OBJECTIVE:To validate the Zürich Composite Measure Pain Scale (ZCMPS) for assessing postoperative pain in cattle undergoing abomasal displacement surgery. STUDY DESIGN:Prospective, randomised, blinded study. ANIMALS:A total of 14 video recordings from 11 cows that underwent laparotomy for abomasal displacement were included. METHODS:A group of six veterinarians with different levels of experience independently assessed the 14 videos. Videos were recorded 2, 6, 12 or 24 hours after surgery. The study consisted of four phases: training and phases I, II and III. In phases I and II, observers scored pain using the ZCMPS. In phase III, they applied a visual analogue scale (VAS) and indicated whether rescue analgesia was required (no/yes) based on clinical judgement. Real-time scoring by two additional observers was used for comparison against video-based assessments. Statistical analyses included intraclass correlation coefficients (ICCs) for inter- and intra-observer reliability, Spearman correlation between ZCMPS and VAS, Mann-Whitney U tests for video versus real-time scoring and receiver operating characteristic curve analysis to evaluate the ability of the ZCMPS to identify cows requiring analgesia. RESULTS:The ZCMPS demonstrated excellent inter- and intra-observer reliability (ICC > 0.9, p < 0.001). Significant correlation was found between ZCMPS and VAS scores (rho = 0.7, p < 0.001), supporting construct validity. Sensitivity and specificity of the ZCMPS were 70% and 77%, respectively, when applying a threshold of ≥ 4/15 for rescue analgesia. Video-based scoring was comparable with real-time assessments, indicating robustness of the scale when applied remotely. CONCLUSIONS AND CLINICAL RELEVANCE:The ZCMPS is a reliable and valid tool for assessing abdominal pain in cattle with abomasal displacement. It can be used by observers with varying experience levels.

To compare the use of postoperative analgesia for mastectomy, 44 dogs were randomly allocated to either the Splash treatment group (group A) or the Transverse Abdominis Plane block treatment group (TAP, group B). Following intramuscular (IM) premedication with pethidine (4 mg kg−1) and acepromazine (0.01 mg kg−1), anesthesia was induced with intravenous (IV) propofol and maintained with isoflurane by an anesthetist (DC) who was unaware of the treatment. In group A, ropivacaine 0.5% (2 mg kg−1) was administered prior to surgical wound closure. In group B, ropivacaine 0.5% (0.8–1 mg kg−1 per point) was administered by ultrasound-guided TAP block with two injection points per treated body side. At the end of the surgery, all dogs received pethidine (4 mg kg−1 IM), meloxicam (0.2 mg kg−1 IV), and acepromazine (0.005 mg kg−1 IV). The animals’ pain was assessed by the anesthetist, who remained unaware of the treatment type used, via the Short Form of the Glasgow Composite Pain Scale. When the pain scores were ≥6, methadone (0.2 mg kg−1 IV) and gabapentin (10 mg kg−1 per oral) were started. When the pain score remained ≥ 6, ketamine (1 mg kg−1 subcutaneously) was administered. The dogs in the TAP block group had lower postoperative pain scores 3–12 h after anesthesia administration was terminated and required significantly less rescue analgesia.

This report describes the case of a 13-month-old, 46 kg, brown-black coloured mountain goat (Caprinae), which was presented for anaesthesia to facilitate surgical repair of a femoral head fracture in the left pelvic limb. Clinical evaluation was unremarkable except for marked lameness (5/5). After sedation, general anaesthesia was induced for open reduction and internal fixation of the fracture using pins. After aseptic preparation, a “GIN & TONIC” block, comprising the combination of an ultrasound-guided greater ischiatic notch (GIN) plane block (bupivacaine 0.25%; 0.25 mL kg–1) and a caudal quadratus lumborum block (C-QLB, bupivacaine 0.25%; 0.3 mL kg–1), was performed. No significant changes in monitored physiologic variables were observed during the fracture repair except for a slight heart rate increase (21% above 77 beats minute-1 at baseline) during fracture reduction, which was treated with a single dose of intravenous ketamine (0.2 mg kg–1). Regurgitation of ruminal contents occurred just before ketamine injection. At extubation, the interior of the endotracheal tube was clear and no signs of aspiration were observed postoperatively. The goat readily accepted food three hours after surgery, and no pain response was elicited on palpation of the surgical site immediately after recovery or during the next 12 hours. This case suggests that the ultrasound-guided greater ischiatic notch plane block combined with the caudal quadratus lumborum block (GIN & TONIC block) offers effective and reliable analgesia for surgeries at the hip joint in goats. Future studies are warranted to further validate the efficacy and safety of this technique in goats and explore its potential benefits in other ruminants undergoing orthopaedic procedures.

A Trotter mare (aged 5 years 8 months) presented with severe thoracic limb lameness 2 years after screw fixation of a third carpal bone fracture. Septic arthritis of the intermediate carpal joint necessitated three anaesthetics: two arthroscopic lavages in dorsal recumbency, followed by a computed tomography-guided screw explantation with curettage of an infected, sclerotic third carpal bone in right lateral recumbency. For each anaesthetic, maintenance was with isoflurane carried in oxygen and air, and a medetomidine constant rate infusion. Twelve days after the third anaesthetic, the horse had severe skin necrosis of the right pinna, which fully healed over the course of 6 weeks. This report describes a potential perianaesthetic complication, most likely caused by incorrect head positioning during anaesthesia leading to ischaemic tissue damage. Though a definitive cause could not be established, this report serves to highlight, and raise awareness of, this postanaesthetic morbidity.

A 5-year-old post-parturient Holstein Friesian cow, with a history of decreased milk production, decreased appetite and metritis, was referred for left abomasal displacement, which was corrected by right paralumbar omentopexy. After aseptic preparation of the right flank, an erector spinae plane block was performed under ultrasound guidance, using 20 mL of lidocaine 2% per point of injection, at the level of the thoracic vertebra 13, and the lumbar vertebrae 1 and 2 to provide flank anaesthesia. The cow reacted to the last 2 cm of the oblique skin incision, that corresponded to the most caudal portion of the flank. After local infiltration of the distal incision with 20 mL lidocaine 2%, the procedure was uneventful, with no anaesthesia-related complications and no reactions to surgical stimulation. The present report describes the clinical application of the erector spinae plane block to provide flank anaesthesia in a cow undergoing standing laparotomy.

Objective To investigate the effect of hypoxaemia, hypotension and hypercapnia, among others, on quality of recovery from general anaesthesia in horses. Study design Retrospective, single-centre study. Animals A sample of 1226 horses that underwent general anaesthesia between June 2017 and June 2021. Methods Horses and ponies weighing > 200 kg, aged > 6 months, anaesthetized using a xylazine- or medetomidine-isoflurane balanced anaesthesia protocol and presenting a complete anaesthetic record were included. Data were extracted from the clinic record system and from the original anaesthesia records. Recoveries were divided into 'good' and 'bad' based on the available recovery scores. Influence of hypoxaemia [PaO2 < 60 mmHg (7.99 kPa)], hypotension (mean arterial pressure < 70 mmHg for at least 15 minutes) and hypercapnia [PaCO2 > 60 mmHg (7.99 kPa)], anaesthesia protocol, body weight, age, breed, sex, American Society of Anesthesiologists status, type of procedure, emergency or nonemergency, duration of anaesthesia, positioning, times spent in lateral and sternal recumbency during recovery, time until standing and nonassisted or assisted recovery on the assigned recovery score (good/bad) were investigated using generalized linear regression analysis (p < 0.05). Results Hypoxaemia and prolonged duration of anaesthesia were significantly associated with a bad recovery score. No other factors had a significant influence on recovery quality. Conclusion and clinical relevance Hypoxaemia and prolonged anaesthesia duration have a negative effect on quality of anaesthetic recovery in horses. Clinically, this highlights the importance of keeping anaesthetic time as short as possible and to monitor oxygenation and treat hypoxaemia as soon as possible.

INTRODUCTION:In Switzerland, compared to the United Kingdom or the United States of America, fewer veterinary anaesthetists are employed in private practice, which raises the question about the reason. The present survey aimed at investigating the awareness of pet owners concerning the specialization of veterinary anaesthesia and the value they attribute to such a specialist. Also, estimation of pain in dogs and cats and the importance of its treatment from the point of view of the pet owners was analysed. Furthermore, the necessity of veterinary anaesthetists in private practice and the influencing factors were investigated. The survey was created on LimeSurvey, an online tool for questionnaires and sent to dog and cat owners of the small animal clinic of the University Hospital of Zurich. 317 fully completed questionnaires were evaluated. In general, pet owners appreciated the specialization of veterinary anaesthesiology. Great importance was attributed to the supervision of anaesthesia and analgesic therapy by a specialist. A preliminary talk with an anaesthetist would be appreciated. Owners would be willing to cover additional costs for a specialized anaesthetist, if recommended by the private veterinarian, and to bring their animal to the University Hospital, in case of an increased anaesthetic risk.

The objective of this study was to investigate the feasibility of external jugular vein catheterization through an ear vein in piglets. Forty-six sevoflurane-midazolam anaesthetized piglets were included. External jugular vein catheterization was conducted through the ear vein using the Seldinger technique. Part 1 (n = 27): optimal puncture site was based on the deltoid tuberosity as a landmark to reach the external jugular vein. The final position of the catheter was verified in 25 piglets using computer tomography. Catheterization time was recorded and patency of the catheter assessed by repeated blood sampling for up to 4 h. Part 2 (n = 19): ear vein catheterization was without taking into account any landmarks. Functionality for blood sampling was evaluated as described in part 1. Catheter advancement was possible in 25/27 and 18/19 piglets in parts 1 and 2, respectively. Median (range) time required for successful catheterization was 1.95 (1-10) min (n = 38). The deltoid tuberosity was a good landmark to reach the external jugular vein. But blood sampling was also possible through catheters ending slightly cranial to the external jugular vein. Despite successful catheter advancement, blood sampling was not possible from one catheter in each part of the study (total: two piglets). One of these catheters presented luminal damage, while the other one presented as normal after being removed from the animal. Summarizing, central vein catheterization through the ear vein was feasible in 93.5% and repeated blood sampling was possible in 89.1% of the piglets (n = 46).

Morbidity and mortality associated with general anaesthesia has been intensively investigated in most domestic species (Johnston et al. 2002; Brodbelt et al. 2008; Gozalo-Marcilla et al. 2021; Shoop-Worrall et al. 2022). However, large multicentre studies investigating morbidity and mortality associated with general anaesthesia of domestic ruminants and camelids, such as cattle, sheep, goats, alpacas and llamas, are lacking.

A 17-year-old, domestic, entire, male, miniature donkey with a history of syncope because of sinus bradycardia, high-grade second degree and occasional third degree atrioventricular block was referred for pacemaker implantation under general anaesthesia. After local anaesthesia with topical EMLA cream and subcutaneous mepivacaine infiltration and following tranquilisation with intravenous acepromazine, a temporary pacing catheter was inserted via introducer catheter through the left jugular vein into the right ventricle's apex. After initiation of internal pacing, medetomidine and butorphanol were administered intravenously, followed by ketamine and diazepam. Maintenance of anaesthesia was with isoflurane combined with medetomidine and lidocaine constant-rate infusions. Intramuscular morphine and intravenous medetomidine were administered for recovery. The procedure was uneventful with no anaesthesia-related complications, and manually assisted recovery was smooth. The present report describes the anaesthetic challenges and management of pacemaker implantation under general anaesthesia in a miniature donkey.

SummaryThis case report describes venous air embolism as a complication of stifle joint arthroscopy in a 16‐year‐old French Saddle Pony. Carbon dioxide was used to achieve joint distension during the procedure and accidentally entered the vasculature, causing the embolism. The diagnosis was based on a sudden onset of laboured breathing, tachycardia and dropping end‐tidal carbon dioxide (PE'CO2) and was confirmed by arterial blood gas analysis showing hypercapnia and large PE'CO2—arterial partial pressure of carbon dioxide (PaCO2) difference. This complication was treated by increasing the fraction of inspired oxygen (FIO2) and immediate ceasing of further gas insufflation. The horse suffered no further complications. To our knowledge, this is the first publication reporting this complication during arthroscopy in a horse. Awareness of this complication should be raised between veterinarians performing arthroscopies when using gas as the distending agent. A high index of suspicion and early recognition of the embolism can improve chances for full and unremarkable recoveries.

Hepatic gene therapy by delivering non-integrating therapeutic vectors in newborns remains challenging due to the risk of dilution and loss of efficacy in the growing liver. Previously we reported on hepatocyte transfection in piglets by intraportal injection of naked DNA vectors. Here, we established delivery of naked DNA vectors to target periportal hepatocytes in weaned pigs by hydrodynamic retrograde intrabiliary injection (HRII). The surgical procedure involved laparotomy and transient isolation of the liver. For vector delivery, a catheter was placed within the common bile duct by enterotomy. Under optimal conditions, no histological abnormalities were observed in liver tissue upon pressurized injections. The transfection of hepatocytes in all tested liver samples was observed with vectors expressing luciferase from a liver-specific promoter. However, vector copy number and luciferase expression were low compared to hydrodynamic intraportal injection. A 10-fold higher number of vector genomes and luciferase expression was observed in pigs using a non-integrating naked DNA vector with the potential for replication. In summary, the HRII application was less efficient (i.e., lower luciferase activity and vector copy numbers) than the intraportal delivery method but was significantly less distressful for the piglets and has the potential for injection (or re-injection) of vector DNA by endoscopic retrograde cholangiopancreatography.

The proximal paravertebral nerve block is commonly used to provide anaesthesia to the flank during standing surgical procedures in adult cattle. It has been reported that additional anaesthetic infiltration may be necessary to provide complete anaesthesia. In humans as well as animal species, another technique-the ultrasound (US)-guided erector spinae plane block (ESPB)-has been described. The goal of the present study was to develop and investigate an US-guided ESPB in comparison to a blind proximal paravertebral nerve block (PPNB) in cow cadavers. In 10 cadaver specimens, injections of methylene blue-lidocaine (1:1) were performed at the level of T13, L1 and L2 vertebras, on one side doing an ESPB block and, on the other side, a PPNB. Five cadavers were injected with high (40 mL per injection for PPNB and 20 mL for ESPB) and five with low (20 and 15 mL, respectively) volumes of injectate. For the ESPB, the ultrasound probe was oriented craniocaudally, and the ventral-cranial aspect of the articular processes (T13, L1 and L2) was targeted for injection. The dye spreading was evaluated by dissection. The landmarks for US-guided injection were easily visualized; however, injections were accidentally performed at T12, T13 and L1. Nevertheless, L2 was stained in 60% of ESPBs. Epidural spreading was observed with both techniques and all volumes. Viscera puncture was reported in two PPNBs. The ESPB resulted in similar nerve staining compared to the PPNB while using a lower volume of injectate. Even better staining is expected with a T13-L2 instead of a T12-L1 ESPB approach. Further studies are warranted to evaluate the clinical efficacy.

A 4-month-old entire male Coton de Tulear dog was referred for balloon valvuloplasty for treatment of severe valvular pulmonic stenosis. During the procedure when attempting to pass the guide wire into the ventricle, the dog developed cardiac arrest. After initial resuscitation with chest compressions, manual ventilation, adrenaline and intravenous fluids, focused cardiac ultrasound revealed pericardial effusion (PE) and cardiac tamponade. Pericardiocentesis resolved the haemodynamic emergency. This case report should raise awareness of pericardial tamponade as a possible complication during pulmonic stenosis balloon valvuloplasty. It describes the clinical signs observed during anaesthesia as well as how to treat it with a positive outcome.

Although facial characteristics are used to estimate horse sedation, there are no studies measuring their reliability and validity. This randomised controlled, prospective, horizontal study aimed to validate a facial sedation scale for horses (FaceSed). Seven horses received detomidine infusion i.v. in low or high doses/rates alone (DL 2.5 μg/kg+6.25 μg/kg/h; DH 5 μg/kg+12.5 μg/kg/h) or combined with methadone (DLM and DHM, 0.2 mg/kg+0.05 mg/kg/h) for 120 min, or acepromazine boli i.v. in low (ACPL 0.02 mg/kg) or high doses (ACPH 0.09 mg/kg). Horses’ faces were photographed at i) baseline, ii) peak, iii) intermediate, and iv) end of sedation. After randomisation of moments and treatments, photos were sent to four evaluators to assess the FaceSed items (ear position, orbital opening, relaxation of the lower and upper lip) twice, within a one-month interval. The intraclass correlation coefficient of intra- and interobserver reliability of FaceSed scores were good to very good (0.74–0.94) and moderate to very good (0.57–0.87), respectively. Criterion validity based on Spearman correlation between the FaceSed versus the numerical rating scale and head height above the ground were 0.92 and -0.75, respectively. All items and the FaceSed total score showed responsiveness (construct validity). According to the principal component analysis all FaceSed items had load factors >0.50 at the first dimension. The high internal consistency (Cronbach´s α = 0.83) indicated good intercorrelation among items. Item-total Spearman correlation was adequate (rho 0.3–0.73), indicating homogeneity of the scale. All items showed sensitivity (0.82–0.97) to detect sedation, however only orbital opening (0.79) and upper lip relaxation (0.82) were specific to detect absence of sedation. The limitations were that the facial expression was performed using photos, which do not represent the facial movement and the horses were docile, which may have reduced specificity. The FaceSed is a valid and reliable tool to assess tranquilisation and sedation in horses.

Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords "recovery anaesthesia horse", entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 "narrative reviews/expert opinions", 16 "retrospective outcome studies", 5 "surveys", 59 "premedication/sedation and induction drugs", 27 "maintenance with inhalant agents", 55 "maintenance with total intravenous anaesthesia (TIVA)", 3 "TIVA versus inhalants", 56 "maintenance with partial intravenous anaesthesia (PIVA)", 27 "other drugs used during maintenance", 18 "drugs before/during recovery", 18 "recovery systems", 21 "respiratory system in recovery", 41 "other factors", 51 "case series/reports" and 6 "systems to score recoveries". Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.

Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg−1 medetomidine or 1.1 mg·kg−1 xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg−1·h−1 medetomidine or 0.7 mg·kg−1·h−1 xylazine, and sedation after anaesthesia with 2 µg·kg−1 medetomidine or 0.3 mg·kg−1 xylazine. Recovery was timed and, using video recordings, numerically scored by two blinded observers. Influence of demographics, procedure, peri-anaesthetic drugs, and intraoperative complications (hypotension, hypoxemia, and tachycardia) on recovery were analysed using regression analysis (p < 0.05). A total of 470 recoveries (medetomidine 279, xylazine 191) were finally included. Following medetomidine, recoveries were significantly longer (median (interquartile range): 57 (43–71) min) than xylazine (43 (32–59) min) (p < 0.001). However, the number of attempts to stand was similar (medetomidine and xylazine: 2 (1–3)). Poorer scores were seen with increased pre-anaesthetic dose of xylazine, intraoperative tetrastarch, or salbutamol. However, use of medetomidine or xylazine did not influence recovery score, concluding that, following medetomidine–isoflurane PIVA, recovery is longer, but of similar quality compared to xylazine.

Chapter 12 Pharmacology of Drugs Used in Equine Anesthesia Phenothiazines Alicia Skelding, Alicia SkeldingSearch for more papers by this authorPatricia Queiroz-Williams, Patricia Queiroz-WilliamsSearch for more papers by this authorRegula Bettschart-Wolfensberger, Regula Bettschart-WolfensbergerSearch for more papers by this authorSimone K. Ringer, Simone K. RingerSearch for more papers by this author Alicia Skelding, Alicia SkeldingSearch for more papers by this authorPatricia Queiroz-Williams, Patricia Queiroz-WilliamsSearch for more papers by this authorRegula Bettschart-Wolfensberger, Regula Bettschart-WolfensbergerSearch for more papers by this authorSimone K. Ringer, Simone K. RingerSearch for more papers by this author Book Editor(s):Tom Doherty MVB, MSc, DACVAA, Tom Doherty MVB, MSc, DACVAA Retired from the College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USASearch for more papers by this authorAlex Valverde DVM, DVSc, DACVAA, Alex Valverde DVM, DVSc, DACVAA Ontario Veterinary College, University of Guelph, Guelph, Ontario, CanadaSearch for more papers by this authorRachel A. Reed DVM, DACVAA, Rachel A. Reed DVM, DACVAA College of Veterinary Medicine, University of Georgia, Athens, GA, USASearch for more papers by this author First published: 26 November 2021 https://doi.org/10.1002/9781119631316.ch12 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Summary This chapter describes the mechanism of action, physiologic effects, clinical use, and contraindications of the drugs used in equine anaesthesia, such as phenothiazines, butyrophenones, α2-adrenergic agonists, adrenergic antagonists, opioids, tramadol, trazadone, benzodiazepines, benzodiazepine antagonists, guaifenesin, ketamine, tiletamine and zolazepam, alfaxalone, propofol, barbiturates, and intravenous lidocaine. Acepromazine is the most commonly used phenothiazine in the domestic horse. Acepromazine interacts with a variety of receptors, displaying a number of effects in the central nervous system. Butyrophenone tranquilizers are mainly used in combination with other drugs to provide immobilization of feral and wild equine species. The use of opioids in horses has been controversial due to the inability of these drugs, when used alone, to cause reliable sedation or reduce minimum alveolar concentration. Manual of Equine Anesthesia and Analgesia, Second Edition RelatedInformation

Chapter 21 General Anesthesia Techniques Regula Bettschart-Wolfensberger, Regula Bettschart-WolfensbergerSearch for more papers by this authorSimone K. Ringer, Simone K. RingerSearch for more papers by this author Regula Bettschart-Wolfensberger, Regula Bettschart-WolfensbergerSearch for more papers by this authorSimone K. Ringer, Simone K. RingerSearch for more papers by this author Book Editor(s):Tom Doherty MVB, MSc, DACVAA, Tom Doherty MVB, MSc, DACVAA Retired from the College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USASearch for more papers by this authorAlex Valverde DVM, DVSc, DACVAA, Alex Valverde DVM, DVSc, DACVAA Ontario Veterinary College, University of Guelph, Guelph, Ontario, CanadaSearch for more papers by this authorRachel A. Reed DVM, DACVAA, Rachel A. Reed DVM, DACVAA College of Veterinary Medicine, University of Georgia, Athens, GA, USASearch for more papers by this author First published: 26 November 2021 https://doi.org/10.1002/9781119631316.ch21 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Summary This chapter discusses general anaesthesia techniques in equine practice. General anesthesia involves a sedation, an induction, a maintenance, and a recovery phase. It is recommended that the induction of anesthesia be preceded by deep sedation. Benzodiazepines alone, or with opioids, may be used for sedation of neonatal foals, but they cause ataxia without sedation in older horses. The chapter provides the drugs used for induction of anesthesia: ketamine, alfaxalone, propofol, tiletamine/zolazepam, and thiopental. Inhalational anesthetics are commonly used to maintain general anesthesia in equines, especially for longer procedures. The use of inhalational anesthetics as induction agents has been recommended for foals. Manual of Equine Anesthesia and Analgesia, Second Edition RelatedInformation