Comparison of two protocols for insulin administration and fasting time in diabetic dogs anaesthetised for phacoemulsification: A prospective clinical trial.
Animals
Dogs
Female
Male
Anesthesia
/ veterinary
Blood Glucose
/ analysis
Clinical Protocols
Diabetes Mellitus
/ drug therapy
Dog Diseases
/ drug therapy
Fasting
Insulin
/ administration & dosage
Intraoperative Complications
/ epidemiology
Phacoemulsification
/ veterinary
Prospective Studies
Time Factors
Treatment Outcome
Journal
The Veterinary record
ISSN: 2042-7670
Titre abrégé: Vet Rec
Pays: England
ID NLM: 0031164
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
18
11
2020
received:
13
07
2020
accepted:
26
12
2020
pubmed:
15
5
2021
medline:
3
8
2021
entrez:
14
5
2021
Statut:
ppublish
Résumé
There is a lack of evidence-based guidelines on perioperative insulin administration and fasting time in diabetic dogs. The aim of this study was to compare two protocols with respect to intraoperative changes in blood glucose (BG) concentrations compared to preoperative values. Thirty-two dogs were included. Dogs of group AM (n = 15) underwent anaesthesia in the morning after 12 hours fasting and received half their usual insulin dose, while dogs of group PM (n = 17) had surgery in the afternoon after 6 hours fasting and received their usual insulin dose; BG was measured before premedication (baseline), after anaesthetic induction, every 30 minutes throughout surgery, at extubation and after anaesthetic recovery. The occurrence of intraoperative complications was recorded. There were no differences between groups in perioperative changes in BG over time, and in the proportion of dogs experiencing complications. Common complications were hypotension (53 per cent of dogs in either groups), hyperglycaemia (67 and 65 per cent in groups AM and PM) and hyperkalaemia (20 and 11 per cent in groups AM and PM). Either protocols may be used in diabetic dogs undergoing anaesthesia. The occurrence of hyperkalaemia in the study population supports routine intraoperative monitoring of blood potassium concentration.
Sections du résumé
BACKGROUND
There is a lack of evidence-based guidelines on perioperative insulin administration and fasting time in diabetic dogs. The aim of this study was to compare two protocols with respect to intraoperative changes in blood glucose (BG) concentrations compared to preoperative values.
METHODS
Thirty-two dogs were included. Dogs of group AM (n = 15) underwent anaesthesia in the morning after 12 hours fasting and received half their usual insulin dose, while dogs of group PM (n = 17) had surgery in the afternoon after 6 hours fasting and received their usual insulin dose; BG was measured before premedication (baseline), after anaesthetic induction, every 30 minutes throughout surgery, at extubation and after anaesthetic recovery. The occurrence of intraoperative complications was recorded.
RESULTS
There were no differences between groups in perioperative changes in BG over time, and in the proportion of dogs experiencing complications. Common complications were hypotension (53 per cent of dogs in either groups), hyperglycaemia (67 and 65 per cent in groups AM and PM) and hyperkalaemia (20 and 11 per cent in groups AM and PM).
CONCLUSIONS
Either protocols may be used in diabetic dogs undergoing anaesthesia. The occurrence of hyperkalaemia in the study population supports routine intraoperative monitoring of blood potassium concentration.
Substances chimiques
Blood Glucose
0
Insulin
0
Types de publication
Clinical Trial, Veterinary
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e81Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 British Veterinary Association.
Références
De Vries M. Diabetes mellitus and anaesthesia: dealing with its potential problems. Vet Times. 2011:1-6. https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/diabetes-mellitus-and-anaesthesia-dealing-with-its-potential-problems.pdf.
Oliver JAC, Clark L, Corletto F, Gould DJ. A comparison of anesthetic complications between diabetic and nondiabetic dogs undergoing phacoemulsification cataract surgery: a retrospective study. Vet Ophthalmol. 2010;13:244-50.
Monticelli P, Dawson C, Adami C. Life-threatening hyperkalemia in a diabetic dog undergoing anaesthesia for elective phacoemulsification. Vet Anaesth Analg. 2018;45:881-2.
Pacheco PF, Galeazzi VS, Patricio GCF, Flôr PB, Safatle AV, Cortopassi SRG. Anesthetic complications in diabetic dogs subjected to phacoemulsification. Brazilian J Vet Res. 2018;38:1423-30.
Kronen PWM, Moon-Massat PF, Ludders JW, Gleed RD, Kern TJ, Randolph J, et al. Comparison of two insulin protocols for diabetic dogs undergoing cataract surgery. Vet Anaesth Analg. 2001;28:146-55.
Adami C, Hayes RS, Sanchez RF, Monticelli P. Effect of insulin and fasting regimen on blood glucose concentrations of diabetic dogs during phacoemulsification. J Am Anim Hosp Assoc. 2020;56:1-6.
Venzon Varela F, Gostelow R, Forcada Y, Church D, Niessen S. The diabetic clinical score (DCS): evaluation of a simple standardised quantification tool to allow rapid description of clinical signs in diabetic cats. Paper presented at: Proceedings of the British Small Animal Veterinary Association; 7-10 April 2019; Birmingham, UK.
Portier K, Ida KK. The ASA physical status classification: what is the evidence for recommending its use in veterinary anesthesia? - A systematic review. Front Vet Sci. 2018;5:204.
Wienesen RC. The clinical evaluation of the Datex Ohmeda GE S/5 Monitor's non-invasive blood pressure (E-PRESTN) module and the optimal placement of measurement cuff on the anaesthetized dog [dissertation]. Utrecht, the Netherlands: Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, University of Utrecht; 2009.
Lane SL, Koenig A, Brainard BJ. Formulation and validation of a predictive model to correct blood glucose concentrations obtained with a veterinary point-of-care glucometer in haemodiluted and haemoconcentrated canine blood samples. J Am Vet Med Assoc. 2015;246:307-12.
Todd J, Powell L. Hypothermia. In: Silverstein DC, Hopper K, editors. Small animal critical care medicine. St. Louis, MO: Saunders Elsevier; 2009. p. 720-22.
Tanifuji Y, Eger EI. Effect of arterial hypotension on anaesthetic requirement in dogs. British J Anaesth. 1976;48:947-52.
Haskins SC. Operating room emergencies. In: Slatter D, editor. Textbook of small animal surgery. 3rd ed. West Philadelphia: Saunders; 2003. p. 2516-31.
Nelson RW. Canine diabetes mellitus. In: Textbook of veterinary internal medicine. 7th ed. St. Louis, MO: Saunders Elsevier; 2010. p. 1782-16.
Adams JG, Peboni Figueiredo J, Graves TK. Physiology, pathophysiology, and anesthetic management of patients with gastrointestinal and endocrine disease. In: Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Robertson SA, editors. Veterinary anesthesia and analgesia, the fifth edition of lumb and jones. Iowa: Wiley Blackwell; 2015. p. 641-80.
Pascoe PJ. Perioperative management of fluid therapy. In: DiBartola S, editor. Fluid, electrolyte, and acid-base disorders in small animal practice. 4th ed. St. Louis, MO: Saunders Elsevier; 2012. p. 405-35.
Hess RS. Diabetic ketoacidosis. In: Silverstein DC, Hopper K, editors. Small animal critical care medicine. 2nd ed. West Philadelphia: Saunders; 2015. p. 343-46.
Koenig A. Hypoglycaemia. In: Textbook of small animal surgery. 2nd ed. St. Louis, MO: Saunders Elsevier; 2015. p. 352-57.
Riordan LL, Schaer M. Potassium disorders. In: Slatter D, editor. Textbook of small animal surgery. 2nd ed. St. Louis, MO: Saunders Elsevier; 2015, p. 269-73.
Adams JG. Cardiopulmonary cerebral resuscitation (CPCR). In: Clarke K, Trim C, editors. Veterinary anaesthesia. 11th ed. St. Louis, MO: Saunders Elsevier; 2014. p. 645-70.
Sawyer DC, Guikema AH, Siegel EM. Evaluation of a new oscillometric blood pressure monitor in isoflurane-anesthetized dogs. Vet Anaesth Analg. 2004;31:27-39.
Deflandre CJA, Hellebrekers LJ. Clinical evaluation of the Surgivet V60046, a non-invasive blood pressure monitor in anaesthetized dogs. Vet Anaesth Analg. 2008;35:13-21.
Murrell JC. Pre-anaesthetic medication and sedation. In: Duke-Novakovsky T, De Vries M, Seymour C, editors. BSAVA manual of canine and feline anaesthesia and analgesia. 3rd ed. Gloucester: British Small Animal Veterinary Association; 2016. p. 170-89.
DiBartola SP, De Morais HA. Disorders of potassium: hypokalemia and hyperkalemia. In: DiBartola SP, editor. Fluid, Electrolyte, and acid-base disorders in small animal practice. 4th en. St. Louis, MO: Saunders Elsevier; 2012. p. 92-119.
Guedes AGP, Rude EP. Effects of pre-operative administration of medetomidine on plasma insulin and glucose in healthy dogs and dogs with insulinoma. Vet Anaesth Analg. 2013;40:472-81.