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Cost-effectiveness analysis applied to the veterinary medicine: The economic value of packed cell value in the prognosis of horse surgical colic
2005
Detilleux, Johann | Serteyn, Didier
peer reviewed | Techniques of cost-effectiveness analyses were applied to determine whether or not it is economically efficient to measure the packed cell volume (PCV) on a colic horse before deciding on abdominal surgery. The effects of this decision of uncertainty on the estimated values of the parameters (probability of survival after surgery, surgery costs, PCV positive predictive value, and length of survival after surgery) were considered along with the monetary values of collecting additional information on those parameters. The effects of uncertainty on the incremental net benefits of each alternative were depicted by tornado diagrams, cost-effectiveness acceptability curves, and posterior probability distributions. The worth of additional information was computed as the expected values of perfect and sampling information. Given previously published results, the best PCV cut-off point to distinguish between survivors and nonsurvivors was at 44%. At this threshold, the most economically effective alternative is to measure PCV before surgery providing the owner is willing to pay less than €672 for each year the horse survives. Uncertainty on probability of survival after surgery largely influenced the decision whether or not to measure the PCV, but one should spend at most €381 in research to reduce this uncertainty. A study of postoperative survival of 500 colic horses would ensure an expected gain of €370 associated with a reduction in uncertainty.
Mostrar más [+] Menos [-]Acute-phase protein profile in horses subjected to different exercise protocols
2019
Assuncao, P. | Barbosa, T. | Yonezawa, L. | Barbosa, L. | Watanabe, M. | Kohayagawa, A. | Schmidt, E.
High-intensity exercise can be associated with the occurrence of muscle injury, as well as the induction of an acute-phase response (APR). The present study aims to investigate the synthesis and profile of serum proteins in horses before and after participating in 2 different exercise protocols and to relate this profile to the presence or absence of muscular injury caused by exercise. Ten purebred Arabian (n = 5) and Criollo (n = 5) horses were subjected to 2 different tests on a treadmill, one consisting of short-duration and rapid-acceleration training (TRA) that was mostly anerobic and the other of long-duration and slow-acceleration training (TLD) that was predominantly aerobic. Blood samples were obtained before the beginning of exercise (T0) and at 6 post-exercise time points: immediately after (T1) and 30 min (T2), 3 h (T3), 12 h (T4), 24 h (T5), and 48 h (T6) after exercise. Hematocrit was determined by the microhematocrit method. Plasma and serum samples were prepared by centrifugation (1500 × g for 5 min) for plasma concentrations of fibrinogen, total serum proteins (TP), sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and creatine-kinase (CK) serum activity. Total protein concentration and CK serum activity were determined in an automated biochemistry analyzer. Fibrinogen was determined by the heat precipitation method in microhematocrit capillary tubes. Estimated concentrations of haptoglobin (Hp) significantly decreased after TRA and estimated concentrations of alpha-1 acid glycoprotein (AGP) significantly increased after both protocols at T2. Albumin increased after the TLD exercise protocol. Changes in hematocrit, haptoglobin, and albumin concentrations in horses subjected to different treadmill exercise protocols are related to a physiological response to hemoconcentration and hemolysis. Increases of AGP in the TLD protocol suggest the release of catecholamines as a response to avoid oxidative damage to tissue.
Mostrar más [+] Menos [-]Effects of a single intravenous bolus injection of alfaxalone on canine splenic volume as determined by computed tomography
2018
Hasiuk, M. M. M. | Garcia-Pereira, F. L. | Berry, C. R. | Ellison, G. W.
The purpose of this study was to evaluate the effects of a single intravenous dose of alfaxalone on canine splenic volume. In 6 adult beagle dogs the splenic volume [mean ± standard error (SE)] was determined by computed tomography to be 0.17 ± 0.02 L before alfaxalone administration and 0.24 ± 0.02 L (P = 0.0091) and 0.23 ± 0.02 L (P = 0.0268) 15 and 30 min, respectively, after alfaxalone administration. Hematocrits (mean ± SE) obtained at the same times were, respectively, 46.3% ± 1.3%, 40.6% ± 1.3% (P = 0.0015), and 41.7% ± 1.3% (P = 0.0057). In conclusion, alfaxalone caused relaxation of the canine splenic capsule and an increase in the splenic volume, along with a decrease in the hematocrit in these dogs.
Mostrar más [+] Menos [-]Oxidative stress, superoxide production, and apoptosis of neutrophils in dogs with chronic kidney disease
2013
Silva, Adriana Carolina Rodrigues Almeida | Almeida, Breno Fernando Martins de | Soeiro, Carolina Soares | Ferreira, Wagner Luis | Lima, Valéria Marçal Félix de | Ciarlini, Paulo César
Oxidative stress is a key component in the immunosuppression of chronic kidney disease (CKD), and neutrophil function may be impaired by oxidative stress. To test the hypothesis that in uremic dogs with CKD, oxidative stress is increased and neutrophils become less viable and functional, 18 adult dogs with CKD were compared with 15 healthy adult dogs. Blood count and urinalysis were done, and the serum biochemical profile and plasma lipid peroxidation (measurement of thiobarbituric acid reactive substances) were determined with the use of commercial reagents. Plasma total antioxidant capacity (TAC) was measured with a spectrophotometer and commercial reagents, superoxide production with a hydroethidine probe, and the viability and apoptosis of neutrophils with capillary flow cytometry and the annexin V-PE system. The plasma concentrations of cholesterol (P = 0.0415), creatinine (P < 0.0001), and urea (P < 0.0001) were significantly greater in the uremic dogs than in the control dogs. The hematocrit (P = 0.0004), urine specific gravity (P = 0.015), and plasma lipid peroxidation (P < 0.0001) were significantly lower in the dogs that were in late stages of CKD than in the control group. Compared with those isolated from the control group, neutrophils isolated from the CKD group showed a higher rate of spontaneous (0.10 ± 0.05 versus 0.49 ± 0.09; P = 0.0033; median ± standard error of mean) and camptothecin-induced (18.53 ± 4.06 versus 44.67 ± 4.85; P = 0.0066) apoptosis and lower levels of superoxide production in the presence (1278.8 ± 372.8 versus 75.65 ± 86.6; P = 0.0022) and absence (135.29 ± 51.74 versus 41.29 ± 8.38; P = 0.0138) of phorbol-12-myristate-13-acetate stimulation. Thus, oxidative stress and acceleration of apoptosis occurs in dogs with CKD, the apoptosis diminishing the number of viable neutrophils and neutrophil superoxide production.
Mostrar más [+] Menos [-]Effect of hematocrit on accuracy of two point-of-care glucometers for use in dogs
2011
Paul, Amanda E.H. | Shiel, Robert E. | Juvet, Florence | Mooney, Carmel T. | Mansfield, Caroline S.
Objective: To determine the effect of Hct on blood glucose readings of dogs obtained by use of 2 point-of-care (POC) blood glucometers and a laboratory analyzer. Animals: 184 dogs, including 139 Greyhounds. Procedures: Venous blood samples collected from 184 dogs with a range of Hcts (measured in EDTA-anticoagulated blood) were immediately analyzed with a handheld glucometer specifically developed for veterinary use and a glucometer developed for use in humans. The remainder of each blood sample was placed in fluoride oxalate tubes, and plasma glucose concentration was measured with a laboratory analyzer. Agreement between results for the POC glucometers and laboratory analyzer and effect of Hct on glucometer accuracy was assessed via regression analysis. Results: Significant differences were detected between results of the glucometers and the reference laboratory analyzer. The Hct affected the correlation between results for the glucometers and the laboratory analyzer. Deviations of the glucometers from the reference interval varied with Hct. The glucometer for veterinary use more closely correlated with the glucose concentration when Hct was within or above its reference interval. The glucometer for use in humans more closely approximated laboratory reference glucose concentrations in anemic dogs. Conclusions and Clinical Relevance: Hct had a relevant impact on the correlation between whole blood and plasma glucose concentrations in dogs. Significant variations between results obtained with the 2 glucometers could be critical when interpreting blood glucose measurements or selecting a POC glucometer for an intensive care setting and precise glycemic control in critically ill dogs.
Mostrar más [+] Menos [-]The use of vascular access ports for blood collection in feline blood donors
2011
Aubert, Isabelle | Abrams-Ogg, Anthony C.G. | Sylvestre, Anne M. | Dyson, Doris H. | Allen, Dana G. | Johnstone, Ian B.
We investigated vascular access ports for feline blood donation. Eight cats were anesthetized for conventional blood collection by jugular venipuncture at the beginning and end of the study. In-between conventional collections, vascular access ports were used for collection with or without sedation every 6 to 8 wk for 6 mo. Ports remained functional except for one catheter breakage, but intermittent occlusions occurred. Systolic blood pressure was lower during conventional collection. Behavioral abnormalities occurred during 3 port collections. Packed red cells prepared from collected blood were stored at 4°C for 25 d and assessed for quality pre- and post-storage. With both collection methods, pH and glucose level declined, and potassium level, lactate dehydrogenase activity and osmotic fragility increased. There were no differences between methods in pre-storage albumin and HCO3− levels, and pre and post-storage hematocrit, lactate dehydrogenase activity, and glucose and potassium levels. Pre-storage pH and pCO2 were higher with conventional collection, and pre- and post-storage osmotic fragility were greater with port collection. One port became infected, but all cultures of packed red cells were negative. Tissue inflammation was evident at port removal. In a second study of conventional collection in 6 cats, use of acepromazine in premedication did not exacerbate hypotension. The use of vascular access ports for feline blood donation is feasible, is associated with less hypotension, and may simplify donation, but red cell quality may decrease, and effects on donors must be considered.
Mostrar más [+] Menos [-]Comparison of the effects of low-molecular-weight and unfractioned heparin in horses
1995
Monreal, L. | Villatoro, A.J. | Monreal, M. | Espada, Y. | Angles, A.M. | Ruiz-Gopegui, R.
Thirty healthy male horses were allotted to 3 groups and treated blindly during 4 days. Group-1 horses received unfractioned calcium heparin (100 IU/kg of body weight, SC, q 12 h). Group-2 horses received a single dose of a low-molecular-weight heparin (50 anti-Xa IU/kg, SC) every morning, and a similar volume of saline solution every evening. Group-3 horses received the vehicle (saline solution), SC, every 12 hours. Citrated and EDTA-anticoagulated blood samples were collected before starting the medication (T-0) and once daily 3 hours after each morning injection (T-3, T-27, T-51, and T-75). The PCV, hemoglobin concentration, RBC and platelet counts, and clotting times (activated partial thromboplastin time and thrombin time) were determined, and a microscopic examination to detect hemagglutination was performed. Plasma concentration of heparin was measured by use of the antifactor Xa activity assay. Bleeding time was determined on the first and fourth days, using a double-template method. The horses given unfractioned heparin had marked agglutination of erythrocytes after the first injection that became more pronounced as treatment progressed. Also, significant decrease in PCV, hemoglobin concentration, and RBC count was observed during treatment. Platelet count was significantly decreased after the first day, and clotting times were significantly prolonged. In contrast to the horses given unfractioned heparin, those given low-molecular-weight heparin did not have any agglutination of erythrocytes during the 4 days of treatment, and there were no significant changes in PCV, hemoglobin concentration, or RBC and platelet counts. Activated partial thromboplastin time increased slightly in the horses given low-molecular-weight heparin, although the values remained within reference range. Both groups of horses achieved adequate concentrations of heparin in plasma for prophylactic purposes, but those given low-molecular-weight heparin achieved those values after the first injection. Bleeding times were not significantly different between heparin-treated horses and horses given saline solution during treatment. We conclude that low-molecular-weight heparin may be used more safely and conveniently in horses, because it does not affect equine erythrocytes, platelets, or clotting and bleeding times.
Mostrar más [+] Menos [-]Alterations in blood viscosity in horses competing in cross country jumping
1994
Sommardahl, C.S. | Andrews, F.M. | Saxton, A.M. | Geiser, D.R. | Maykuth, P.L.
Packed cell volume and plasma total protein (TP), serum albumin (Alb) and globulin (Glb), and plasma ionized calcium (PCa) concentrations, blood viscosity (BV), and plasma viscosity (PV) were measured in 42 horses at rest and after the cross country jumping phase of a horse trial competition. The BV and Pv were determined at 6 shear rates (230, 115, 46, 23, 11.5, 5.75 s 1), using a digital rotational cone and plate microviscometer. A paired t-test was used to determine differences between PCV, TP, Alb, Glb and PCa values at rest and after exercise. The PCV, TP, Alb, and Glb values increased (P < 0.05) in horses after exercise. The PCa concentration decreased (P < 0.05) in horses after exercise. Mean BV and Pv in the 42 horses at rest and after exercise were fitted to an asymptotic function. Significant (P < 0.05) correlation at aH shear rates was seen between BV at rest and PCV, TP, Alb, Glb, and PCa values at rest; and between BV after exercise and PCV, TP, Alb, Glb, and PCa values after exercise. Significant correlation was not seen between PV at rest and TP, Alb, Glb, and PCa at rest, or between PV after exercise and TP, Alb, Glb, and PCa concentrations after exercise at any shear rate.
Mostrar más [+] Menos [-]Altered platelet indices in dogs with hypothyroidism and cats with hyperthyroidism
1993
Sullivan, P. | Gompf, R. | Schmeitzel, L. | Clift, R. | Cottrell, M. | McDonald, T.P.
Changes in platelet indices (platelet count and platelet size) and PCV associated with thyroid disease were studied in 7 dogs with hypothyroidism and 21 cats with hyperthyroidism that were admitted to the veterinary teaching hospital. Compared with control (euthyroid) dogs, dogs with hypothyroidism had higher platelet count (P = 0.003), smaller platelet size (P = 0.01), and lower PCV (P = 0.02). Comparison of the group of hyperthyroid cats with a group of similarly aged, clinically normal cats with normal thyroxine values indicated that the group of hyperthyroid cats had significantly (P = 0.03) higher mean platelet size than did control cats, but differences were not found in mean platelet count or PCV. Results of this investigation indicate that the changes in platelet size reported in human beings with thyroid endocrinopathies also are found in animals so-affected. Although the pathogenesis of platelet abnormalities in animals with thyroid derangement is unclear and likely is multifactorial, the observed relation between platelet and erythrocyte production in this group of dogs is consistent with reports of an inverse relation between thrombocytopoiesis and erythropoiesis in iatrogenically hyperthyroid mice and in mice exposed to hypoxia.
Mostrar más [+] Menos [-]Effects of dietary protein and calorie restriction in clinically normal cats and in cats with surgically induced chronic renal failure
1993
Adams, L.G. | Polzin, D.J. | Osborne, C.A. | O'Brien, T.D.
To determine the effects of long-term dietary protein restriction in cats with chronic renal failure (CRF), 4 healthy adult cats and 7 cats with surgically induced CRF were fed a high-protein (HP, 51.7% protein) diet and 4 healthy adult cats and 7 cats with surgically induced CRF were fed a low-protein (LP, 27.6% protein) diet for 1 year. Cats with induced CRF that were fed the LP diet had reduced serum urea nitrogen concentrations, despite lower glomerular filtration rates, compared with cats with CRF fed the HP diet. Despite five-sixths reduction in renal mass, reduced glomerular filtration rate, and azotemia, 13 of the 14 cats with induced CRF retained the ability to concentrate urine and produced urine with a specific gravity > 1.035. Cats fed the HP diet consumed significantly more calories than did cats fed the Lp diet, presumably because the HP diet was more palatable. As a result of the lower caloric intake in cats fed the LP diet, these cats were protein and calorie restricted, compared with cats fed the HP diet. Cats fed the HP diet weighed significantly more than did cats fed the LP diet. Mean hematocrit and mean serum albumin concentration ere significantly lower in control cats and in cats with CRF fed the LP diet, compared with control cats and cats with CRF fed the HP diet. Hypokalemia developed in 4 of 7 cats with CRF fed the HP diet (containing 0.3% potassium); hypokalemia did not develop in control cats fed the same diet or in cats with CRF fed the LP diet containing 0.4% potassium. Excessive kaliuresis, hypomagnesemia, and metabolic acidosis did not appear to contribute to the hypokalemia. Subsequent supplementation of the HP diet with potassium gluconate prevented hypokalemia in cats with CRF.
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