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Vincent Marolf Claudia Spadavecchia Nicole Müller Charlotte Sandersen Helene Rohrbach 《Veterinary anaesthesia and analgesia》2021,48(3):398-406
ObjectiveTo determine the intraoperative and early postoperative opioid requirement after ultrasound-guided sciatic and/or femoral nerve block or epidural anaesthesia in dogs undergoing tibial plateau levelling osteotomy (TPLO).Study designProspective, masked, pilot, randomized, clinical trial.AnimalsA total of 40 client-owned dogs undergoing TPLO.MethodsEach dog was randomly assigned to group SF (combined sciatic and femoral nerve block), group S (sciatic nerve block), group F (femoral nerve block) or group E (epidural anaesthesia). A total of 0.3 mL kg–1 of ropivacaine 0.5% was administered to each nerve or in the epidural space. Intraoperatively, fentanyl (2 μg kg–1) was administered intravenously when heart rate, mean arterial pressure or respiratory rate increased by >30% compared with baseline values. Postoperatively, a visual analogue scale (VAS) and a modified German version of the French pain scale (4AVet) were used to assess pain every 30 minutes for 150 minutes and again once the morning after surgery. Methadone (0.1 mg kg–1) was administered intravenously if the VAS was ≥ 4 cm [maximal value 10 cm; median (interquartile range)] or the composite pain score was ≥5 [maximal value 15; median (interquartile range)]. Significance was defined as p ≤ 0.05.ResultsGroups SF and E required less total intraoperative and early postoperative opioid doses compared with groups S and F (p = 0.031). No dogs in group SF had a block failure or required postoperative methadone. A reduced methadone requirement was found in group SF compared with all the other groups up to 150 minutes after recovery (p = 0.041).Conclusions and clinical relevanceCombined sciatic and femoral nerve block and epidural anaesthesia lead to less cumulative consumption of perioperative opioids than single nerve blockade. Sciatic or femoral nerve block alone might be insufficient to control nociception and early postoperative pain in dogs undergoing TPLO. 相似文献
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Catecholamine Metabolism in a Shetland Pony with Suspected Pheochromocytoma and Pituitary Pars Intermedia Dysfunction 
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Stacie Aarsvold Jennifer A. Reetz Jean K. Reichle Ian D. Jones Christopher R. Lamb Maria G. Evola Michele A. Keyerleber Angela J. Marolf 《Veterinary radiology & ultrasound》2015,56(3):272-277
Primary pulmonary neoplasia is relatively uncommon in cats and generally has a poor prognosis. In this multicenter, retrospective study of 57 cats with pulmonary neoplasia, the most frequent presenting signs were anorexia/inappetence (39%) and cough (37%). The pulmonary tumors were considered to be incidental findings in 9% cats. In computed tomographic (CT) images, primary pulmonary tumors appeared as a pulmonary mass in 55 (96%) cats and as a disseminated pulmonary lesion without a defined mass in two (4%) cats. Most pulmonary tumors were in the caudal lobes, with 28 (49%) in the right caudal lobe and 17 (30%) in the left caudal lobe. CT features associated with pulmonary tumors included mass in contact with visceral pleura (96%), irregular margins (83%), well‐defined borders (79%), bronchial compression (74%), gas‐containing cavities (63%), foci of mineral attenuation (56%), and bronchial invasion (19%). The mean (range) maximal dimension of the pulmonary masses was 3.5 cm (1.1–11.5 cm). Additional foci of pulmonary disease compatible with metastasis were observed in 53% cats. Pleural fluid was evident in 30% cats and pulmonary thrombosis in 12% cats. The histologic diagnoses were 47 (82%) adenocarcinomas, six (11%) tumors of bronchial origin, three (5%) adenosquamous cell carcinomas, and one (2%) squamous cell carcinoma. In this series, adenocarcinoma was the predominant tumor type, but shared many features with less common tumor types. No associations were identified between tumor type and CT features. Prevalence of suspected intrapulmonary metastasis was higher than in previous radiographic studies of cats with lung tumors. 相似文献
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Computed Tomographic Angiography under Sedation in the Diagnosis of Suspected Canine Pancreatitis: A Pilot Study 下载免费PDF全文
下载免费PDF全文 A.M. Adrian D.C. Twedt S.L. Kraft A.J. Marolf 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2015,29(1):97-103
Background
Computed tomography (CT) is highly accurate for diagnosing pancreatitis in humans. The diagnosis of pancreatitis in dogs is based on clinical signs, laboratory findings, and ultrasonographic (US) changes. There are, however, inherent limitations in relying on laboratory and ultrasound findings for the clinical diagnosis of pancreatitis in dogs.Hypothesis/Objectives
We hypothesized that CT angiography would be a rapid and reliable method to confirm pancreatitis in dogs compared to ultrasonography. The aim was to describe the CT characteristics and compare them to ultrasound findings and correlate the CT appearance to the severity of the patients'' clinical course.Animals
A prospective pilot case series; 10 dogs with pancreatitis were enrolled if the history, clinical signs, laboratory, and ultrasonographic findings were indicative of pancreatitis.Methods
A 3‐phase angiographic CT was performed under sedation. Afterward, each dog had US‐guided aspirates of the pancreas collected and blood drawn for cPLi assay. Images were evaluated for portion of visible pancreas, pancreatic size and margin, pancreatic parenchyma, presence of peripancreatic changes and contrast enhancement pattern. The results were compared with outcome.Results
An enlarged, homogeneously to heterogeneously attenuating and contrast‐enhancing pancreas with ill‐defined borders was identified in all dogs. CT identified more features characterizing pancreatic abnormalities compared to US. Thrombi were found in 3/10 dogs. Three dogs with heterogeneous contrast enhancement had an overall poorer outcome than those with homogenous enhancement.Conclusions and Clinical Importance
CT angiography under sedation was used in dogs to confirm clinically suspected pancreatitis and identified clinically relevant and potentially prognostic features of pancreatitis in dogs. 相似文献5.
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Vincent Marolf Helene Rohrbach Géraldine Bolen Anne-Sophie Van Wijnsberghe Charlotte Sandersen 《Veterinary anaesthesia and analgesia》2019,46(1):106-115
Objective
To develop a modified ultrasound-guided parasacral approach to the sciatic nerve and compare the effects of a volume of 0.2 mL kg–1 of 0.5% levobupivacaine with an equivalent volume of 0.9% saline injected near the sciatic nerve.Study design
Cadaveric and experimental, blinded, randomized study.Animals
Seven canine cadavers and seven experimental Beagle dogs.Methods
Both sciatic nerves of seven cadavers were identified using a modified in-plane ultrasound-guided approach. Methylene blue solution (0.2 mL) was injected perineurally, and success was evaluated through dissection. The same approach was repeated in seven Beagle dogs sedated with dexmedetomidine (50 μg kg–1) injected intramuscularly (IM). After randomization, 0.2 mL kg–1 of 0.5% levobupivacaine (limb L) and 0.2 mL kg–1 of 0.9% saline (limb C) were injected perineurally on either right or left limb. Block success was determined by sensory deficits every hour for 8 hours after an atipamezole injection (0.2 mg kg–1) IM. Reaction to pinprick (binary score) over the course of the sciatic nerve (four locations) and locomotion were assessed.Results
The overall sciatic nerve block success was 93% in cadavers and 86% in sedated dogs. It was impossible to localize the sciatic nerves in one obese sedated dog. Significant differences between limb L and limb C were observed for pinprick at great trochanter, caudal thigh and lateral tarsal joint (p < 0.0001). Reaction to pinprick was absent in all dogs at great trochanter and caudal thigh up to at least 3 hours on limb L. Locomotion was impaired in all but one dog for 60 (30–210) minutes (median; interquartile range). No complications were observed.Conclusions and clinical relevance
A volume of ≥0.2 mL kg–1 and a concentration of 0.5% levobupivacaine can be recommended when using a modified ultrasound-guided parasacral approach to the sciatic nerve in dogs. 相似文献8.
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Marolf AJ Leach L Gibbons DS Bachand A Twedt D 《Journal of the American Animal Hospital Association》2012,48(1):36-42
Cholangitis is a common inflammatory disorder of the biliary system in cats. There are two major forms based on the predominate type of inflammatory cell infiltrates: lymphocytic or neutrophilic. Ultrasound is a common imaging modality used in these patients. This retrospective study evaluated the ultrasound examinations of 26 cats with a histologic diagnosis of cholangitis. Most cats with cholangitis had sonographically normal liver size, echogenicity, and normal biliary systems. Statistically significant sonographic changes for cats with cholangitis included hyperechoic liver parenchyma, hyperechoic gallbladder contents, and increased pancreatic size. No statistically significant changes were noted to distinguish lymphocytic and neutrophilic forms of cholangitis. Cats with the sonographic features of diffuse liver hyperechogenicity, gallbladder contents and enlarged pancreas may suggest cholangitis. 相似文献