15 Oct 2018
Alex Gough takes another look over the latest veterinary studies in his latest Research Review.
Alex Gough
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Image: Stefano Garau / Adobe Stock
Furosemide is a mainstay of the treatment of left-sided congestive heart failure, and is often given IV in acute heart failure.
Ohad et al1 performed a retrospective study to compare the effects of constant rate infusion (CRI) versus intermittent bolus administration to see which had the superior outcome in cases of acute left-sided congestive heart failure. A total of 76 dogs and 24 cats were included in the study.
The median dose of furosemide in the CRI group was lower than in the bolus group. In both the CRI and bolus groups, the respiratory rate was lower after treatment than before.
No short-term difference in mortality between the groups was noted. However, creatinine and total plasma protein levels were higher in the CRI group, suggesting a higher risk of dehydration.
The authors recommended further studies to assess the safety profiles of the two techniques.
Sotalol is an antiarrhythmic drug commonly used to treat ventricular arrhythmias. However, it has beta blocker activity, which may have an effect on ventricular function.
Visser et al2 performed a prospective study to assess the acute echocardiographic effects of sotalol on systolic function in dogs with ventricular arrhythmias.
A total of 35 dogs were included in the study – 27 dogs had an echocardiogram and ECG performed at baseline two to four hours after sotalol, while the remaining 8 had the same tests, but without administration of sotalol.
Most echocardiographic measurements suggested a mild decrease in ventricular systolic function. The arrhythmias and heart rate also improved after treatment with sotalol. No dogs appeared to exhibit an adverse event after the administration of sotalol.
The authors concluded although sotalol may cause a mild decrease in systolic function, it is well tolerated.
Gastropexy is a surgical technique to prevent gastric volvulus either before (preventively) or after an episode of gastric dilatation-volvulus (GDV) to prevent recurrence. Several different techniques exist that could be used.
Formaggini and Degna3 performed a prospective, descriptive cohort study to describe the complications and long-term efficacy of a modified belt loop gastropexy in dogs.
A total of 100 dogs that had presented with GDV were included in the study. No intraoperative complications were observed.
Based on follow-up conversations, no dogs had a recurrence of GDV in the follow-up period, which was a minimum of one year.
The authors concluded the study provided strong evidence the modified belt loop gastropexy prevents recurrence of GDV.
Low-level laser therapy (LLLT) has been widely used to stimulate healing and reduce pain in various conditions.
Kennedy et al4 performed a controlled trial to assess the effect of LLLT on synovial inflammation, pain, function, healing and OA after tibial plateau-levelling osteotomy (TPLO).
A total of 12 dogs with unilateral cranial cruciate ligament rupture were included in the study.
The dogs were fitted with an accelerometer from two weeks before surgery until eight weeks after. The dogs were then randomised to receive LLLT or a red light control immediately before, and at regular intervals, after surgery for up to eight weeks.
The outcome was assessed by an owner-completed Canine Brief Pain Inventory, force plate analysis, radiography, synoviocentesis and physical and orthopaedic examinations. Inflammation markers were analysed in the synovial fluid.
The improvement in the force plate analysis was greater at two and four weeks in the control group than the LLLT group, and the owner-assessed pain scores were lower in the control group than the LLLT group for weeks one to five.
The authors concluded the protocol used in this study had no beneficial effect on pain or limb function after TPLO.
Further studies are required to determine whether LLLT has an effect on pain and healing – and, if so, to determine the best protocol.
A large number of techniques exist for managing cranial crucial ligament (CCL) rupture in dogs, and many papers investigating the evidence for and against these techniques have been mentioned in this column over the years.
Von Pfeil et al5 performed a cross-sectional study involving a survey of members of the Veterinary Orthopaedic Society to evaluate the preferred method of treatment of CCL rupture in dogs weighing more than 15kg.
A total of 221 out of 575 members responded.
The mean length of time since graduation of respondents was 23 years, 78.6% preferred TPLO, 13.9% preferred tibial tuberosity advancement (TTA), 5.9% preferred lateral fabellar suture and 1.6% preferred tightrope-like braided multifilament suture (TR). TPLO was preferred independently of whether the respondent was board-certified.
The respondents believed titanium implants used in TTA had the lowest rate of complications, while the braided multifilament suture used in TR had the highest rate of complications.
The authors concluded TPLO was generally the preferred treatment for CCL rupture in larger dogs and recommended caution in the use of the TR technique in light of the perception of a higher complication rate.
Gabapentin is an anti-epileptic medication that is also commonly used in the treatment of pain – particularly of neurological origin.
Guedes et al6 performed a blinded, placebo-controlled, randomised crossover study to assess the effect of gabapentin on older cats with OA.
A total of 20 cats older than 10 years with OA were given either gabapentin or placebo twice daily for two weeks, after which the alternate treatment was given, with no washout period.
The activity of the cats was assessed with an accelerometer mounted on the collar. Clients also completed questionnaires regarding selected activities.
Gabapentin administration was found to decrease mean daily activity, but improved the ability of cats to perform activities that were impaired by the OA. Gabapentin was also associated with sedation, ataxia, weakness and muscle tremors. Sedation was the most common side effect.
The authors concluded gabapentin was associated with improvement in impaired activities as assessed by owners.
Rodenticide exposure in domestic animals can be fatal without treatment.
Walton and Otto7 performed a retrospective study to determine the prevalence of rodenticide exposure in cats and evaluate the use of gastrointestinal decontamination (GID) following exposure. A total of 146 cats were included in the study over an 11-year period. Risk factors included being young, entire or in the autumn season.
Two-thirds of the cats lived outdoors. A total of 50% of cases involved an unknown toxin. Where the toxin was known, anticoagulant rodenticides were by far the most common. Cholecalciferol and bromethalin were less common.
In 21 out of 36 cats with a known exposure to an anticoagulant rodenticide, GID was attempted. Emesis was attempted in 81%, and charcoal was administered in 14 of the cats that underwent GID. No improvement in prothrombin time related to GID was noted 48 hours after exposure.
The authors noted this study showed cats consume rodenticides and a lack of evidence exists for effectiveness of GID. Therefore, they recommended evaluation of a prothrombin time 48 hours after exposure, with treatment being based on this.
