Successful treatment of hyperkalaemic periodic paralysis in a horse during isoflurane anaesthesia

Pang, Daniel S. J.; Panizzi, Luca; Paterson, Jessica M.

doi:10.1111/j.1467-2995.2010.00592.x

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…There are numerous reports of confirmed HYPP in the veterinary literature, including case reports of peri‐anaesthetic management 28,29 . HYPP was first identified in 1985 in quarter horse breeds related to the stallion, impressive.…”

Section: Discussionmentioning

confidence: 99%

Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse

Ryan

Gurney²,

Steinbacher

2021

Equine Veterinary Journal

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Vagal reflexes have been well documented in both human and veterinary anaesthetic literature. A trigeminocardiac reflex (TCR) is a vagal reflex frequently documented in human medicine, and subtypes such as the oculocardiac reflex (OCR) are well documented in veterinary medicine throughout numerous species. 1-3 A further TCR subtype, the maxillomandibulocardiac reflex (MCR) has been documented in human literature associated with facial fractures and has recently been described in a sole case report in a dog. 4 Thus far, it has not been documented in a horse. The current case report aims to describe the perianaesthetic management of a horse that developed asystole due to a suspected TCR of either OCR or MCR in origin, in combination with hyperkalaemia of unknown cause which may or may not have contributed to the suspected vagal event, a relationship that has been previously documented. 5,6 Both causes will be discussed as independent or contributory factors.

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Section: Discussionmentioning

confidence: 99%

Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse

Ryan

Gurney²,

Steinbacher

2021

Equine Veterinary Journal

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“…Unanticipated, severe hyperkalaemia can develop acutely during general anaesthesia and requires prompt recognition and treatment. Several cases are reported in dogs, 7–12 non‐domestic large felids 13–18 and horses 19–23 . Unexpected hyperkalaemia in a domestic cat during general anaesthesia has been recently reported, 24 and in other cats in which the cause has been attributed to hyperacute rhabdomyolysis 25 and malignant hyperthermia (MH) 26–28 .…”

Section: Introductionmentioning

confidence: 99%

“…Several cases are reported in dogs, [7][8][9][10][11][12] non-domestic large felids [13][14][15][16][17][18] and horses. [19][20][21][22][23] Unexpected hyperkalaemia in a domestic cat during general anaesthesia has been recently reported, 24 and in other cats in which the cause has been attributed to hyperacute rhabdomyolysis 25 and malignant hyperthermia (MH). [26][27][28] The increasing number of cases described may reflect the frequency of this phenomenon, which is still believed to be under-reported in veterinary medicine.…”

Section: Introductionmentioning

confidence: 99%

Hyperkalaemia during two consecutive anaesthetics in an aggressive Bengal cat

Casoria

Flaherty

Auckburally

2021

Vet Record Case Reports

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The development of unanticipated hyperkalaemia during general anaesthesia in healthy veterinary patients is an increasingly recognized phenomenon. Cases have been reported in dogs, cats, horses and non‐domestic felids. However, recurrent hyperkalaemia has not yet been described in domestic cats. We report the development of hyperkalaemia during two consecutive anaesthetics in a 5‐year‐old, Bengal cat, anaesthetised for medial patella luxation repair and 3 months later for implant removal. During both procedures, hyperkalaemia was diagnosed. However, it was only during the first anaesthetic that the hyperkalaemia became life‐threatening, necessitating treatment. The reasons why some animals develop hyperkalaemia during general anaesthesia are still unknown. Considering the apparent increasing frequency of this condition, hyperkalaemia should be considered as a potential cause of intraoperative bradydysrhythmias and must be investigated and treated appropriately.

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“…Bailey et al 1996;Pang et al 2011). Horses may undergo one uneventful general anaesthetic, but stress-related incidents may cause an episode during a second(Cornick et al 1994; …”

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confidence: 99%

“…by stress, anaesthesia, diets high in potassium, transport and concurrent disease. During anaesthesia, HPP causes hypercapnia, muscle fasciculations and hyperkalaemia leading to bradycardia-associated changes in the electrocardiogram(Robertson et al 1992;Traub-Dargatz et al 1992;Cornick et al 1994;Moody et al 1995;Bailey et al 1996;Baetge 2007;Pang et al 2011). Occasionally, paradoxical tachycardia is reported(Cornick et al 1994; …”

mentioning

confidence: 99%

Mortality and morbidity in equine anaesthesia

Deutsch

Taylor

2021

Equine Veterinary Education

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Equine peri-anaesthetic mortality and morbidity are of interest to anaesthetists, practitioners, horse owners and insurance companies. The largest prospective study, 'The Confidential Enquiry into Perioperative Equine Fatalities' (CEPEF) was conducted more than 20 years ago. It included over 40,000 horses from multiple centres and reported mortality to be 1.9% that decreased to 0.9% when only elective cases were considered. This is in stark contrast to mortality rates in small animal (dogs: 0.17%, cats: 0.24%) and human anaesthesia (0.04-7/10,000). In spite of developments in understanding the pathophysiology of equine anaesthesia mortality has not decreased in the intervening years. The main contributors to peri-anaesthetic equine mortality are cardiac arrest, fractures and myopathy or neuropathy. Spinal cord myelopathy and cerebral necrosis are less common. Malignant hyperthermia and hyperkalaemic periodic paralysis are diseases associated with genetic mutations that can be triggered during general anaesthesia and may be fatal if not recognised and treated immediately. Morbidities are reported less frequently, presumably because often they do not cause permanent harm and may resolve within a short period of time. Complications in equine anaesthesia are numerous and include injuries at induction and recovery, damage to the airway associated with orotracheal or nasotracheal intubation, post-anaesthetic myopathy or neuropathy, regurgitation and aspiration of stomach contents, ocular injuries and complications associated with intravascular cannulation. Hypotension, hypoventilation, hypoxaemia, hypothermia and dysrhythmias may occur both during the maintenance phase of anaesthesia but also in recovery. Airway obstruction during recovery has repeatedly been reported over the years as causing pulmonary oedema, which is often fatal if the airway is not restored extremely quickly. This review summarises the literature on the risk of mortality and morbidity. Information has been gathered from single case reports as well as larger research studies.

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Successful treatment of hyperkalaemic periodic paralysis in a horse during isoflurane anaesthesia

Cited by 18 publications

References 23 publications

Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse

Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse

Hyperkalaemia during two consecutive anaesthetics in an aggressive Bengal cat

Mortality and morbidity in equine anaesthesia

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