Kim D, et al. J Vet Sci. 2022 Sep;23:e81. https://doi.org/10.4142/jvs.22105

A 14-year-old intact female mongrel dog presented for periodontal disease underwent anesthesia for dental procedures. During surgery, the dog developed cardiopulmonary arrest (CPA) characterized by a sudden drop in end-tidal carbon dioxide and pulseless electrical activity. Cardiopulmonary resuscitation was initiated and return of spontaneous circulation was achieved after 20 min. Post-resuscitation imaging revealed moderate pneumoperitoneum, hepatic portal venous gas, and gas within the caudal vena cava without evidence of gastrointestinal rupture or peritonitis. Conservative management including intensive monitoring and supportive care resulted in progressive resolution of these gas accumulations and complete clinical recovery. This is the first veterinary report to describe pneumoperitoneum following CPR during dental surgery. The case broadens current understanding of nonsurgical etiologies of pneumoperitoneum in small animals and demonstrates that conservative management may be a viable option in selected post-resuscitation patients.

Geonho Choi, Dongseok Kim, Eungmo Tae, Ilgwon Jung, Sang-Kwon Lee, Won-Jae Lee, Sung-Ho Yun, Young-Sam Kwon, Min Jang. J Vet Clin 2023;40:44-9. https://doi.org/10.17555/jvc.2023.40.1.44

To evaluate the accuracy, agreement, and trending ability of the pulse contour cardiac output (PulseCO) system calibrated with echocardiography-derived cardiac output (CO) in sevoflurane-anesthetized healthy dogs during 8 hours of general anesthetic. Prospective, randomized, blinded experimental study. A total of five healthy Beagle dogs, three intact females and two intact males. Dogs were anesthetized using intravenous alfaxalone for induction and sevoflurane in 100% oxygen for maintenance for 8 hours. CO was estimated using three methods: pulmonary artery catheter thermodilution (PAC-TD)-derived CO (CO_PAC-TD), Doppler-based echocardiography-derived CO (CO_Echo), and PulseCO-derived CO (CO_PulseCO). The PulseCO monitor was calibrated at baseline using CO_Echo and not recalibrated during the anesthetic. Measurements were taken at baseline and at intervals up to 8 hours. All CO values were converted to cardiac index (CI) by indexing to body surface area. Statistical analysis included Bland-Altman and linear regression analyses for agreement assessment and Critchley's four-quadrant and polar plots for trending analysis. A total of 100 paired CI measurements were obtained. Bland-Altman analysis revealed a mean bias of -0.1 L minute^-1 m^-2 and percentage error of 28.3% for CI_PAC-TDversus CI_PulseCO, and a mean bias of 0.01 L minute^-1 m^-2 with a percentage error of 24.9% for CI_PAC-TDversus CI_Echo. Trending analysis between CI_PAC-TD and CI_PulseCO showed a concordance rate of 98.2% in the four-quadrant plot and a mean angular bias of 2.6 ° with radial limits of agreement ranging from -21.47 ° to 26.67 ° in the polar plot. The results indicate that the PulseCO system has acceptable accuracy, agreement, and trending ability compared with the traditional reference method of PAC-TD. This highlights the potential of the PulseCO system as a minimally invasive and practical monitoring tool in sevoflurane-anesthetized dogs.

Dongseok Kim, Geonho Choi, Sang-Kwon Lee, Kija Lee, Won-Jae Lee, Sung-Ho Yun, Young-Sam Kwon, Min Jang. J Vet Clin 2022;39:277-81. https://doi.org/10.17555/jvc.2022.39.5.277