Transient distal renal tubular acidosis in a dog with gastric-dilatation-volvulus.

A case of distal renal tubular acidosis occurring as a transient complication in a 13-year-old female greyhound dog with gastric-dilatation-volvulus was diagnosed. The acute renal ischemia and inflammatory condition associated with this syndrome could be considered the main underlying mechanisms responsible for the acute, severe, and complicating renal tubular dysfunction.

Acidose tubulaire rénale distale transitoire chez un chien atteint de volvulus et de dilatation gastrique. Un cas d'acidose rénale distale se manifestant comme une complication transitoire chez une chienne Lévrier anglais âgée de 13 ans atteinte de dilatation gastrique-volvulus a été diagnostiqué. L'ischémie rénale aiguë et l'affection inflammatoire associées à ce syndrome pourrait être considérées comme les principaux mécanismes sous-jacents responsables de la dysfonction tubulaire rénale grave et complexe.(Traduit par Isabelle Vallières).

Prevalence of and risk factors for intraoperative gastroesophageal reflux and postanesthetic vomiting and diarrhea in dogs undergoing general anesthesia.

OBJECTIVE: To determine the prevalence of intraoperative gastroesophageal reflux (GER) and postanesthetic vomiting and diarrhea, and to evaluate risk factors associated with these gastrointestinal disorders (GID) in dogs undergoing general anesthesia. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: Two hundred thirty-seven client-owned dogs undergoing general inhalant anesthesia for diagnostic or surgical purposes. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Patient, surgical, and anesthetic variables, and postanesthetic treatments administered in the immediate postanesthesia period were evaluated in relation to GID using univariate and multivariate logistic regression analysis (P < 0.05). Seventy-nine of the 237 (33.4%) dogs developed GID during the perianesthetic period. The prevalences of GER, vomiting, and diarrhea were 17.3%, 5.5%, and 10.5%, respectively. Intraabdominal surgery (P = 0.016; odds ratio [OR] 2.82, 95% confidence interval [CI]: 1.21-6.62), changes in body position (P = 0.003; OR 3.17, 95% CI: 1.47-6.85), and length of anesthesia (P = 0.052; OR 1.006, 95% CI: 1.000-1.013) were associated with GER. Changes in the ventilation mode during surgery (P = 0.011; OR 6.54, 95% CI: 1.8-23.8), length of anesthesia (P = 0.024; OR 1.001, 95% CI: 1.001-1.020), and rescue synthetic colloid support due to hypotension (P = 0.005; OR 6.9, 95% CI: 1.82-26.3) were positively associated with postanesthetic vomiting. On the contrary, dogs that received acepromazine as premedication were significantly less likely (P < 0.019; OR 12.3, 95% CI: 1.52-100) to vomit. Finally, length of anesthesia, changes in body position, changes in ventilation mode, or hypoxemia during the procedure tended to increase the risk (univariate model) of diarrhea during the recovery phase. CONCLUSIONS: GID are common in dogs undergoing general anesthesia. Duration and characteristics of the procedure, anesthetic management, and changes in certain patient variables are significant risk factors for the presence of GID in the perioperative period.

The sedative effects of intramuscular low-dose medetomidine in combination with butorphanol or methadone in dogs.

OBJECTIVE: To compare the sedative effects of an intramuscular (IM) low dose of medetomidine in combination with butorphanol or methadone in dogs. STUDY DESIGN: Prospective, blinded, randomized clinical trial. ANIMALS: Forty-eight healthy adult dogs that required sedation for diagnostic or surgical elective procedures. METHODS: Dogs were sedated IM with medetomidine (2.5 µg kg(-1)) and either butorphanol (0.4 mg kg(-1)) or methadone (0.4 mg kg(-1)). The degree of sedation was assessed every 10 minutes, for 30 minutes, using a numeric descriptive scale. Data on heart rate (HR), respiratory rate, capillary refill time, temperature and response to a toe pinch were recorded. The response to venous catheterization at minute 30 was also evaluated. RESULTS: Both combinations produced moderate to deep sedation with a maximal effect at 20-30 minutes without significant differences in the degree of sedation between the treatments at any studied time-point. HR decreased from minute 10 to minute 30 with both opioid combinations (p<0.05); this reduction did not differ between groups (p>0.05). No differences between groups were detected in any of the other variables. CONCLUSIONS AND CLINICAL RELEVANCE: Combinations of a low dose of medetomidine with butorphanol or methadone, respectively, provide similar degrees of sedation.

Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?

Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia were recorded. Surgical wounds were assessed daily for infection during hospitalisation and follow up information was obtained after discharge. A total of 84 adult horses were included. SSI developed in 34 (40.4%) horses. Multivariate logistic regression showed that PaO2, anaesthetic time and subcutaneous suture material were predictors of SSI (AUC=0.76, sensitivity=71%, specificity=65%). The use of polyglycolic acid sutures increased the risk and horses with a PaO2 value < 80 mm Hg [10.6 kPa] and anaesthetic time >2h had the highest risk of developing SSI (OR=9.01; 95% CI 2.28-35.64). The results of this study confirm the hypothesis that low intraoperative PaO2 contributes to the development of SSI following colic surgery.

Locally administered prostaglandin E2 prevents aeroallergen-induced airway sensitization in mice through immunomodulatory mechanisms.

Prostaglandin E2 attenuates airway pathology in asthmatic patients and exerts a protective effect in antigen-sensitized mice when administered systemically. We aimed to establish the consequences of intranasal PGE2 administration on airway reactivity to aeroallergens in mice and reveal the underlying immunoinflammatory mechanisms. PGE2 was administered either daily during a 10-day exposure to house dust mite (HDM) extracts or for limited intervals. Airway hyperreactivity was measured by whole-body and invasive plethysmography. The phenotypes of lung immune cells and cytokine production were analysed by flow cytometry and ELISA, respectively. Airway hyperreactivity was sustainably reduced only when PGE2 administration was restricted to the initial 5 days of exposure to HDM. Lung inflammation, IL-4 production, and airway mast cell activity were also prevented under this early short-term treatment with PGE2. Interestingly, a Th2 response was already committed on day 5 of exposure to HDM. This was paralleled by GM-CSF and osteopontin upregulation and a decreased number of plasmacytoid dendritic and T regulatory cells, as well as a trend towards reduced IL-10 expression. Local PGE2 administration prevented the increase of airway IL-13 and osteopontin and kept lung plasmacytoid dendritic cell counts close to baseline. GM-CSF and Tregs were unaffected by the treatment. These findings suggest that the protection provided by PGE2 is a result of the modulation of early lung immunomodulatory mechanisms, and possibly a shift in the balance of dendritic cells towards a tolerogenic profile.

Ultrasound guidance for the performance of sciatic and saphenous nerve blocks in dogs.

The aim of this study was to investigate the use of ultrasound (US) guidance to perform sciatic and saphenous nerve blocks in dogs. Five dogs were sedated with medetomidine and butorphanol. A high-resolution US transducer was used to locate the nerves, guide placement of the needle and visualise the perineural injection of lidocaine 2%. Electrostimulation was used to confirm correct placement prior to the sciatic block. Nerve functions were evaluated over a 3 h period following administration of atipamezole. Successful identification of the nerves and the quality of the blocks were recorded. Location of the nerves, complete sensory block of the saphenous nerve, and partial to complete sensory and motor blocks of the sciatic nerve were achieved in all dogs. The resultant US guidance is potentially valuable for blocking the sciatic and saphenous nerves in dogs, although further work will be required to ensure a complete block of the sciatic nerve.