylazine (6 mg/kg i.m.) and ketamine (7 mg/kg i.m.). The deer were intubated orotracheally and maintained with isoflurane in oxygen. The deer were positioned in dorsal recumbency and positive pressure ventilated. Heart rate (HR), arterial blood pressure, end-tidal carbon dioxide concentration (FE/CO2), and CO2 insufflation pressure were recorded every 5 min. Respiratory parameters, plasma electrolytes, and peak inspiratory pressure were measured immediately before tilting deer in the head-down position (45-55 degrees), 5 min after tilting, and immediately before the end of the procedure (while tilted). Butorphanol (0.05 mg/kg i.m.) was administered at the end of the procedure and yohimbine (0.2 mg/kg i.v.) administered before release. The deer weighed 52 kg (28-70 kg) [median (minimum-maximum)]. The peak inspiratory pressure in dorsal recumbency while still horizontal was 25 cm H2O (16-28 cm H2O), which increased to 29 cm H2O (18-46 cm H2O) after tilting (P = 0.02). PaO2, PaCO2, FE/CO2, and pH did not change after tilting in the head-down position or after insufflation. HR did not change during the anesthetic period. Mean arterial pressure did not change after tilting or abdominal insufflation, but decreased by the end of the anesthetic period (approximately 1 hr). Time from intubation to extubation was 117 min (72-170 min) (n = 5) and surgery time was 31 min (17-60 min; n = 10). We conclude that captured white-tailed deer have minimal derangements to acid-base, blood gas, or physiologic parameters during laparoscopy in the head-down position with abdominal insufflation, and thus this procedure may be performed safely in ventilated white-tailed deer.

Comparison of lidocaine and compression for velvet antler analgesia in wapiti.

This research compared ring block lidocaine anesthesia (L) and compression (C) for velvet antler removal in elk. Thirty-two wapiti were given 1 mg/kg body weight of zuclopenthixol acetate. The next day, they were restrained in a hydraulic chute and given either a compression device or a lidocaine ring block on the antler pedicle. Behavioral and physiological responses to treatment application and antler removal were recorded, and blood was collected for cortisol analysis. During application of L and C, increases in mean heart rate and systolic arterial blood pressure were greater in the C treatment group (P < 0.05, and P = 0.05, respectively). When antler was removed, more behavioral responses occurred in the C treatment group (P = 0.02) and its median behavior score was higher (P = 0.03). Mean heart rates increased for both treatment groups when antlers were removed (P < 0.01). It was concluded that application of C may be painful, and that C was not as effective as L for analgesia for velvet antler removal.

Outcome of limb amputations in wapiti: 13 cases (1995-2001).

The object of this investigation was to determine the outcome of limb amputation in wapiti. Medical records of 13 wapiti that underwent limb amputation were reviewed to determine age, weight, sex, injury preceding amputation, limb amputated, amputation location, length of hospital stay, complications, and outcome. Ages ranged from 3 months to 8 years and weights from 70 kg to 280 kg. All animals were female. Eleven animals sustained catastrophic long bone fractures prior to amputation. Five animals had front limb amputations and 8 had hind limb amputations. Of these animals, 1 with a front limb amputaiton and 5 with hind limb amputations survived. Postsurgical inability to stand is associated with hospitalization of > 1 day. Of the 13 wapiti reviewed, 5 with hind limb amputations have produced and reared offspring. Hind limb amputation can be considered a viable alternative to euthanasia when catastrophic orthopedic injuries occur in female wapiti.

Comparison of analgesic techniques for antler removal in wapiti.

The purpose of this research was to compare the effectiveness of ring block anesthesia (LA) and electroanesthesia (A) for antler removal in elk given a long-acting tranquilizer to remove stress from restraint. Thirty-two male wapiti were given 1 mg/kg body weight of zuclopenthixol acetate; the next day, they were restrained in a hydraulic chute, provided with electroanesthesia or a lidocaine ring block, and had their antlers removed. Behavioral response to antler removal was scored. Significantly more (P = 0.032) animals responded to antler removal in the EA group. Heart rates and arterial pressures were measured by a catheter connected to a physiological monitor. Heart rate increased significantly over time with EA, but not with LA. Heart rate increased from baseline significantly more in the EA group immediately prior to antler removal (P = 0.017), immediately post antler removal (P = 0.001), and at 1 min post antler removal (P = 0.037). It was concluded that EA is not as effective a method of anesthesia as is LA for antler removal.

External skeletal fixation for treatment of comminuted fractures in wapiti: 5 cases.

External skeletal fixators were used successfully to treat severely comminuted fractures in 5 wapiti.

Use of a type-III trilateral external skeletal fixation device in three deer with comminuted fractures.

A type-III trilateral external skeletal fixation device was used to repair comminuted fractures of metacarpal and tibial bones in 3 deer. Mean weight of the deer was 25 kg, and mean age was 4 months. Mean interval from application until removal of the device was 6.5 weeks. All deer had complete function of their previously fractured limbs and had minimal complications during healing. Several factors should be considered when choosing a method of repair for wildlife with fractured limbs. Economic constraints and demeanor of the animal may limit the number of options. Analysis of results of our findings indicated that type-III trilateral external skeletal fixation devices can be used for the repair of comminuted fractures in young deer.

Disbudding of red deer stag calves to prevent antler growth.

Red deer stag calves aged five to seven months were disbudded with a standard cattle disbudding iron as a means of preventing antler growth and development. Two sizes of iron, one 2.2 cm in diameter and one 1.5 cm in diameter, were compared at disbudding in November or January. Disbudding in November and January with the 2.2 cm iron had success rates of 97 per cent and 92 per cent, respectively. Treatment with the 1.5 cm iron was less effective at both times. There was no significant difference between the liveweights of the treated groups and a non-disbudded control group at turnout in the spring or at slaughter in November when the stags were 16 months of age.