https://www.vmedtechnology.com/Post-surgical%20deaths.pdf

The risk of death: the confidential enquiry into perioperative small animal fatalities.

Objective—To describe a simple method of laparoscopic-assisted ovariohysterectomy (LAOHE) and compare duration of surgery, complications, measures of surgical stress, and postoperative pain with open ovariohysterectomy (OHE) in dogs. Design—Randomized, prospective clinical trial. Animals—20 healthy sexually intact female dogs weighing > 10 kg (22 lb). Procedures—Dogs were randomly allocated to receive conventional OHE or LAOHE. Intraoperative complications, anesthetic complications, total anesthesia time, and total surgery time were recorded. Serum cortisol and glucose concentrations, temperature, heart rate, and respiratory rate were measured preoperatively and 1, 2, 4, 6, 12, and 24 hours postoperatively. Pain scores were assigned by a nonblinded observer at 1, 2, 4, 6, 12, and 24 hours postoperatively. Duration of surgery, pain scores, objective measures of surgical stress, anesthetic complications, and surgical complications were compared between OHE and LAOHE. Results—Age, weight, PCV, and duration o...

Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs

Rationale: The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge. Relevance: Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian‐client‐patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care. Approaches: The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals. Evidence base: The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.

/pdf/2015-aaha-aafp-pain-management-guidelines-for-dogs-and-cats-52ov3lm2de.pdf

2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats*

Guidelines for recognition, assessment and treatment of pain: WSAVA Global Pain Council members and co-authors of this document:.

The use of hypertonic saline in the treatment of traumatic brain injury.

Objective—To compare indicators of postoperative pain and behavior in dogs with and without a lowdose ketamine infusion added to usual perioperative management. Design—Prospective, randomized, blinded clinical study. Animals—27 dogs undergoing forelimb amputation. Procedure—Dogs were anesthetized with glycopyrrolate, morphine, propofol, and isoflurane. Thirteen dogs were treated with ketamine IV, as follows: 0.5 mg/kg (0.23 mg/lb) as a bolus before surgery, 10 µg/kg/min (4.5 µg/lb/min) during surgery, and 2 µg/kg/min (0.9 µg/lb/min) for 18 hours after surgery. Fourteen dogs received the same volume of saline (0.9% NaCl) solution. All dogs received an infusion of fentanyl (1 to 5 µg/kg/h [0.45 to 2.27 µg/lb/h]) for the first 18 hours after surgery. Dogs were evaluated for signs of pain before surgery, at the time of extubation, and 1, 2, 3, 4, 12, and 18 hours after extubation. Owners evaluated their dogs' appetite, activity, and wound soreness on postoperative days 2, 3, and 4. Results—Dogs that received ...

Use of low doses of ketamine administered by constant rate infusion as an adjunct for postoperative analgesia in dogs.

6 – Objective, Categoric Methods for Assessing Pain and Analgesia

The prevention and management of pain is fundamental to the practice of both human and veterinary medicine. The recognition and treatment of pain represents an important indicator of the quality of care delivered in human hospitals and veterinary hospitals. Yet, both human and veterinary health care professionals have cited inadequate knowledge as a significant barrier to effective pain management. The aims of this pilot study were twofold: (1) to gauge veterinary medical students' current attitudes regarding their training in pain management and (2) to assess the impact of training and practice on the use of a canine acute pain assessment teaching tool. Participants, third-year professional veterinary medical students, completed a 16-item survey questionnaire before a 30-minute training session on pain assessment using the teaching tool and completed it again after training and a one-week practice period. Questions related to canine pain, assessment of canine pain, pain management education in the professional veterinary curriculum, and an example case presentation (video) were included in the survey. The analysis of survey results indicated that professional veterinary medicine students find value in didactic and clinical training in canine pain assessment. Additionally, use of the canine acute pain teaching tool in conjunction with a training program improved students' knowledge and skill in assessment while pointing out the importance of further training. Differences with regard to gender and tracking were found and warrant further exploration.

https://jvme.utpjournals.press/doi/pdf/10.3138/jvme.37.4.358

Effects of a Pilot Training Program on Veterinary Students' Pain Knowledge, Attitude, and Assessment Skills

The legal market for recreational and medicinal cannabis for human consumption is growing worldwide. At the same time, marketing of cannabis products for use in pets is expanding. Yet, there is little research exploring the effects of cannabis use in veterinary medicine. This study used an anonymous, online survey to assess Canadian pet owners' reasons for purchasing cannabis products for their dogs, and their perceptions regarding efficacy of these treatments. Owners purchased cannabis products for treatment of pain, inflammation, and anxiety in dogs, and perceived these preparations to be equally or more effective than conventional medications. Most owners reported only minimal side effects in their dogs. Despite indicating comfort in discussing canine cannabis administration with their veterinarian, most owners relied on commercial websites for product information. The main reasons for choosing cannabis products were the ability to use as an adjuvant to other therapies, and the perception of it being a natural substance. Given this information, it is incumbent upon veterinarians to appropriately counsel their clients, and also to advocate for evidence-based studies to evaluate the efficacy of cannabis use in non-human species.

Canadian dog owners' use and perceptions of cannabis products.

OBJECTIVE To assess the prevalence of medical errors (specifically, near misses [NMs] and adverse events [AEs]) and their personal and professional impact on veterinarians. DESIGN Cross-sectional study. SAMPLE Members of the Veterinary Information Network (n = 46,481). PROCEDURES An electronic survey regarding veterinarians' experiences with NMs and AEs was distributed via email to an online veterinary community between September 24 and October 21, 2015. Responses were summarized and compared between genders by means of the χ2 test. RESULTS 606 veterinarians completed the survey (1.3% response rate). Overall, 447 (73.8%) respondents reported involvement in ≥ 1 NM (n = 389 [64.2%]) or AE (179 [29.5%]). The NMs had a short-term (≤ 1 week) adverse impact on professional life for 68.0% (261/384) of respondents and longer-term negative impact for 36.4% (140/385). The impact on respondents' personal lives was similar (63.6% [245/385] and 33.5% [129/385], respectively). For AEs, these numbers were 84.1% (148/176), 56.2% (99/177), 77.8% (137/176), and 50.6% (89/175), respectively. Both NMs and AEs were more likely to negatively impact female veterinarians than male veterinarians. CONCLUSIONS AND CLINICAL RELEVANCE These findings suggested that many veterinarians experience emotional distress after a medical error. Support should be provided to mitigate this adverse impact on the wellbeing of veterinarians and, potentially, their future patients.

Veterinarians' experiences with near misses and adverse events.

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