Nov 25, 2006 - basal conditions only, four underwent myelography (contrast medium: iohexol, non-ionic, 300 mg iodine/ml, administered intra venously at 3 ...
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Short Communications Plasma cortisol levels in dogs undergoing diagnostic imaging procedures E. Cavallone, B. Secchiero, M. Di Giancamillo, A. B. Lovati, E. M. Rimoldi
Veterinary Record (2006) 159, 749 E. Cavallone, BSc, B. Secchiero, DVM, M. Di Giancamillo, DVM, A. B. Lovati, DVM, E. M. Rimoldi, DVM, Veterinary Clinical and Experimental Radiology Section, Department of Veterinary Clinical Science, Faculty of Veterinary Medicine, University of Milan, Via Celoria 10, 20133 Milan, Italy
MAMMALS react to adverse experiences such as pain with the activation of hypothalamus-hypophysis-adrenal gland axis, which promotes the synthesis of corticosteroids, leading to increased serum concentrations. Cortisol is the most significant of the corticosteroids in dogs (Cavallone and others 2001, 2002). There have been reports concerning cortisol levels in dogs subjected to anaesthesia and surgical stress (Fox and others 1998, Marcovich and others 2001, Naitoh and others 2002, Vaisanen and others 2002), but there appear to be no reports related to diagnostic imaging. This short communication describes a study in which the variations in plasma cortisol concentrations were studied during diagnostic imaging procedures in dogs in order to evaluate possible states of discomfort or pain that may be induced by the administration of contrast medium and by positioning manoeuvres. Thirteen dogs affected with various pathologies were studied during procedures carried out under general anaesthesia with propofol and isoflurane. Eight dogs underwent
Ms Cavallone is also at the Central Radioisotopes Laboratory, Faculty of Veterinary Medicine, University of Milan, Milan, Italy
TABLE 1: Serum cortisol levels in 13 dogs undergoing diagnostic imaging procedures and intravenous and intrathecal contrast studies. The dogs were classed as stressed or nonstressed on the basis of their serum cortisol level on admission
Dog
Breed
Stressed 1 Mixed
Sex Age* Investigation F
4
2 3
Mixed
M
GSD
FN
6 11
4
Mixed
FN
7
5
GSD
M
6
6
Mixed
FN
8
FN
7
GSD 7 Non-stressed 8 Mixed 9 Rottweiler 10 Bull mastiff 11 Schnauzer 12 Cocker spaniel 13 Boxer
8 5 10 FN 8 FN 8
MN
M M
M
10
CT spinal cord L7-S1
Diagnosis
Left ventrallateral hernia CT tympanic bubbles Cholesteatoma CT, myelography Left ventral-lateral cervical hernia CT brain Left parietal neoplasia and oedema Myelography Ventral hernia L4-L5 Myelography Right ventrallateral prolapse T12-T13 Direct radiography Non-union of the anconeal process CT spinal cord C6-T2 Healthy CT brain Cranial base sarcoma CT spinal cord L2-S3 Healthy CT brain Healthy CT spinal cord C2-C3 Calcified ventral (no contrast medium) prolapse Myelography Left prolapse C2-C3
Serum cortisol concentration† 1 2 3 61·6
79·9 171·3
137·1 110·6 119·8 129·0 90·8 196·6 45·8 130·4 158·4 116·3
94·0 139·4
139·4 143·5 180·2 37·2
20·5 132·9
25·9 16·3 16·8 26·2 24·6
17·6 13·2 11·2 19·9 25·7
15·8 10·6 16·2 26·0 30·6
25·7
25·4
28·3
* Years
† Serum
concentrations (ng/ml) were measured in blood samples taken on admission to the clinic (1), after inhalational anaesthesia (2) and 15 minutes after the administration of contrast medium and positioning (3) GSD German shepherd dog, F Female, M Male, FN Female neutered, MN Male neutered, CT Computed tomography
The Veterinary Record, November 25, 2006
computed tomography (CT), under basal conditions and after the administration of contrast medium (iopromide, non-ionic/iodine-based, 31 mg iodine/ml, administered intravenously at 600 mg/kg). One dog underwent CT under basal conditions only, four underwent myelography (contrast medium: iohexol, non-ionic, 300 mg iodine/ml, administered intravenously at 3 ml/kg), and one underwent direct radiography. The dogs were classed as ‘stressed’ and ‘non-stressed’ (Table 1) on the basis of their serum cortisol levels on admission to the clinic. Blood samples were taken between 09.00 and 12.00, the first at admission, the second after general anaesthesia had been induced and the third 15 minutes after the contrast medium had been administered by intravenous or intrathecal routes and after the animal had been positioned. Cortisol was measured in duplicate by a competitive radioimmunoassay validated for canine species (Immunotech). Reference values (measured in 80 dogs) of 6·6 to 30 ng/ml, mean (sd) 18·8 (5·8) ng/ml were obtained from the authors’ laboratory. In the ‘stressed’ dogs (Table 1), an increase in serum cortisol was observed during all the diagnostic procedures at the third blood sampling (of up to 40 per cent relative to the second sampling). This increase was particularly notable in the dog that underwent direct radiography, in which the serum cortisol level increased from 20·5 ng/ml at the second blood sampling to 132·9 ng/ml (an increase of 80 per cent at the third sampling). In the ‘non-stressed’ dogs (Table 1), variations in serum cortisol were negligible and the concentrations remained within the reference values. The authors hypothesise that the administration of contrast medium under anaesthesia does not represent an additional stress factor; however, positioning the animal has the potential to cause discomfort or pain. In the present study, the dogs whose serum cortisol levels rose the most during the procedure were those that were classed as stressed on the basis of their serum cortisol levels on admission. The authors therefore recommend that in animals showing signs of pain or anxiety it is advisable to choose protocols that are able to induce a deeper level of anaesthesia during diagnostic imaging procedures.
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Downloaded from veterinaryrecord.bmj.com on March 20, 2013 - Published by group.bmj.com
Plasma cortisol levels in dogs undergoing diagnostic imaging procedures E. Cavallone, B. Secchiero, M. Di Giancamillo, et al. Veterinary Record 2006 159: 749
doi: 10.1136/vr.159.22.749
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