Elena Moldal

PhD
Norwegian School of Veterinary Science · Department of Small Animal Clinical Sciences
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Topics (5)

Publications (4) View all

  • Article: Evaluation of inflammatory and hemostatic surgical stress responses in male cats after castration under general anesthesia with or without local anesthesia.
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    ABSTRACT: Objective-To characterize acute inflammatory and hemostatic surgical stress responses following castration in cats and to evaluate whether the addition of local anesthesia to the anesthetic protocol attenuates these responses. Animals-39 male cats. Procedures-Cats undergoing castration were randomly assigned to 2 groups: both groups underwent surgery with general anesthesia, and 1 group additionally received a local anesthetic (lidocaine [2.0 mg/kg in total, divided intratesticularly and SC]) prior to incision. Blood samples were collected after anesthetic induction (baseline) and 1, 5, and 24 hours later. Thromboelastography and coagulation variables (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) were analyzed; fibrinolysis was assessed with plasma D-dimer concentrations. The acute-phase response was evaluated via measurement of plasma fibrinogen and serum amyloid A (last time point, 28 hours) concentrations. Hematologic variables were analyzed at baseline and 1, 5, and 24 hours later. Results-Evidence of hemostatic and inflammatory activation after surgery was detected in both groups. Maximum amplitude and G (global clot strength) were significantly increased at 24 hours, and significant, but not clinically relevant, decreases were detected in aPTT at 5 and 24 hours and in PT at 24 hours, compared with baseline values. Serum amyloid A concentrations were significantly higher at 24 and 28 hours than at baseline, and plasma fibrinogen concentration was significantly increased at 24 hours; WBC and RBC counts and Hct were significantly increased at multiple time points. No differences between groups were detected for any variables. Conclusions and Clinical Relevance-Castration appeared to induce hypercoagulability and an acute-phase inflammatory response in cats. Local anesthesia with lidocaine did not attenuate this response.
    American Journal of Veterinary Research 11/2012; 73(11):1824-31. · 1.27 Impact Factor
  • Article: Intratesticular and subcutaneous lidocaine alters the intraoperative haemodynamic responses and heart rate variability in male cats undergoing castration.
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    ABSTRACT: Objective  To evaluate the usefulness of intratesticular and subcutaneous lidocaine in alleviating the intraoperative nociceptive response to castration, measured by pulse rate (PR) and mean arterial pressure (MAP), and to test the applicability of heart rate variability (HRV) analysis in assessing this response. Study design  Randomized, controlled, observer-blinded experimental trial. Animals  Thirty-nine healthy male cats admitted for castration. Methods  One group received general anaesthesia and served as control group (GA), while the treatment group (LA) additionally received local anaesthesia (lidocaine 2 mg kg(-1) ) intratesticularly and subcutaneously. PR and MAP were recorded at anaesthesia baseline (T0), treatment (T1), incision left testicle (T2), traction on spermatic cord (T3), tightening of the autoligature and resection of the cord (T4), incision on the right side (T5), traction on spermatic cord (T6), and tightening of the autoligature and resection of cord (T7). HRV analysis was divided into three 5-minute intervals: baseline (H0), treatment (H1), and surgery (H2). Results  There were significant increases in PR and MAP for both groups during surgery from T3 onwards; however, the increase in the treatment group (LA) was significantly lower than for the control group (GA). For HRV analysis, significant differences were found between groups in the following parameters during surgery: TP (total power), VLF (very low frequency), SDNN (standard deviation of NN intervals [=the interval between two consecutive R-waves in the ECG]), and TI (triangular index), which were lower in the LA group. Mean NN was significantly lower in the GA group, whereas LF (low frequency) and LFn (low frequency, normalized value) were lower in the LA group. HF (high frequency) and HFn (high frequency, normalized value) decreased significantly from H1 to H2 in both groups. Conclusions and clinical relevance  The study showed that the nociceptive response to surgery was alleviated by the use of intratesticular and subcutaneous lidocaine and that HRV analysis is a promising research tool to estimate intraoperative nociception in cats during general anaesthesia.
    Veterinary Anaesthesia and Analgesia 10/2012; · 0.94 Impact Factor
  • Article: Canine Serum Amyloid A (SAA) Measured By Automated Latex Agglutination Turbidimetry Is Useful for Routine Sensitive and Specific Detection of Systemic Inflammation in a General Clinical Setting.
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    ABSTRACT: Canine serum amyloid A (SAA) is a useful diagnostic marker of systemic inflammation. A latex agglutination turbidimetric immunoassay (LAT) was validated for automated measurements. The aim of the study was to evaluate the clinical applicability of SAA measured by the LAT. SAA was measured in 7 groups of dogs with and without systemic inflammation (n=247). Overlap performance was investigated. Diagnostic performance was compared to body temperature and leukocyte markers. Clinical decision limits for SAA were estimated. In dogs with neurological, neoplastic, or gastrointestinal disorders (n=143), it was investigated whether a higher proportion of SAA positive dogs could be detected in cases of complications with risk of systemic inflammation. Significantly higher concentrations of SAA were measured in dogs with (range [48.75; 5,032 mg/l]), compared to dogs without systemic inflammation [0; 56.4 mg/l]. SAA was a more sensitive and specific marker of systemic inflammation [area under the receiver-operating characteristic curve (AUC) 1.00], compared to body temperature (0.6) and segmented neutrophils (best performing leukocyte marker, 0.84). A clinical decision limit of 56.4 mg/l was established giving close to perfect discrimination between dogs with and without systemic inflammation. Higher proportions of SAA-positive dogs were observed in dogs with neurological, neoplastic, and gastrointestinal disorders with complications known to increase risk of systemic inflammation, compared to uncomplicated cases. The automated LAT makes SAA applicable as a relevant diagnostic marker of systemic inflammation in dogs for routine random-assess real-time use in a general clinical setting.
    Journal of Veterinary Medical Science 11/2012; · 0.85 Impact Factor
  • Article: Hemostatic response to surgical neutering via ovariectomy and ovariohysterectomy in dogs.
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    ABSTRACT: To investigate the hemostatic response to surgery and compare the response for ovariohysterectomy with that for ovariectomy and to evaluate the usefulness of thromboelastography on plasma samples. 42 female dogs. Dogs were assigned to undergo ovariohysterectomy or ovariectomy. Blood samples were collected immediately before and 1, 6, and 24 hours after surgery and stored at -80°C for subsequent analysis. Plasma samples were subjected to thromboelastography after thawing. In addition, coagulation variables were measured, including concentrations of von Willebrand factor antigen, fibrinogen, antithrombin, and protein C; activity of factor VIII; activated partial thromboplastin time; prothrombin time; and thrombin time. The fibrinolytic response was assessed via concentrations of D-dimer, plasminogen, and α-2-antiplasmin (plasmin inhibitor). Substantial hemostatic and fibrinolytic activation was evident after surgery in both groups, as characterized by significantly increased global clot strength and an overall hypercoagulable state at 4 hours after surgery in addition to decreases in von Willebrand factor antigen and factor VIII concentrations and shortened prothrombin and thrombin times. The dogs also typically had activation of the fibrinolytic system, as evidenced by increased postoperative concentrations of D-dimer, plasminogen, and plasmin inhibitor. Differences between the 2 groups could not be detected for any variables. Elective surgery with limited tissue trauma induced hemostatic activation in dogs, which led to hypercoagulability after surgery. A difference between the ovariohysterectomy and ovariectomy groups was not detected. Thromboelastography can be used on plasma samples and may be useful for evaluating patterns over time.
    American Journal of Veterinary Research 09/2012; 73(9):1469-76. · 1.27 Impact Factor

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