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1.
A 13-year-old Shire horse was anesthetized for an elective orthopedic procedure. During recovery from anesthesia, the occurrence of severe acute dyspnea required a second anesthetic to allow endoscopy-guided nasotracheal intubation. Endoscopic findings were decreased mobility and swelling of the arytenoids with narrowing of the laryngeal aditus. Owing to a dislodgement of the nasotracheal tube during recovery, a third anesthetic was carried out to perform emergency tracheostomy. Recovery from the third anesthetic was long and the horse developed a post-anesthetic myopathy. The clinical conditions improved during the following 48 hours, and an endoscopic examination performed before discharge revealed unremarkable laryngeal function. It was hypothesized that mechanical stimulation of the trachea during the phases of intubation and extubation caused traumatic laryngeal dysfunction, and that draft horses might require additional care during the perioperative period.  相似文献   

2.
ObjectiveTo determine the incidence of canine post-anesthetic aspiration pneumonia (AP) and to identify anesthetic agents, procedures and management factors associated with the development of AP.Study designMulticenter, randomized, case-controlled retrospective study.AnimalsTwo hundred and forty dogs affected with AP and 488 unaffected control dogs.MethodsElectronic medical record databases at six Veterinary colleges were searched for dogs, coded for anesthesia or sedation and pneumonia from January 1999 to December 2009. The resultant 2158 records were hand-searched to determine eligibility for inclusion. Diagnosis of AP was made radiographically. Two unaffected control dogs were randomly selected for each affected dog, from a list of dogs that underwent sedation or anesthesia in the same time period and did not develop aspiration pneumonia. Fifty-seven factors were then evaluated for association with aspiration pneumonia. Data analysis was performed using univariate Chi-square or student t-tests, then multivariate logistic regression.ResultsIncidence of post-anesthetic AP was 0.17%, from 140,711 cases anesthetized or sedated over the 10 year period. Two anesthesia-related events were significantly associated with development of AP: regurgitation and administration of hydromorphone at induction. Administration of anticholinergics was not associated with AP. Procedures associated with increased odds of aspiration pneumonia included laparotomy, upper airway surgery, neurosurgery, thoracotomy and endoscopy. Orthopedic surgery, ophthalmologic surgery, dental procedures, MRI, CT, bronchoscopy, cystoscopy, tracheoscopy and neutering were not associated with development of AP. Three patient factors were associated with the development of AP: megaesophagus, and a history of pre-existing respiratory or neurologic disease. Sixty-nine% of dogs with two or more of the above independent predictive variables developed AP.Conclusion and clinical relevanceMost anesthetic agents and procedures were not associated with the development of AP. We need to devise and evaluate strategies to protect at risk patients.  相似文献   

3.
Intracompartmental muscle pressure, temperature and pH were measured in a group of 23 anesthetized horses in an attempt to elucidate the etiology of post-anesthetic lameness (PAL). The intramuscular pressure remained reasonably constant throughout anesthesia in most horses, while muscle temperature and pH fell. Five of the horses became lame after anesthesia. Two of these lame horses exhibited atypical trends in the physiological variables measured. The etiology of PAL is discussed in the lightof the results.  相似文献   

4.
OBJECTIVE: To determine if pain of the dorsal margin of the sole in horses can be attenuated by anesthesia of either the distal interphalangeal (DIP) joint or the palmar digital (PD) nerves. STUDY DESIGN: A unilateral forelimb lameness was induced by creating solar pain. Response to administration of local anesthetic or saline solution into the DIP joint and to administration of local anesthetic around the PD nerves was evaluated. Animals: Six horses. METHODS: Lameness was induced by creating pressure on the dorsal margin of the sole by screwing set-screws into a nut welded to the inside of each branch of a shoe. Gaits were evaluated before and after application of set-screws and after a local anesthetic or saline solution was administered into the DIP joint and, in a second trial, after a local anesthetic was injected around the PD nerves. Gaits recorded on videotape were evaluated, and lameness scores were assigned to each gait. RESULTS: Lameness scores were high after application of set-screws and remained high after saline solution was administered into the DIP joint. Scores decreased significantly (P < or = .05) after a local anesthetic was administered into the DIP joint or around the PD nerves. CONCLUSIONS: Analgesia of the DIP joint or the PD nerves desensitizes at least a portion of the sole. CLINICAL RELEVANCE: Pain arising from the sole should not be excluded as a cause of lameness when lameness is attenuated by analgesia of the DIP joint or PD nerves.  相似文献   

5.
OBJECTIVE: To identify hind limb and pelvic kinematic variables that change in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and after subsequent intra-articular administration of anesthetic. ANIMALS: 8 clinically normal adult horses. PROCEDURE: Kinematic measurements were made before and after transient endotoxin-induced lameness of the distal intertarsal and tarsometatarsal joints and after intra-articular administration of anesthetic. Fourteen displacement and joint angle (metatarsophalangeal [fetlock] and tarsal joints) measurements were made on the right hind limb, sacrum, and the right and left tubera coxae. Kinematic measurements were compared by general linear models, using a repeated measures ANOVA. Post hoc multiple comparisons between treatments were evaluated with a Fisher least squared difference test at alpha = 0.05. RESULTS: After lameness induction, fetlock and tarsal joint extension during stance decreased, fetlock joint flexion and hoof height during swing increased, limb protraction decreased, and vertical excursion of the tubera coxae became more asymmetric. After intra-articular administration of anesthetic, limb protraction returned to the degree seen before lameness, and vertical excursion of the tubera coxae became more symmetric. CONCLUSIONS AND CLINICAL RELEVANCE: Increased length of hind limb protraction and symmetry of tubera coxae vertical excursion are sensitive indicators of improvement in tarsal joint lameness. When evaluating changes in tarsal joint lameness, evaluating the horse from the side (to assess limb protraction) is as important as evaluating from the rear (to assess pelvic symmetry).  相似文献   

6.
The medical records of 20 cats with post-anesthetic cortical blindness were reviewed. Information collected included signalment and health status, reason for anesthesia, anesthetic protocols and adverse events, post-anesthetic visual and neurological abnormalities, clinical outcome, and risk factors. The vascular anatomy of the cat brain was reviewed by cadaver dissections. Thirteen cats were anaesthetised for dentistry, four for endoscopy, two for neutering procedures and one for urethral obstruction. A mouth gag was used in 16/20 cats. Three cats had had cardiac arrest, whereas in the remaining 17 cases, no specific cause of blindness was identified. Seventeen cats (85%) had neurological deficits in addition to blindness. Fourteen of 20 cats (70%) had documented recovery of vision, whereas four (20%) remained blind. Two cats (10%) were lost to follow up while still blind. Ten of 17 cats (59%) with neurological deficits had full recovery from neurological disease, two (12%) had mild persistent deficits and one (6%) was euthanased as it failed to recover. Four cats (23%) without documented resolution of neurological signs were lost to follow up. Mouth gags were identified as a potential risk factor for cerebral ischemia and blindness in cats.  相似文献   

7.
A prospective study of the diagnostic results on 25 previously untreated, slightly lame Standardbred horses showed that manipulative tests are of some help in diagnosis. The lameness of each horse was diminished or the horse went lame on the opposite limb after being given an injection of anesthetic in the cunean bursa, and lameness improved more when local anesthetic was injected in the distal intertarsal and tarsometatarsal articulations. In four horses, lesions of the distal articulation of the hock were evident on radiography.  相似文献   

8.
Seven horses, 2 to 4 years of age, were examined because of moderate-to-severe forelimb lameness, mild effusion of the middle carpal joint (3 horses), and pain on palpation of the origin of the suspensory ligament (4 horses). The lameness was abolished by anesthetic infiltration of the middle carpal joint in six horses. In four of them, a high palmar nerve block also abolished the lameness. A linear radiolucency in the proximal end of the third metacarpal bone (McIII) was interpreted as an incomplete longitudinal fracture. In one horse, distinct intramedullary sclerosis limited to the palmar cortex was indicative of an incomplete fracture confined to the palmar cortex. No osteoproliferative lesions were identified on the dorsal cortex of any of the horses. Surgical treatment with cortical screws in lag fashion accompanied by a rest period was successful in one horse. In four horses, rest for at least 3 months resulted in clinical soundness. In two horses, a shorter rest period resulted in recurrence of the lameness even though the horses were sound when put back into training. Careful clinical and radiographic examinations helped differentiate incomplete longitudinal fractures from lesions involving the carpus and proximal aspect of the suspensory ligament.  相似文献   

9.
The incidence of lameness in cows recorded by five veterinary practices over one year and one practice over four years was plotted with rainfall and potential soil moisture deficit. Correlation coefficients calculated between lameness, rainfall and potential soil moisture deficit over two-week periods showed the incidence of lameness in summer to be significantly related to the potential soil moisture deficit in the same two-week period and rainfall in the previous two-week period. Differences in patterns of lameness incidence among practices and years were also partly explained by differences in rainfall and potential soil moisture deficit; however, these effects were small compared with those of other factors that affect lameness incidence such as herd size, age and stage of lactation.  相似文献   

10.
This study aimed to compare the prevalence of lameness on organic and non-organic dairy farms in the United Kingdom (UK) and to assess which cow and farm factors influenced lameness levels. Forty organic and 40 non-organic dairy farms across the UK were repeatedly visited over a 2.5 year period. On each visit all milking cows were locomotion scored, and information about farm housing, management and husbandry practices was recorded on-farm. Over the whole study, the mean herd lameness prevalence was 16.2%, 16.3% and 19.3% in the autumn, winter and spring observation periods, respectively. Lameness prevalence was lower (P=0.012) on organic farms compared to non-organic farms. Numerous specific factors were found to significantly influence the prevalence of lameness. This study provided evidence that organic management reduced herd lameness. It supported previous research which suggested that lameness is a serious problem on many farms in the UK and further emphasised the multi-factorial aetiology of lameness problems.  相似文献   

11.
ObjectiveTo report serum cardiac troponin I (cTnI) and C-reactive protein (CRP) concentrations in dogs anesthetized for elective surgery using two anesthetic protocols.Study designProspective, randomized clinical study.AnimalsTwenty client-owned dogs presenting for elective ovariohysterectomy or castration.MethodsThe dogs were randomized into two groups. All dogs were premedicated with glycopyrrolate (0.011 mg kg?1) and hydromorphone (0.1 mg kg?1) IM approximately 30 minutes prior to induction of anesthesia. Anesthesia in dogs in group 1 was induced with propofol (6 mg kg?1) IV to effect and in dogs in group 2 with diazepam (0.2 mg kg?1) IV followed by etomidate (2 mg kg?1) IV to effect. For maintenance of anesthesia, group 1 received sevoflurane (adjustable vaporizer setting 0.5–4%) and group 2 received a combination of fentanyl (0.8 μg kg?1 minute?1) and midazolam (8.0 μg kg?1 minute?1) IV plus sevoflurane (adjustable vaporizer setting 0.5–4%) to maintain anesthesia. Serum cTnI and CRP concentrations were measured at baseline and 6, 18, and 24 hours post-anesthetic induction. Biochemical analysis was performed at baseline. Lactate was obtained at baseline and 6 hours post-anesthetic induction. Heart rate and mean arterial blood pressure were measured intra-operatively.ResultsBaseline serum cTnI and CRP concentrations were comparable between groups. A significant difference in serum cTnI or CRP concentrations was not detected post-operatively between groups at any time point. Serum CRP concentrations were significantly increased post-anesthetic induction in both groups, which was attributed to surgical trauma.Conclusions and clinical relevanceThere was no significant difference in serum cTnI and CRP concentrations between anesthetic protocols. Further investigation in a larger number of dogs is necessary to confirm the current findings.  相似文献   

12.
Objective — To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses.
Study Design — Experimental investigation.
Animals — Six clinically normal horses.
Methods — Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL of 2% mepivacaine hydrochloride. All video recordings were then rerecorded onto master tapes in a random sequence. Four clinicians, unaware of the animal identity related to observation time or limb treated, independently viewed these tapes and graded the lamenesses.
Results — There was a significant reduction in lameness 5 and 30 minutes after anesthetic was injected into the distal interphalangeal joint. Lameness scores 60 minutes after anesthetic administration were not significantly different than baseline values. Gross pathological examination confirmed marked inflammation of the treated navicular bursae and normal appearance of the distal interphalangeal joints.
Conclusions — Intra-articular anesthesia of the distal interphalangeal joint can alleviate lameness associated with the navicular bursa.
Clinical Relevance — Intra-articular anesthesia of the distal interphalangeal joint is not specific only for lameness originating in the distal interphalangeal joint.  相似文献   

13.
CASE DESCRIPTION-A 4-year-old Quarter Horse stallion was evaluated because of a 10-month history of moderate (grade 3/5) left forelimb lameness (detectable during trotting over a smooth, hard surface). CLINICAL FINDINGS-No abnormalities were detected in either forelimb via palpation or application of hoof testers; however, lameness was eliminated after administration of a palmar digital nerve block in the left forelimb. Whereas radiography and ultrasonography did not identify any left forelimb foot abnormalities, magnetic resonance (MR) imaging revealed a circumscribed soft tissue mass in the distal aspect of the digital flexor tendon sheath (DFTS) dorsal to the lateral aspect of the deep digital flexor tendon. Subsequently, the left forelimb DFTS was injected with local anesthetic, which resulted in 90% improvement of the horse's lameness. TREATMENT AND OUTCOME-The distal aspect of the left forelimb DFTS was evaluated tenoscopically. The mass was removed under tenoscopic guidance, after which the distal digital annular ligament was transected. The horse received phenylbutazone orally for 10 days, and the left forelimb DFTS was injected with hyaluronic acid and methylprednisolone acetate 7 days after the surgery. Following a rehabilitation program, the horse was returned to full training at 6 months after surgery and competed successfully during a 2-year follow-up period. CLINICAL RELEVANCE-Use of MR imaging should be considered in all lame horses for which a definitive diagnosis cannot be made via radiography, ultrasonography, or other imaging techniques, especially when the lameness has been localized to a specific anatomic region by use of diagnostic anesthesia.  相似文献   

14.
REASONS FOR PERFORMING STUDY: Lameness related to the middle carpal joint (MCJ) occurs in up to 30% of young Standardbred horses in race training and the incidence increase with radiographic severity of third carpal bone (C3) sclerosis on DPr-DDIO (skyline) view of the carpus. Factors predisposing horses to carpal injury have not been well investigated. OBJECTIVES: To determine the importance of MCJ lameness as a cause of wastage in young Standardbred racehorses, stage of training at which it occurs and predisposing factors, and to describe clinical findings and diagnosis. METHODS: Standardbred horses (n = 114) entering their first year of race training were examined at approximately 3-month intervals over 12-18 months. For 87 of the horses, a training diary was available and these horses were trained at 3 different stables, each using a different exercise regime. At each examination, forelimb conformation, MCJ effusion, MCJ lameness and radiographic findings were graded, and training history and reasons for lost training days recorded. Nuclear scintigraphy and exploratory arthroscopy were performed on a limited selection of horses. Results for horses that developed MCJ lameness during the study period were compared statistically with results for horses that did not. RESULTS: Carpal lameness occurred in 28% of horses and was present in 56% with forelimb lameness. In most cases lameness was mild, bilateral and with little or no MCJ effusion and was attributed to subchondral bone pain associated with radiographic evidence of C3 sclerosis. Carpal lameness was the most common reason for >1 month's rest during the study period. It occurred at any stage of training but, in most cases, some speed training had begun. Of the variables studied, poor forelimb conformation and more intense speed training were predisposing factors. CONCLUSIONS AND POTENTIAL RELEVANCE: The information gained should assist in making recommendations regarding training young Standardbreds to reduce the incidence of MCJ lameness. However, further investigations to determine the optimal training regime are warranted.  相似文献   

15.
VCARS, the Veterinary Computerized Anesthetic Record System, has been developed to capture pre-, peri- and post-anesthetic data using Tablet PCs, 802.11b wireless networks, and a web-based database. Patient demographics, anticipated procedures and anesthetist, service information and hematologic and chemistry values are imported from the Veterinary Medical Teaching Hospital patient information system. Using a wireless Tablet PC, pre-anesthetic examination findings are recorded and an anesthetic plan including anesthetic drugs and anesthetic and monitoring equipment is developed. During induction and maintenance of anesthesia, physiologic variables, drug, fluid, anesthetic gas and oxygen administration, laboratory values, patient location, and important events can be charted with the simplicity of a paper anesthetic record. This information can be manipulated for display in a variety of ways depending on the specific needs of the case. Tools for calculating optimal fluid rates and drug dosages are incorporated into the design. The anesthetic records from multiple cases can be viewed simultaneously using a centrally-located monitor. Detailed audit trails ensure data integrity. A high-end search engine will allow rapid and complete retrieval of patient and anesthetic information. Macromedia flash is used to allow temporary disconnection from the wireless network without losing the ability to view, add, or edit data. The initial stages of software development are nearing completion, a wireless network is in place and hardware is being purchased. A pilot study will be conducted using manual entry of physiologic data prior to integration of automatically captured patient physiological variables. It is anticipated that this system will drastically improve the accuracy of data collection and retrieval and will provide important information about anesthetic management allowing improvement in overall patient care.  相似文献   

16.
A survey of 73 dairy farms in south-western Victoria was conducted to assess the cost and mean herd incidence of foot lameness for the period from calving to the end of November, 1985, and to identify the herd, management and environmental factors associated with foot lameness. The mean herd size was 125 cows (range 82 to 220). Lameness occurred in 64 (88%) herds, and the mean herd incidence was 7.0% (range 0.0 to 30.9%). The main clinical signs associated with lameness were the presence of overworn and/or bruised soles, or stones lodged in the interdigital cleft. Factors associated with lameness were: property and herd size, age of cow, bail feeding, voluntary entry into the bails, and features of the farm track including its length, the presence of steep slopes, the type of surface material, presence and treatment of broken sections and maintenance including rolling history. The association of these factors with specific clinical signs was examined. The mean cost was estimated to be $42.90 per lame cow due to loss of production, treatment, the culling or death of lame cows, and extra man hours spent managing lame cows. It was concluded that the site, construction, maintenance and use of the farm track were of major importance to the incidence of lameness in herds in this area and recommendations for reducing lameness are made.  相似文献   

17.
Second phalangeal fractures have been classified as either simple or multiple and have been managed in a variety of ways. The removal of small osteochondral fragments originating from the palmar midsagittal aspect of the proximal second phalanx is reported. This lesion has been described as a coincidental finding unrelated to lameness. Based on our clinical finding of lameness in this case and the response to an intraarticular injection of anesthetic, excision of the fragment was elected. However, the importance of confirming the significance of a radiographic lesion with local anesthesia prior to surgical intervention must be stressed.  相似文献   

18.
This study describes the successful use of modified dorsolumbar epidural anesthesia with a fixed volume of anesthetic in a bovine referral center. Among the 130 Holstein cattle scheduled for flank surgery, 90 cattle received a mixed anesthetic consisting of 1 ml of xylazine hydrochloride and 3 ml of lidocaine hydrochloride by modified dorsolumbar epidural anesthesia. Eighteen cattle with dehydration and/or lameness received a mixed anesthetic containing 0.5 ml of xylazine and 3 ml of lidocaine. Infiltration anesthesia was performed in 22 cattle whose epidural space could not be reached in order to perform the flank surgery. The surgeries began about 12 min after the administration of the anesthetic and lasted for about 36 min. The modified method using a fixed volume of anesthetic was successfully introduced and effectively used in a bovine referral center. This modified method will allow veterinarians to save time and effort, thus lowering the cost of each surgery.  相似文献   

19.
The objective of this study was to identify factors that may affect recovery from and duration of a case of lameness in a stratified random sample of Michigan horses. This was done using data from Phase-II of the Michigan equine monitoring system (MEMS Phase-II), the equine health-monitoring study [Kaneene et al., Prev. Vet. Med. 29 (1997b) 277-292; Ross and Kaneene, Prev. Vet. Med. 28 (1996a) 209-224; Ross and Kaneene, Prev. Vet. Med. 29 (1996b) 59-75; Ross et al., Am. J. Vet. Res. 59 (1997) 23-29]. In this study, statistical modelling was conducted to evaluate risk factors affecting recovery from and duration of lameness using multivariable logistic regression and Cox's proportional hazards regression, respectively. Of 357 incident lameness cases reported during MEMS Phase-II, 280 (78.6%) were reported to have recovered. The median duration of a lameness case was 18 days (1st quartile (Q): 1, maximum (Max): 360). A total of 296 of 357 (82.9%) incident lameness cases received some type of treatment. Of 619 total treatments used, 329 (53.2%) were administered, conducted or applied by a veterinarian. Horses experiencing other types of lameness were less likely to recover than those experiencing hoof lameness (odds ratio (OR) = 0.48; 95% CI: 0.25, 0.93). Horses that had participated in exercise-related activities during the study period and prior to the lameness were more likely to recover (OR = 1.91; 95% CI: 1.05, 3.50). Treatment of the lameness was associated with an increased likelihood of recovery (OR = 1.82; 95% CI: 0.97, 3.45). Cases with a veterinarian involved in the diagnosis were associated with a decreased risk of recovery (OR = 0.48; 95% CI: 0.27, 0.84) and a longer duration lameness (HR = 0.58; 95% CI: 0.45, 0.73)--which might indicate that these cases were more complex or severe. Although cases treated for lameness were more likely to recover (OR = 1.82; 95% CI: 1.05, 3.50), treatment was not associated with lameness duration (HR = 0.58; 95% CI: 0.45, 0.73).  相似文献   

20.
OBJECTIVE: To determine the effect of weight reduction on clinical signs of lameness among overweight dogs with clinical and radiographic signs of hip osteoarthritis. DESIGN: Nonblinded prospective clinical trial. ANIMALS: 9 client-owned dogs with radiographic signs of hip osteoarthritis that weighed 11 to 12% greater than their ideal body weight and were examined because of hind limb lameness. PROCEDURE: Dogs were weighed, and baseline body condition, hind limb lameness, and hip function scores were assigned. Severity of lameness was scored using a numerical rating scale and a visual analogue scale. Dogs were fed a restricted-calorie diet, with amount of diet fed calculated to provide 60% of the calories needed to maintain the dogs' current weights. Evaluations were repeated midway through and at the end of the weight-loss period. RESULTS: Dogs lost between 11 and 18% of initial body weight. Body weight, body condition score, and severity of hind limb lameness were all significantly decreased at the end of the weight-loss period. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in overweight dogs with hind limb lameness secondary to hip osteoarthritis, weight reduction alone may result in a substantial improvement in clinical lameness.  相似文献   

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