Objective: Investigate the effect of bilateral ultrasound-guided quadratus lumborum block (QLB) in the need for additional opioid administration in response to intraoperative nociception during ovariectomy in cats. Methods: Thirty-six feral cats were randomly allocated to group control (C) or group QLB with 0.4 mL kg−1 of 0.25% bupivacaine per hemiabdomen. Hemodynamic data were collected at five intraoperative time points. A 20% increase in pulse rate or respiratory rate was treated with fentanyl. Results: Pulse rate and respiratory rate were higher in the C group compared to the QLB group during ovarian manipulation. No differences in systolic and mean arterial pressure and hypotension were comparable in both groups. The QLB group required less administration of intraoperative fentanyl than the C group at 4/16 and 10/16, respectively (p < 0.05). Conclusions: The bilateral QLB with bupivacaine led to a reduction in opioid consumption in feral cats undergoing elective ovariectomy.

Background: The monitoring of nociception/antinociception poses a significant challenge during anesthesia, making the incorporation of new tools like the Parasympathetic Tone Activity (PTA) monitor an added value in feline anesthesia. Objectives: To compare the effectiveness and speed of PTA monitoring when compared to heart rate (HR) in detecting surgical stimuli (SS) during the intraoperative period in 49 female cats undergoing ovariectomy (OV). Methods: Instantaneous Parasympathetic Tone Activity (PTAi) values, HR, fR, and non-invasive SAP and MAP were continuously monitored and systematically assessed. The time required for HR (HR time) and PTAi (PTAi time) to reach their minimum peak values following each surgical stimulus was collected at five points for each anaesthetized cat. Each collected surgical stimulus was categorized into 3 groups for statistical analysis: no nociception detection, no hemodynamic reaction and a PTAi > 50 (Nhre); no hemodynamic reaction and a PTAi < 50 (Nhre < 50); and hemodynamic reaction and PTAi < 50 (Hre < 50). Results: PTAi response demonstrated effectiveness in detecting nociception compared to HR. The SS were categorized as 36.1% in the Nhre group, 50% in the Nhre < 50 group, and only 13.9% in the Hre < 50 group. In the Hre < 50 group, PTAi time and HR time had similar speeds in detecting the SS (p = 0.821); however, PTA time was significantly slower in the Nhre < 50 group when compared to the Hre < 50 group (p = 0.001). Conclusions: PTA monitoring may be a useful tool to complement HR monitoring for detecting nociception. PTA monitoring demonstrated a superior diagnostic value compared to HR for detecting nociception in cats undergoing OV and a similar speed to HR in detecting SS when HR increases above 20%. Future studies are needed to understand in a clinical setting the meaning of sympathetic activation/nociception detected using the PTA monitor when the HR increase is not clinically relevant.

Objectives The aim of the present study was to evaluate the differences in intraoperative nociception, incision size and operative time between midline (OVE m) and flank ovariectomy (OVE f) in feral or stray cats. Methods Two groups of animals, the OVE m group (n = 19) and the OVE f group (n = 19), were evaluated at six intraoperative time points. Cats assigned to both groups were premedicated with dexmedetomidine (20 μg/kg IM) and methadone (0.2 mg/kg IM). General anaesthesia was induced with intravenous propofol to effect and maintained with isoflurane in 100% oxygen. The data collected included heart rate, non-invasive systolic and median blood pressure, respiratory rate, weight, body condition score, surgical time, incision size and rescue analgesia. Results Significant differences were observed between surgical approaches, with larger incision size ( P <0.001) and longer surgery time ( P = 0.04) in the OVE m group. No significant differences between surgical approaches were detected regarding intraoperative nociception ( P >0.05). Conclusions and relevance Based on intraoperative nociception, there is no strong reason to advocate a preferred surgical approach for feline OVE in sterilisation programmes; however, considering surgery time and incision size, the OVE f approach may contribute to the sterilisation of more animals and reduce the risk of wound dehiscence as it allows for smaller incisions to be made in animals where postoperative wound control is difficult or impossible.

Background: Ultrasound-guided quadratus lumborum block (QLB) and sacrococcygeal epidural anaesthesia (ScE) have been used for neutering cats, providing effective pain relief. Objectives: To compare the effects of the QLB with those of ScE in cats undergoing ovariectomies. Methods: Feral cats undergoing ovariectomy were premedicated with dexmedetomidine (20 μg kg−1) and methadone (0.2 mg kg−1) intramuscularly. Anaesthesia was induced with 2–4 mg kg−1 of propofol intravenously and maintained with isoflurane in oxygen. The cats were randomly allocated to the groups QLB (bilateral QLB with 0.4 mL kg−1 of 0.25% bupivacaine) and ScE (0.3 mL kg−1 of 0.25% bupivacaine). Hemodynamic data and analgesia rescue were collected at four intraoperative periods. The pain scale and motor block were assessed in both groups during the postoperative period. Results: The ScE results in increased hypotension, prolonged extubation time, and higher postoperative motor block than the QLB (p < 0.05). The QLB and ScE groups required a similar number of intraoperative rescues and presented the same postoperative pain scale classification. Conclusions: The QLB with 0.25% bupivacaine is a potential alternative to ScE with 0.25% bupivacaine in perioperative pain management in elective cat ovariectomy. The QLB promoted less hypotension and postoperative motor block when compared with the ScE group.

The ovariectomy (OVE) procedure can trigger somatosensory and visceral peritoneal nociception. Sacrococcygeal epidural (ScE) anesthesia may complement or replace systemic analgesia used for feline OVE, reducing opioid consumption and their related undesirable adverse effects and consequently reducing or completely blocking the sympathetic nervous system activation during this procedure. The present study aimed to evaluate the activation of the sympathetic nervous system resulting from adding an ScE injection of bupivacaine 0.25% (0.3 mL kg−1) in feline OVE and identify whether this translates to hemodynamic variables stability. A Parasympathetic Tone Activity (PTA) monitor was applied given that it performs analysis of heart rate variability (HRV) detecting changes in sympathetic and parasympathetic tone, making it a good tool for detecting activation of the sympathetic nervous system during the study. Two groups of animals were evaluated in five perioperative times, namely, the control group (CG) (n = 18) with systemic analgesia alone and the sacrococcygeal epidural group (ScEG) (n = 20) with 0.25% bupivacaine combined with systemic analgesia. Thirty-eight female cats were selected. All animals assigned to CG and ScEG were premedicated with dexmedetomidine (20 μg kg−1 IM) and methadone (0.2 mg kg−1 IM). General anesthesia was induced with propofol IV ad effectum and maintained with isoflurane in 100% oxygen. Heart rate, non-invasive systolic and median blood pressure, respiratory rate, and instantaneous parasympathetic tone activity were recorded. Compared to systemic analgesia alone (CG), sacrococcygeal epidural (ScEG) reduced the rise of common hemodynamic variables but did not prevent sympathetic nervous system activation.

Background and Aim: Passive hip laxity (PHL) is considered the primary risk factor for canine hip dysplasia (HD) and is estimated, in stress hip radiographs, using the distraction index (DI). The study aimed to associate the early PHL using the hip Distractor of University of Trás-os-Montes and Alto Douro (DisUTAD) and the late HD grades. Materials and Methods: A total of 41 dogs (82 hips) were submitted to a follow-up study. First, between 4 and 12 months of age, dogs were radiographed using the DisUTAD hip distractor and were determined the DI for each hip joint. Then, after 12 months of age, dogs were reevaluated for HD using the conventional hip ventrodorsal projection and hips were evaluated for HD using the Fédération Cynologique Internationale (FCI) scoring system. Results: Hips of dogs’ in the second examination with FCI grades of A (n=28), B (n=11), C (n=22), and D and E (n=21) had an early DI of 0.32±0.1, 0.38±0.08, 0.50±0.12, and 0.64±0.11, respectively. Statistical analysis using the general linear model univariate, with the DI as dependent variable and the FCI grades, side and sex as fixed factors, and the post hoc Bonferroni correction test showed significant differences among FCI grades (p<0.05). Conclusion: These results show the association between early DI and the late FCI HD grades and the DisUTAD is recommended for the early canine HD diagnosis.

Hip dysplasia (HD) is one of the most common hereditary orthopaedic diseases in dogs, with serious implications for the quality of life of the affected animals. Radiographic screening is essential for the selection of breeding stock in some at-risk breeds, and radiography is also used in the diagnosis of clinical HD cases. A definitive diagnosis of HD is based on radiographic examination, and the most commonly used view is the ventrodorsal hip extended projection, sometimes in combination with various hip stress-based techniques. Radiographic images require high quality positioning and dogs are usually anesthetized and often manually restrained to facilitate optimal positioning. The 'as low as reasonably achievable' (ALARA) principle used in human radioprotection is not always fulfilled in veterinary practice, except in the UK, where human exposure to ionizing radiation in veterinary medicine is strictly regulated. While each dose of ionizing radiation is small, doses accumulate over a lifetime, which can eventually result in substantial radiation exposure. Therefore, manual restraint should be avoided and mechanical immobilization, sedation or general anaesthesia should be used. This review examines the biological effects of human exposure to ionizing radiation and common sources of veterinary exposure. The diagnostic quality of imaging methods for the diagnosis of canine HD is compared between manually restrained and hands-free dog positioning. Hands-free radiographic techniques are available to assess hip laxity, degenerative joint changes and hip osseous structure while preserving image quality, and can be used to select animals for breeding or for the diagnosis of HD.

ABSTRACT The aim of this study was to test the accuracy of a new automated computer software tool for the assessment of passive hip laxity. The hip laxity was estimated using the dedicated computer software by two blinded evaluators, one previously trained and one without specific training for distraction index measurement, in two independent sessions using 230 hip joints from 115 dogs that underwent screening for passive hip laxity using the distraction view. Previously, all of these radiographs were sent to PennHIP Analysis Center for an official distraction index record. The measurement repeatability of the two sessions was adequate for both evaluators. The reproducibility of the official distraction index measurement, mean distraction index±standard deviation 0.44±0.15, was adequate (P>0.05) for the trained evaluator, 0.44±0.15, and non-adequate (P<0.05), for the non-trained evaluator 0.47±0.17. The distraction index measurement tool proposed can be used with confidence for hip laxity evaluation by trained evaluators, as it provided good repeatability and reproducibility of official reports. The simplicity of the process described leads to a less time-consuming and more affordable procedure.

Hip dysplasia (HD) is an important hereditary orthopedic disease in the dog associated with osteoarthritis and inadequate welfare for affected animals. The radiographic ventrodorsal hip extended (VDHE) view is used worldwide to select the better animals for breeding. This view normally is performed with manual restraining of the dog to obtain radiographs with acceptable technical quality. The veterinarian exposition to ionizing radiation is inevitable. In this study, the technical quality of VDHE radiographs and hip measurements was compared in 65 dogs radiographed twice, one with the common veterinarian manual restraining and the other obtained using a hind limb holder device, without the veterinarian within the X-ray room. The variables studied were pelvic tilting, patella displacement index, Norberg angle (NA), and subluxation hip category. The results showed a random distribution of right and left pelvic tilting, patella lateral or medial displacement, and hip subluxation categories in both samples (P > 0.05). The holder device positioning showed a better pelvic symmetry (P < 0.05) and a similar patellar displacement (P > 0.05). The mean ± standard deviation of NA was 101.1° ± 6.2° and 100.9° ± 6.1° in the manual and holder device hind limb restraining, respectively (P > 0.05), and the lower limit of 95% confidence interval of intraclass correlation coefficient was >0.75. These results showed statistical reproducibility of NA measurements by the hind limb holder device, and the examiner was protected from exposure to ionizing radiation within the X-ray room.

Canine hip dysplasia is the most common orthopedic developmental condition in the dog and early hip laxity is the main risk factor. The importance of hip laxity in young animals in the development of hip dysplasia is unanimously recognized among researchers and veterinarians due to its medical applicability in terms of disease control and prevention. In the market, there is some certified hip distractors to promote joint laxity. However, the clinical use of some of these distractors complies with a set of usage rules, that can limit its medical application. In this study was compared the technical quality of radiographs and hip distraction using a certified hip distractor (CertD) and Dis-UTAD in 104 dogs (208 joints). The mean pelvic tilting of 1.5 ± 1.6° and 1.5 ± 1.8° were similar when using the CertD and the Dis-UTAD distractors, respectively (P > 0.05). In the CertD sample, the mean hip distraction index (DI) was 0.46 ± 0.17 and in the Dis-UTAD 0.46 ± 0.16; the mean DI differences was 0.001 ± 0.045, resulting in a non-significant paired t-test (P = 0.65) and a significant intraclass correlation coefficient of 0.96, with the 95% lower limit confidence interval of 0.95 (P < 0.05). The statistical power analysis showed a very low distraction index difference effect size. The results suggest that the statistical reproducibility of CertD hip distraction by the Dis-UTAD and the DI mean differences of 0.001 might be considered without clinical importance. The Dis-UTAD might be considered adequate to promote dog hip laxity.

Abstract Objective The aim of this study was to evaluate the effect of pelvic tilting along the long axis and femoral rotation on Norberg angle (NA), subluxation index (SI) and subluxation category (SC) in the standard ventrodorsal hip extended (VDHE) radiographical view on live animals. Study Type This was a retrospective clinical study. Materials and Methods Pairs of VDHE views, one adequately positioned and the other with pelvic tilting or femoral internal or external rotation, were compared for the NA, SI and SC. Results On the malpositioned pelvis set, on the underside the mean ± SD NA was 98.7 ± 6.1°, the SI was 0.27 ± 0.12 and the SC was 2.8 ± 0.8 versus, on the acceptable set, the NA was 99.2 ± 6.4° (p > 0.05), the SI was 0.25 ± 0.12 (p < 0.05) and the SC was 2.3 ± 0.9 (p < 0.05); on the malpositioned upperside, the NA was 102.1 ± 6.4°, the SI was 0.21 ± 0.14 and the SC was 1.7 ± 1.1 versus, on the acceptable positioned set, the NA was 100.8 ± 6.7° (p < 0.05), the SI was 0.24 ± 0.15 (p < 0.05) and the SC was 2.3 ± 1.2 (p < 0.05). Femoral internal or external rotation sets did not show significant differences between malpositioned and acceptable positioned sets (p > 0.05). Conclusions In clinical practice, pelvic tilting along the long axis in VDHE view results in non-favourable hip changes in the NA, SI and SC on the underside and favourable on the upperside, and the internal or external femoral rotation did not affect these variables.

Summary Objectives: To study the symmetry of the iliac horizontal diameter (IHD) maximum obturator foramen width (OFW), ischiatic femoral overlap (IFO), pelvic horizontal radius (PHR), femoral head diameter (FHD), and obturator foramen area (OFA) parameters in the normal hip extended radiographic view and to evaluate the correlation of pelvic rotation with the magnitude of asymmetry of these parameters. Methods: Nine canine cadavers from adult, large and giant breeds were radiographed in standard hip extended views and with 2°, 4° and 6° degrees of rotation. The variables IHD, OFW, IFO, PHR, FHD, and OFA were analysed in radiographs. Results: The IHD measurements exhibited repeatability, bilateral symmetry and 95% of confidence interval of asymmetry in different pelvic rotations without superposition (p <0.05); OFW and IFO exhibited repeatability, bilateral symmetry and a small superposition in 95% of confidence interval of asymmetry according different pelvic rotations; PHR, FHD and OFA exhibited repeatability, bilateral symmetry and unacceptable superposition in 95% of confidence interval of asymmetry depending on pelvic rotation. Clinical significance: The IHD is the recommended variable and OFW is an acceptable variable in order to evaluate slight pelvic rotation. The data may be used in qualitative analyses of hip extended radiographic views. In the future, complementary studies should be performed to evaluate the impact of degree of pelvic rotation on the hip dysplasia score.