This pilot randomized controlled clinical trial of patients with ARDS was implemented to study the impact of inhaled nitric oxide (inhNO) on lung function, morbidity, and mortality. Thirty patients with ARDS were randomly allocated to usual care or usual care plus inhNO. The optimal dose of inhNO was determined to be between 0.5 and 40 parts-per-million daily. All therapeutic interventions were standardized. ARDS resulted mainly from sepsis (25 of the 30). During the first 24 h, the hypoxia score increased greatly in patients treated with inhNO + 70.4 mm Hg ( + 59%) versus + 14.2 mm Hg ( + 9.3%) for the control group (p = 0.02), venous admixture decreased from 25.7 to 15.2% in the inhNO group, and from only 19.4 to 14.9% in the control group (p = 0.05). After the first day of therapy no further beneficial effect of inhNO was detected. Forty percent of the patients treated with inhNO were alive and weaned from mechanical ventilation within 30 d after randomization compared with 33.3% in the control group (p = 0.83). The 30-d mortality rate was similar in the two groups; most deaths (11 of 17) were due to multiple organ dysfunction syndrome. This study shows that inhNO, in this population, may improve gas exchange but does not affect mortality.

Objective—To determine prevalence of adverse effects associated with epidural administration of morphine with or without bupivacaine in dogs and cats undergoing surgery and evaluate effects of epidural administration of morphine on postoperative pain severity. Design—Retrospective study. Animals—242 dogs and 23 cats. Procedure—Morphine with or without bupivacaine was administered prior to surgery with a Tuohy needle, spinal needle, or epidural catheter. In 18 dogs that underwent surgery twice, results of preemptive epidural administration of morphine with or without bupivacaine were compared with results of systemic administration of oxymorphone and ketoprofen. Results—The delivered fraction of isoflurane was significantly lower in animals given morphine and bupivacaine than in animals given morphine alone. Analgesia was of significantly longer duration in dogs given morphine and bupivacaine than in dogs given morphine alone. During anesthesia, mild respiratory and cardiovascular depression was reported. Seven dogs and 2 cats had urine retention, and 2 dogs developed pruritus. Six dogs vomited when a second dose of morphine was given epidurally the day after surgery. Eight of 72 dogs had delayed hair growth. In 18 dogs that underwent surgery twice, the delivered fraction of isoflurane was significantly lower and the duration of analgesia was significantly longer when morphine with or without bupivacaine was given epidurally than when oxymorphone and ketoprofen were given. Conclusions and Clinical Relevance—Results suggest that preemptive epidural administration of morphine with or without bupivacaine is a safe and effective method of inducing long-lasting analgesia in dogs and cats and is superior to standard management of postoperative pain with repeated injection of oxymorphone and ketoprofen. (J Am Vet Med Assoc 2002;221:666–672)

This study aimed to characterize osteoarthritis (OA)-related chronic pain and disability in experimental cats with naturally occurring OA. Peak vertical ground reaction force (PVF), accelerometer-based motor activity (MA) and the von Frey anesthesiometer-induced paw withdrawal threshold were used to define OA and to test the efficacy of meloxicam. A diagnosis of OA was based on radiographic and orthopedic examinations. Cats with OA (n=39) and classified as non-OA (n=6) were used to assess the reliability and sensitivity of the parameters to assess OA over 3weeks while being administered placebo medication. A randomised parallel design study was then used to investigate the effects on OA of daily oral meloxicam treatment for 4weeks at different dose rates (0.025mg/kg, n=10mg/kg; 0.04mg/kg, n=10; 0.05mg/kg, n=9), compared to cats administered a placebo (n=10). The test-retest repeatability for each tool was good (intra-class correlation coefficient ⩾0.6). The PVF and the von Frey anesthesiometer-induced paw withdrawal threshold discriminated OA (P<0.05). Meloxicam did not add to the PVF improvement observed in placebo-treated cats during the treatment period (adj-P⩽0.01). The 0.025 and the 0.05mg/kg meloxicam-treated cats experienced a higher night-time (17:00-06:58h) MA intensity during the treatment period compared to the placebo period (adj-P=0.04, and 0.02, respectively) and this effect was not observed in the placebo group. The high allodynia rate observed in the 0.04mg/kg meloxicam-treated group may explain the lower responsiveness to the drug. The von Frey anesthesiometer-induced paw withdrawal threshold demonstrated no responsiveness to meloxicam. The results from this study indicated that daily oral meloxicam administration for 4weeks provided pain relief according to night-time MA.

With osteoarthritis being the most common degenerative disease in pet animals, a very broad panel of natural health products is available on the market for its management. The aim of this systematic review and meta-analysis, registered on PROSPERO (CRD42021279368), was to test for the evidence of clinical analgesia efficacy of fortified foods and nutraceuticals administered in dogs and cats affected by osteoarthritis. In four electronic bibliographic databases, 1578 publications were retrieved plus 20 additional publications from internal sources. Fifty-seven articles were included, comprising 72 trials divided into nine different categories of natural health compound. The efficacy assessment, associated to the level of quality of each trial, presented an evident clinical analgesic efficacy for omega-3-enriched diets, omega-3 supplements and cannabidiol (to a lesser degree). Our analyses showed a weak efficacy of collagen and a very marked non-effect of chondroitin-glucosamine nutraceuticals, which leads us to recommend that the latter products should no longer be recommended for pain management in canine and feline osteoarthritis.