5.3 RESULTS
Unexpected reactions of all cats to the nutrient i nfusions resulted in a curtailment of the
planned experimental protocol . Figure
5.2
is a graphic representation of the protocol as it occurred during the study.Figure 5.2 : Schematic representation of actual experimental protocol
Procedures performed IPN Legend : Cat 1 IPN DPL X X * X X X X
= intraperitoneal nutrient del ivery = diagnostic peritoneal lavage
= procedure performed
= procedure performed unsuccessfully
Cat
1
received 10% amino acid solution. Immediately after receiving its sedation, rectal tem perature was measured as38. 2°C
and heart rate 144 beats per minute (bpm ). Rectaltem perature dropped to
35.8°C
within 20 minutes and remained subnormal for12
hours. No other complications were encountered during i nfusion. Six hours after the infusion heart rate was 200 bpm, and m ucous membranes pale and tacky. The cat was becoming increasingly ataxic. Three-hundred mls of Hartmann's solutionm was administered subcutaneously over the following two hours. The cat was placed i nto a heated humidicrib (Amecare®, Ameda Medical Equipment, Switzerland) with the ambienttem perature set at
33°C.
This cat recovered uneventfully over the next12
hours. No further infusions of this solution were attempted.Intraperitoneal Nutrient Delivery in the Cat
Cat 2
This cat received 20% dextrose sol ution . Immediately after sedation, rectal temperature was 37.8°C and heart rate 160bpm . At the completion of infusion rectal tem perature had dropped to 34. 9°C and remained subnormal for the fol lowing 10 hours. Five hours after infusion, although hypothermic (34. 6°C), heart rate and respiratory rate were within normal ranges and the cat appeared to be recovering wel l from sedation . Six hours post i nfusion the cat was found lateral ly recumbent and unresponsive to verbal or physical rousing. Pupils were dilated and palpebral and corneal reflexes absent. Mucous membranes were dry and pale gray. Due to the paler of the mucous membranes capil lary refill time was unable to be assessed. Heart rate was 226 bpm with weak femoral pulses. A respiratory rate of 24 breaths per minute was accom panied by an i ncreased respi ratory effort. Oxygen was delivered by face mask, i ntravenous access obtained and crystal loid solution (Compound Sodi um Lactate Intravenous Infusion, Baxter Healthcare pty Ltd) administered intravenously at 60ml/kg/hr until a cli nica l response was achieved. This was judged by an improvement in pulse quality, return of mucous membrane colour and reduction in heart rate. At time, the rate of fl uid administration was reduced to 30ml/hr. The cat was maintained on this rate for next six hours fol lowed by 12ml/hr for a further ten hours. Intravenous fl uids ceased 22 hours after the dextrose i nfusion as the cat had resumed eating and drin king. Bodyweight had i ncreased from a baseline of 3.4kg to 3.7kg on the second day. This i ncrease was presumed to be due to overhydration. Bodyweight dropped to 3. 5kg on the third day. No further infusions of this solution were attempted.
Cat 3
This cat received 20% l i pid solution. Initial infusion was performed without com plications. Mild hypothermia was noted after sedation with rectal temperature dropping from a
Intraperitoneal Nutrient Delivery in the Cat
baseline value of 38.6°C to 36.6°C measured after nutrient infusion. Two hours after
completion of nutrient infusion the cat was recovering well and active. The cat was
uncooperative for further tem perature measurements
so
none were taken. Food, provided four and ten hours post infusion, was consumed willingly. This cat was given free access to water four hours after infusion.Sedation was repeated on the second day of the study and additional thermal support
was provided in the form of passive i nsulation suits.
19
Rectal temperature was recordedpre-infusion and hourly post-infusion. A nadir of 37.6°C was reached at the time of first tem perature recording. As planned, prior to nutrient infusion, sterile saline was insti l led
i nto the peritoneal cavity for diagnostic lavage at the rate of 20ml/kg. No lavage fluid was
a ble to be col lected and DPL was aborted pending re-eval uation of the technique. Lipid solution was i nfused as planned. Two hours post-infusion, subcutaneous leakage of the
li pid solution was noted . Moderate swelling of subcutaneous tissues extending a radius of a pproximately three centimeters from the abdominal puncture site accompanied the leakage. Aspi ration of this area was attem pted and no fl uid returned. The cat resented abdominal palpation at this ti me. An abdominal compression bandage was placed i n an attempt to reduce subcutaneous leakage of fl uid and the cat given ketoprofenn at
2 . 0mg/kg subcutaneously. Buprenorphi ne0 was administered at 0.01mg/kg subcutaneously an hour later for additional analgesia. Four hours after the infusion this cat was extremely agitated, manifested by vocalising and rolling around its cage. The abdominal wrap was removed and the cat sedated with 0.02mg/kg acetyl promazine administered intramuscularly. The cat was closely monitored for the next three hours.
n Ketofen® 1%, Rhone Merieux, Animal Health Division Rhone-Poulenc, N.Z. o Temgesic® injection, Reckitt & Col man pty Ltd, U.K.