Anesthetic complications in diabetic dogs subjected to phacoemulsification

Abstract

The aim of this paper was to compare the incidence of anesthetic complications in diabetic and nondiabetic dogs subjected to phacoemulsification. In total, 30 male and female dogs of different breeds were used. The dogs were distributed into two groups: diabetic (DG) (n=15) and control (CG) (n=15). The animals were premedicated with acepromazine (0.03mg/kg) and meperidine (4mg/kg), intramuscularly. After 20 minutes, anesthesia was induced with propofol (2 to 5mg/kg) and maintained with isoflurane. The animals were monitored and the heart rate, respiratory rate, peripheral oxyhemoglobin saturation, end tidal carbon dioxide tension, inspired and expired isoflurane fraction, and invasive arterial pressure were recorded at 10 minute intervals during the surgical procedure. Arterial hemogasometry was performed after anesthetic induction (T0) and at the end of the surgical procedure. Diabetic patients (DG 10±2 years) were older than non-diabetic group (CG 6±2 years). The expired isoflurane fraction after induction was 30% higher in the control group (CG 1.3±0.3%, DG 1.0±0.2%) (p<0.01). The most common anesthetic complication was hypotension. In total, 80% of the diabetic animals (n=12) exhibited mean arterial pressure (MAP) lower than 60mmHg (54±9.6mmHg) after anesthetic induction, and 83% of the hypotensive dogs (n=10) required vasoactive drugs to treat hypotension. Regarding hemodynamic changes, diabetic patients subjected to general anesthesia were more likely to exhibit hypotension which may be due to the response of older animals to the drugs used; however, this change deserves further investigation.

Intra and postoperative effectives of oral transmucosal administration of phenylbutazone for pain managament in dogs

“…There were no significant differences between the experimental groups taking intraoperative monitoring values (mean ± SD). All of these values were within the respective reference ranges for anesthetized dogs (Pacheco et al, 2018) (Table 2). Mean (± SD) diastolic and mean blood pressure (BP) values increased 20% in the control group following the ligation procedure (Table 2, T2 time point).…”

Comparison of two protocols for insulin administration and fasting time in diabetic dogs anaesthetised for phacoemulsification: A prospective clinical trial

“…However, the incidence of hypotension in the dogs of the current study was lower than in other comparable canine populations 2,4 . One study found that the proportion of diabetic dogs experiencing intraoperative hypotension was 80%, of which 83% required treatment with vasoactive drugs 4 . The higher incidence of hypotension in that study compared to the current investigation may be due to the choice of method for BP measurement and premedication.…”

“…Besides hyperglycaemia, another common intraoperative complication was hypotension. However, the incidence of hypotension in the dogs of the current study was lower than in other comparable canine populations 2,4 . One study found that the proportion of diabetic dogs experiencing intraoperative hypotension was 80%, of which 83% required treatment with vasoactive drugs 4 .…”

“…The use of oscillometry and Doppler, which are non‐invasive techniques, may have resulted in some inaccurate blood pressure readings in our study, possibly leading to mis‐estimation of hypotension. Regarding the premedication choice, the use of a relatively high dose of ace‐promazine (0.03 mg/kg) in the aforementioned study may have caused or exacerbated vasodilation‐induced hypotension in some dogs 4,23 . In another previously published work, both diabetic (71%) and non‐diabetic (63%) dogs had a higher incidence of hypotension, defined as mean BP < 55 mm Hg, than our study dogs, suggesting that hypotension is a common anaesthetic complication regardless of the population 2 .…”

“…Owing to a number of factors, including surgery‐induced stress response and interruption of food intake, which can unpredictably alter glucose homeostasis, the perioperative management of dogs with diabetes mellitus (DM) is challenging even for experienced veterinarians 1 . The consequences of vast derangements in blood glucose (BG) have yet to be determined in animals; nevertheless, life‐threatening hyperkalaemia as well as a high incidence of hypotension have been reported in diabetic dogs undergoing general anaesthesia 2-4 …”