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Physiotherapy in the Canine Intensive Care Setting: with focus on the effects of recumbency, the post-operative management of dogs with brachycephalic airway obstructive syndrome, and aspiration pneumonia following tick (Ixodes holocyclus) poisoning.Helen Nicholson Unknown Date (has links)
Abstract Introduction: Physiotherapy in the human intensive care setting is in common use and supported by Level 1 evidence. In the canine intensive care setting, however, physiotherapy is novel, despite many studies published to support aspects of human physiotherapy being conducted on experimental dogs and there being 83 canine intensive care beds in Sydney alone. As veterinary care progresses and people place more importance on their pet’s health care, an opportunity arises to examine the potential for physiotherapy to augment the veterinary care of client-owned dogs in a veterinary referral hospital setting. The first objective of this thesis was therefore to determine which common conditions cause dogs to present recumbent to veterinary referral hospitals, and then to conduct a literature review on these conditions and ways in which physiotherapy has the potential to add to the treatment of them. The next objective was to describe the short-term effects of recumbency on a number of key body systems in clinically unwell dogs, as concern was that recumbency itself may contribute to pathogenesis and/or poorer recovery, however this could not be investigated before preliminary studies like this were performed. The next objective was to conduct clinical trials of the use of two well-proven techniques in human physiotherapy on dogs with conditions commonly reported in the earlier studies of this thesis. The chosen techniques were continuous positive airway pressure (CPAP) to assist in the recovery of dogs with brachycephalic airway obstructive syndrome (BAOS) from general anaesthetic, and the use of manual chest physiotherapy in dogs with aspiration pneumonia following tick (Ixodes holocyclus) poisoning. Design: Retrospective epidemiological study; Literature review; Cross-sectional descriptive study; Randomised controlled trial; Clinical trial. Results: Dogs admitted recumbent represented 3.18% of total admissions, however had a confirmed survival rate of only 43.5%. Sydney canine intensive care units have a combined capacity of 83 beds, so many other dogs experience recumbency as part of their veterinary management, despite being admitted ambulant, and therefore also have the potential to benefit from physiotherapy. Diagnoses were split into categories, with suspected intervertebral disc disease the most common neurological diagnosis, hit by car the most common orthopaedic diagnosis, collapse the most common diagnosis in the ‘otherwise unwell’ category and tick (Ixodes holocyclus) poisoning and poison (e.g. metaldehyde) ingestion the most common toxicology diagnosis, all of which have the potential to be just as amenable to physiotherapy in dogs as they are in people. However, interspecies comparisons revealed that although the dogs studied had broadly comparable diagnoses to humans, they had a higher mortality rate and received much less physiotherapy than humans. Key body systems were therefore measured in recumbent dogs, with the finding that the dogs included under the strict definition of recumbency in this study maintained a fairly consistent clinical state in the short-term of their period of recumbency (median days 3 to 5 of hospitalization). This finding supported the investigation of physiotherapy as a potential to not only reduce the mortality rate but to speed return to function, which has the potential to also lower the economic burden of prolonged hospitalization on owners. Continuous positive airway pressure was therefore investigated for its potential to improve the safety of recovery from general anaesthetic in dogs with BAOS. Tolerance and effect of CPAP were investigated with positive results demonstrated to improve time to recovery, with no additional distress, in dogs with BAOS recovering from a general anaesthetic. An evidence-based protocol of manual chest physiotherapy was then tested on dogs with aspiration pneumonia following tick (Ixodes holocyclus) poisoning. Demeanour, saturation of peripheral oxygen and auscultation all improved following the first manual chest physiotherapy session, demonstrating tolerance and effect. Conclusions: Primary recumbency is an uncommon but serious condition in dogs that warrants attention by physiotherapy researchers, as dogs admitted ambulant but who spend part of their hospitalization recumbent also have the potential to benefit. This thesis determined the common causes of recumbency in dogs and determined that key body systems of recumbent dogs are clinically stable without the assistance of physiotherapy to improve their short-term rate of recovery. Positive short-term results were yielded from the use of CPAP and manual chest physiotherapy that may benefit other clinically unwell dogs with similar respiratory conditions. Further research should be conducted into other ways in which physiotherapy can augment the care of recumbent dogs, as well as lower the mortality rate and speed the return to function in dogs in the intensive care setting, as it is possible that not all positive findings in human research were replicated in these studies due to Type II error resulting from small sample sizes due to abnormal weather patterns that reduced the number of presentations of dogs with BAOS or tick poisoning during the study period.
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Efeitos do modo ventilatório sobre as variáveis hemogasométricas em equinos submetidos à mudança de decúbito durante a anestesia geral inalatória com halotanoSá, Paula Aguiar [UNESP] 12 September 2008 (has links) (PDF)
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sa_pa_me_botfmvz.pdf: 312992 bytes, checksum: b7e2461b0b5749453a7647e0f5532c22 (MD5) / Em eqüinos, mudanças de decúbito durante anestesias prolongadas podem contribuir para a redução da oxigenação sanguínea; uma vez que o lobo pulmonar não dependente (funcional) é repentinamente comprimido. Hipotetizou-se que a mudança de decúbito durante a anestesia reduziria significativamente a oxigenação sanguínea (PaO2) e que a instituição da ventilação controlada seria capaz de prevenir a diminuição da PaO2 após a mudança de decúbito. Foram utilizados 16 eqüinos adultos hígidos, sem raça definida, com peso corpóreo de 444,3 ± 42,5 Kg, provenientes do Regimento de Cavalaria “Dragões da Independência”. Os animais foram submetidos a procedimentos cirúrgicos onde fosse necessária a mudança de decúbito. Mediante jejum alimentar de 12 horas e hídrico de 4 horas, os animais foram premedicados com acepromazina (0,05 mg/kg, IM) e após 30 minutos, com xilazina (0,5 mg/kg, IV). A anestesia foi induzida com diazepam (0,1 mg/kg, IV) e cetamina (2,2 mg/kg, IV) e mantida com halotano diluído em O2. A dobutamina foi empregada para manter a pressão arterial média acima de 70 mm Hg durante todo o procedimento. Os animais foram equitativamente divididos em 2 grupos, sendo que no grupo VE a anestesia foi mantida sob ventilação espontânea, enquanto no grupo VC a anestesia foi mantida sob ventilação controlada (frequência respiratória: 6 mov/min, relação inspiração/expiração: 1/3, volume corrente: 15 mL/kg e pressão de pico inspiratório entre 25 a 30 cm H2O). Os procedimentos cirúrgicos foram iniciados em decúbito lateral esquerdo (DLE) e, após 75 minutos, os animais foram reposicionados em decúbito lateral direito (DLD) até o término da cirurgia. Análises hemogasométricas do sangue arterial foram realizadas após 30 e 75 minutos de posicionamento em cada decúbito (M1 e M2 no DLE e M3 e M4 no DLD, respectivamente). Durante a VE, observou-se... / In horses, changes in body position during anesthesia may contribute to a reduction in arterial oxygenation because the non-dependent lung (functional) is suddenly compressed. It was hypothesized that the change in recumbency during anesthesia would significantly reduce the arterial oxygenation (PaO2) and the institution of controlled ventilation would prevent the descrease in PaO2 after the change in body position. A total of 16 healthy adult mixed breed horses horses of the Cavalry Regiment “Dragões da Independência”, weighting 444,3 ± 42,5 Kg, were used. All animals underwent procedures in which a change in body position would be necessary to perform surgery. Food and water were withheld for 12 and 4 hours respectively. All animals received acepromazine (0.05 mg/kg, IM), followed 30 minutes later by xylazine (0.5 mg/kg, IV). Anesthesia was induced with diazepam (0.1 mg/kg, IV) and ketamine (2.2 mg/kg, IV) and maintained with halothane in oxygen. Dobutamine was used to maintain mean arterial blood pressure above 70 mmHg throughout the procedure. The animals were equally divided into 2 groups: in the SV group anesthesia was maintaned under spontaneous ventilation whereas in the CV group anesthesia was maintained under controlled ventilation (respiratory rate: 6 breaths/min, inspiration-to-expiration ratio: 1/3, tidal volume: 15 ml/kg, and peak inspiratory pressure between 20 and 30 cmH2O). All surgical procedures were commenced in left lateral recumbency (LLR) and 75 minutes later the animals were repositioned in right lateral recumbency (RLR). Arterial blood gas analysis was performed at 30 and 75 minutes after the animals were placed in left recumbency (M1 and M2, respectively), and at 30 and 75 minutes after the animals were repositioned in right lateral recumbency (M3 and M4, respectively). Hypercapnia (PaCO2 > 45 mm Hg) and respiratory acidosis (pH < 7.35)... (Complete abstract click electronic access below)
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Pulmonary atelectasis : computed tomography findings in healthy Beagles under general anaesthesiaLe Roux, Christelle January 2016 (has links)
A large proportion of dogs undergoing computed tomography are anaesthetised and receive concurrent supplementary oxygen. Both factors promote the development of pulmonary atelectasis, which may mask or mimic lung pathology and compromise image quality, which is of concern to the radiologist. The aim of the study was firstly to determine whether significant atelectasis would develop using a commonly employed anaesthetic protocol in a typical hospital setting, especially where dogs may have been anaesthetised in lateral recumbency prior to scanning. Secondly, to determine whether a change in body position to sternal recumbency would be sufficient to resolve atelectasis.
Six healthy adult Beagles were anaesthetised in sternal recumbency and using a breath-hold technique, baseline helical transverse thoracic images were acquired. Dogs were then placed in either right or left lateral recumbency for 30 minutes, with scans performed at predetermined lung lobe locations and time intervals. Dogs were then repositioned in sternal recumbency for a further 20 minutes, with similar scans performed. The study was repeated two weeks later in the opposite lateral recumbency. Changes in Hounsfield units and cross-sectional area of all lung lobes were measured.
Lateral recumbency did not result in true atelectasis in healthy Beagles of normal body condition. Infrequently, patchy increased attenuation, which failed to resolve completely during sternal recumbency, was visualised in the left cranial lobe during left lateral recumbency. The degree of attenuation changes in healthy Beagles was minimal, and thus if dogs were anaesthetised in lateral recumbency prior to computed tomography, this should not preclude scanning. / Dissertation (MMedVet)--University of Pretoria, 2016. / Companion Animal Clinical Studies / MMedVet / Unrestricted
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Vorkommen und Bedeutung von Normokalzämien bei post partum festliegenden KühenBäuml, Dominic 22 May 2014 (has links) (PDF)
Die vorliegende Untersuchung hatte zur Zielsetzung, bei Kühen die Unterschiede zwischen
hypokalzämischen und normokalzämischen Festliegern zu analysieren. Es sollte geklärt
werden, welche klinischen und labordiagnostischen Veränderungen, außer der Kalzium- (Ca)
Konzentration, dem normokalzämische Festliegen zugrunde liegen. Des Weiteren wurden die
TNF-α-, Haptoglobin- (Hp-) und TEAC-Konzentrationen in Beziehung zum Festliegen, den
Mineralstoffkonzentrationen sowie hinsichtlich diagnostischer Information geprüft.
Außerdem wurden die Festlieger mit Nachgeburtsverhaltung (Ret. sec.) und die Kühe mit
Exitus letalis labordiagnostisch genauer analysiert.
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Efeitos do modo ventilatório sobre as variáveis hemogasométricas em equinos submetidos à mudança de decúbito durante a anestesia geral inalatória com halotano /Sá, Paula Aguiar. January 2008 (has links)
Orientador: Francisco José Teixeira Neto / Banca: Antonio José de Araújo Aguiar / Banca: Eduardo Raposo Monteiro / Resumo: Em eqüinos, mudanças de decúbito durante anestesias prolongadas podem contribuir para a redução da oxigenação sanguínea; uma vez que o lobo pulmonar não dependente (funcional) é repentinamente comprimido. Hipotetizou-se que a mudança de decúbito durante a anestesia reduziria significativamente a oxigenação sanguínea (PaO2) e que a instituição da ventilação controlada seria capaz de prevenir a diminuição da PaO2 após a mudança de decúbito. Foram utilizados 16 eqüinos adultos hígidos, sem raça definida, com peso corpóreo de 444,3 ± 42,5 Kg, provenientes do Regimento de Cavalaria "Dragões da Independência". Os animais foram submetidos a procedimentos cirúrgicos onde fosse necessária a mudança de decúbito. Mediante jejum alimentar de 12 horas e hídrico de 4 horas, os animais foram premedicados com acepromazina (0,05 mg/kg, IM) e após 30 minutos, com xilazina (0,5 mg/kg, IV). A anestesia foi induzida com diazepam (0,1 mg/kg, IV) e cetamina (2,2 mg/kg, IV) e mantida com halotano diluído em O2. A dobutamina foi empregada para manter a pressão arterial média acima de 70 mm Hg durante todo o procedimento. Os animais foram equitativamente divididos em 2 grupos, sendo que no grupo VE a anestesia foi mantida sob ventilação espontânea, enquanto no grupo VC a anestesia foi mantida sob ventilação controlada (frequência respiratória: 6 mov/min, relação inspiração/expiração: 1/3, volume corrente: 15 mL/kg e pressão de pico inspiratório entre 25 a 30 cm H2O). Os procedimentos cirúrgicos foram iniciados em decúbito lateral esquerdo (DLE) e, após 75 minutos, os animais foram reposicionados em decúbito lateral direito (DLD) até o término da cirurgia. Análises hemogasométricas do sangue arterial foram realizadas após 30 e 75 minutos de posicionamento em cada decúbito (M1 e M2 no DLE e M3 e M4 no DLD, respectivamente). Durante a VE, observou-se ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: In horses, changes in body position during anesthesia may contribute to a reduction in arterial oxygenation because the non-dependent lung (functional) is suddenly compressed. It was hypothesized that the change in recumbency during anesthesia would significantly reduce the arterial oxygenation (PaO2) and the institution of controlled ventilation would prevent the descrease in PaO2 after the change in body position. A total of 16 healthy adult mixed breed horses horses of the Cavalry Regiment "Dragões da Independência", weighting 444,3 ± 42,5 Kg, were used. All animals underwent procedures in which a change in body position would be necessary to perform surgery. Food and water were withheld for 12 and 4 hours respectively. All animals received acepromazine (0.05 mg/kg, IM), followed 30 minutes later by xylazine (0.5 mg/kg, IV). Anesthesia was induced with diazepam (0.1 mg/kg, IV) and ketamine (2.2 mg/kg, IV) and maintained with halothane in oxygen. Dobutamine was used to maintain mean arterial blood pressure above 70 mmHg throughout the procedure. The animals were equally divided into 2 groups: in the SV group anesthesia was maintaned under spontaneous ventilation whereas in the CV group anesthesia was maintained under controlled ventilation (respiratory rate: 6 breaths/min, inspiration-to-expiration ratio: 1/3, tidal volume: 15 ml/kg, and peak inspiratory pressure between 20 and 30 cmH2O). All surgical procedures were commenced in left lateral recumbency (LLR) and 75 minutes later the animals were repositioned in right lateral recumbency (RLR). Arterial blood gas analysis was performed at 30 and 75 minutes after the animals were placed in left recumbency (M1 and M2, respectively), and at 30 and 75 minutes after the animals were repositioned in right lateral recumbency (M3 and M4, respectively). Hypercapnia (PaCO2 > 45 mm Hg) and respiratory acidosis (pH < 7.35)... (Complete abstract click electronic access below) / Mestre
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Vorkommen und Bedeutung von Normokalzämien bei post partum festliegenden KühenBäuml, Dominic 08 April 2014 (has links)
Die vorliegende Untersuchung hatte zur Zielsetzung, bei Kühen die Unterschiede zwischen
hypokalzämischen und normokalzämischen Festliegern zu analysieren. Es sollte geklärt
werden, welche klinischen und labordiagnostischen Veränderungen, außer der Kalzium- (Ca)
Konzentration, dem normokalzämische Festliegen zugrunde liegen. Des Weiteren wurden die
TNF-α-, Haptoglobin- (Hp-) und TEAC-Konzentrationen in Beziehung zum Festliegen, den
Mineralstoffkonzentrationen sowie hinsichtlich diagnostischer Information geprüft.
Außerdem wurden die Festlieger mit Nachgeburtsverhaltung (Ret. sec.) und die Kühe mit
Exitus letalis labordiagnostisch genauer analysiert.
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Sedation With Xylazine Hydrochloride Decreases the Stress Response in Merino Meat Sheep During Routine Hoof Trimming in a Tilt TableAmin, Safaa, Wagner, Romy, Fieseler, Helena, Rizk, Awad, Schmicke, Marion, Spilke, Joachim, Mielenz, Norbert, Baumgartner, Walter, Schären-Bannert, Melanie, Starke, Alexander 22 January 2024 (has links)
We hypothesized that the hoof trimming in sheep in dorsal recumbency implicates a short
but intensive stress situation and that the sedation with xylazine causes a decrease in the
stress response in this situation. Ten healthy female merino meat sheep were randomly
divided into two groups receiving either xylazine hydrochloride (0.1 mg/kg body mass
(BM) applied intramuscularly) or a placebo treatment with 0.9% NaCl. Routine hoof
trimming was performed in a tilt table and vital signs (rectal temperature (RT), heart
rate (HR), and respiratory rate (RR)), 33 different behavioral traits and blood cortisol
concentrations were recorded throughout the experiment at six different time points (total
of 55min). The procedure itself elicited a clear stress response (increase in the RR, RT,
defensive movements, lip twitching, swallowing, and flight behavior). Parallelly, the blood
cortisol concentrations were increased, reaching their maximum with 81.5 ng/ml in the
control group when the sheep were tilted back into a standing position. In the sedated
sheep, no increase in the RR and RT and a decrease in the HR were observed. In addition,
the behavioral signs showed a decrease in flight, defensive, and general stress behavior
(decrease in licking,movement of head and legs, and sitting on knees), complemented by
the serum cortisol concentrations showing 2.28 times reduced concentration at the end
of the procedure, compared to the control sheep. The results confirm our hypothesis
and support the conduction of future trials investigating the feasibility and benefit of a
sedation of sheep prior to routine hoof trimming under practical circumstances.
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