A 12-year-old captive male Persian leopard (Panthera pardus saxicolor) required general anaesthesia for examination and treatment of a recurrent oral fistula. Medetomidine (0.065 mg/kg) and ketamine (3.6 mg/kg) administered intramuscularly by blowpipe darting effectively immobilised the animal that was maintained under general anaesthesia with inhaled isoflurane. In absence of clinical signs, acute hyperkalaemia (7.26 mmol/l) was incidentally recognised by the end of anaesthesia. Factors that might have played a role in hyperkalaemia development, such as the use of α2-adrenoceptor agonists, stress response, acidosis or dopamine administration, are discussed. Hyperkalaemia should be considered as a potential complication while anaesthetising large non-domestic felids.
This report documents the practical introduction of an EZ-blocker to achieve one-lung ventilation in two medium-sized dogs for video-assisted thoracoscopic pericardiectomy and right caudal lung lobectomy. Bronchoscopy was performed after blind introduction of the device through the endotracheal tube at the level of the tracheobronchial bifurcation. The EZ-blocker was successfully placed on the first attempt in the first case but initially remained trapped in the Murphy eye of the endotracheal tube in the second case, requiring repositioning. Surgical visibility was considered satisfactory when the left lung lobes were collapsed but not optimal when the right lung lobes had to be collapsed because the right cranial lung lobe could not be isolated for anatomical reasons. Both dogs recovered from anaesthesia uneventfully. Anaesthetic management with particular emphasis on the practical use of the EZ-blocker is reported. Placement of the EZ-blocker and challenges associated with right lung isolation are described.
Background Epidural administration of morphine has been shown to be an effective analgesic strategy in horses; however, the possible occurrence of side effects limits its usage. In order to decrease their frequency, it is important to target the minimal effective plasma concentration and avoid overdosing. As to date species-specific pharmacokinetics data are not available for epidural morphine, the dosing regimen is usually established on the basis of clinical reports and personal experience. In certain physiological conditions, like gestation, the outcome of an empirical dosing scheme can be unpredictable. The aim of this case report is to describe the pharmacological profile of morphine and its metabolites after prolonged epidural administration in a pregnant mare and her foal. Case presentation A 20 years old pregnant mare was presented to our hospital because of severe lameness, 2 months before delivery. Following an ineffective systemic pain treatment, an epidural catheter was inserted and morphine administered (initial dose 0.1 mg/kg every 8 h). Due to its efficacy in controlling pain, it was continued until end of gestation. Plasmatic concentration of morphine and its metabolites were assessed in the mare 6 weeks after starting the treatment, and in both the mare and foal during the first days after delivery. Plasmatic values similar to those previously reported in the literature following morphine short term administration through various routes and not accompanied by side effects were found in the mare, except during an excitatory period. Moreover, no evidence of dangerous drug accumulation or significant milk passage was noticed in the foal. Mild reduction of feces production with no signs of colic and two self-limiting episodes of excitement occurred during treatment in the mare. No side effects occurred during gestation and first phases of life in the foal. Conclusion Prolonged epidural administration of morphine in a pregnant mare allowed good pain control in absence of clinically relevant side effects, in both the mare and her foal. Sudden increase in morphine plasmatic concentration can occur and side effects appear; careful treatment to the lowest effective dose and continuous monitoring of the clinical condition of the treated horse should be performed.
A fractious nine-year-old, 520-kg, neutered Swiss Warmblood was presented with a history of anorexia, progressive weight loss and mild hindlimb lameness. Because of its temperament, standard physical examination was considered to be only feasible under general anaesthesia. For safety reasons, general anaesthesia was planned to be induced by blowpipe darting. Two attempts are described and discussed in the present report. The first attempt, using a combination of medetomidine and tiletamine-zolazepam, was unsuccessful. Conversely, detomidine combined with butorphanol, followed by a second dart of detomidine and tiletamine-zolazepam, proved to be adequate to induce anaesthesia. Factors that could have influenced the outcome, such as different therapeutic approach, drug protocol and dosages, stress level, or genetic mutations, are presented and discussed.
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