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A Study On Postural Sway In Horses During Different Sedation Protocols Along With Clinico-Biochemical Evaluation In Clinical Cases

By: Hamad Bin Rashid (92-AG-676) | Prof. Dr. Muhammad Sarwar Khan.
Contributor(s): Prof. Dr. Muhammad Arif Khan | Prof. Dr. Muhammad Ashraf.
Material type: materialTypeLabelBookPublisher: 2017Description: 163p.Subject(s): Clinical Medicine | Phd. ThesisDDC classification: 2970-T Dissertation note: 6.1. Observational study of postural sway using accelerometer in horses sedated with different sedative combinations Balance is the ability to maintain center of gravity by a body within the base of support, whereas the phenomenon of continuous movement and improvement of the position of the center of gravity within the base of support is referred to as postural sway. Most of the living creatures including man, horse and other animals need to maintain their postural balance for their daily requirements, as most of them are either bipeds or quadrupeds. To attain this balance, co-ordination between sensory system, skeletal muscle system and the central nervous system is required. These systems are responsible for the pattern of walk in the horses, which is called as gait. Any abnormality in the nervous system results in an altered gait, which if assessed properly is a useful tool in diagnosing many ailments & disorders of the locomotor system. To assess these changes in the gait pattern, many methods have evolved over the years. The gait can be assessed by Kinematic or Kinetic Analysis. An accelerometer is a detecting element that measures acceleration. Accelerometers can measure: vibrations, shocks, tilt, impacts and motion of an object. An accelerometer by itself is only a sensing element, in order for it to be useful the sensor needs to be combined with other elements such as, power, logic, memory and a means to translate the output. An acceleration recorder incorporates all of these elements into one package. There is a measurable difference in postural sway at stance between different sedation protocols. This study aims to document and quantify the postural sway of horses undergoing various sedation protocols, with the aim of identifying a sedation protocol that will reduce sway and improve the ease with which standing non-painful diagnostic imaging procedures (Radiography, Scintigraphy and MRI) can be carried out. The present study assessed the postural sway during sedation in horses and evaluated a sedation protocol with minimal sway in horses. Equine surgery depends heavily on various imaging procedures. Diagnostic imaging plays important roles-first, in diagnosing and localising a disease process; second, in assessing the surgical intervention to be applied; and third, in the follow-up evaluation of the patient. Many imaging techniques like Radiography, Ultrasonography, Scintigraphy, Magnetic Resonance Imaging and Computed Tomography are used at veterinary hospitals and clinics, the world over. In order to achieve good results for these diagnostic modalities, various drugs and their combinations have been used by scientists to achieve good standing sedation in horses (e.g., Acepromazine, Butorphanol, Detomidine, Ketamine, Romifidine, Xylazine, etc.). The reason for integrating sedations which use combinations with Ketamine in this study and its different effect on the musculature i.e. increasing the muscle tone, while the alpha2-agonists (Romifidine, Detomidine, Xylazine), all reduced the muscle tone. Potentially, increasing the muscle tone of a horse will reduce the sway, as the constant correction of postural position with reduced muscle tone may be avoided. Horses that are In-Patients and Out-Patients brought to the Large Animal Hospital, Dept. of Vet. Clinical Studies, EBVC, RDSVS, UoE, UK, and have the medical need for diagnostic imaging procedures, and that require sedation so that these procedures can be carried out safely, were included in the study. The measurements were recorded pre-sedation and post-sedation while the horse is being imaged. The horses were observed during Radiography, Ultrasonography, Scintigraphy and Magnetic Resonance Imaging, or some other minor/major surgical intervention, under the influence of standing sedation. The body sway was measured using a MicroStrain G-link wireless triaxial accelerometer. It was secured on the skin above the midline of the sacrum with adhesive tape. Both sway episodes as well as continuous postural adaptations was assessed from the sum vector of the three acceleration traces. The results of current study showed no significant difference (p>0.05) in the mean values of postural sway between different drug groups. All drug combinations produced sedation in standing horses. However, pre-sedation mean values were significantly different from post-sedation mean values of postural sway. This shows that the subjects which were administered different combinations of sedatives exhibited variation in the postural control over time that is the readings of accelerometer either increased or decreased after sedation when compared to baseline (pre-sedation) values. The findings of current investigation also revealed a significant combined effect of drug groups and measurement time. Which means that the horses within groups, administered with different sedative combinations showed a change in postural sway values measured by accelerometer over time and these mean values either increased or decreased post-sedation. However, Post hoc Tukey’s test could not establish a significant difference (p<0.05) in the multiple comparision tests. Although post-sedation mean values of postural sway of group 2 (romifidine alone) and group 7 (detomidine alone) were different from pre-sedation values (p<0.1). The mean values of accelerometer for group 1 (detomidine+butorphenol) and group 4 (xylazine alone) were decreased from pre-sedation values that means the horses in these groups were more stable and had better control over their stance when compared with pre-sedation values. In the current study, the mean values of accelerometer for group 2 (romifidine alone) and group 7 (detomidine alone) were increased from pre-sedation values that means the horses in these groups were less stable and had poor control over their stance. This showed that detomidine alone with a dose range of 3 to 9 μg/kg is insufficient for standing procedures.
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6.1. Observational study of postural sway using accelerometer in horses sedated with different sedative combinations
Balance is the ability to maintain center of gravity by a body within the base of support, whereas the phenomenon of continuous movement and improvement of the position of the center of gravity within the base of support is referred to as postural sway. Most of the living creatures including man, horse and other animals need to maintain their postural balance for their daily requirements, as most of them are either bipeds or quadrupeds. To attain this balance, co-ordination between sensory system, skeletal muscle system and the central nervous system is required. These systems are responsible for the pattern of walk in the horses, which is called as gait. Any abnormality in the nervous system results in an altered gait, which if assessed properly is a useful tool in diagnosing many ailments & disorders of the locomotor system. To assess these changes in the gait pattern, many methods have evolved over the years. The gait can be assessed by Kinematic or Kinetic Analysis. An accelerometer is a detecting element that measures acceleration. Accelerometers can measure: vibrations, shocks, tilt, impacts and motion of an object. An accelerometer by itself is only a sensing element, in order for it to be useful the sensor needs to be combined with other elements such as, power, logic, memory and a means to translate the output. An acceleration recorder incorporates all of these elements into one package.
There is a measurable difference in postural sway at stance between different sedation protocols. This study aims to document and quantify the postural sway of horses undergoing various sedation protocols, with the aim of identifying a sedation protocol that will reduce sway and improve the ease with which standing non-painful diagnostic imaging procedures (Radiography, Scintigraphy and MRI) can be carried out. The present study assessed the postural sway during sedation in horses and evaluated a sedation protocol with minimal sway in horses. Equine surgery depends heavily on various imaging procedures. Diagnostic imaging plays important roles-first, in diagnosing and localising a disease process; second, in assessing the surgical intervention to be applied; and third, in the follow-up evaluation of the patient. Many imaging techniques like Radiography, Ultrasonography, Scintigraphy, Magnetic Resonance Imaging and Computed Tomography are used at veterinary hospitals and clinics, the world over. In order to achieve good results for these diagnostic modalities, various drugs and their combinations have been used by scientists to achieve good standing sedation in horses (e.g., Acepromazine, Butorphanol, Detomidine, Ketamine, Romifidine, Xylazine, etc.). The reason for integrating sedations which use combinations with Ketamine in this study and its different effect on the musculature i.e. increasing the muscle tone, while the alpha2-agonists (Romifidine, Detomidine, Xylazine), all reduced the muscle tone. Potentially, increasing the muscle tone of a horse will reduce the sway, as the constant correction of postural position with reduced muscle tone may be avoided. Horses that are In-Patients and Out-Patients brought to the Large Animal Hospital, Dept. of Vet. Clinical Studies, EBVC, RDSVS, UoE, UK, and have the medical need for diagnostic imaging procedures, and that require sedation so that these procedures can be carried out safely, were included in the study. The measurements were recorded pre-sedation and post-sedation while the horse is being imaged. The horses were observed during Radiography, Ultrasonography, Scintigraphy and Magnetic Resonance Imaging, or some other minor/major surgical intervention, under the influence of standing sedation. The body sway was measured using a MicroStrain G-link wireless triaxial accelerometer. It was secured on the skin above the midline of the sacrum with adhesive tape. Both sway episodes as well as continuous postural adaptations was assessed from the sum vector of the three acceleration traces.
The results of current study showed no significant difference (p>0.05) in the mean values of postural sway between different drug groups. All drug combinations produced sedation in standing horses. However, pre-sedation mean values were significantly different from post-sedation mean values of postural sway. This shows that the subjects which were administered different combinations of sedatives exhibited variation in the postural control over time that is the readings of accelerometer either increased or decreased after sedation when compared to baseline (pre-sedation) values. The findings of current investigation also revealed a significant combined effect of drug groups and measurement time. Which means that the horses within groups, administered with different sedative combinations showed a change in postural sway values measured by accelerometer over time and these mean values either increased or decreased post-sedation. However, Post hoc Tukey’s test could not establish a significant difference (p<0.05) in the multiple comparision tests. Although post-sedation mean values of postural sway of group 2 (romifidine alone) and group 7 (detomidine alone) were different from pre-sedation values (p<0.1).
The mean values of accelerometer for group 1 (detomidine+butorphenol) and group 4 (xylazine alone) were decreased from pre-sedation values that means the horses in these groups were more stable and had better control over their stance when compared with pre-sedation values. In the current study, the mean values of accelerometer for group 2 (romifidine alone) and group 7 (detomidine alone) were increased from pre-sedation values that means the horses in these groups were less stable and had poor control over their stance. This showed that detomidine alone with a dose range of 3 to 9 μg/kg is insufficient for standing procedures.

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