A prospective study was undertaken to compare the analgesic effect of intra-articular bupivacaine, morphine, or saline in the 24-hour period following cranial cruciate ligament repair in dogs. Thirty-six clinical patients with ruptured cranial cruciate ligaments were randomly assigned to one of three groups. After surgical stabilization, and before skin closure, an intra-articular injection was given; group one (n = 12) received 0.5% bupivacaine HCl at 0.5 mL/kg, group two (n = 12) received morphine at 0.1 mg/kg diluted with saline to a volume of 0.5 mL/kg, and group three (n = 12) received saline at 0.5 mL/kg. Heart rate, respiratory rate, mean arterial blood pressure, cumulative pain score, visual analog pain score, and pain threshold test on both stifles were recorded preoperatively and at 0 to 6 and 24 hours postoperatively. Surgeons and pain scoring investigators were unaware of the intra-articular medication given. Supplemental analgesia, if needed, was provided in the postoperative period according to subjective assessment of patient discomfort. Postoperative pain scores were lowest in the bupivacaine group and highest in the saline group. Pain threshold, measured by applying calibrated loads to the knee, was higher postoperatively in the bupivacaine group than in the saline group. Dogs in the morphine and bupivacaine groups required less supplemental analgesia than dogs in the saline group. The local provision of analgesia reduces the need for systemic drugs with potential side effects. Both intra-articular morphine and intra-articular bupivacaine provided better postoperative analgesia than intra-articular saline, with intra-articular bupivacaine showing the greatest effect.
Intra-abdominal pressure (IAP) was indirectly measured, using a transurethral catheterization technique, in 20 client-owned dogs before and after elective ovariohysterectomy. Mean preoperative IAP was 4.50 +/- 0.44 cm H2O. Elective abdominal surgery caused significant elevations in mean postoperative IAP (mean 7.50 +/- 0.45 cm H2O, range 0 to 15 cm H2O) that persisted for at least 24 hours. However, the increase in IAP caused no clinically evident complications; thus, after elective abdominal surgery an elevation in IAP up to 15 cm H2O is to be expected. Intra-abdominal pressure was also measured in 20 consecutive clinical cases with gross abdominal distension, before or after laparotomy, or both. Included in this group were dogs with gastric dilation and volvulus, closed pyometra, hemoperitoneum, acute ascites, and diaphragmatic hernias. All dogs with gross abdominal distension had an elevated IAP (> or = 16 cm H2O) either before or after surgery. Severe elevations of IAP were associated with anuria in two dogs, necessitating surgical decompression; one with hemoperitoneum (47 cm H2O) and one after repair of a chronic diaphragmatic hernia (30 cm H2O).
Background: Laryngeal paralysis commonly affects older Labrador retrievers. Currently, dogs with severe disease require surgical intervention, most commonly arytenoid lateralization. Anecdotally, doxepin has been proposed to help dogs with laryngeal paralysis.Hypothesis: Doxepin will improve quality of life measures assessed by owners of Labrador retrievers with laryngeal paralysis not requiring emergency surgery.Animals: Twenty-two Labrador retrievers with laryngeal paralysis.Methods: Dogs were randomized to receive doxepin (3-5 mg/kg q12h PO) or placebo for 28 days. Owners completed quality-of-life assessments before and after completing the study. Data were compared between groups using Rank-Sum tests or Fisher's exact tests. Results:The 2 groups of dogs did not differ at baseline except for owner-perceived degree of ataxia (owners of dogs receiving doxepin considered them more ataxic than owners of dogs receiving placebo). After 28 days, owner-assessed quality of life measures did not differ between dogs receiving doxepin or placebo (dogs worsening: doxepin = 2, placebo = 1; dogs unchanged: doxepin = 6, placebo = 7; dogs improved: doxepin = 4, placebo = 2; P = .84). Dogs receiving placebo had a greater improvement in client-assessed overall health than dogs receiving doxepin (mean ranks: doxepin = 4.36, placebo = 6.64; P = .04). The study was terminated at this interim analysis.
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