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| 2. |
- Bergström, Karin, et al.
(author)
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Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden
- 2012
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In: Acta Veterinaria Scandinavica. - : Springer Science and Business Media LLC. - 0044-605X .- 1751-0147. ; 54, s. 1-14
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Journal article (peer-reviewed)abstract
- BACKGROUND: The first outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010. METHOD: This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by spa-typing and pulsed-field gel electrophoresis (PFGE) were performed. RESULTS: Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months.Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA spa-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases. CONCLUSIONS: Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the dedication of staff were essential for the development and implementation of new, improved routines. Demonstration of the outbreak strain in the environment was useful for interventions such as improvement of cleaning routines and interior design, and increased compliance with basic hygienic precautions. The interventions led to a reduction in MRSA-positive samples and the outbreak was considered curbed as no new cases occurred for over a year.
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| 3. |
- Fahlman, Åsa, et al.
(author)
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Oxygen supplementation in anesthetized brown bears (Ursus arctos) - how low can you go?
- 2014
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In: Journal of Wildlife Diseases. - : Wildlife Disease Association. - 0090-3558 .- 1943-3700. ; 50, s. 574-581
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Journal article (peer-reviewed)abstract
- Hypoxemia is anticipated during wildlife anesthesia and thus should be prevented. We evaluated the efficacy of low flow rates of supplemental oxygen for improvement of arterial oxygenation in anesthetized brown bears (Ursus arctos). The study included 32 free-ranging brown bears (yearlings, subadults, and adults; body mass 12-250 kg) that were darted with medetomidine-zolazepam-tiletamine (MZT) from a helicopter in Sweden. During anesthesia, oxygen was administered intranasally from portable oxygen cylinders at different flow rates (0.5-3 L/min). Arterial blood samples were collected before (pre-O-2), during, and after oxygen therapy and immediately processed with a portable analyzer. Rectal temperature, respiratory rate, heart rate, and pulse oximetry-derived hemoglobin oxygen saturation were recorded. Intranasal oxygen supplementation at the evaluated flow rates significantly increased the partial pressure of arterial oxygen (PaO2) from pre-O-2 values of 9.1 +/- 1.3 (6.3-10.9) kPa to 20.4 +/- 6.8 (11.1-38.7) kPa during oxygen therapy. When oxygen therapy was discontinued, the PaO2 decreased to values not significantly different from the pre-O-2, values. In relation to the body mass of the bears, the following oxygen flow rates are recommended: 0.5 L/min to bears <51 kg, 1 L/min to bears 51-100 kg, 2 L/min to bears 101-200 kg, and 3 L/min to bears 201-250 kg. In conclusion, low flow rates of intranasal oxygen were sufficient to improve arterial oxygenation in brown bears anesthetized with MZT. Because hypoxemia quickly recurred when oxygen was discontinued, oxygen supplementation should be provided continuously throughout anesthesia.
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| 4. |
- Fahlman, Åsa, et al.
(author)
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Physiologic Evaluation of Capture and Anesthesia with Medetomidine–Zolazepam–Tiletamine in Brown Bears (Ursus arctos)
- 2011
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In: Journal of Zoo and Wildlife Medicine. - : American Association of Zoo Veterinarians. - 1042-7260 .- 1937-2825. ; 42, s. 1-11
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Journal article (peer-reviewed)abstract
- Physiologic variables during anesthesia with medetomidine-zolazepam-tiletamine were evaluated in 52 free-ranging brown bears (Ursus arctos) darted from a helicopter and in six captive brown bears darted at a zoo. During anesthesia, rectal temperature, respiratory rate, heart rate, and pulse oximetry derived hemoglobin oxygen saturation were recorded. Arterial blood samples were collected and immediately analyzed for evaluation of pulmonary gas exchange, acid base status, and selected hematologic and plasma variables. At the end of anesthesia, atipamezole was administered intramuscularly at five times the medetomidine dose. Capture-induced hyperthermia and lactic acidemia were documented in free-ranging bears. Hypoxemia during anesthesia was documented in both free-ranging and captive bears. In free-ranging bears, rectal temperature, heart rate, lactate, hematocrit, and hemoglobin decreased significantly during anesthesia, whereas partial pressure of arterial carbon dioxide, pH, potassium, and glucose increased. Yearlings had a significantly higher heart rate, pH, base excess, bicarbonate, and glucose, and had a significantly lower rectal temperature, sodium, hematocrit, and hemoglobin when compared with subadult and adult brown bears. In conclusion, alterations in pulmonary gas exchange and acid base status in brown bears during anesthesia with medetomidine zolazepam tiletamine with the doses and capture methods used in this study were identified. Oxygen supplementation is recommended to counteract hypoxemia during anesthesia.
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| 5. |
- Fahlman, Åsa, et al.
(author)
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TREATMENT OF HYPOXEMIA DURING ANESTHESIA OF BROWN BEARS (URSUS ARCTOS)
- 2010
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In: Journal of Zoo and Wildlife Medicine. - : American Association of Zoo Veterinarians. - 1042-7260 .- 1937-2825. ; 41, s. 161-164
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Journal article (peer-reviewed)abstract
- This study assessed whether arterial oxygenation could be increased by treatment with intranasal oxygen supplementation in brown bears (Ursus arctos) with hypoxemia during anesthesia with medetomidine-zolazepam-tiletamine. Arterial blood samples were collected anaerobically from the femoral artery before and during oxygen supplementation. An oxygen flow rate of 2-5 L/min administered intranasally to brown bears weighing 12-120 kg markedly increased arterial oxygenation. Intranasal oxygen supplementation proved to be a simple and efficient method for treatment of hypoxemia in anesthetized bears.
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| 6. |
- Grubb, Tamara, et al.
(author)
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Effects of pulse-delivered inhaled nitric oxide administration on pulmonary perfusion and arterial oxygenation in dorsally recumbent isoflurane-anesthetized horses
- 2014
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In: American Journal of Veterinary Research. - : American Veterinary Medical Association (AVMA). - 0002-9645. ; 75, s. 949-955
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Journal article (peer-reviewed)abstract
- Objective-To image the spatial distribution of pulmonary blood flow by means of scintigraphy, evaluate ventilation-perfusion (V-A/Q) matching and pulmonary blood shunting (Qs/Qt) by means of the multiple inert gas elimination technique (MIGET), and measure arterial oxygenation and plasma endothelin-1 concentrations before, during, and after pulse-delivered inhaled nitric oxide (PiNO) administration to isoflurane-anesthetized horses in dorsal recumbency.Animals-3 healthy adult Standardbreds.Procedures-Nitric oxide was pulsed into the inspired gases in dorsally recumbent isoflurane-anesthetized horses. Assessment of V-A/Q matching, Qs/Qt, and PaO2 content was performed by use of the MIGET, and spatial distribution of pulmonary blood flow was measured by perfusion scintigraphy following IV injection of technetium Tc 99m-labeled macroaggregated human albumin before, during, and 30 minutes after cessation of PiNO administration.Results-During PiNO administration, significant redistribution of blood flow from the dependent regions to the nondependent regions of the lungs was found and was reflected by improvements in V-A/Q matching, decreases in Qs/Qt, and increases in PaO2 content, all of which reverted to baseline values at 30 minutes after PiNO administration.Conclusions and Clinical Relevance-Administration of PiNO in anesthetized dorsally recumbent horses resulted in redistribution of pulmonary blood flow from dependent atelectatic lung regions to nondependent aerated lung regions. Because hypoxemia is commonly the result of atelectasis in anesthetized dorsally recumbent horses, the addition of nitric oxide to inhaled gases could be used clinically to alleviate hypoxemia in horses during anesthesia.
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| 8. |
- Grubb, Tamara, et al.
(author)
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The effects of pulse-delivered inhaled nitric oxide on arterial oxygenation, ventilation-perfusion distribution and plasma endothelin-1 concentration in laterally recumbent isoflurane-anaesthetized horses
- 2013
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In: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 40:6, s. E19-E30
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Journal article (peer-reviewed)abstract
- Objectives Anaesthetized horses commonly become hypoxaemic due to ventilation/perfusion ((V) over dot(A)/(Q) over dot) mismatch and increased pulmonary shunt fraction ((Q) over dots/(Q) over dott). Pulse-delivered inhaled nitric oxide may improve oxygenation but may increase plasma concentration of the potent vasoconstrictor, endothelin-1 (ET-1). Objectives: Study 1) compare arterial oxygen concentration (PaO2) and saturation (SaO(2)), calculated ((Q) over dots/(Q) over dott) and ET-1 concentration; and Study 2) assess ((V) over dot(A)/(Q) over dot) matching and measured ((Q) over dots/(Q) over dott) in isoflurane-anaesthetized horses in left lateral recumbency receiving pulse-delivered inhaled nitric oxide (PiNO group) or inhalant gas only (C group). Study design Prospective research trial. Animals Ten Healthy adult Standardbred horses. Two horses were anaesthestized in both groups in a random cross-over design with >4 weeks between studies. Methods Study 1) Cardiopulmonary data including PaO2, SaO(2), ((Q) over dots/(Q) over dott) and ET-1 concentration were measured or calculated prior to and at various points during PiNO administration in 6PiNO and 6C horses. Two-way repeated measures ANOVA with Bonferroni significant difference test was used for data analysis with p < 0.05 considered significant. Study 2) ((V) over dot(A)/(Q) over dot) matching and ((Q) over dots/(Q) over dott) were determined using the multiple inert gas elimination technique in 3 horses. Data were collected after 60 minutes of anaesthesia without PiNO (baseline) and 15 minutes after PiNO was pulsed during the first 30%, and then the first 60%, of inspiration. Data were descriptive only. Results Study 1) PaO2 and SaO2 were higher and calculated ((Q) over dots/(Q) over dott) was lower in the PiNO group than the C group at most time points. ET-1 was not different over time or between groups. Study 2) ((V) over dot(A)/(Q) over dot) matching and measured ((Q) over dots/(Q) over dott) were improved from baseline in all horses but PiNO60% provided no improvement when compared to PiNO30%. Conclusions and Clinical Relevance PiNO delivered in the initial portion of the inspiration effectively relieves hypoxaemia in anaesthetized horses by improving ((V) over dot(A)/(Q) over dot) matching and decreasing ((Q) over dots/(Q) over dott) without affecting ET-1.
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| 9. |
- Hansson, Monica, et al.
(author)
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Effect of local anaesthesia and/or analgesia on pain responses induced by piglet castration
- 2011
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In: Acta Veterinaria Scandinavica. - : Springer Science and Business Media LLC. - 0044-605X .- 1751-0147. ; 53
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Journal article (peer-reviewed)abstract
- Background Surgical castration in male piglets is painful and methods that reduce this pain are requested. This study evaluated the effect of local anaesthesia and analgesia on vocal, physiological and behavioural responses during and after castration. A second purpose was to evaluate if herdsmen can effectively administer anaesthesia. Methods Four male piglets in each of 141 litters in five herds were randomly assigned to one of four treatments: castration without local anaesthesia or analgesia (C, controls), analgesia (M, meloxicam), local anaesthesia (L, lidocaine), or both local anaesthesia and analgesia (LM). Lidocaine (L, LM) was injected at least three minutes before castration and meloxicam (M, LM) was injected after castration. During castration, vocalisation was measured and resistance movements judged. Behaviour observations were carried out on the castration day and the following day. The day after castration, castration wounds were ranked, ear and skin temperature was measured, and blood samples were collected for analysis of acute phase protein Serum Amyloid A concentration (SAA). Piglets were weighed on the castration day and at three weeks of age. Sickness treatments and mortality were recorded until three weeks of age. Results Piglets castrated with lidocaine produced calls with lower intensity (p < 0.001) and less resistance movements (p < 0.001) during castration. Piglets that were given meloxicam displayed less pain-related behaviour (huddled up, spasms, rump-scratching, stiffness and prostrated) on both the castration day (p = 0.06, n.s.) and the following day (p = 0.02). Controls had less swollen wounds compared to piglets assigned to treatments M, L and LM (p < 0.001). The proportion of piglets with high SAA concentration (over threshold values 200, 400 mg/l) was higher (p = 0.005; p = 0.05) for C + L compared to M + LM. Ear temperature was higher (p < 0.01) for controls compared to L and LM. There were no significant treatment effects for skin temperature, weight gain, sickness treatments or mortality. Conclusions The study concludes that lidocaine reduced pain during castration and that meloxicam reduced pain after castration. The study also concludes that the herdsmen were able to administer local anaesthesia effectively
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| 10. |
- Nalin, Lovisa, et al.
(author)
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Positron emission tomography imaging of the glucagon-like peptide-1 receptor in healthy and streptozotocin-induced diabetic pigs
- 2014
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In: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 41:9, s. 1800-1810
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Journal article (peer-reviewed)abstract
- PurposeThe glucagon-like peptide-1 receptor (GLP-1R) has been proposed as a target for molecular imaging of beta cells. The feasibility of non-invasive imaging and quantification of GLP-1R in pancreas using the positron emission tomography (PET) tracer [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 in non-diabetic and streptozotocin (STZ)–induced diabetic pigs treated with insulin was investigated.MethodsNon-diabetic (n = 4) and STZ-induced diabetic pigs (n = 3) from the same litter were examined. Development of diabetes was confirmed by blood glucose values, clinical examinations and insulin staining of pancreatic sections post mortem. Tissue perfusion in the pancreas and kidneys was evaluated by [15O]water PET/computed tomography (CT) scans. The in vivo receptor specificity of [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 was assessed by administration of either tracer alone or by competition with 3–6.5 μg/kg of Exendin-4. Volume of distribution and occupancy in the pancreas were quantified with a single tissue compartment model.Results[15O]water PET/CT examinations showed reduced perfusion in the pancreas and kidneys in diabetic pigs. [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 uptake in the pancreas of both non-diabetic and diabetic pigs was almost completely abolished by co-injection of unlabeled Exendin-4 peptide. [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 uptake did not differ between non-diabetic and diabetic pigs. In all animals, administration of the tracer resulted in an immediate increase in the heart rate (HR).ConclusionPancreatic uptake of [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 was not reduced by destruction of beta cells in STZ-induced diabetic pigs.
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| 11. |
- Nyman, Görel, et al.
(author)
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Pulsed delivery of inhaled nitric oxide counteracts hypoxaemia during 2.5 hours of inhalation anaesthesia in dorsally recumbent horses
- 2012
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In: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 39:5, s. 480-487
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Journal article (peer-reviewed)abstract
- Objective The study aimed to investigate the effect of varying pulse lengths of inhaled nitric oxide (iNO), and 2.5 hours of continuous pulse-delivered iNO on pulmonary gas exchange in anaesthetized horses.Study Design Experimental study. Animals Six Standardbred horses.Methods Horses received acepromazine, detomidine, guaifenesin, thiopentone and isoflurane in oxygen, were positioned in dorsal recumbency and were breathing spontaneously. iNO was on average pulsed during the first 20, 30, 43 or 73% of the inspiration in 15 minute steps. The pulse length that corresponded to the highest (peak) partial pressure of arterial oxygen (PaO2) in the individual horses was determined and delivered for a further 1.5 hours. Data measured or calculated included arterial and mixed venous partial pressures of O2 and CO2, heart rate, respiratory rate, expired minute ventilation, pulmonary and systemic arterial mean pressures, cardiac output and venous admixture. Data (mean +/- SD) was analysed using anova with p < 0.05 considered significant.Results Although the pulse length of iNO that corresponded to peak PaO2 varied between horses, administration of all pulse lengths of iNO increased PaO2 compared to baseline. The shortest pulse lengths that resulted in the peak PaO2 were 30 and 43% of the inspiration. Administration of iNO increased PaO2 (12.6 +/- 4.1 kPa [95 +/- 31 mmHg] at baseline to a range of 23.0 +/- 8.4 to 25.3 +/- 9.0 kPa [173 to 190 mmHg]) and PaCO2 (8.5 +/- 1.2 kPa [64 +/- 9 mmHg] to 9.8 +/- 1.5 kPa [73 +/- 11 mmHg]) and decreased venous admixture from 32 +/- 6% to 25 +/- 6%. The increase in PaO2 and decrease in venous admixture was sustained for the entire 2.5 hours of iNO delivery.Conclusions The improvement in arterial oxygenation during pulsed delivery of iNO was significant and sustained throughout 2.5 hours of anaesthesia.Clinical relevance Pulsed iNO potentially could be used clinically to counteract hypoxemia in anaesthetized horses.
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