Topics in Companion Animal Medicine RSS feed: Current Issue. Topics in Companion Animal Medicine is dedicated to providing the practitioner with the most recent advances in companion animal medicine. Each quarterly issue includes a comprehensive review of the latest developments and techniques regarding an important topic in veterinary medicine, guest edited by a leading expert in the field. Topics in Companion Animal Medicine also features peer-reviewed original research articles, case reports and review articles; as well as timely editorials addressing issues that affect the companion animal practitioner. New and Forthcoming Issues February Chronic Pain Management May Anesthesia Update August Infectious Disease Update November Emerging Issues in Feline Medicine http://www.companimalmed.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Topics in Companion Animal Medicine1938-9736252May 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.companimalmed.com/article/PIIS1938973610000231/abstract?rss=yesEditorial Board10.1053/S1938-9736(10)00023-1Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4iihttp://www.companimalmed.com/article/PIIS1938973610000243/abstract?rss=yesContents10.1053/S1938-9736(10)00024-3Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4iiiiiihttp://www.companimalmed.com/article/PIIS1938973610000309/abstract?rss=yesI graduated from the College of Veterinary Medicine at Texas A&M University in 1989 and went into private mixed practice in rural Oregon. We saw a wide variety of patients in that practice but our small animal anesthetic case load was overwhelmingly healthy, young patients admitted to the hospital for elective procedures. Sure, we occasionally anesthetized a diabetic cat for dental extractions or an older dog with heart disease for a lipoma removal, but these were the exception, not the rule.IntroductionTamara L. Grubb10.1053/j.tcam.2010.04.001Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews6969http://www.companimalmed.com/article/PIIS1938973609001056/abstract?rss=yesMany perioperative pain management protocols for cats and dogs are overly complex, some are ineffective, and still others expose patients to unnecessary risk. The purpose of this article is to provide clinicians with a basic understanding of the pathophysiology of perioperative pain and a working knowledge of the principles of effective therapy. First, the concept of multimodal analgesic therapy is discussed. Next, the pathophysiology of perioperative pain and the clinical pharmacology of the major classes of analgesic drugs are reviewed. And last, a simplified approach to managing perioperative pain in cats and dogs is presented.Analgesia for Anesthetized PatientsKip A. Lemke, Catherine M. Creighton10.1053/j.tcam.2009.12.003Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews7082http://www.companimalmed.com/article/PIIS1938973609001032/abstract?rss=yesCerebral blood flow may be altered in anesthetized patients, and this could be detrimental to patients with intracranial disease. Cerebral blood flow is autoregulated and held constant over a mean arterial pressure range of 50 to 150 mm Hg. Changes in cerebral blood volume are reflected by cerebral blood flow, whereas intracranial pressure varies directly with cerebral blood volume. Cerebral blood flow is also under chemical regulation and varies directly with arterial carbon dioxide tension over the range of 25 to 70 mm Hg. A reduction in arterial oxygen tension to below 60 mm Hg also dramatically increases cerebral blood flow. Changes in both arterial carbon dioxide and oxygen tensions are common in anesthetized patients. Furthermore, anesthetic drugs can alter cerebral blood flow. Injectable anesthetics, except ketamine, tend to preserve cerebral blood flow. Inhalant anesthetics may be associated with cerebral vasodilation, increased cerebral blood flow, and raised intracranial pressure. However, low concentrations of inhalant anesthetics combined with controlled ventilation are effective in preventing exacerbation of raised intracranial pressure. Factors affecting cerebral blood flow should be considered before anesthetizing patients with intracranial disease.Anesthesia for Patients with Neurologic DiseaseStephen A. Greene10.1053/j.tcam.2009.12.001Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews8386http://www.companimalmed.com/article/PIIS1938973609001044/abstract?rss=yesGeneral anesthesia may be necessary for patients with significant disease processes such as renal disease or hepatic disease. A basic understanding of the effects of general anesthetics on these organs and the anticipated problems of renal and hepatic impairment on the anesthetic process is necessary to optimize conditions for patients with renal or hepatic disease. Patient preparation, drug selection, and monitoring strategies will be discussed for patients with renal and liver disease.Anesthesia for Patients with Renal/Hepatic DiseaseAnn B. Weil10.1053/j.tcam.2009.12.002Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews8791http://www.companimalmed.com/article/PIIS193897361000019X/abstract?rss=yesShelter medicine presents a unique challenge that is different from veterinary medicine in a hospital setting. The shelter and/or mobile unit environment requires special anesthetic considerations to support high-volume spay-neuter and feral animal programs with high quality of anesthesia/immobilization for surgery and diagnostic procedures. The anesthetic protocols can be tailored to the needs of each specific shelter setting. An ideal shelter anesthesia protocol will have a wide safety margin for animals of all ages. The protocol must also be effective, economical, and easy to use with a small volume for injection, have rapid on- and off-set with a reasonable surgical duration after a single administration, be predictable, and possess perioperative analgesic properties. An anesthesia protocol with a combination of tiletamine-zolazepam and dexmedetomidine in combination with an opioid fits the criteria of the shelter anesthesia protocols. These combinations possess rapid induction of immobilization, unconsciousness, and muscle relaxation with an anesthesia duration of 30 to 45 minutes. Specific and nonspecific reversal agents are also available to facilitate recovery. This article describes the use of these anesthetic protocols as well as monitoring support for these protocols.Anesthesia in Shelter MedicineJeff C. Ko, Aime G. Berman10.1053/j.tcam.2010.03.001Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews9297http://www.companimalmed.com/article/PIIS1938973610000048/abstract?rss=yesThe increase in the use of magnetic resonance imaging (MRI) for diagnostic use in companion animals has increased the demand for anesthesia support in a strong magnetic environment. In many instances, this may necessitate anesthesia being provided by individuals that are unfamiliar with MRI and the hazards associated with it. The objective of this article is to describe the conditions and hazards associated with a strong magnetic field, review considerations for safe and effective anesthetic management of patients during an MRI, and promote close collaboration and communication between personnel in an effort to insure staff awareness and safety. This report describes conditions that exist for the superconducting high field strength magnets, 1.0, 1.5, and 3.0 Tesla, that are commonly used for clinical imaging of companion animals. Many of these same safety and anesthesia considerations can be applied to any MRI facility.Hazards, Safety, and Anesthetic Considerations for Magnetic Resonance ImagingJulie A. Smith10.1053/j.tcam.2010.01.003Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews98106http://www.companimalmed.com/article/PIIS1938973610000036/abstract?rss=yesAnesthetic management of orthopedic patients could vary from normal routine management to more challenging critical management depending on the state in which the patient is presented. Multimodal pain management strategies incorporating opioids, which are the mainstay drugs for pain management, along with adjunctive drugs like local anesthetics (eg, lidocaine), dissociative anesthetics (eg, ketamine), and α-2 agonists (eg, dexmedetomidine), could improve overall patient comfort and help prevent establishment of chronic pain pathways. Also, use of local nerve blocks can prevent nociception right at the point of origin. Orthopedic patients with multiple organ traumas like head injuries, spinal injuries, pulmonary fat embolism, compartment syndrome, or thoracic injuries are high-risk patients in which any life-threatening organ pathology should be addressed before the patient is put under general anesthesia. Interactions of various drugs like antibiotics and neuromuscular blocking agents used in the perioperative period in orthopedic patients should warrant a careful consideration with respect to their interactions with each other and other anesthetic drugs used.Anesthetic Considerations in Orthopedic Patients With or Without TraumaAmandeep S. Chohan10.1053/j.tcam.2010.01.002Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews107119http://www.companimalmed.com/article/PIIS1938973610000024/abstract?rss=yesBecause the airway extends from the oral or nasal cavity to the alveoli, airway compromise or respiratory disease has numerous manifestations. Complications can be encountered in both the upper and lower airways and include a vast range of problems including laryngeal paralysis, collapsing trachea, pneumonia, pulmonary edema, pneumothorax, intrathoracic masses and diaphragmatic hernias. Anesthesia can cause further complications because anesthetic drugs and equipment can exacerbate or even cause airway difficulties and respiratory compromise. When anesthetizing patients with respiratory disease or airway complications, the choice of the actual anesthetic drugs is not necessarily dictated by the presence of respiratory compromise, but rather by the overall health of the patient. The choice of anesthetic technique (e.g., method of induction, method of intubation, use of positive-pressure ventilation, etc.), on the other hand, is often critical.Anesthesia for Patients with Respiratory Disease and/or Airway CompromiseTamara Grubb10.1053/j.tcam.2010.01.001Topics in Companion Animal Medicine 25, 2 (2010)2010-05-01Topics in Companion Animal Medicine2010-05-01252S1938-9736(10)X0003-4Topical Reviews120132