A survey of animal poisonings in New Zealand veterinary practices: perceptions of incidence and frequency of poisoning cases.

AIMS: To survey New Zealand veterinary practices on the incidence and frequency of animal poisonings encountered over a 1-year period. METHODS: A national questionnaire-based cross-sectional online survey was made available to all members of the New Zealand Veterinary Association, active as of 2010, via an email supplying a link to the questionnaire. Veterinary practices listed by the Veterinary Council of New Zealand were also contacted via email or phone. Respondents entered their information on the online survey site or provided a hard copy of their responses, which were then entered by the authors into the database. The questionnaire contained a mixture of tick box options and short answer questions. Responses were analysed using descriptive statistics. RESULTS: Of 463 veterinary practices deemed eligible to complete the survey, 120 (25.9%) responded to the survey. However, only 94 (78.3%) questionnaire entries (78.3%) were deemed adequate for analysis. Veterinary practices (45 mixed practices, 38 companion animal-only practices, nine large animal practices, and two equine-only practices) from 14/16 regions of New Zealand were represented. All respondents affirmed that in the last 12 months, cases of suspected poisoning in animals were attended by veterinarians at their practices and estimated a total of 5,326 poisoning cases. The subcategories most commonly associated with estimated cases of poisoning were pasture mycotoxins (2,133/5,326; 40%), anticoagulant rodenticides (753/5,326; 14.1%), plants (469/5,326; 8.8%), slug/snail baits (305/5,326; 5.7%) and chocolate (221/5,326; 4.1%). Except for anticoagulant rodenticides (once a month), and slug/snail baits, human prescription or over-the-counter drugs, and chocolate (once a year), the majority of respondents reported toxicants caused poisonings seasonally or infrequently. CONCLUSIONS: A variety of poisons were encountered with environmental toxins and household pest control agents being the most common cause of poisoning for animals attended by veterinarians in New Zealand. Most cases of poisoning in animals occurred seasonally or infrequently. Further research is needed to determine the actual number of animals poisoned, the affected species, and the seasons when poisoning occurs in New Zealand. CLINICAL RELEVANCE: : This report provides baseline information on cases of poisoning in animals in New Zealand which could be used for case management, prevention through client education, and poisoning risk assessment.

European Space Agency experiments on thermodiffusion of fluid mixtures in space.

This paper describes the European Space Agency (ESA) experiments devoted to study thermodiffusion of fluid mixtures in microgravity environment, where sedimentation and convection do not affect the mass flow induced by the Soret effect. First, the experiments performed on binary mixtures in the IVIDIL and GRADFLEX experiments are described. Then, further experiments on ternary mixtures and complex fluids performed in DCMIX and planned to be performed in the context of the NEUF-DIX project are presented. Finally, multi-component mixtures studied in the SCCO project are detailed.

Urine retention in cattle putatively associated with injection of an ivermectin and closantel anthelmintic formulation into the ischiorectal fossa.

CASE HISTORY: A group of 39, 19-22-month-old Friesian bulls were administered an ivermectin/closantel anthelmintic via intended S/C injection in the ischiorectal fossa on 15 June 2017 (Day 0). Over the next 50 days, 22 affected bulls presented various degrees of anorexia, abdominal pain and urine dribbling. Seventeen bulls were examined by transrectal ultrasonography which revealed urinary bladder distension in all 17, and peritoneal fluid accumulation in some. Overall, eight bulls died or were subjected to euthanasia. On-farm postmortem examination of three bulls revealed urinary bladder rupture. CLINICAL FINDINGS: On Day 50 one affected live bull was admitted to Massey University for further investigation. This bull continuously dribbled urine and had an overtly distended urinary bladder as determined by rectal palpation and ultrasonography. PATHOLOGICAL FINDINGS: Postmortem examination of this bull revealed a markedly distended urinary bladder, massive subcapsular and pericapsular renal oedema with retroperitoneal fluid accumulation, minimal hydronephrosis and no evidence of mechanical urinary outflow obstruction. The right ischiorectal fossa contained multifocal areas of tissue fibrosis that extended into areas innervated by the distal cutaneous branch of the pudendal nerve and the pelvic nerve. Histopathological changes consisted of extensive fibrosis, myonecrosis and neurodegeneration, and evidence of granulation tissue and inflammation at the putative injection site and in surrounding tissues. DIAGNOSIS: A local inflammatory reaction at the presumed injection site together with localised peripheral neurodegeneration and myelopathy may have led to detrusor-sphincter dyssynergia causing urine retention. CLINICAL RELEVANCE: These cases of urine retention and bladder rupture in cattle were of putative iatrogenic origin. Veterinarians should be aware of this rare complication after S/C injections in the ischiorectal fossa.

Impacto del número de episodios diarios de incontinencia de urgencia en los resultados descritos por el paciente con vejiga hiperactiva / Impact of daily number of urgency urinary incontinence episodes on overactive bladder patient reported outcomes

Objetivo: Explorar el impacto de la incontinencia urinaria de urgencia (IUU) en el bienestar de los pacientes no institucionalizados con vejiga hiperactiva (VH) en una muestra de la comunidad. Métodos: Se llevó a cabo un estudio transversal basado en Internet en la población general, incluyendo hombres y mujeres, >18 años de edad. Los pacientes con probable VH se identificaron utilizando un algoritmo validado junto con una puntuación ≥8 en la escala OAB-V8. La presencia de comportamiento de adaptación se consideró determinante para el diagnóstico clínico de la VH. Se determinó bienestar individual a través de una batería de mediciones de resultados comunicados por el paciente (PRO) incluida la evaluación de la calidad de vida relacionada con la salud (EQ-5D), alteraciones del sueño (sueño MOS) y satisfacción con la vida (LISAT-8). Los pacientes fueron agrupados de acuerdo con el número de episodios diarios de IUU (gravedad IUU): 0 (VH seca), 1, 2-3 o ≥4. Se realizó un análisis multivariado para evaluar los factores que afectan de forma independiente la calidad de vida. Resultados: Un total de 396 pacientes (52,5% mujeres, media de edad: 55,3 [11,1] años, OAB-V8 puntuación media: 14,5 [7,9]) de 2.035 sujetos participantes de la población general cumplieron los criterios de VH: 203 (51,3%) con 0 episodios; 119 (30,1%) con 1; 52 (13,1%) con 2 o 3 y 22 (5,6%) con >4 episodios. Se encontró una asociación ajustada lineal estadísticamente significativa entre el número de episodios de IUU y las puntuaciones de PRO. Los participantes con más episodios tenían peores perfiles de salud y calidad de autoevaluación de la vida, peor satisfacción con la vida, más trastornos del sueño y menos horas de sueño por noche. El número de episodios de incontinencia fue factor independiente para afectar a la calidad de vida utilizando los cuestionarios LISAT-8 y MOS. Conclusión: La gravedad de la IUU se asoció significativamente con peor bienestar individual en los sujetos con VH en una muestra comunitaria en España

Objective: To explore the impact of urgency urinary incontinence (UUI) on well-being in non-institutionalized patients with overactive bladder (OAB) in a community sample. Methods: A cross-sectional web-based study was conducted in the general population, including males and females, >18 years of age. Patients with probable OAB were identified using a validated algorithm together with a score ≥8 on the OAB-V8 scale. Presence of coping behavior was considered determinant for the clinical diagnosis of OAB. Individual well-being was determined through a battery of patient-reported outcomes (PRO) measurements including assessment of health-related quality of life (EQ-5D), sleep disturbances (MOS Sleep), and life satisfaction (LISAT-8). Patients were grouped according to the number of daily UUI episodes (UUI severity): 0 (dry OAB),1, 2-3, or ≥4. Multivariate analysis to evaluate factors independently affecting quality of life was undertaken. Results: A total of 396 patients (52.5% women, mean age: 55.3 [11.1] years, OAB-V8 mean score: 14.5 [7.9]) out of 2035 subjects participating from the general population met the criteria for OAB: 203 (51.3%) with 0 episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with ≥4 episodes. A statistically significant linear adjusted association was found between number of UUI episodes and PRO scores. Participants with more episodes had poorer health profiles and self-evaluated quality of life, worse life satisfaction, and more sleep disturbances and fewer hours of sleep per night. Number of incontinence episodes was independent factor to affect quality of life using both LISAT-8 and MOS questionnaires. Conclusion: Severity of UUI was significantly associated with poorer individual well-being in subjects with OAB in a community sample in Spain

Impact of daily number of urgency urinary incontinence episodes on overactive bladder patient reported outcomes.

OBJECTIVE: To explore the impact of urgency urinary incontinence (UUI) on well-being in non-institutionalized patients with overactive bladder (OAB) in a community sample. METHODS: A cross-sectional web-based study was conducted in the general population, including males and females, >18 years of age. Patients with probable OAB were identified using a validated algorithm together with a score ≥8 on the OAB-V8 scale. Presence of coping behavior was considered determinant for the clinical diagnosis of OAB. Individual well-being was determined through a battery of patient-reported outcomes (PRO) measurements including assessment of health-related quality of life (EQ-5D), sleep disturbances (MOS Sleep), and life satisfaction (LISAT-8). Patients were grouped according to the number of daily UUI episodes (UUI severity): 0 (dry OAB),1, 2-3, or ≥4. Multivariate analysis to evaluate factors independently affecting quality of life was undertaken. RESULTS: A total of 396 patients (52.5% women, mean age: 55.3 [11.1] years, OAB-V8 mean score: 14.5 [7.9]) out of 2035 subjects participating from the general population met the criteria for OAB: 203 (51.3%) with 0episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with ≥4 episodes. A statistically significant linear adjusted association was found between number of UUI episodes and PRO scores. Participants with more episodes had poorer health profiles and self-evaluated quality of life, worse life satisfaction, and more sleep disturbances and fewer hours of sleep per night. Number of incontinence episodes was independent factor to affect quality of life using both LISAT-8 and MOS questionnaires. CONCLUSION: Severity of UUI was significantly associated with poorer individual well-being in subjects with OAB in a community sample in Spain.

Sedative and mechanical hypoalgesic effects of butorphanol in xylazine-premedicated donkeys.

REASONS FOR PERFORMING STUDY: Combinations of α2 -adrenoceptor and opioid agonists are commonly used in equids, but little scientific information is available on donkeys. OBJECTIVES: To compare the sedative and hypoalgesic effects of xylazine alone or in combination with different dosages of butorphanol in donkeys. STUDY DESIGN: Placebo-controlled, operator-blinded, randomised, crossover, Latin square study. METHODS: Six donkeys received intravenous normal saline and normal saline (NS-NS); xylazine (0.5 mg/kg bwt) and normal saline (X-NS); xylazine and 10 µg/kg bwt butorphanol (X-B10); xylazine and 20 µg/kg bwt butorphanol (X-B20); xylazine and 30 µg/kg bwt butorphanol (X-B30); and xylazine and 40 µg/kg bwt butorphanol (X-B40). Sedation scores (SS), head height above ground (HHAG) and mechanical nociceptive thresholds (MNT) were assessed before and for 120 min after treatment. Areas under the curve (AUC) values for 0-30, 30-60 and 60-120 min were computed for SS, HHAG and MNT. As appropriate, differences between treatments were analysed using the Friedman test followed by Dunn's test and a repeated measures one-way analysis of variance followed by Tukey's test; significance was set at P<0.05. RESULTS: All treatments apart from NS-NS induced sedation. Butorphanol treatments induced significantly larger SS-AUC0 -30 values than those for NS-NS (P<0.05). Compared to corresponding NS-NS values, HHAG-AUC0 -30 values were significantly smaller for all other treatments (P<0.001) and HHAG-AUC30-60 values were significantly smaller for X-B40 (P<0.05). Compared to NS-NS, all treatments induced mechanical hypoalgesia and yielded significantly larger MNT-AUC0-30 values (P<0.001). Treatment X-NS yielded significantly smaller MNT-AUC0 -30 values than those for X-B30 and X-B40 (P<0.05). Only MNT-AUC30 -60 values for X-B30 and X-B40 were significantly larger than those for NS-NS and X-NS (P<0.05). CONCLUSIONS: Sedation and mechanical hypoalgesia induced by xylazine were enhanced by butorphanol at 40 µg/kg bwt. This drug combination may be suitable for chemical restraint of donkeys undergoing certain clinical procedures.

La severidad de la vejiga hiperactiva modifica la carga asistencial y la productividad laboral / The Effect of Hyperactive Bladder Severity on Healthcare Utilization and Labor Productivity

Objetivo: Explorar la relación entre la severidad de la incontinencia urinaria de urgencia (IUU) y la utilización de recursos sanitarios o la pérdida de productividad laboral en pacientes con vejiga hiperactiva (VH) en la población general española. Métodos: Análisis secundario de un estudio transversal realizado por vía telemática (Internet) en la población general, > 18 años, mediante una batería de preguntas relacionadas con el uso de recursos sanitarios y la productividad laboral. Los sujetos con probable VH fueron identificados mediante un algoritmo previamente validado. Las preguntas sobre el uso de recursos sanitarios abarcaron la medicación concomitante, el empleo de absorbentes y las visitas médicas. Los pacientes se agruparon según el número de episodios de IUU en: 0, 1, 2-3 o 4 +. Resultados: De un total de 2.035 sujetos participantes de la población general se identificaron 396 pacientes (52,5% mujeres, edad media [DE] 55,3 [11,1] años, puntuación media en OAB-V8: 14,5 [7,9]), con probable VH: 203 (51,3%) con 0 episodios, 119 (30,1%) con uno, 52 (13,1%) con 2-3 y 22 (5,6%) con 4 +. Se observó una relación lineal significativa, de manera que a mayor número de episodios de IUU mayor uso de recursos sanitarios. Los sujetos con más episodios realizaron con mayor frecuencia visitas médicas, tanto de asistencia primaria (p < 0,001) como al especialista (p = 0,009) y emplearon mayor cantidad de absorbentes tanto en horario diurno (p < 0,001) como nocturno (p < 0,001) de ansiolíticos (p = 0,021) y de antibióticos (p = 0,05). Conclusión: La severidad de la incontinencia urinaria de urgencia, según el número diario de episodios de incontinencia de urgencia, mostró una relación lineal significativa con un uso más frecuente de recursos sanitarios y una disminución en la productividad laboral en pacientes con probable VH en España

Objective: To explore the relationship between the severity of urinary urge incontinence (UUI) on healthcare resources utilization (HRU) and loss of labor productivity of subjects with overactive bladder (OAB) in the general population in Spain. Methods: Secondary analysis of a cross-sectional web-based study conducted in the general population >18 years, through a battery of HRU questions asked using an online method. Probable OAB subjects were identified using a previously validated algorithm and a score > 8 in the OAB-V8 questionnaire. HRU questions included an assessment of concomitant medication used as a consequence of OAB/UUI, pad utilization, and medical office visits. Patients were grouped according to the number of UUI episodes into 0, 1, 2-3 or 4 + episodes. Results: Of a total of 2,035 subjects participating from the general population, 396 patients [52.5% women, mean age: 55.3 (11.1) years, OAB-V8 mean score: 14.5 (7.9)] were analyzed; 203 (51.3%) with 0 episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with 4 or more episodes. A linear and significant adjusted association was observed between the number of UUI episodes and HRU; the higher the number of daily episodes the higher the HRU. Subjects with more episodes had medical visits more frequently at the primary care (P = 0.001) and specialist (P = 0.009) level as well. Consumption of day (P < 0.001) and night (P < 0.001) urinary absorbents, anxiolytic medicines (P = 0.021) and antibiotics (P = 0.05) was higher in patients with more UUI episodes. Conclusion: The severity of OAB in terms of frequency of daily urge incontinence episodes was significantly and linearly associated with higher healthcare resources utilization and a decrease in labor productivity in subjects with probable OAB in Spain

Beneficio terapéutico tras cambiar tolterodina por otros nuevos antimuscarínicos / Therapeutic benefit in patients switching tolterodine to other novel antimuscarinic agents

Objetivos: Explorar en la práctica clínica diaria el beneficio clínico y del paciente conseguido tras cambiar su primer tratamiento para la vejiga hiperactiva (VH) con tolterodina de liberación prolongada (LP), por otro antimuscaríninico de última generación. Materiales y métodos: Análisis post hoc de un estudio observacional, multicéntrico retrospectivo y transversal. Se incluyeron pacientes adultos de ambos sexos, con VH y puntuación OAB-V8 ≥ 8, con respuesta insuficiente al tratamiento previo con tolterodina LP sustituido por fesoterodina o solifenacina en los 3-4 meses previos. Se seleccionaron 92 pacientes para cada grupo de tratamiento, emparejados (1:1) según probabilidad condicionada utilizando el propensity score. Se valoraron el beneficio del cambio percibido por el médico y el paciente mediante las escalas de Impresión clínica global de mejoría (ICG-M) y del Beneficio del tratamiento (TBS) respectivamente. También se analizaron el grado de preocupación, la molestia y el impacto en la vida diaria de la VH, el grado de satisfacción y la preferencia por la medicación actual. Resultados: Fesoterodina proporcionó una mejora significativamente mayor que solifenacina en cuanto a beneficio terapéutico percibido por el médico según la ICG-M. El 96,7% de los pacientes tratados con fesoterodina vs. 81,6% con solifenacina mostraron una puntuación de mejoría en la TBS (p < 0,05). La fesoterodina también resultó mejor valorada que la solifenacina en cuanto a la satisfacción y preferencia por el nuevo tratamiento (93,4 vs. 78,2%, p < 0,05). Conclusiones: En la práctica clínica diaria el cambio de tolterodina LP a fesoterodina parece proporcionar mayores beneficios tanto desde el punto de vista del médico como del paciente, comparado con el que aporta solifenacina

Objectives: To explore in the daily clinical practice setting that antimuscarinic, Fesoterodine or Solifenacin, provides a greater clinical benefit after changing their prior Overactive Bladder (OAB) therapy with tolterodine extended-release (ER) to other novel antimuscarinic agents. Material and methods: A post-hoc analysis of data from an observational multicenter, cross sectional, retrospective study. Adult patients of both sexes, with OAB and OAB-V8 score≥8, who switched to fesoterodine or solifenacin within the 3-4 months before study visit from their priortolterodine-ER-based therapy due to poor response were included. 92 patients were selected for each treatment group, matched (1:1) according to conditioned probability using the propensity score. Benefit of treatment change perceived by the physician and patient was evaluated by means of the Clinical Global Impression of Improvement subscale (CGI-I) and Treatment Benefit Scale (TBS), respectively. Degree of worry, bother and interference with daily living activities due to urinary symptoms, level of satisfaction, and preference for current treatment were also assessed. Results: Fesoterodine provided a significantly greater improvement than solifenacina in terms of therapeutic benefit perceived by the physician according to ICG-I. 96.7% of the patients on fesoterodine treatment vs. 81.6% of the solifenac in group showed a score of improvementin TBS (P < 0.05). Fesoterodine was also better rated than solifenacin with regard to satisfaction and preference for the new treatment (93.4 vs. 78.2% P < 0.05). Conclusions: In daily clinical practice the switch from tolterodine LP to fesoterodine seems to provide greater benefits both from the physician’s and the patient’s point of view compared with those provided by solifenacin

The effect of hyperactive bladder severity on healthcare utilization and labor productivity.

OBJECTIVE: To explore the relationship between the severity of urinary urge incontinence (UUI) on healthcare resources utilization (HRU) and loss of labor productivity of subjects with overactive bladder (OAB) in the general population in Spain. METHODS: Secondary analysis of a cross-sectional web-based study conducted in the general population >18 years, through a battery of HRU questions asked using an online method. Probable OAB subjects were identified using a previously validated algorithm and a score >8 in the OAB-V8 questionnaire. HRU questions included an assessment of concomitant medication used as a consequence of OAB/UUI, pad utilization, and medical office visits. Patients were grouped according to the number of UUI episodes into 0, 1, 2-3 or 4+ episodes. RESULTS: Of a total of 2,035 subjects participating from the general population, 396 patients [52.5% women, mean age: 55.3 (11.1) years, OAB-V8 mean score: 14.5 (7.9)] were analyzed; 203 (51.3%) with 0 episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with 4 or more episodes. A linear and significant adjusted association was observed between the number of UUI episodes and HRU; the higher the number of daily episodes the higher the HRU. Subjects with more episodes had medical visits more frequently at the primary care (P = .001) and specialist (P = .009) level as well. Consumption of day (P < .001) and night (P < .001) urinary absorbents, anxiolytic medicines (P = .021) and antibiotics (P = .05) was higher in patients with more UUI episodes. CONCLUSION: The severity of OAB in terms of frequency of daily urge incontinence episodes was significantly and linearly associated with higher healthcare resources utilization and a decrease in labor productivity in subjects with probable OAB in Spain.

Therapeutic benefit in patients switching tolterodine to other novel antimuscarinic agents.

OBJECTIVES: To explore in the daily clinical practice setting that antimuscarinic, Fesoterodine or Solifenacin, provides a greater clinical benefit after changing their prior Overactive Bladder (OAB) therapy with tolterodine extended-release (ER) to other novel antimuscarinic agents. MATERIAL AND METHODS: A post-hoc analysis of data from an observational multicenter, cross-sectional, retrospective study. Adult patients of both sexes, with OAB and OAB-V8 score≥8, who switched to fesoterodine or solifenacin within the 3-4 months before study visit from their prior tolterodine-ER-based therapy due to poor response were included. 92 patients were selected for each treatment group, matched (1:1) according to conditioned probability using the propensity score. Benefit of treatment change perceived by the physician and patient was evaluated by means of the Clinical Global Impression of Improvement subscale (CGI-I) and Treatment Benefit Scale (TBS), respectively. Degree of worry, bother and interference with daily living activities due to urinary symptoms, level of satisfaction, and preference for current treatment were also assessed. RESULTS: Fesoterodine provided a significantly greater improvement than solifenacina in terms of therapeutic benefit perceived by the physician according to ICG-I. 96.7% of the patients on fesoterodine treatment vs. 81.6% of the solifenacin group showed a score of improvement in TBS (P<.05). Fesoterodine was also better rated than solifenacin with regard to satisfaction and preference for the new treatment (93.4 vs. 78.2% P<.05). CONCLUSIONS: In daily clinical practice the switch from tolterodine LP to fesoterodine seems to provide greater benefits both from the physician's and the patient's point of view compared with those provided by solifenacin.

Comparison of the mechanical hypoalgesic effects of five α2-adrenoceptor agonists in donkeys.

Pharmacological pain management is necessary under many clinical situations, but in donkeys little information on analgesic drugs is available. This controlled, randomised, crossover, Latin-square, operator-blinded study aimed to assess and compare the hypoalgesic effects of intravenously administered saline and five α2-adrenoceptor agonists on mechanical nociceptive thresholds (MNT) in donkeys. Areas under the threshold change versus time curve values for 0-30, 30-60, 60-90 and 90-120 minutes postdrug administration were used to compare the effect of treatment. As compared with saline, which did not increase MNT, the overall degree of mechanical hypoalgesia induced by xylazine (1.1 mg/kg), detomidine (20 µg/kg), medetomidine (5 µg/kg) and dexmedetomidine (3.5 µg/kg) was limited to 0-60 minutes, and that of romifidine (100 µg/kg) to 0-120 minutes. Although there were no significant differences between the five α2-adrenoceptor agonists during the first 30 minutes postadministration, hypoalgesia induced by xylazine and dexmedetomidine was significantly less intense than that achieved by detomidine and/or romifidine from 30 to 60 minutes. Differences in the overall degree of hypoalgesia induced by each of the α2-adrenoceptor agonists may influence veterinary surgeons towards choosing a particular drug over others for a particular donkey patient.

Use of analgesic drugs for pain management in sheep.

Awareness of pain and its effects is increasing within the veterinary profession, but pain management in food animals has been neglected. Sheep seldom receive analgesics despite various conditions, husbandry practice and experimental procedures being known to be painful, e.g. footrot, mastitis, vaginal prolapse, castration, vasectomy, penis deviation, and laparoscopy. The evidence supporting use of analgesic drugs in this species is reviewed here. Opioid agonists are of dubious efficacy and are short acting. α2-agonists such as xylazine are good, short-lived analgesics, but induce hypoxaemia. Non-steroidal anti-inflammatory drugs (NSAID) such as ketoprofen provide long-lasting analgesia, but not as marked as that from α2-agonists; they should be more widely used for inflammatory pain. Local anaesthetics reliably block pain signals, but may also induce motor blockade. Balanced analgesia using more than one class of drug, such as an α2 agonist (e.g. medetomidine) and N-methyl-D-aspartate antagonist (e.g. ketamine), with the combination selected for the circumstances, probably provides the best analgesia for severe pain. It should be noted that there are no approved analgesic drugs for use in sheep and therefore the use of such drugs in this species has to be off-label. This information may be useful to veterinary practitioners, biomedical researchers, and regulators in animal welfare to develop rational analgesic regimens which ultimately may improve the health and welfare of sheep in both farming and experimental conditions.

Efficacy of tropicamide, homatropine, cyclopentolate, atropine and hyoscine as mydriatics in Angora goats.

AIM: To document the efficacy of five commercially available mydriatics for their potential for diagnostic and therapeutic use in Angora goats. METHODS: Over 8 weeks, the mydriatic effects of 1% tropicamide, 2% homatropine, 1% cyclopentolate, 1% atropine and 0.25% hyoscine were evaluated. Given as block treatments, drugs were applied randomly to one eye of 10 Angora goats, and the contralateral eye served as a control. Vertical and horizontal pupil diameters were measured to document onset of effect, time to reach a difference of 5 mm in the vertical/horizontal pupil diameter between eyes, time to maximum pupillary dilation, and duration of mydriatic action. RESULTS: Onset of mydriasis for all drugs occurred within 15 minutes. Time to reach a difference of 5 mm in the vertical pupil diameter between eyes was shortest for 1% tropicamide and 0.25% hyoscine (0.5 h), then 2% homatropine and 1% atropine (0.75 h), and longest for 1% cyclopentolate (1.5 h). The maximum vertical pupillary dilation occurred earliest with 1% tropicamide and 1% atropine (2 h), followed by 0.25% hyoscine (3 h), 2% homatropine (4 h), and latest with 1% cyclopentolate (8 h). The duration of vertical dilation of the pupil was shortest with 1% tropicamide (6 h), then 2% homatropine (12 h), 1% cyclopentolate (12 h), 1% atropine (24 h), and longest for 0.25% hyoscine (96 h). The time to reach maximum horizontal dilation of the pupil in treated eyes was shortest with 1% cyclopentolate (1 h), followed by 1% tropicamide (1.5 h), 0.25% hyoscine (3 h), 2% homatropine (3.5 h), and 1% atropine (4 h). The duration of horizontal pupil dilation was shortest with 1% tropicamide (4.5 h), and longest with 0.25% hyoscine (48 h). CONCLUSION: All five mydriatics induced clinical dilation. Tropicamide (1%) had the shortest duration of effect, but gave incomplete dilation. Good dilation was achieved with 1% cyclopentolate and 2% homatropine, but took too long to reach maximum dilation for routine mydriasis. The largest vertical dilation of the pupil was achieved with 1% atropine and 0.25% hyoscine, but pupils remained dilated for more than 24 h. CLINICAL RELEVANCE: For routine mydriasis in goats, it is recommended that 1% tropicamide be used, though there may be incomplete dilation. For a longer duration of mydriasis, such as in the treatment of anterior uveitis, 1% atropine or 0.25% hyoscine would be the drugs of choice.

[Assessment of reasons for overactive bladder treatment change]. / Evaluación de los motivos del cambio de tratamiento para la vejiga hiperactiva.

OBJECTIVES: although efficacious, some patients do not respond optimally to overactive bladder (OAB) treatment. The objective of this study was to identify the reasons why some patients do not respond and to look for reasons for changes in treatment and patient satisfaction with the new treatment. MATERIALS AND METHODS: epidemiological, cross-sectional, non-interventional study to determine the reasons for OAB treatment switching and satisfaction with such OAB treatment switch. OAB patients (OAB-V8≥8), 18 years or more, who had modified their treatment during the previous 3-4 months, were recruited. Demographic data, symptoms, previous, current and concomitant treatments, reasons for treatment switch, clinical global impression (CGI) on disease severity and symptom improvement, Morinsky Green questionnaire, satisfaction with treatment, treatment preference and treatment benefit scale (TBS) were compared. RESULTS: out of 3,365 successive patients, 2,038 (61%) were eligible (61.1±11.2 years; 77% women). The physician decided to switch in 69% of the cases and 31% of patients asked for a change in treatment. Reasons for switching were lack of clinical benefit (60%), side effects (24%), patients' request (8%), non-compliance (6%) and other (2%). 52% of patients complied with new treatment. According to the CGI, 65.4% showed improvement with respect to their previous treatment. 60% were quite/very satisfied with current treatment, 91% preferred it to their previous treatment and 93% reported that their symptoms had improved. CONCLUSIONS: the lack of clinical benefit is the main reason for changing OAB treatment. Most of the patients that switched prefer their new treatment.

Evaluación de los motivos del cambio de tratamiento para la vejiga hiperactiva / Assessment of reasons for overactive bladder treatment change

Objetivos: aunque el tratamiento de la vejiga hiperactiva (VH) es eficaz, muchos pacientes no responden, por lo que interesa estudiar los motivos de cambio de tratamiento y la satisfacción del paciente con el nuevo tratamiento. Material y métodos: estudio epidemiológico, transversal, no intervencionista para determinar los motivos del cambio de tratamiento en VH y la satisfacción con dicho cambio. Se reclutaron pacientes con VH (OAB-V8 ≥ 8), de ambos sexos, mayores de 18 años, que habían modificado su tratamiento en los 3-4 meses previos. Se recogieron datos demográficos, síntomas, tratamiento previo, actual y concomitante, motivo del cambio, impresión clínica global (ICG) de gravedad y de mejoría, cuestionario Morinsky Green, satisfacción con el tratamiento, preferencia del mismo y la escala del beneficio del tratamiento (TBS). Resultados: de 3.365 pacientes reclutados, 2.038 (61%) fueron evaluables (61,1±11,2 años; 77% mujeres). El médico solicitó el cambio de tratamiento en un 69% y el paciente en un 31% por motivos de falta de beneficio clínico (60%), efectos secundarios (24%), petición del paciente (8%), incumplimiento terapéutico (6%) y otros (2%). El 52% de los pacientes cumplió con el nuevo tratamiento. Según ICG, el 65,4% presentó mejoría respecto al tratamiento anterior. Un 60% de los pacientes se mostró bastante/muy satisfecho con el tratamiento actual, un 91% lo prefirió al previo y un 93% opinó que sus síntomas habían mejorado. Conclusiones: la falta de beneficio clínico es el principal motivo del cambio de tratamiento de la VH. La mayoría de los pacientes prefieren el nuevo tratamiento (AU)

Objectives: although efficacious, some patients do not respond optimally to overactive bladder (OAB) treatment. The objective of this study was to identify the reasons why some patients do not respond and to look for reasons for changes in treatment and patient satisfaction with the new treatment. Materials and methods: epidemiological, cross-sectional, non-interventional study to determine the reasons for OAB treatment switching and satisfaction with such OAB treatment switch. OAB patients (OAB-V8≥8), 18 years or more, who had modified their treatment during the previous 3-4 months, were recruited. Demographic data, symptoms, previous, current and concomitant treatments, reasons for treatment switch, clinical global impression (CGI) on disease severity and symptom improvement, Morinsky Green questionnaire, satisfaction with treatment, treatment preference and treatment benefit scale (TBS) were compared. Results: out of 3,365 successive patients, 2,038 (61%) were eligible (61.1±11.2 years; 77% women). The physician decided to switch in 69% of the cases and 31% of patients asked for a change in treatment. Reasons for switching were lack of clinical benefit (60%), side effects (24%), patients’ request (8%), non-compliance (6%) and other (2%). 52% of patients complied with new treatment. According to the CGI, 65.4% showed improvement with respect to their previous treatment. 60% were quite/very satisfied with current treatment, 91% preferred it to their previous treatment and 93% reported that their symptoms had improved. Conclusions: the lack of clinical benefit is the main reason for changing OAB treatment. Most of the patients that switched prefer their new treatment (AU)

Synergistic depression of NMDA receptor-mediated transmission by ketamine, ketoprofen and L-NAME combinations in neonatal rat spinal cords in vitro.

BACKGROUND AND PURPOSE: Spinal N-methyl-D-aspartate (NMDA) receptor/cyclooxygenase (COX) and nitric oxide synthase (NOS) pathways play a major role in nociceptive processing, and influencing them simultaneously may induce synergistic analgesia. This study determined the spinal antinociceptive interactions between ketamine (NMDA receptor channel blocker), ketoprofen (COX inhibitor) and L-NAME (NOS inhibitor) combinations. EXPERIMENTAL APPROACH: Using an in vitro neonatal rat spinal cord preparation, two A-fibre-mediated reflexes, the monosynaptic reflex (MSR) and the low-intensity excitatory postsynaptic potential (epsp), and one C-fibre-mediated reflex, the high-intensity epsp, were evoked electrically. The effect of drugs and drug combinations on these reflexes was assessed and the type of interaction determined by isobolographic analysis. KEY RESULTS: Infusion of ketamine alone decreased all three reflexes. That of ketoprofen decreased both the low and the high-intensity epsp only. Infusion of L-NAME alone produced no significant effects. Co-infusion of fixed ratios of IC(40) fractions of both (ketamine+ketoprofen) and (ketamine+L-NAME) were synergistic for depressing the low and the high-intensity epsps. The interaction was sub-additive for both combinations on the MSR. The only significant effect for the (ketoprofen+L-NAME) combination was synergism on the high-intensity epsp. CONCLUSIONS AND IMPLICATIONS: All three combinations synergistically depressed nociceptive spinal transmission, and both ketamine and ketoprofen and ketamine and L-NAME combinations did so with potentially decreased motor side effects. If such combination profiles also occur in vivo, the present findings raise the possibility of ultimate therapeutic exploitation of increased analgesia with fewer side effects.

Developmental changes in threshold, conduction velocity, and depressive action of lignocaine on dorsal root potentials from neonatal rats are associated with maturation of myelination.

Conduction velocity of primary afferent fibres and blocking actions of local anaesthetics seem to be developmentally regulated. The current work investigated physiological (threshold, conduction velocity, and myelination) and pharmacological (lignocaine (0.0625 to 2 mmol/L) and capsaicin (2 micromol/L)) ontogenic changes on in vitro sciatic nerve-dorsal root preparations from 0- to 12-day-old rats. As rats aged, stimulus intensities necessary to evoke A-fibre thresholds significantly decreased and A-fibre conduction velocities significantly increased. For C-fibres, thresholds significantly increased and conduction velocities significantly varied with age. The blocking potency of lignocaine varied with age: A-fibres from 4-day-old rats and younger were significantly more resistant than those from older rats, and C-fibres were blocked more uniformly amongst ages. Capsaicin significantly depressed C-fibres irrespective of age, and A-fibres were significantly reduced during the first postnatal week only. Myelination significantly increased as rats aged. A-fibre physiological parameters were significantly correlated with both other A-fibre physiological and pharmacological parameters, but C-fibre parameters were not. Peripheral A-fibre transduction mechanisms seem to require time to acquire their full stimulus-response sensitivity, which coincides with development of myelination. In contrast, peripheral C-fibres seem to have mature transduction mechanisms from the first days of postnatal life.

The stress caused by laparoscopy in sheep and its alleviation.

AIM: To determine the plasma cortisol response to laparoscopy in ewes and investigate means of reducing it. METHODS: Ewes without lambs at foot (n=40) were subjected to one of three control or one laparoscopy treatments (n=10 ewes/treatment), being: no restraint or drugs; acepromazine maleate (ACP) control and no restraint; ACP and restraint in a cradle for 5 min; and laparoscopy following ACP. Additional ewes with lambs at foot (n=30) were subjected to: laparoscopy following ACP; laparoscopy following ACP and ketoprofen; and laparoscopy following detomidine. Drugs were injected 20 min before treatment, after a first blood sample had been taken. Blood samples were taken by jugular venepuncture from the ewes 20 min before treatment and at 20, 40, 60, 90, 120, 150 and 180 min after treatment, while all ewes were held in a pen. Plasma was harvested and assayed for its concentration of cortisol. RESULTS: Plasma cortisol concentrations (PCC) remained constant in ewes in the control restraint group for 80 min. In ewes given ACP, PCC increased for the first 20 min after treatment but then returned to pre-treatment concentrations. PCC of ewes given ACP and restrained in a cradle were elevated above pre-treatment concentrations for 90 min. PCC in ewes subjected to laparoscopy following sedation with ACP increased to a peak at 40 min and returned to pre-treatment concentrations after 60 (with lambs) or 120 (without lambs) min. When ACP and ketoprofen were given before laparoscopy, PCC peaked at 20 min and returned to pre-treatment concentrations by 40 min. PCC of ewes given detomidine before laparoscopy remained at pre-treatment concentrations throughout. PCC of ewes subjected to laparoscopy with ACP sedation only were greater than those of control restraint, ACP control, and ewes subjected to laparoscopy after being given ketoprofen or detomidine between 20 and 60 min after treatment. PCC of ewes subjected to laparoscopy were greater than those of control ewes placed in a cradle at 20 and 40 min. PCC of ewes given ketoprofen were lower than those of ewes subject to laparoscopy following ACP. CONCLUSIONS: Laparoscopy, even after sedation with ACP, caused some distress in ewes, as evidenced by increased plasma cortisol levels. Plasma cortisol response was alleviated by the administration of ketoprofen and eliminated by detomidine, probably because of both analgesic and sedative effects of the latter drug.