Effects of phenylbutazone, firocoxib, and dipyrone on the diuretic response to furosemide in horses.

BACKGROUND: Treatment with phenylbutazone (nonselective COX inhibitor) decreases the diuretic and natriuretic effects of furosemide by nearly 30% but the effects of COX-2 specific inhibitors (firocoxib) and atypical NSAIDs (dipyrone) are unknown. HYPOTHESIS: Furosemide-induced diuresis after pretreatment with firocoxib or dipyrone is diminished to a lesser extent than after pretreatment with phenylbutazone. ANIMALS: Eight healthy mares. METHODS: Each mare received 4 treatments in a prospective experimental crossover study using a replicated 4 × 4 Latin Square design: furosemide alone (FU), furosemide and phenylbutazone (PB), furosemide and firocoxib (FX), and furosemide and dipyrone (DP). After 24 hours of NSAID treatment at recommended dosages, ureteral catheters were placed for continual urine collection. After a 30-minute baseline collection period, furosemide (1.0 mg/kg, IV) was administered, and urine and blood samples were collected for 4 hours. Data were assessed by repeated measures ANOVA. RESULTS: Four-hour urine volume was (mean ± SD) ~25% less (P < .001) after pretreatment with all NSAIDs (PB 19.1 ± 2.1 mL/kg, FX 17.7 ± 3.5 mL/kg, DP 19.1 ± 3.9 mL/kg), as compared to FU (23.4 ± 5.1 mL/kg) (P < .001), but there were no differences between PB, FX, or DP. Interindividual variability in furosemide diuresis after pretreatment with different NSAIDs was observed. CONCLUSIONS AND CLINICAL IMPORTANCE: Though COX-2 selective NSAIDs and dipyrone might have less severe or fever gastrointestinal adverse effects in horses, our data suggest minimal differences in effects on furosemide-induced diuresis, and possibly, risk of nephrotoxicosis.

The Impact of Extracurricular Surgical Experience on Veterinary Students' Performance of Canine Ovariohysterectomy and Orchidectomy in a Clinical Skills Curriculum.

Veterinary students may pursue extracurricular surgical experiences before performing ovariohysterectomy or orchidectomy in their veterinary curriculum. We sought to evaluate the impact of these experiences on student confidence and subsequent surgical performance during students' first canine ovariohysterectomy or orchidectomy during their veterinary school curriculum. We enrolled 69 third-year veterinary students to complete pre- and post-operative surveys reporting their confidence to perform surgery and self-assessing their performance. Students had all completed five semesters of surgical skills training on models and cadavers but varied in their participation in extracurricular surgical experiences. A subset of students (n = 27) were digitally recorded while performing ovariohysterectomy (16) or orchidectomy (11). Digital recordings were scored by a blinded rater using task-specific rubrics and a global rating scale, and time to perform the procedure was recorded. The number of extracurricular surgeries students had performed was positively correlated with their confidence to perform orchidectomy (r = .78) but not ovariohysterectomy (r = -.17). There was no correlation between extracurricular surgeries performed and subsequent rubric scores or surgical times for the first ovariohysterectomy (r = -.01 and r = -.14, respectively) or orchidectomy (r = .09 and r = -.18, respectively) performed as part of their veterinary curriculum. Our results suggest that extracurricular surgical experiences may not impart a long-term improvement on performance scores or surgical time during students' first surgery of their veterinary curriculum. Additional research is necessary to clarify how model training and extracurricular surgical experiences on live animals interact to affect students' subsequent surgical performance.