Hypoxemia in horses refers to a condition characterized by low levels of oxygen in the blood. It can occur due to various respiratory or circulatory issues, impacting the horse's overall health and performance. Causes of hypoxemia in horses may include pulmonary diseases, airway obstructions, or cardiovascular problems. The condition is identified through clinical signs and diagnostic tests, such as arterial blood gas analysis. Monitoring and managing hypoxemia are essential for maintaining equine health, particularly in athletic horses or those undergoing anesthesia. This page compiles peer-reviewed research studies and scholarly articles that explore the causes, diagnosis, and management of hypoxemia in horses.
O'Donovan KA, Aarnes TK, Hubbell JA, Parker EM, Mollenkopf D, Lerche P, Ricco Pereira CH, Bini G, Bednarski RM.To report anesthetic-related complications and determine risks associated with anesthesia in draft horses. Methods: Retrospective study. Methods: A total of 401 anesthetic records for draft horse breeds that underwent general anesthesia from January 2010 through December 2020 were reviewed; horses euthanized during general anesthesia were excluded. Methods: Demographics, perioperative drugs used, procedure type and duration, time to extubation, number of attempts to stand, use of sling in recovery and perioperative morbidity and mortality were investigated. Morbidity and mortality statistical ...
Marchese GA, Crystal J, Louro LF.Prevalence and risk factors of severe hypoxemia in anesthetized horses undergoing emergency exploratory laparotomy are sparsely documented. The aim of this study was to report incidence of severe hypoxemia ( PaO2 < 60 mmHg) in horses undergoing emergency exploratory laparotomy and identify potential risk factors for this complication. A single center retrospective cross sectional designed was used. Clinical data of 714 horses undergoing general anesthesia for emergency explorative laparotomy were reviewed. A backward stepwise elimination procedure was used to determine the final multivariable ...
Milnes EL, Skelding AM, Larouche CB, Ferro A, Delnatte P, Dutton C, Anderson NE.To compare ketamine-butorphanol-azaperone-medetomidine (KBAM) to detomidine-etorphine-acepromazine (DEA) for field anesthesia in captive Przewalski horses (Equus przewalskii). Methods: 10 adult Przewalski horses. Methods: A prospective randomized crossover trial was conducted. Each horse was immobilized once with KBAM (200 mg ketamine, 109.2 mg butorphanol, 36.4 mg azaperone, and 43.6 mg medetomidine) and once with DEA (40 mg detomidine premedication, followed 20 minutes later by 3.9 to 4.4 mg etorphine and 16 to 18 mg acepromazine). Both protocols were administered by IM remote dart injection...
Clark-Price SC, Lascola KM, Auckburally A, Boone LH, Caldwell FJ, Weatherall KM, Hanson RR.Impairment of oxygen uptake can occur during general anesthesia in horses resulting in hypoxemia. Multiple treatments have been investigated for correction of hypoxemia with varying levels of success. In clinical trials, albuterol, a short-acting β2 adrenergic agonist, improved arterial oxygen partial pressure (PaO2) in anesthetized horses unresponsive to adjustments in mechanical ventilation and administration of positive inotropic drugs. However, controlled studies comparing the magnitude of change and duration of effect of albuterol on PaO2 in healthy, nonhypoxemic anesthetized horses are ...
Hummer EV, Soares JHN, Crockett DC, Aguiar AJA, Tran MC, Cronin JN, Brosnan RJ, Braun C, Formenti F.The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. Objective: The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO2 (PaO2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. Methods: In vivo experimental study. Methods: Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteri...
Hovda T, Love L, Chiavaccini L.Hypoxaemia is a common concern during equine general anaesthesia. The prevalence and predictors of hypoxaemia in horses undergoing elective anaesthesia in particular are poorly documented. Objective: To determine and compare the prevalence of hypoxaemia (defined as PaO2  ≤ 80 mm Hg, on the lowest value recorded) in horses undergoing anaesthesia for exploratory laparotomy and elective procedures, and to identify risk factors in both subpopulations. Methods: Retrospective cohort study. Methods: Data were collected from 774 records of 708 horses undergoing general anaesthesia between April 2...
Roşu O, Melega I, Evans AL, Arnemo JM, Küker S.Feral horses are immobilized for a variety of reasons including population control via contraceptives. Although opioid combinations have been successfully used for immobilization of feral horses, there is a need for combinations using drugs that are more readily available and present less of a human health hazard. We evaluated the chemical immobilization with physiological measurements and blood gas analyses of 91 free-ranging feral horses () remotely immobilized with a combination of 30 mg medetomidine and 775 mg ketamine in a single disposable 6 ml dart. During immobilization, heart rate, re...
Trenholme HN, Barletta M, Quandt JE, Reed RA, Kleine SA, Hofmeister EH.Low arterial oxygen is a common complication in anesthetized horses and placing the animal in reverse Trendelenburg (RT) position may treat hypoxemia. The objective of this study was to assess the arterial partial pressure of oxygen (PaO) in horses placed in a 5-degree RT compared to horizontal (H) position. Client-owned healthy horses (n = 60) undergoing elective surgeries were enrolled in a randomized controlled clinical study. Horses were sedated with butorphanol, an α-adrenoceptor agonist, ± acepromazine and induced with ketamine combined with a benzodiazepine, propofol, or guaifenesin...
Peña-Cadahia C, Manso-DÃaz G, Santiago-Llorente I, Villalba-Orero M.A 2-day-old filly was referred to the hospital with abdominal pain and constipation. The foal presented tachycardia, tachypnea, hypoxemia, hyperlactatemia, and abdominal distension. Meconium impaction was diagnosed, and the filly underwent abdominal surgery. Diazepam and butorphanol were administered for anesthesia premedication, but sedative effects were mild. Xylazine was used to enhance sedation and ketamine was subsequently administered for induction. The foal showed swallow reflex and head movement when intubation was attempted. Consequently, isoflurane on oxygen was provided via an anest...
Dupont J, Serteyn D, Sandersen C.Horses are susceptible to developing large areas of pulmonary atelectasis during recumbency and anesthesia. The subsequent pulmonary shunt is responsible for significant impairment of oxygenation. Since ventilation perfusion mismatch persists into the post-operative period, hypoxemia remains an important concern in the recovery stall. This case report describes the diagnosis and supportive therapy of persistent hypoxemia in a 914 kg draft horse after isoflurane anesthesia. It highlights how challenging it can be to deal with hypoxemia after disconnection from the anesthesia machine and how lif...
Sage AM, Keating SC, Lascola KM, Schaeffer DJ, Clark-Price SC.To evaluate cardiopulmonary and recovery characteristics of horses administered total intravenous anesthesia (TIVA) with xylazine and ketamine combined with midazolam or propofol. Methods: Randomized crossover study. Methods: A group of eight adult horses, aged 7-22 years, weighing 493-740 kg. Methods: Horses were administered xylazine (1 mg kg) intravenously (IV), and anesthesia was induced with ketamine (2.2 mg kg) IV. Anesthesia was maintained for 45 minutes via IV infusion of xylazine (0.016 mg kg minute) and ketamine (0.03 mg kg minute) combined with midazolam at 0.002 mg kg minute (MKX),...
Hopster K, Wittenberg-Voges L, Geburek F, Hopster-Iversen C, Kästner SBR.Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia. During part A arterial oxygen saturation (SaO) was reduced by reducing inspiratory oxygen fraction in steps...
Aoki M, Wakuno A, Kushiro A, Mae N, Kakizaki M, Nagata SI, Ohta M.Anesthetic and cardiorespiratory effects of total intravenous anesthesia (TIVA) technique using propofol-guaifenesin-medetomidine (PGM) and alfaxalone-guaifenesin-medetomidine (AGM) were preliminarily evaluated in Thoroughbred horses undergoing castration. Twelve male Thoroughbred horses were assigned randomly into two groups. After premedication with intravenous (IV) administrations of medetomidine (5.0 µg/kg) and butorphanol (0.02 mg/kg), anesthesia was induced with guaifenesin (10 mg/kg IV), followed by either propofol (2.0 mg/kg IV) (group PGM: n=6) or alfaxalone (1.0 mg/kg IV) (group AGM...
Auckburally A, Nyman G.To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them. Methods: Google Scholar and PubMed, using the search terms horse, pony, exercise, anaesthesia, hypoxaemia, oxygen, mortality, morbidity and ventilation perfusion mismatch. Conclusions: Although there is no evidence that hypoxaemia is associated with increased morbidity and mortality in anaesthetized horses, mos...
Robertson SA, Bailey JE.To compare the arterial pH and blood gas values, heart rate and mean arterial blood pressure, in hypoxaemic anaesthetized horses, before and after treatment, with a salbutamol (albuterol) aerosol. Methods: Eighty-one client-owned horses weighing between 114 and 925 kg. Fifty-seven underwent emergency abdominal surgery and 24 were anaesthetized for elective procedures. Methods: Pre-anaesthetic medication included xylazine, detomidine, butorphanol and morphine, alone or in various combinations. Induction of anaesthesia was achieved with guaifenesin and ketamine, diazepam and ketamine, or guaifen...
Guedes A, Aleman M, Davis E, Tearney C.To determine physiologic responses to apnea-induced severe hypoxemia in anesthetized horses. Methods: Prospective experimental study. Methods: Six university-owned horses with a median (range) body weight of 500 (220-510) kg and aged 13.5 (0.8-24.0) years scheduled for euthanasia. Methods: Xylazine-midazolam-ketamine-anesthetized horses breathing room air spontaneously were instrumented with a facial artery catheter for pressure measurement and blood sampling, and were made apneic with atlanto-occipital intrathecal lidocaine (4 mg kg ). Cardiopulmonary, biochemical and hematologic variable...
Coutu P, Caulkett N, Pang D, Boysen S.Hypoxemia is common during equine field anesthesia. Our hypothesis was that oxygen therapy from a portable oxygen concentrator would increase PaO2 during field anesthesia compared with the breathing of ambient air. Methods: Prospective clinical study. Methods: Fifteen yearling (250 - 400Â kg) horses during field castration. Methods: Horses were maintained in dorsal recumbency during anesthesia with an intravenous infusion of 2000Â mg ketamine and 500Â mg xylazine in 1Â L of 5% guaifenesin. Arterial samples for blood gas analysis were collected immediately post-induction (PI), and at 15 and 30Â...
Hubbell JA, Muir WW.Horses are the most difficult of the common companion animals to anaesthetise. Hypoxaemia or inadequate oxygen delivery to peripheral tissues during anaesthesia would seem a potential cause of increased mortality, but no direct link has been established. A number of methods of increasing oxygenation and oxygen delivery have been reported, with varying results and potential applicability. The purpose of this article is to review the literature with regard to oxygenation, oxygen delivery and methods to improve each and to make recommendations for clinical application.
Ida KK, Fantoni DT, Ibiapina BT, Souto MT, Zoppa AL, Silva LC, Ambrósio AM.To evaluate equine cardiopulmonary function and recovery quality after administration of 0.25 or 0.50 mg/kg xylazine intravenously (IV) during recovery. Methods: Randomized, blinded, prospective, clinical study. Methods: Horses (n = 20). Methods: During recovery after 3 hours of isoflurane anesthesia for arthroscopic surgery, horses were administered either 0.25 mg/kg (G25, n = 10) or 0.50 mg/kg (G50, n = 10) xylazine intravenously. Vital signs and arterial blood samples were obtained during recovery before sedation (baseline), 5, 10, 20, 30, and 45 minutes after xylazine and 30 minutes after ...
Grubb T, Frendin JH, Edner A, Funkquist P, Hedenstierna G, Nyman G.Anaesthetized horses commonly become hypoxaemic due to ventilation/perfusion (V·A/Q·) mismatch and increased pulmonary shunt fraction (Qs·/Qt·). Pulse-delivered inhaled nitric oxide may improve oxygenation but may increase plasma concentration of the potent vasoconstrictor, endothelin-1 (ET-1). Objectives: Study 1) compare arterial oxygen concentration (PaO2) and saturation (SaO2), calculated Qs·/Qt· and ET-1 concentration; and Study 2) assess V·A/Q· matching and measured Qs·/Qt· in isoflurane-anaesthetized horses in left lateral recumbency receiving pulse-delivered inhaled nitric ox...
Crumley MN, McMurphy RM, Hodgson DS, Kreider SE.To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses. Methods: 8 healthy adult horses. Methods: In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% o...
Mosing M, Rysnik M, Bardell D, Cripps PJ, MacFarlane P.Hypoxaemia is a common problem during equine anaesthesia. Continuous positive airway pressure (CPAP) is a ventilation mode routinely employed in man to overcome hypoxaemia but has not been objectively assessed in horses. Objective: To test the effects of CPAP on oxygenation and its indices in anaesthetised horses in a clinical setting. Methods: Twenty-four healthy horses requiring anaesthesia in dorsal recumbency were anaesthetised using a standard protocol. Following orotracheal intubation and connection to an anaesthetic machine capable of applying CPAP, horses were randomly allocated to ven...
Franklin SH, Van Erck-Westergren E, Bayly WM.Horses are elite athletes when compared with other mammalian species. In the latter, performance is limited by cardiovascular or musculoskeletal performance whereas in athletic horses it is the respiratory system that appears to be rate limiting and virtually all horses exercising at high intensities become hypoxaemic and hypercapnoeic. This is due to both diffusion limitation and a level of ventilation inadequate for the metabolic level that enables horses to exercise at these intensities. In conjunction with these blood gas changes, total pulmonary resistance increases and the work of breath...
Nyman G, Grubb TL, Heinonen E, Frendin J, Edner A, Malavasi LM, Frostell C, Högman M.The study aimed to investigate the effect of varying pulse lengths of inhaled nitric oxide (iNO), and 2.5 hours of continuous pulse-delivered iNO on pulmonary gas exchange in anaesthetized horses. Methods: Experimental study. Methods: Six Standardbred horses. Methods: Horses received acepromazine, detomidine, guaifenesin, thiopentone and isoflurane in oxygen, were positioned in dorsal recumbency and were breathing spontaneously. iNO was on average pulsed during the first 20, 30, 43 or 73% of the inspiration in 15 minute steps. The pulse length that corresponded to the highest (peak) partial pr...
Kaartinen MJ, Pang DS, Cuvelliez SG.CASE 1: A two-year old, 462 kg Standard bred horse was anesthetized for arthroscopy and castration. During anesthesia, hyperemia of the mucosal membranes and urticaria were noticed. During 5 hours of anesthesia subcutaneous edema of the eyelids and neck region developed. In the recovery box, the orotracheal (OT) tube was left in situ and secured in place with tape. Following initial attempts to stand, the horse became highly agitated and signs consistent with pulmonary edema developed subsequently. Arterial hypoxemia (PaO(2): 3.7 kPa [28 mmHg]) and hypocapnia (PaCO(2): 3.1 kPa [23 mmHg]) were ...
Muir WW, Lerche P, Erichson D.Studies have demonstrated the clinical usefulness of propofol for anaesthesia in horses but the use of a concentrated solution requires further investigation. Objective: To determine the anaesthetic and cardiorespiratory responses to a bolus injection of 10% propofol solution in mature horses. Methods: Three randomised crossover experimental trials were completed. Trial 1: 6 horses were selected randomly to receive 10% propofol (2, 4 or 8 mg/kg bwt i.v.). Trial 2: 6 horses received 1.1 mg/kg bwt i.v. xylazine before being assigned at random to receive one of 5 different doses (1-5 mg/kg bwt) o...
Steffey EP, Mama KR, Brosnan RJ, Imai A, Maxwell LK, Cole CA, Stanley SD.To compare characteristics of horses recovering from 4 hours of desflurane anesthesia with and without immediate postanesthetic IV administration of propofol and xylazine. Animals-8 healthy horses (mean +/- SEM age, 6.6 +/- 1.0 years; mean body weight, 551 +/- 50 kg). Methods: Horses were anesthetized twice. Both times, anesthesia was induced with a combination of xylazine hydrochloride, diazepam, and ketamine hydrochloride and then maintained for 4 hours with desflurane in oxygen. Choice of postanesthetic treatment was randomly assigned via a crossover design such that each horse received an ...
Garcia Lascurain AA, Sumano Lopez H, Steffey EP, Santillán Doherty P, Hernandez EN.To characterize behavioral and physiological responses to short-term, unsupplemented intravenous (IV) anesthesia in healthy horses at high altitude (2240 m), and to test the hypothesis that the dose of butorphanol modifies the response of the horse to propofol anesthesia following xylazine pre-medication. Methods: Randomized prospective butorphanol dose cross-over experimental design. Animals Eight healthy horses, 13 +/- 6 (mean +/- SD) years of age, and weighing 523 +/- 26 kg. Methods: Each horse was anesthetized three times with at least 3 weeks between each anesthesia. After collecting pre-...
Wagner PD, Gillespie JR, Landgren GL, Fedde MR, Jones BW, DeBowes RM, Pieschl RL, Erickson HH.Arterial hypoxemia has been reported in horses during heavy exercise, but its mechanism has not been determined. With the use of the multiple inert gas elimination technique, we studied five horses, each on two separate occasions, to determine the physiological basis of the hypoxemia that developed during horizontal treadmill exercise at speeds of 4, 10, 12, and 13-14 m/s. Mean, blood temperature-corrected, arterial PO2 fell from 89.4 Torr at rest to 80.7 and 72.1 Torr at 12 and 13-14 m/s, respectively, whereas corresponding PaCO2 values were 40.3, 40.3, and 39.2 Torr. Alveolar-arterial PO2 di...
Bayly WM, Hodgson DR, Schulz DA, Dempsey JA, Gollnick PD.The effects of exercise intensity and duration on blood gases in thoroughbred horses were studied to characterize the apparent exercise-induced failure in pulmonary gas exchange that occurs in these animals. In response to 2 min of exercise, arterial CO2 tension (PaCO2) decreased in mild and moderate exercise, returned to normocapnic levels in moderate to heavy exercise, and rose 5-10 Torr above resting values during very heavy exercise when CO2 production (VCO2) exceeded 20 times the resting value, and mixed venous CO2 tension approximated 140 Torr. Exercise-induced hypoxemia occurred at the ...
Couëtil LL, Denicola DB.The purpose of this study was to evaluate the relationship between bronchoalveolar lavage (BAL) cytology, arterial blood gases and plasma lactate concentration during a standardised treadmill test (STT) in racehorses with small-airway inflammation (SAI), or exercise-induced pulmonary haemorrhage (EIPH). Sixteen Thoroughbred and 20 Standardbred actively racing racehorses, were divided into a control group (n = 10), EIPH group (n = 13) and SAI group (n = 13). Each STT consisted of a 2 min trot at 4 m/s followed by 5 x 1 min, incremental speed steps (6, 8, 10, 11 and 12 m/s) at 10% incline for Th...
Forster HV, Bisgard GE, Rasmussen B, Orr JA, Buss DD, Manohar M.The present study was designed to provide further insight into the role of the carotid and aortic chemoreceptors in ventilatory (VE) acclimatization during sojourn at altitude. Measurements were made: 1) on 10 ponies near sea level (SL, 740 Torr) under normal conditions, 2) on 6 of these at SL following chemoreceptor denervation (CD), and 3) subsequently on all 10 during 4 days of hypobaric hypoxia (PaO2 = 40-47 Torr). CD resulteo in hypoventilation at SL (deltaPaCO2 = d8 Torr, P less than 0.05), and it prevented hyperventilation normally observed with injection of NaCN and acute exposure to h...
Franklin SH, Van Erck-Westergren E, Bayly WM.Horses are elite athletes when compared with other mammalian species. In the latter, performance is limited by cardiovascular or musculoskeletal performance whereas in athletic horses it is the respiratory system that appears to be rate limiting and virtually all horses exercising at high intensities become hypoxaemic and hypercapnoeic. This is due to both diffusion limitation and a level of ventilation inadequate for the metabolic level that enables horses to exercise at these intensities. In conjunction with these blood gas changes, total pulmonary resistance increases and the work of breath...
Auckburally A, Nyman G.To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them. Methods: Google Scholar and PubMed, using the search terms horse, pony, exercise, anaesthesia, hypoxaemia, oxygen, mortality, morbidity and ventilation perfusion mismatch. Conclusions: Although there is no evidence that hypoxaemia is associated with increased morbidity and mortality in anaesthetized horses, mos...
Robertson SA, Bailey JE.To compare the arterial pH and blood gas values, heart rate and mean arterial blood pressure, in hypoxaemic anaesthetized horses, before and after treatment, with a salbutamol (albuterol) aerosol. Methods: Eighty-one client-owned horses weighing between 114 and 925 kg. Fifty-seven underwent emergency abdominal surgery and 24 were anaesthetized for elective procedures. Methods: Pre-anaesthetic medication included xylazine, detomidine, butorphanol and morphine, alone or in various combinations. Induction of anaesthesia was achieved with guaifenesin and ketamine, diazepam and ketamine, or guaifen...
Steffey EP, Wheat JD, Meagher DM, Norrie RD, McKee J, Brown M, Arnold J.Effects of body position and type of ventilation were determined on arterial blood gases (PaO2, PaCO2) and pH during and immediately following clinical halothane anesthesia in 36 young, physically conditioned horses. Horses in dorsal recumbency had a lower PaO2 than did similarly breathing horses in a lateral position. Predictably controlled positive-pressure ventilation inproved arterial oxygenation and permitted maintenance of a normal PaCO2. Most horses, regardless of type of ventilation and operative body positioning, were hypoxemic in the immediate postanesthetic period.
Art T, Lekeux P.Five healthy, fit Standardbreds (mean +/- SEM, 490.4 +/- 15.0 kg, 4.0 +/- 0.5 years) were studied during a standardized test carried out on a treadmill. The test consisted of an 8-minute warm-up and a 9-minute exercise period (1 minute at 1.7, 4, 7, 8, 9, and 10 m/s; 2 minutes at 4 m/s; and a 1-minute walk at a 6% slope). Respiratory airflow, tidal volume (V(T)), and respiratory frequency (f) were continuously recorded, using 2 ultrasonic pneumotachographs connected to a face mask and mass spectrometer. Oxygen uptake, carbon dioxide output, and expired minute volume (V(E)) were obtained on a b...
Forster HV, Pan LG.In humans alveolar ventilation (VA) is adjusted almost perfectly to the metabolic demands of mild and moderate exercise. For example, in exercise transitions and in the steady state, PaCO2 rarely deviates by more than 1 to 3 mmHg from the value at rest. This near-homeostasis contrasts to most other mammalian species; equines for example, demonstrate a progressive hypocapnia and alkalosis as exercise intensity is increased to moderate levels. In equines, the control systems seem programmed for a specific hyperventilation that contributes to maintenance of PaO2 homeostasis. Generally, during hea...
Hubbell JA, Muir WW.Horses are the most difficult of the common companion animals to anaesthetise. Hypoxaemia or inadequate oxygen delivery to peripheral tissues during anaesthesia would seem a potential cause of increased mortality, but no direct link has been established. A number of methods of increasing oxygenation and oxygen delivery have been reported, with varying results and potential applicability. The purpose of this article is to review the literature with regard to oxygenation, oxygen delivery and methods to improve each and to make recommendations for clinical application.
Dupont J, Serteyn D, Sandersen C.Horses are susceptible to developing large areas of pulmonary atelectasis during recumbency and anesthesia. The subsequent pulmonary shunt is responsible for significant impairment of oxygenation. Since ventilation perfusion mismatch persists into the post-operative period, hypoxemia remains an important concern in the recovery stall. This case report describes the diagnosis and supportive therapy of persistent hypoxemia in a 914 kg draft horse after isoflurane anesthesia. It highlights how challenging it can be to deal with hypoxemia after disconnection from the anesthesia machine and how lif...
Marntell S, Nyman G.The clinical and cardiorespiratory effects of premedication with acepromazine, butorphanol or diazepam in addition to romifidine before induction of anaesthesia with ketamine were studied in 6 horses on 4 random occasions. Administration of romifidine alone or in combination with butorphanol resulted in an increase in arterial blood pressure, accompanied by a significant decrease in heart rate with second-degree atrio-ventricular heart block. Induction of anaesthesia with ketamine returned the heart rate to baseline value, but the arterial blood pressure was significantly increased compared to...
Steffey EP, Mama KR, Brosnan RJ, Imai A, Maxwell LK, Cole CA, Stanley SD.To compare characteristics of horses recovering from 4 hours of desflurane anesthesia with and without immediate postanesthetic IV administration of propofol and xylazine. Animals-8 healthy horses (mean +/- SEM age, 6.6 +/- 1.0 years; mean body weight, 551 +/- 50 kg). Methods: Horses were anesthetized twice. Both times, anesthesia was induced with a combination of xylazine hydrochloride, diazepam, and ketamine hydrochloride and then maintained for 4 hours with desflurane in oxygen. Choice of postanesthetic treatment was randomly assigned via a crossover design such that each horse received an ...
Mosing M, Rysnik M, Bardell D, Cripps PJ, MacFarlane P.Hypoxaemia is a common problem during equine anaesthesia. Continuous positive airway pressure (CPAP) is a ventilation mode routinely employed in man to overcome hypoxaemia but has not been objectively assessed in horses. Objective: To test the effects of CPAP on oxygenation and its indices in anaesthetised horses in a clinical setting. Methods: Twenty-four healthy horses requiring anaesthesia in dorsal recumbency were anaesthetised using a standard protocol. Following orotracheal intubation and connection to an anaesthetic machine capable of applying CPAP, horses were randomly allocated to ven...
O'Donovan KA, Aarnes TK, Hubbell JA, Parker EM, Mollenkopf D, Lerche P, Ricco Pereira CH, Bini G, Bednarski RM.To report anesthetic-related complications and determine risks associated with anesthesia in draft horses. Methods: Retrospective study. Methods: A total of 401 anesthetic records for draft horse breeds that underwent general anesthesia from January 2010 through December 2020 were reviewed; horses euthanized during general anesthesia were excluded. Methods: Demographics, perioperative drugs used, procedure type and duration, time to extubation, number of attempts to stand, use of sling in recovery and perioperative morbidity and mortality were investigated. Morbidity and mortality statistical ...
Crumley MN, McMurphy RM, Hodgson DS, Kreider SE.To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses. Methods: 8 healthy adult horses. Methods: In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% o...
Manohar M, Goetz TE.The present study examined whether Thoroughbred horses performing strenuous exercise exhibit intrapulmonary arteriovenous shunting that may contribute to the observed arterial hypoxemia. Experiments were carried out on seven healthy, exercise-trained Thoroughbreds at rest, maximal exercise (galloping at 14 m/s on a 3.5% uphill grade for 120 s), and submaximal exertion (8 m/s on a 3.5% uphill grade for 150 s). Along with blood gas/hemodynamic parameters, intrapulmonary arteriovenous shunting was studied by injecting 15-microm-diameter microspheres, labeled with different stable isotopes, into t...
Gunkel CI, Valverde A, Robertson SA, Thompson MS, Keoughan CG, Ferrell EA.A mature horse developed acute signs of bronchoconstriction causing hypoxemia and hypercapnia during anesthesia for computerized tomography of the maxillary sinus after i.v. administration of diatrizoate contrast medium. The horse was treated with aerosolized albuterol, atropine, and oxygen insufflation and recovered uneventfully despite severe hypoxemia and low hemoglobin saturation. The horse's condition continued to improve after treatment, and the horse was discharged with no further complications. Caution is advised with the use of contrast media in anesthetized horses.
Caillaud C, Connes P, Bouix D, Mercier J.Exercise-induced arterial hypoxemia (EIAH), i.e., a significant drop of O2 arterial partial pressure during sea level exercise, has been shown in both aerobically trained athletes and athletic animal species. The mechanisms potentially involved include ventilation/perfusion inequality and/or pulmonary diffusing capacity limitation. In thoroughbred horses, EIAH is going with pulmonary haemorrhage (EIPH). Stress failure of pulmonary capillaries leading to diffusion limitation has been proposed. Indeed, during intense exercise, the increased cardiac output and blood viscosity combine to rise capi...
McMurphy RM, Cribb PH.This study was designed to investigate the effect of the nasotracheal insufflation of oxygen at a flow rate of 15 L/min on the arterial partial pressure of oxygen during the recovery period following inhalation anesthesia in the horse. It has been stated that this is a suitable flow rate to prevent postoperative hypoxemia but without any experimental evidence to support those statements. Horses being used for the study of healing of cartilage were anesthetized on two separate occasions. Following one period of anesthesia they were allowed to recover breathing room air, and following the other ...
Goetz TE, Manohar M, Hassan AS, Baker GJ.The present study was carried out to examine whether nasal strip application would improve the exercise-induced arterial hypoxemia and hypercapnia, diminish anaerobic metabolism, and modify the incidence of exercise-induced pulmonary hemorrhage (EIPH) in horses. Two sets of experiments, control and nasal strip experiments, were carried out on seven healthy, sound, exercise-trained Thoroughbred horses in random order, 7 days apart. Simultaneous measurements of core temperature, arterial and mixed venous blood gases/pH, and blood lactate and ammonia concentrations were made at rest, during subma...
Sage AM, Keating SC, Lascola KM, Schaeffer DJ, Clark-Price SC.To evaluate cardiopulmonary and recovery characteristics of horses administered total intravenous anesthesia (TIVA) with xylazine and ketamine combined with midazolam or propofol. Methods: Randomized crossover study. Methods: A group of eight adult horses, aged 7-22 years, weighing 493-740 kg. Methods: Horses were administered xylazine (1 mg kg) intravenously (IV), and anesthesia was induced with ketamine (2.2 mg kg) IV. Anesthesia was maintained for 45 minutes via IV infusion of xylazine (0.016 mg kg minute) and ketamine (0.03 mg kg minute) combined with midazolam at 0.002 mg kg minute (MKX),...
Mason DE, Muir WW, Wade A.The effects of body position and postoperative oxygen supplementation on arterial blood gas tensions (PaO2 and PaCO2) and pH were examined in clinically normal adult horses during recovery from halothane anesthesia. Hypoxemia developed during recovery from anesthesia in spite of adequate alveolar ventilation in horses without postanesthetic oxygen supplementation. Hypoxemia developed in horses positioned in left lateral or right lateral recumbency, and in horses that were rolled to the opposite side during the recovery period. Arterial blood gas tensions were not significantly (P greater than ...
Manohar M, Goetz TE, Hassan AS.Strenuously exercising horses exhibit arterial hypoxemia and exercise-induced pulmonary hemorrhage (EIPH), the latter resulting from stress failure of pulmonary capillaries. The present study was carried out to examine whether the structural changes in the blood-gas barrier caused by a prior bout of high-intensity short-term exercise capable of inducing EIPH would affect the arterial hypoxemia induced during a successive bout of exercise performed at the same workload. Two sets of experiments, double- and single-exercise-bout experiments, were carried out on seven healthy, sound Thoroughbred h...
Hovda T, Love L, Chiavaccini L.Hypoxaemia is a common concern during equine general anaesthesia. The prevalence and predictors of hypoxaemia in horses undergoing elective anaesthesia in particular are poorly documented. Objective: To determine and compare the prevalence of hypoxaemia (defined as PaO2  ≤ 80 mm Hg, on the lowest value recorded) in horses undergoing anaesthesia for exploratory laparotomy and elective procedures, and to identify risk factors in both subpopulations. Methods: Retrospective cohort study. Methods: Data were collected from 774 records of 708 horses undergoing general anaesthesia between April 2...
Bedenice D, Heuwieser W, Solano M, Rand W, Paradis MR.The medical records of 163 neonatal foals that had thoracic radiographs taken within 48 hours of admission to a referral hospital were reviewed. The objectives of this study were (1) to identify risk factors for the development of thoracic radiographic changes and (2) to identify prognostic indicators for survival in foals with radiographic evidence of pulmonary disease. Failure of transfer of passive immunity (IgG concentration < or = 400 mg/dL) was the only risk factor for radiographic evidence of respiratory disease identified by multivariate analysis. Hypoxemic patients (PaO2 1.7 mg/dL...
Coutu P, Caulkett N, Pang D, Boysen S.Hypoxemia is common during equine field anesthesia. Our hypothesis was that oxygen therapy from a portable oxygen concentrator would increase PaO2 during field anesthesia compared with the breathing of ambient air. Methods: Prospective clinical study. Methods: Fifteen yearling (250 - 400Â kg) horses during field castration. Methods: Horses were maintained in dorsal recumbency during anesthesia with an intravenous infusion of 2000Â mg ketamine and 500Â mg xylazine in 1Â L of 5% guaifenesin. Arterial samples for blood gas analysis were collected immediately post-induction (PI), and at 15 and 30Â...
Nyman G, Grubb TL, Heinonen E, Frendin J, Edner A, Malavasi LM, Frostell C, Högman M.The study aimed to investigate the effect of varying pulse lengths of inhaled nitric oxide (iNO), and 2.5 hours of continuous pulse-delivered iNO on pulmonary gas exchange in anaesthetized horses. Methods: Experimental study. Methods: Six Standardbred horses. Methods: Horses received acepromazine, detomidine, guaifenesin, thiopentone and isoflurane in oxygen, were positioned in dorsal recumbency and were breathing spontaneously. iNO was on average pulsed during the first 20, 30, 43 or 73% of the inspiration in 15 minute steps. The pulse length that corresponded to the highest (peak) partial pr...
Hopster K, Wittenberg-Voges L, Geburek F, Hopster-Iversen C, Kästner SBR.Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia. During part A arterial oxygen saturation (SaO) was reduced by reducing inspiratory oxygen fraction in steps...
