Vet360 Vol 4 Issue 4 August 2017 Vet 360 - Page 17

CPD ACCREDITED ARTICLE This study assessed puppy vigour and survival follow- ing medetomidine, propofol and sevoflurane anaes- thesia for elective CS. Materials and Methods This is a retrospective, descriptive study that included 292 CSs in 256 privately owned bitches which under- went a CS and were selected from the general ob- stetric population because of increased obstetric risk. High-risk pregnancies in the current study were con- sidered those occurring in bitches from breeds with a high risk of complicated parturition 20 , with a history of dystocia 21 , or with known very large litters 22 . All the bitches were admitted 3 to 4d prior to the predicted parturition date calculated as 57d following D0**. **D1 was redefined as D0 because it chronically caused the error of vets starting to count from the old d1 and the next day d2 whereas it should be d1 = 0 and the next day is d1, this led to intervals between cytological dioestrus and parturition being wrong (out with 24 hours) which can be devastating in the bitch when timing CS During these days, the bitches were observed for signs of impending parturition (panting, inappetence, nesting behaviour, tenesmus) and by 6 hourly vagi- nal speculum examinations to assess the cervix. The decision on when to perform a CS was based upon the first appearance of any degree of dilatation of the cervix. Once the decision to perform a CS was made, an ultrasound examination of the abdomen was per- formed to establish if there were any dead foetuses (absence of detectable heartbeat). Starting at induction, fluid therapy commenced and the PCV before and after CS determined as previous- ly described 23 . All bitches weighed more than of 20 kg. The anaesthetic protocol used in the current study included the alpha-2-adrenergic agonist medetomi- dine hydrochloride (Domitor®, Zoetis Animal Health, Sandton, South Africa) at 7 µg/kg iv as a premedicant, followed one minute later by propofol (Fresenius propoven®1%, Fresenius Kabi, Midrand, South Africa) at 1 to 2 mg/kg iv as an induction agent. The propo- fol was administered as follows, the calculated dose of 2 mg/kg was drawn up in syringe and 1 mg/kg/iv was administered as a bolus. The remaining propofol was used as top-up if required. This was followed by immediate intubation and inhalation of room air. Fol- lowing surgical preparation (averaging 3 to 5 min), the bitch was connected to a closed-circuit anaesthet- ic machine with 2% sevoflurane (Sevoflo®, Safeline Pharmaceuticals, North Cliff, South Africa) in oxygen for maintenance of anaesthesia. The CS was performed in standard fashion as de- scribed 24 . Meloxicam (Metacam®, Boehringer Ingel- heim, Randburg, SA) was administered iv (0.1 mg/kg) intra-operatively, as previously proposed 25 , immedi- ately after delivery of the last puppy. The processing of puppies following delivery involved immediate administration of atipamezole hydrochloride (Antise- dan®, Zoetis Animal Health, Sandton, South Africa) at the dose of 50 µg/puppy sc, tying off of the umbilicus and applying 10% povidone iodine thereto, drying the puppies, gently shaking fluids from their airways and placing them in an air-heated incubator set at 35°C. No oxygen support was offered to the puppies after delivery. Also, immediately after surgery, atipamezole hydro- chloride at the dose of 20 µg/kg was administered iv (extra label route of admin) to the bitch. The bitch was observed until the coughing reflex returned and was then extubated and observed until she was breathing comfortably whilst in sternal recumbency, sitting up- right or standing. It was recorded if the bitches were fully ambulatory within 15 minutes following extuba- tion. After delivery of the puppies the following re- cords were made; total number of puppies delivered, live puppies, dead puppies, deformed puppies and puppies euthanased. The Apgar scores were assessed starting with the first puppy 15 minutes after the last puppy was delivered according to the methods pub- lished 26 and later used by 27 . The bitch and puppies were discharged usually 2 to 3/h following surgery. The puppy survival rate was established immediately after delivery, at 2 hours post CS and 7d post CS and Shift to training and research solutions made to measure. Partner with Enterprises University of Pretoria to make the shift towards integrated training, research and advisory services by collaborating with world-class experts to create all-inclusive corporate solutions. TRAINING SOLUTIONS RESEARCH SOLUTIONS Training programmes and short courses • Applied research Online and CPD courses • Advisory services Customised courses for corporate training Earn a certificate from the University of Pretoria • Specialised services • Direct access to experts from the University of Pretoria You have a plan. We have a way to make it happen. Ask us how. SMS the keyword ENTERPRISES followed by VET360 your name and email to 43366 to receive more information about our full offering. Shifting knowledge to insight +27 (0)12 434 2500 | Issue 04 | AUGUST 2017 | 17