{"title":"Epidural and Spinal Anesthesia and Analgesia in the Equine","authors":"Cláudio C. Natalini DVM, MS, PhD , Bernd Driessen DVM, PhD, Dipl. ACVA & ECVPT","doi":"10.1053/j.ctep.2007.05.008","DOIUrl":"10.1053/j.ctep.2007.05.008","url":null,"abstract":"<div><p>In human and animal anesthesia, epidural and spinal administration of drugs is used to provide surgical anesthesia and/or postoperative analgesia. Several local anesthetic drugs are used to produce epidural anesthesia, such as lidocaine, bupivacaine, ropivacaine, and mepivacaine. Epidural analgesia is obtained with opioid agonists, alpha<sub>2</sub><span>-adrenergic agonists, and ketamine. In horses, caudal epidural anesthesia is used to desensitize the anus, rectum, perineum, vulva, vagina, urethra, and bladder. The goal is to produce surgical regional anesthesia without losing motor function of the hind limbs. A combination of a local anesthetic drug with an alpha</span><sub>2</sub><span><span>-adrenergic agonist or an opioid is the most popular option as this combination extends the period of action of the epidural anesthesia or analgesia in horses, humans, and small animals. Spinal analgesia and anesthesia has not been used in horses as an adjunct to general anesthesia as much as it has in small animals and human beings. The epidural administration of opioids with or without local anesthetics is commonly performed in dogs and </span>cats before surgery to reduce general anesthetic requirements as well as to provide intraoperative and postoperative pain control. The perioperative use of epidural and spinal analgesia in horses is likely to increase in the future as recent studies have shown that administration of epidural or subarachnoid alpha</span><sub>2</sub>-adrenergic agonists, phencyclidines, opioids, and low-dose local anesthetic produce intense antinociceptive effects.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 2","pages":"Pages 145-153"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2007.05.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91402279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Regula Bettschart-Wolfensberger PD DMV, PhD, Dipl. ECVAA, M. Paula Larenza DMV, Dipl. ECVAA
{"title":"Balanced Anesthesia in the Equine","authors":"Regula Bettschart-Wolfensberger PD DMV, PhD, Dipl. ECVAA, M. Paula Larenza DMV, Dipl. ECVAA","doi":"10.1053/j.ctep.2007.05.002","DOIUrl":"10.1053/j.ctep.2007.05.002","url":null,"abstract":"<div><p>The following article aims at giving an overview on currently available balanced anesthetic regimens for horses. In horses, maintenance of cardiovascular function and thus muscular perfusion during anesthesia is essential. Also, a smooth recovery phase which should be completed within at least 1 hour of termination of drug administration is crucial. All inhalation anesthetics depress cardiovascular function dose dependently. Thus, drugs that decrease the need for inhalation anesthetics (decrease MAC) might improve cardiovascular function during anesthesia. Lidocaine constant rate infusion (CRI), at clinically used dose rates, decreases MAC<span> by about 25%, and no untoward cardiovascular side effects have been reported. In horses anesthetized for several hours, careful dosing is advised. Toxicity due to accumulation, masked during anesthesia, might become apparent during recovery. Ketamine is the only drug used for balanced anesthesia that might positively influence cardiovascular function. But following continuous ketamine administration for longer time periods (>2 hours), rough recoveries can occur. Preliminary results with S-ketamine CRIs showed better results in this respect, but further studies are warranted. Medetomidine CRI does decrease MAC about 30% at recommended dose rates. Cardiovascular function in comparison to lidocaine balance is moderately impaired, but horses show less intraoperative awakening following surgical stimulation. Recovery phase following medetomidine balance is clearly smoother than with any other regimen. In conclusion, lidocaine, ketamine, and medetomidine are mainly used for balanced anesthesia in horses. In cardiovascularly compromised patients, ketamine might be advantageous. If a smooth recovery phase is crucial, medetomidine should be the drug of choice.</span></p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 2","pages":"Pages 104-110"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2007.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83432645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel C. Murray MA, VetMB, MS, PhD, Sue Dyson MA, VetMB, PhD
{"title":"Image Interpretation and Artifacts","authors":"Rachel C. Murray MA, VetMB, MS, PhD, Sue Dyson MA, VetMB, PhD","doi":"10.1053/j.ctep.2006.11.002","DOIUrl":"10.1053/j.ctep.2006.11.002","url":null,"abstract":"<div><p>Magnetic resonance (MR) imaging is a complex modality that produces vast amounts of information. This information is shown as gray scale contrast derived from variations in signal intensity. Normal tissues have characteristic signal intensity patterns and contours. Alterations in tissue biochemical composition, structure, shape, and size can be detected using MR imaging and are seen as alterations in signal intensity and contour of the anatomical structures being evaluated. However, the appearance of MR images are affected greatly by the pulse sequences used in acquisition, the imaging options, and positioning of the region of interest. MR imaging is also prone to a variety of artifacts. It is therefore important that the interpreter has an understanding of the limitations of MR imaging and how best to optimize and interpret the information collected. It is also important that this information is interpreted in the light of the clinical findings and other diagnostic information for each horse.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 16-25"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77472921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marion V. Branch BSc, PhD , Rachel C. Murray MA, VetMB, MS, PhD , Sue J. Dyson MA, VetMB, PhD , Allen E. Goodship BVSc, PhD
{"title":"Magnetic Resonance Imaging of the Equine Tarsus","authors":"Marion V. Branch BSc, PhD , Rachel C. Murray MA, VetMB, MS, PhD , Sue J. Dyson MA, VetMB, PhD , Allen E. Goodship BVSc, PhD","doi":"10.1053/j.ctep.2006.11.009","DOIUrl":"10.1053/j.ctep.2006.11.009","url":null,"abstract":"<div><p>Noninvasive imaging modalities for in vivo monitoring of distal tarsal osteochondral structure are needed. The objectives of this paper were to use high-field magnetic resonance (MR) imaging to describe tarsal structure, variations in association with age, exercise, and distal tarsal pain. Cadaver tarsi of specific ages and exercise histories, and from horses with a history of distal tarsal pain, were examined using MR imaging. Quantitative and subjective analysis of subchondral bone (SCB) was performed according to predefined criteria. There was a repeatable SCB thickness pattern across normal tarsi, with greatest thickness at dorsal and lateral sites. Subchondral bone thickness increased with age. High intensity exercise was associated with altered mediolateral and proximodistal thickness patterns. There was loss of the repeatable SCB thickness pattern in painful tarsi, and MR imaging detected many different types of pathology. This paper provides new information regarding structure and pathological changes in the equine tarsus, which can be used as reference material for clinical situations.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 96-102"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89598890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Magnetic Resonance Imaging of the Equine Carpus","authors":"Rachel C. Murray MA, VetMB, MS, PhD","doi":"10.1053/j.ctep.2006.11.008","DOIUrl":"10.1053/j.ctep.2006.11.008","url":null,"abstract":"<div><p>Although it is possible to acquire magnetic resonance images of the equine carpus, there is very limited published description of such images. This paper describes the anatomy of the equine carpus on magnetic resonance images, based on comparison between magnetic resonance images and frozen cadaver sections. The range of abnormalities seen in 42 carpi from horses with and without a history of carpal lameness is summarized.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 86-95"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78366953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel C. Murray MA, VetMB, MS, PhD , Sue Dyson MA, VetMB, PhD , Marion Branch BSc, PhD , Michael Schramme DMV, PhD
{"title":"Validation of Magnetic Resonance Imaging Use in Equine Limbs","authors":"Rachel C. Murray MA, VetMB, MS, PhD , Sue Dyson MA, VetMB, PhD , Marion Branch BSc, PhD , Michael Schramme DMV, PhD","doi":"10.1053/j.ctep.2006.11.003","DOIUrl":"10.1053/j.ctep.2006.11.003","url":null,"abstract":"<div><p>To have confidence in magnetic resonance (MR) imaging as a diagnostic tool for evaluation of the equine limb, validation of the procedures involved in image acquisition and interpretation is required. It is also important to understand the benefits and limitations of MR imaging by comparison with the macroscopic and microscopic structural abnormalities present within the tissues. This paper outlines various validation procedures that we have undertaken for image acquisition, image interpretation and measurement of structures, and comparison between MR images, macroscopic and histological examination of the equine foot, tarsal, and carpal tissues.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 26-36"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81750128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Magnetic Resonance Imaging of the Equine Foot","authors":"Sue Dyson MA, VetMB, PhD, Rachel Murray MA, VetMB, MS, PhD","doi":"10.1053/j.ctep.2006.11.005","DOIUrl":"10.1053/j.ctep.2006.11.005","url":null,"abstract":"<div><p>Magnetic resonance imaging has revolutionized the diagnosis of foot-related pain, defining many soft tissue injuries that had previously been poorly recognized and greatly enhancing our understanding of pathological abnormalities of the navicular bone. The concept of multiple injuries contributing to lameness has been recognized. It has become clear that lesions may predate the onset of lameness. A better understanding of pain causing lameness is required.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 46-61"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77455158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Magnetic Resonance Imaging of the Equine Patient: A Comparison of High- and Low-Field Systems","authors":"Natasha M. Werpy DVM, Dipl ACVR","doi":"10.1053/j.ctep.2006.11.004","DOIUrl":"10.1053/j.ctep.2006.11.004","url":null,"abstract":"<div><p>As use of magnetic resonance (MR) imaging evolves in veterinary medicine, the importance of field strength will be a continued source of debate. This article addresses the fundamental differences between high- and low-field MR imaging systems. The magnet and room construction, examination time, image quality, and implications on diagnostic accuracy are discussed. Although many injuries can be well characterized with both high- and low-field systems, a high-field system is required to identify certain lesions. Further studies are needed to define the difference in the detectability of lesions on high-field versus low-field MR imaging systems.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 37-45"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79723308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Russell L. Tucker DVM, DACVR, Sarah N. Sampson DVM
{"title":"Magnetic Resonance Imaging Protocols for the Horse","authors":"Russell L. Tucker DVM, DACVR, Sarah N. Sampson DVM","doi":"10.1053/j.ctep.2006.11.001","DOIUrl":"10.1053/j.ctep.2006.11.001","url":null,"abstract":"<div><p><span>Magnetic resonance (MR) imaging provides the opportunity to evaluate structures within the limbs and head that were previously unable to be visualized in live horses. MR imaging has also enabled osseous and soft tissue structures, visible with radiography and ultrasonography, to be evaluated in greater anatomic and physiologic detail. For MR imaging to provide the most accurate and useful information in horses, it is important that the examinations be standardized. It is also important that collection of the images be performed in the most time-efficient manner. This chapter outlines the imaging planes and sequence selection that are most useful when imaging the limbs and head of the horse using a 1.0 Tesla superconducting magnet with the horse under general anesthesia. With this system, imaging of the head, cranial cervical vertebrae<span>, feet, pasterns, </span></span>fetlocks<span>, metacarpal and metatarsal regions, carpi, and tarsi is possible in the adult horse. In foals and miniature horses, it is possible to image more proximally on the limbs and more caudally in the cervical vertebrae.</span></p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 2-15"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91534649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Magnetic Resonance Imaging of the Equine Fetlock","authors":"Sue Dyson MA, VetMB, PhD, Rachel Murray MA, VetMB, MS, PhD","doi":"10.1053/j.ctep.2006.11.006","DOIUrl":"10.1053/j.ctep.2006.11.006","url":null,"abstract":"<div><p>Indications for magnetic resonance imaging (MRI) of the fetlock region are discussed. Normal anatomy is described by reference to figures illustrating sagittal, transverse, and dorsal plane scans using T1-weighted spoiled gradient echo, T2* gradient echo, and short tau inversion recovery (STIR) sequences. Examples of the more common abnormalities identified using MRI are provided.</p></div>","PeriodicalId":100279,"journal":{"name":"Clinical Techniques in Equine Practice","volume":"6 1","pages":"Pages 62-77"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.ctep.2006.11.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73050174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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