Objective: To evaluate the use of midazolam, ketamine, and xylazine for total IV anesthesia (TIVA) in horses. Animals: 6 healthy Thoroughbred mares. Procedures: Horses were sedated with xylazine (1.0 mg/kg, IV). Anesthesia was induced with midazolam (0.1 mg/kg, IV) followed by ketamine (2.2 mg/kg, IV) and was maintained with an IV infusion of midazolam (0.002 mg/kg/min), ketamine (0.03 mg/kg/min), and xylazine (0.016 mg/kg/min). Horses underwent surgical manipulation and injection of the palmar digital nerves; duration of the infusion was 60 minutes. Additional ketamine (0.2 to 0.4 mg/kg, IV) was administered if a horse moved its head or limbs during procedures. Cardiopulmonary and arterial blood variables were measured prior to anesthesia; at 10, 20, 30, 45, and 60 minutes during infusion; and 10 minutes after horses stood during recovery. Recovery quality was assessed by use of a numeric (1 to 10) scale with 1 as an optimal score. Results: Anesthesia was produced for 70 minutes after induction; supplemental ketamine administration was required in 4 horses. Heart rate, respiratory rate, arterial blood pressures, and cardiac output remained similar to preanesthetic values throughout TIVA. Arterial partial pressure of oxygen and oxygen saturation of arterial hemoglobin were significantly decreased from preanesthetic values throughout anesthesia; oxygen delivery was significantly decreased at 10- to 30-minute time points. Each horse stood on its first attempt, and median recovery score was 2. Conclusions and Clinical Relevance: Midazolam, ketamine, and xylazine in combination produced TIVA in horses. Further studies to investigate various dosages for midazolam and ketamine or the substitution of other α2-adrenoceptor for xylazine are warranted.

Objective: To identify cardiac mechanisms that contribute to adaptation to high altitudes in Tibetan antelope (Pantholops hodgsonii). Animals: 9 male Tibetan antelope and 10 male Tibetan sheep (Ovis aries). Procedures: Tibetan antelope and Tibetan sheep inhabiting a region with an altitude of 4,300 m were captured, and several cardiac variables were measured. Expression of genes for atrial natriuretic peptide, brain natriuretic peptide, and calcium-calmodulin–dependent protein kinase II δ was measured via real-time PCR assay. Results: Ratios of heart weight to body weight for Tibetan antelope were significantly greater than those of Tibetan sheep, but ratios of right-left ventricular weights were similar. Mean ± SD baseline heart rate (26.33 ± 6.15 beats/min) and systolic arterial blood pressure (97.75 ± 9.56 mm Hg) of antelope were significantly lower than those of sheep (34.20 ± 6.57 beats/min and 130.06 ± 17.79 mm Hg, respectively). The maximum rate of rise in ventricular pressure in antelope was similar to that in Tibetan sheep, but after exposure to air providing a fraction of inspired oxygen of 14.6% or 12.5% (ie, hypoxic conditions), the maximum rate of rise in ventricular pressure of the antelope increased significantly to 145.1% or 148.1%, respectively, whereas that of the sheep decreased to 68.4% or 70.5%, respectively. Gene expression of calcium-calmodulin–dependent protein kinase II δ and atrial natriuretic peptide, but not brain natriuretic peptide, in the left ventricle of the heart was significantly higher in antelope than in sheep. Conclusions and Clinical Relevance: Hearts of the Tibetan antelope in this study were well adapted to high-altitude hypoxia as shown by higher heart weight ratios, cardiac contractility in hypoxic conditions, and expression of key genes regulating cardiac contractility and cardiac hypertrophy, compared with values for Tibetan sheep.

The objective of this study was to determine the effects of the administration of a high volume of isotonic crystalloid at a rapid rate on cardiovascular function in normovolemic, isoflurane-anesthetized dogs during induced hypotension. Using a prospective study, 6 adult dogs were induced to general anesthesia and cardiovascular and hematological values were measured while the dogs were maintained at 3 hemodynamic states: first during light anesthesia with 1.3% end-tidal isoflurane (ETI); then during a hypotensive state induced by deep anesthesia with 3% ETI for 45 min while administered 1 mL/kg body weight (BW) per minute of isotonic fluids; and then decreased to 1.6% ETI while receiving 1 mL/kg BW per minute of fluids for 15 min. End-tidal isoflurane (ETI) at 3.0 ± 0.2% decreased arterial blood pressure (ABP), cardiac index (CI), and stroke volume index (SVI), and increased stroke volume variation (SVV) and central venous pressure (CVP). Fluid administration during 3% ETI decreased only SVV and systemic vascular resistance index (SVRI), while CVP increased progressively. Decreasing ETI to 1.6 ± 0.1% returned ABP and SVI to baseline (ETI 1.3 ± 0.1%), while CI and heart rate increased and SVV decreased. There was significant progressive clinical hemodilution of hemoglobin (Hb), packed cell volume (PCV), total protein (TP), colloid osmotic pressure (COP), arterial oxygen content (CaO2), and central-venous oxygen content (CcvO2). High-volume, rapid-rate administration of an isotonic crystalloid was ineffective in counteracting isoflurane-induced hypotension in normovolemic dogs at a deep plane of anesthesia. Cardiovascular function improved only when anesthetic depth was reduced. Excessive hemodilution and its adverse consequences should be considered when a high volume of crystalloid is administered at a rapid rate.

Objective-To measure the effects of tidal volume, ventilatory frequency, and oxygen insufflation flow on the fraction of inspired oxygen in cadaveric horse heads attached to a lung model. Sample-8 heads of equine cadavers. Procedures-Each cadaveric horse head was intubated with a nasotracheal tube that extended into the proximal portion of the trachea. Oxygen was delivered through an oxygen catheter contained within and extending to the tip of the nasotracheal tube. The trachea was connected to the lung model by use of a spiral-wound hose with a sampling adaptor. Eight treatment combinations involving 2 tidal volumes (5 and 8 L), 2 ventilatory frequencies (6 and 12 mechanical breathes/min), and 2 insufflation rates (10 and 15 L/min) were applied to each head. Hand-drawn inspired gas samples were collected and analyzed for oxygen concentrations. Results-The fraction of inspired oxygen (measured at mid trachea) ranged from 26.8% to 39.4%. Fraction of inspired oxygen was significantly higher with a smaller tidal volume, lower ventilatory frequency, and higher insufflation rate. Conclusions and Clinical Relevance-In the study model, measured fraction of inspired oxygen varied with ventilatory pattern as well as oxygen insufflation rate. Clinically, this information could be beneficial for interpretation of data regarding arterial blood gases and hemoglobin saturation and in making appropriate oxygen insufflation decisions for anesthetized horses that are breathing room air.

Objective: To determine the minimum anesthetic concentration (MAC) of sevoflurane in thick-billed parrots (Rhynchopsitta pachyrhyncha) and compare MAC obtained via mechanical and electrical stimulation. Animals: 15 healthy thick-billed parrots. Procedures: Anesthesia was induced in each parrot by administration of sevoflurane in oxygen. An end-tidal sevoflurane concentration of 2.5% was established in the first bird. Fifteen minutes was allowed for equilibration. Then, 2 types of noxious stimulation (mechanical and electrical) were applied; stimuli were separated by 15 minutes. Responses to stimuli were graded as positive or negative. For a positive or negative response to a stimulus, the target end-tidal sevoflurane concentration of the subsequent bird was increased or decreased by 10%, respectively. The MAC was calculated as the mean end-tidal sevoflurane concentration during crossover events, defined as instances in which independent pairs of birds evaluated in succession had opposite responses. A quantal method was used to determine sevoflurane MAC. Physiologic variables and arterial blood gas values were also measured. Results: Via quantal analysis, mean sevoflurane MAC in thick-billed parrots determined with mechanical stimulation was 2.35% (90% fiducial interval, 1.32% to 2.66%), which differed significantly from the mean sevoflurane MAC determined with electrical stimulation, which was 4.24% (90% fiducial interval, 3.61% to 8.71%). Conclusions and Clinical Relevance: Sevoflurane MAC in thick-billed parrots determined by mechanical stimulation was similar to values determined in chickens and mammals. Sevoflurane MAC determined by electrical stimulation was significantly higher, which suggested that the 2 types of stimulation did not induce similar results in thick-billed parrots.

Objective: To determine effects of syringe type and storage conditions on blood gas and acid-base values for equine blood samples. Sample: Blood samples obtained from 8 healthy horses. Procedures: Heparinized jugular venous blood was equilibrated via a tonometer at 37°C with 12% O2 and 5% CO2. Aliquots (3 mL) of tonometer-equilibrated blood were collected in random order by use of a glass syringe (GS), general-purpose polypropylene syringe (GPPS), or polypropylene syringe designed for blood gas analysis (PSBGA) and stored in ice water (0°C) or at room temperature (22°C) for 0, 5, 15, 30, 60, or 120 minutes. Blood pH was measured, and blood gas analysis was performed; data were analyzed by use of multivariable regression analysis. Results: Blood Po2 remained constant for the reference method (GS stored at 0°C) but decreased linearly at a rate of 7.3 mm Hg/h when stored in a GS at 22°C. In contrast, Po2 increased when blood was stored at 0°C in a GPPS and PSBGA or at 22°C in a GPPS; however, Po2 did not change when blood was stored at 22°C in a PSBGA. Calculated values for plasma concentration of HCO3 and total CO2 concentration remained constant in the 3 syringe types when blood was stored at 22°C for 2 hours but increased when blood was stored in a GS or GPPS at 0°C. Conclusions and Clinical Relevance: Blood samples for blood gas and acid-base analysis should be collected into a GS and stored at 0°C or collected into a PSBGA and stored at room temperature.

Objective: To assess the effects of dopamine and dobutamine on the blood pressure of isoflurane-anesthetized Hispaniolan Amazon parrots (Amazona ventralis). Animals: 8 Hispaniolan Amazon parrots. Procedures: A randomized crossover study was conducted. Each bird was anesthetized (anesthesia maintained by administration of 2.5% isoflurane in oxygen) and received 3 doses of each drug during a treatment period of 20 min/dose. Treatments were constant rate infusions (CRIs) of dobutamine (5, 10, and 15 μg/kg/min) and dopamine (5, 7, and 10 μg/kg/min). Direct systolic, diastolic, and mean arterial pressure measurements, heart rate, esophageal temperature, and end-tidal partial pressure of CO2 were recorded throughout the treatment periods. Results: Mean ± SD of the systolic, mean, and diastolic arterial blood pressures at time 0 (initiation of a CRI) were 132.9 ± 22.1 mm Hg, 116.9 ± 20.5 mm Hg, and 101.9 ± 22.0 mm Hg, respectively. Dopamine resulted in significantly higher values than did dobutamine for the measured variables, except for end-tidal partial pressure of CO2. Post hoc multiple comparisons revealed that the changes in arterial blood pressure were significantly different 4 to 7 minutes after initiation of a CRI. Overall, dopamine at rates of 7 and 10 μg/kg/min and dobutamine at a rate of 15 μg/kg/min caused the greatest increases in arterial blood pressure. Conclusions and Clinical Relevance: Dobutamine CRI at 5, 10, and 15 μg/kg/min and dopamine CRI at 5, 7, and 10 μg/kg/min may be useful in correcting severe hypotension in Hispaniolan Amazon parrots caused by anesthesia maintained with 2.5% isoflurane.

Objective: To determine cardiopulmonary effects of incremental doses of dopamine and phenylephrine during isoflurane-induced hypotension in cats with hypertrophic cardiomyopathy (HCM). Animals: 6 adult cats with severe naturally occurring HCM. Procedures: Each cat was anesthetized twice (once for dopamine treatment and once for phenylephrine treatment; treatment order was randomized). Hypotension was induced by increasing isoflurane concentration. Cardiopulmonary data, including measurement of plasma concentration of cardiac troponin I (cTnI), were obtained before anesthesia, 20 minutes after onset of hypotension, and 20 minutes after each incremental infusion of dopamine (2.5, 5, and 10 μg/kg/min) or phenylephrine (0.25, 0.5, and 1 μg/kg/min). Results: Mean ± SD end-tidal isoflurane concentration for dopamine and phenylephrine was 2.44 ± 0.05% and 2.48 ± 0.04%, respectively. Cardiac index and tissue oxygen delivery were significantly increased after administration of dopamine, compared with results after administration of phenylephrine. Systemic vascular resistance index was significantly increased after administration of phenylephrine, compared with results after administration of dopamine. Oxygen consumption remained unchanged for both treatments. Systemic and pulmonary arterial blood pressures were increased after administration of both dopamine and phenylephrine. Acid-base status and blood lactate concentration did not change and were not different between treatments. The cTnI concentration increased during anesthesia and infusion of dopamine and phenylephrine but did not differ significantly between treatments. Conclusions and Clinical Relevance: Dopamine and phenylephrine induced dose-dependent increases in systemic and pulmonary blood pressure, but only dopamine resulted in increased cardiac output. Hypotension and infusions of dopamine and phenylephrine caused significant increases in cTnI concentrations.

Objective: To compare anesthetic, analgesic, and cardiorespiratory effects in dogs after IM administration of dexmedetomidine (7.5 μg/kg)–butorphanol (0.15 mg/kg)–tiletamine-zolazepam (3.0 mg/kg; DBTZ) or dexmedetomidine (15.0 μg/kg)-tramadol (3.0 mg/kg)-ketamine (3.0 mg/kg; DTrK) combinations. Animals: 6 healthy adult mixed-breed dogs. Procedures: Each dog received DBTZ and DTrK in a randomized, crossover-design study with a 5-day interval between treatments. Cardiorespiratory variables and duration and quality of sedation-anesthesia (assessed via auditory stimulation and sedation-anesthesia scoring) and analgesia (assessed via algometry and electrical nerve stimulation) were evaluated at predetermined intervals. Results: DBTZ or DTrK induced general anesthesia sufficient for endotracheal intubation ≤ 7 minutes after injection. Anesthetic quality and time from drug administration to standing recovery (131.5 vs 109.5 minutes after injection of DBTZ and DTrK, respectively) were similar between treatments. Duration of analgesia was significantly longer with DBTZ treatment, compared with DTrK treatment. Analgesic effects were significantly greater with DBTZ treatment than with DTrK treatment at several time points. Transient hypertension (mean arterial blood pressure > 135 mm Hg), bradycardia (heart rate < 60 beats/min), and hypoxemia (oxygen saturation < 90% via pulse oximetry) were detected during both treatments. Tidal volume decreased significantly from baseline with both treatments and was significantly lower after DBTZ administration, compared with DTrK, at several time points. Conclusions and Clinical Relevance: DBTZ or DTrK rapidly induced short-term anesthesia and analgesia in healthy dogs. Further research is needed to assess efficacy of these drug combinations for surgical anesthesia. Supplemental 100% oxygen should be provided when DBTZ or DTrK are used.

The effects of 2 different continuous rate infusions (CRIs) of medetomidine over an 8-hour period on sedation score, selected cardiopulmonary parameters, and serum levels of medetomidine were evaluated in 6 healthy, conscious dogs using a crossover study design. The treatment groups were: CONTROL = saline bolus followed by saline CRI; MED1 = 2 μg/kg body weight (BW) medetomidine loading dose followed by 1 μg/kg BW per hour CRI; and MED2 = 4 μg/kg BW medetomidine loading dose followed by 2 μg/kg BW per hour CRI. Sedation score (SS), heart rate (HR), respiratory rate (RR), temperature (TEMP), systolic arterial pressure (SAP), mean arterial pressure (MAP), and diastolic arterial pressure (DAP), arterial and mixed venous blood gas analyses, lactate, and plasma levels of medetomidine were evaluated at baseline, at various intervals during the infusion, and 2 h after terminating the infusion. Statistical analysis involved a repeated measures linear model. Both infusion rates of medetomidine-induced dose-dependent increases in SS and dose-dependent decreases in HR, SAP, MAP, and DAP were measured. Respiratory rate (RR), TEMP, central venous pH, central venous oxygen tension, and oxygen extraction ratio also decreased significantly in the MED2 group at certain time points. Arterial oxygen and carbon dioxide tensions were not significantly affected by either infusion rate. In healthy dogs, both infusion rates of medetomidine-induced clinically relevant sedative effects, accompanied by typical alpha2 agonist-induced hemodynamic effects, which plateaued during the infusion and subsequently returned to baseline. While additional studies in unhealthy animals are required, the results presented here suggest that medetomidine infusions at the doses studied may be useful in canine patients requiring sedation for extended periods.