@article{heniff_petritz_carpenter_lewbart_balko_2024, title={Anesthetic efficacy of dexmedetomidine-ketamine in eastern box turtles<i> (Terrapene</i><i> carolina</i><i> carolina)</i> is enhanced with the addition of midazolam and when administered in the forelimb versus the hindlimb}, volume={85}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.23.10.0226}, abstractNote={OBJECTIVE
To compare dexmedetomidine-ketamine (DK; 0.1 and 10 mg/kg, respectively) with midazolam (M; 1.0 mg/kg) or 0.9% sodium chloride (S; 0.2 mL/kg) administered IM in the forelimb (F) or hindlimb (H) in eastern box turtles (Terrapene carolina carolina).


ANIMALS
20 clinically healthy, captive adult eastern box turtles.


METHODS
In a randomized, blinded, complete crossover study with 1-week washout periods, turtles were administered each of 3 treatments: F-DKS, F-DKM, or H-DKM. Palpebral reflex, muscle tone, and withdrawal responses were serially assessed and used to calculate cumulative sedation scores at each 5-minute time point. The ability to intubate was evaluated. At 60 minutes, atipamezole (1.0 mg/kg) and either flumazenil (F-DKM, H-DKM; 0.05 mg/kg) or 0.9% sodium chloride (F-DKS; 0.5 mL/kg) were administered IM.


RESULTS
All treatments resulted in clinically relevant anesthetic effects. F-DKM produced significantly higher sedation scores than H-DKM or F-DKS at all time points between 10 and 60 minutes (P < .05). Sedation score variability was observed with all treatments with significantly higher variability for H-DKM (P < .05). Intubation was successful in 32, 89, and 11% of turtles in F-DKS, F-DKM, and H-DKM, respectively. Median (range) recovery time was 10 (5-22), 16 (7-45), and 12 (4-28) minutes for F-DKS, F-DKM, and H-DKM, respectively.


CLINICAL RELEVANCE
In eastern box turtles, forelimb dexmedetomidine-ketamine resulted in clinically relevant anesthetic effects that were heightened with the addition of midazolam. Hindlimb administration of midazolam-dexmedetomidine-ketamine resulted in reduced and more variable anesthetic effects compared to forelimb administration, supporting a hepatic first-pass effect.}, number={2}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Heniff, Ashlyn C. and Petritz, Olivia A. and Carpenter, Rachel G. and Lewbart, Gregory A. and Balko, Julie. A.}, year={2024}, month={Feb} }
 @article{kirby_balko_goertz_lewbart_2023, title={Characterization of Current Husbandry and Veterinary Care Practices of the Giant Pacific Octopus (Enteroctopus dofleini) Using an Online Survey}, volume={10}, ISSN={["2306-7381"]}, url={https://www.mdpi.com/2306-7381/10/7/448}, DOI={10.3390/vetsci10070448}, abstractNote={Simple Summary Giant Pacific octopuses (Enteroctopus dofleini) (GPOs) are commonly found in zoos or aquariums. However, veterinarians or animal care professionals may be reluctant to perform diagnostic or other procedures due to limited information on best practices for sedation, anesthesia, or euthanasia of the species. The purpose of this study was to survey aquatic veterinarians and animal care professionals on current animal and veterinary care, including anesthesia and euthanasia, of GPOs. An online survey was distributed with participation from 52 institutions. Results included animal care practices consistent with current recommendations and highly variable involvement with veterinary care. Over 20 institutions have used anesthesia or sedation for procedures that do not involve euthanasia. Anesthesia and euthanasia methods were reported, including a variety of techniques and large dose ranges compared to techniques used for smaller cephalopods. Observations described include side effects such as failure to adequately anesthetize or euthanize, inking, delayed recovery, or behavior changes. The results of this study may help guide additional studies in GPO anesthesia. Abstract Giant Pacific octopuses (Enteroctopus dofleini) (GPOs) are commonly housed in zoos or aquaria, and sedation, anesthesia, and/or euthanasia may be indicated for a variety of reasons. Despite this need, evidence-based data on best practices is limited and focuses on smaller or more tropical species. The objectives of this study were to survey the aquatic community regarding the husbandry and veterinary care of GPOs, with a specific focus on anesthetic and euthanasia protocols. A two-part web-based survey was distributed to four aquatic and/or veterinary email listservs. Individuals from fifty-two institutions participated in phase one. Results documented that 40 (78 percent) participating institutions currently house GPOs, with most housing one and nine institutions housing two to three GPOs. The median (range) habitat volume is 5405 (1893–16,465) L, and 78 percent of systems are closed. Of the institutions surveyed, 23 have anesthetized or sedated a GPO for nonterminal procedures, including wound care, biopsies, and hemolymph collection. Reported methods of sedation or anesthesia include magnesium chloride, ethanol, isoflurane, tricaine methanesulfonate (MS-222), magnesium sulfate, benzocaine, and dexmedetomidine. Drugs or methods used for euthanasia include magnesium chloride, ethanol, mechanical decerebration, pentobarbital, isoflurane, MS-222, magnesium sulfate, benzocaine, potassium chloride, dexmedetomidine, and freezing. Reported observed side effects include ineffectiveness or inadequate sedation, inking, prolonged drug effects, and behavior changes. Survey data have the potential to guide the husbandry and veterinary care of GPOs and build the framework for future prospective studies on GPO sedation and anesthesia.}, number={7}, journal={VETERINARY SCIENCES}, author={Kirby, Ashley J. and Balko, Julie A. and Goertz, Caroline E. C. and Lewbart, Gregory A.}, year={2023}, month={Jul} }
 @article{cassady_balko_bailey_posner_robertson_minter_2023, title={EVALUATION OF OSCILLOMETRIC BLOOD PRESSURE MEASUREMENT USING A FINGER CUFF IN ANESTHETIZED CHIMPANZEES (PAN TROGLODYTES)}, volume={54}, ISSN={["1937-2825"]}, DOI={10.1638/2021-0001}, abstractNote={Abstract: Cardiovascular disease is common among chimpanzees (Pan troglodytes), and serial blood pressure monitoring in conscious animals may improve disease surveillance and guide hypertension treatment strategies. The objective of this study was to compare the accuracy of a noninvasive, oscillometric blood pressure monitor using a finger blood pressure cuff with invasively measured blood pressure in anesthetized chimpanzees. Twelve chimpanzees were anesthetized with tiletamine–zolazepam intramuscularly, intubated, and maintained on inhaled isoflurane to effect. Blood pressure measurements, which included systolic arterial pressure (SAP), mean arterial pressure (MAP), and diastolic arterial pressure (DAP), were collected simultaneously from an oscillometric blood pressure cuff placed on a forelimb digit (FBP) and a direct arterial catheter (IBP) every 5–10 min while anesthetized. One hundred paired samples were collected, and results were compared using Bland–Altman plots and analysis. FBP showed good agreement with IBP for SAP, MAP, and DAP but consistently overestimated values compared with IBP. FBP may be useful for serial blood pressure monitoring in conscious chimpanzees.}, number={1}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Cassady, Katherine R. and Balko, Julie A. and Bailey, Kate M. and Posner, Lysa P. and Robertson, James B. and Minter, Larry J.}, year={2023}, month={Mar}, pages={16–22} }
 @article{heniff_gorges_lewbart_balko_2023, title={Evaluation of Targeted Injections of Ivermectin or Potassium Chloride for Euthanasia of Anesthetized Thorny Devil Stick Insects (<i>Eurycantha calcarata</i>)}, volume={4}, ISSN={["2673-5636"]}, DOI={10.3390/jzbg4010020}, abstractNote={Insects are commonly utilized in biomedical research and have become increasingly popular in museum collections and as pets. Despite this, objective evaluation of insect euthanasia is scarce. This study investigated the effectiveness of targeted injections of ivermectin or potassium chloride (KCl) for the euthanasia of anesthetized thorny devil stick insects (Eurycantha calcarata). Ten clinically healthy mature insects (six males, four females) were enrolled. Insects were weighed and anesthetized via exposure to a cotton ball soaked with 1.6 mL of liquid isoflurane in a 1 L sealed chamber until loss of righting reflex and response to stimulation (induction). Insects then received one of three treatments: ivermectin 100 mg/kg (n = 4), KCl 200 mEq/kg (n = 4), or 0.9% sodium chloride 100 mL/kg (n = 2) injected along the ventral thoracic midline between the first leg plate and the caudal adjacent plate. Following injection, insects were serially monitored for return of spontaneous movement and righting reflex. Death was defined as the absence of spontaneous movement for 48 h. Median (range) induction time and isoflurane concentration at induction was 36 (22–39) min (n = 9) and 22 (19–22)%, respectively. Euthanasia was successful in 4/4, 3/4, and 0/2 isoflurane-anesthetized insects receiving ivermectin, KCl, or 0.9% sodium chloride, respectively. Recovery was prolonged at 10.5 (sodium chloride female), 11.0 (KCl male), and 18.0 (sodium chloride male) hours. This is the first prospective investigation of euthanasia in adult E. calcarata. In this preliminary study, ivermectin 100 mg/kg via ventral midline injection was effective for euthanasia of thorny devil stick insects.}, number={1}, journal={JOURNAL OF ZOOLOGICAL AND BOTANICAL GARDENS}, author={Heniff, Ashlyn C. and Gorges, Melinda A. and Lewbart, Gregory A. and Balko, Julie A.}, year={2023}, month={Mar}, pages={231–239} }
 @article{olagbaju_troan_balko_2023, title={Investigation of Potassium Chloride for Euthanasia of Anesthetized African Clawed Frogs (<i>Xenopus laevis</i>)}, volume={62}, ISSN={["1559-6109"]}, DOI={10.30802/AALAS-JAALAS-22-000112}, abstractNote={Euthanasia is frequently performed in amphibians, but techniques are currently limited in number and variable in effectiveness. The current study examined the use of potassium chloride (KCl) for euthanasia of anesthetized African clawed frogs (Xenopus laevis). Twenty adult, female African clawed frogs were anesthetized by immersion in buffered tricaine methanesulfonate (MS-222) for 5 min beyond loss of righting reflex. Frogs were then randomly assigned to receive one of 4 treatments: KCl via intracardiac injection (10 mEq/kg; IC, n = 5), intracoelomic injection (100 mEq/kg; ICe, n = 5), immersion (4,500 mEq/L; IMS, n = 5), or no treatment (C, n = 5). After treatment, serial heart rate was measured via Doppler device until either the loss of Doppler sounds, a 60 min endpoint (IC, ICe, IMS), or recovery (C). Times to loss of righting reflex, loss of Doppler sounds, and/or recovery were recorded. Plasma potassium concentrations were measured immediately after Doppler sound cessation in frogs in IC (n = 1), ICe (n = 2), and IMS (n = 5). Injection failure occurred in 1 IC frog, and 1 ICe frog regained spontaneous movement 4 min after treatment administration. Data from these 2 frogs were not included in statistical analysis. Doppler sound cessation occurred in 4 of 4, 4 of 4, 0 of 5, and 0 of 5 frogs in IC, ICe, IMS, and C, respectively. Median (range) times to Doppler sound cessation in IC and ICe were 6 (0 to 16) s and 18 (10 to 25) min, respectively. Plasma potassium concentration was greater than 9.0 mmol/L in sampled frogs. Intracardiac KCl at 10 mEq/kg and intracoelomic KCl at 100 mEq/kg were effective for euthanasia of anesthetized African clawed frogs. Return to MS-222 solution after KCl administration may be warranted to prevent unintended, premature anesthetic recovery prior to death.}, number={4}, journal={JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE}, author={Olagbaju, Tolulope and Troan, Brigid V and Balko, Julie A.}, year={2023}, month={Jul}, pages={362–369} }
 @article{heniff_balko_2023, title={POTASSIUM CHLORIDE ADMINISTERED VIA FOUR ROUTES FOR EUTHANASIA OF ANESTHETIZED GOLDFISH (<i>CARASSIUS AURATUS</i>)}, volume={54}, ISSN={["1937-2825"]}, DOI={10.1638/2022-0130}, abstractNote={Abstract: Immersion overdose in tricaine methanesulfonate (MS-222) is ineffective for euthanasia of adult goldfish (Carassius auratus), and investigation of alternative techniques is warranted. This study evaluated potassium chloride (KCl) administered via four routes for goldfish euthanasia. Thirty clinically healthy adult goldfish (17.2–41.9 g) were anesthetized via immersion in buffered MS-222 (300 mg/L) for 5 min beyond anesthetic induction. Fish were then randomly administered one of five treatments: KCl (333 mg/mL, 4.5 mmol/mL, 4.5 mEq/mL) via intracardiac injection at 10 mEq/kg (IC), intracoelomic injection (ICe) or bilateral topical delivery over the gill filaments (T) at 100 mEq/kg, or 90-min immersion at 4,500 mEq/L (saturated solution) dissolved in induction solution (water [W]), or no treatment (control [C]). Following treatment, all fish were moved to anesthetic-free freshwater. Serial heart rates were collected via Doppler device until sound cessation or recovery. Median (range) time to perform treatments was 5.3 (1.2–8.0) min, 3 (3–3) s, and 10 (10–10) s in IC, ICe, and T, respectively. Doppler cessation occurred in 6/6, 6/6, 6/6, 6/6, and 0/6 fish in median (range) times of 3 (0–210), 18 (10–45), 118 (90–390), and 150 (60–240) min in IC, ICe, T, W, and C, respectively; this was significantly different between groups (P = 0.002). Following or during treatment, 1/6, 2/6, 6/6, and 4/6 fish in IC, ICe, T, and W, respectively, exhibited intermittent transient jerking movements. Median (range) time to recovery in C was 5.5 (3.5–6.5) min. All administration routes were effective, but time to Doppler cessation varied and transient movements were noted. Preliminary follow-up research determined that return to MS-222 induction solution following ICe KCl treatment abolished movements. ICe KCl at 100 mEq/kg was technically simple and resulted in Doppler sound cessation in a clinically relevant time frame in 6/6 anesthetized goldfish. Return to MS-222 immersion following KCl administration is recommended.}, number={3}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Heniff, Ashlyn C. and Balko, Julie A.}, year={2023}, month={Sep}, pages={435–442} }
 @article{gonzalez_balko_sadar_alexander_sheldon_doss_keller_gardhouse_petritz_2023, title={Retrospective evaluation of wobbly hedgehog syndrome in 49 African pygmy hedgehogs (<i>Atelerix albiventris</i>): 2000-2020}, volume={261}, ISSN={["1943-569X"]}, DOI={10.2460/javma.23.03.0167}, abstractNote={OBJECTIVE
To retrospectively evaluate the prevalence and clinical progression of wobbly hedgehog syndrome (WHS) and concurrent incidence of neoplasia in a cohort of African pygmy hedgehogs (Atelerix albiventris).


ANIMALS
49 hedgehogs.


CLINICAL PRESENTATION AND PROCEDURES
Medical records of hedgehogs from 7 institutions across the US over a 20-year period (2000 to 2020) were retrospectively reviewed. Inclusion criteria were hedgehogs of any sex or age with postmortem CNS histopathology consistent with WHS. Collected data included sex, age at onset and euthanasia, major histopathologic findings, reported neurologic clinical signs, and treatments administered.


RESULTS
24 males and 25 females were included. Fifteen of 49 (31%) individuals had subclinical WHS with no reported antemortem neurologic clinical signs. In neurologically affected (clinical) hedgehogs (n = 34), the mean ± SD age at onset was 3.3 ± 1.5 years with a median (range) time from onset to euthanasia of 51 days (1 to 319 days). In neurologically affected hedgehogs, the most commonly reported clinical signs were ataxia (n = 21) and pelvic limb paresis (16) and the most commonly administered treatment was meloxicam (13). Overall, 31 of 49 (63%) hedgehogs had a concurrent histopathologic diagnosis of neoplasia outside of the CNS.


CLINICAL RELEVANCE
The prognosis for hedgehogs with WHS is poor. No treatment had a significant effect on survival time, and neoplasia was a common comorbidity in the current cohort. A small but clinically relevant subset of neurologically normal hedgehogs had a histopathologic diagnosis of WHS.}, number={9}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Gonzalez, Gabriela A. and Balko, Julie A. and Sadar, Miranda J. and Alexander, Amy B. and Sheldon, Julie D. and Doss, Grayson A. and Keller, Krista A. and Gardhouse, Sara M. and Petritz, Olivia A.}, year={2023}, month={Sep} }
 @article{pla_evans_lee_chiang_bishawi_vekstein_kang_zapata_gross_carnes_et al._2022, title={A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft}, ISSN={["1940-087X"]}, DOI={10.3791/63114}, abstractNote={Cardiac transplantation is the gold standard treatment for end-stage heart failure. However, it remains limited by the number of available donor hearts and complications such as primary graft dysfunction and graft rejection. The recent clinical use of an ex vivo perfusion device in cardiac transplantation introduces a unique opportunity for treating cardiac allografts with therapeutic interventions to improve function and avoid deleterious recipient responses. Establishing a translational, large-animal model for therapeutic delivery to the entire allograft is essential for testing novel therapeutic approaches in cardiac transplantation. The porcine, heterotopic heart transplantation model in the intraabdominal position serves as an excellent model for assessing the effects of novel interventions and the immunopathology of graft rejection. This model additionally offers long-term survival for the pig, given that the graft is not required to maintain the recipient's circulation. The aim of this protocol is to provide a reproducible and robust approach for achieving ex vivo delivery of a therapeutic to the entire cardiac allograft prior to transplantation and provide technical details to perform a survival heterotopic transplant of the ex vivo perfused heart.}, number={180}, journal={JOVE-JOURNAL OF VISUALIZED EXPERIMENTS}, author={Pla, Michelle Mendiola and Evans, Amy and Lee, Franklin H. and Chiang, Yuting and Bishawi, Muath and Vekstein, Andrew and Kang, Lillian and Zapata, Diego and Gross, Ryan and Carnes, Alexis and et al.}, year={2022}, month={Feb} }
 @article{gregory_heniff_gorges_lathan_lewbart_balko_2022, title={Development and Evaluation of a Serum Transfusion Process in the Thorny Devil Stick Insect (Eurycantha calcarata)}, volume={9}, ISSN={["2297-1769"]}, DOI={10.3389/fvets.2022.847043}, abstractNote={The thorny devil stick insect (Eurycantha calcarata) is a common invertebrate maintained under human care. Blood (hemolymph) transfusions are a widely used therapeutic tool in other species, but investigation in terrestrial arthropods remains scarce. Study objectives were development and evaluation of a serum transfusion process in the thorny devil stick insect. Twenty-five clinically healthy adult insects (9.9–23.0 g) were enrolled and baseline body weights were collected. Hemolymph collection was not successful in males, thus, all were recipient only (n = 12, MR). Females were divided into donor (n = 4, FD) or donor and recipient (n = 9, FDR) groups. Females were manually restrained and up to 1 mL of hemolymph was collected from the abdominal segment caudal to the proximal hindlimb using an 18 g hypodermic needle and passive collection via gravity. Hemolymph was quantified, centrifuged, and the serum separated. Insects were then injected superficially at the lateral aspect of the abdomen with 0.01 mL/g FD serum (MR), lactated Ringer's solution (LRS) equal to collected hemolymph volume (FD), or a combination of FDR serum and LRS equal to collected hemolymph volume (FDR). Response to stimulation, surface temperature, and righting reflex and mortality were serially assessed for up to 24 h and 7 days, respectively, following injection. In FD, median (range) injected LRS dose was 0.04 (0.03–0.06) mL/g. In FDR, median (range) injected serum, LRS, and combined serum and LRS dose was 0.03 (0.02–0.04), 0.01 (0–0.04), and 0.04 (0.02–0.06) mL/g, respectively. A mild temperature increase (maximum +2.9°C) (MR n = 10, FD n = 3, FDR n = 8) and delayed righting reflex (MR n = 4, FD n = 3, FDR n = 7) occurred in a subset of insects following injection. Two deaths occurred at 2 min (n = 1, FDR) and 96 h (n = 1, FD) post-injection. This is the first report of serum transfusions in thorny devil stick insects, and while largely successful, minor to severe transfusion reactions may occur.}, journal={FRONTIERS IN VETERINARY SCIENCE}, author={Gregory, Taylor M. and Heniff, Ashlyn C. and Gorges, Melinda A. and Lathan, Andrew W. and Lewbart, Gregory A. and Balko, Julie A.}, year={2022}, month={Apr} }
 @article{mones_heniff_harms_balko_2022, title={EVALUATION OF INTRACARDIAC ADMINISTRATION OF POTASSIUM CHLORIDE, IVERMECTIN, OR LIDOCAINE HYDROCHLORIDE FOR EUTHANASIA OF ANESTHETIZED BLUE CRABS (CALLINECTES SAPIDUS)}, volume={53}, ISSN={["1937-2825"]}, DOI={10.1638/2022-0012}, abstractNote={Abstract: Methods to anesthetize and euthanize aquatic invertebrates have proven unreliable in decapods; thus studies to optimize euthanasia techniques for crustaceans are needed. Study objectives were to evaluate efficacy of intracardiac potassium chloride (KCl), ivermectin, or lidocaine hydrochloride (HCl) for euthanasia of anesthetized blue crabs (Callinectes sapidus). Twenty adult male crabs (n = 5/group) were immersed in 500 mg/L eugenol for 5 min beyond loss of the righting reflex and then randomly administered intracardiac 10 mEq/kg KCl (333 mg/mL), 5 mg/kg ivermectin (10 mg/ml), 100 mg/kg lidocaine hydrochloride (HCl) (20 mg/ml), or 5 ml/kg saline (0.9%). Serial heart rate assessments were made using a Doppler probe placed over the dorsum, and times to loss of righting reflex, Doppler sound cessation, and/or recovery were recorded. Median (range) time to loss of righting reflex was 32 (17–57) min. One crab in all groups, except lidocaine HCl, had no detectable Doppler sounds prior to injection. In the remaining crabs, Doppler sound cessation occurred in 4/4, 4/4, 4/5, and 0/4 crabs administered KCl, ivermectin, lidocaine HCl, and saline, respectively. Median (range) time to Doppler sound cessation was 30 (0–55), 18 (16–28), and 50 (0–90) s in KCl, ivermectin, and lidocaine HCl groups, respectively. Tonic limb movements were observed in 5/5 KCl-treated crabs. Median (range) time to recovery was 180 (115–345) and 300 m in four saline-treated crabs and one lidocaine HCl–treated crab, respectively. Intracardiac KCl at 10 mEq/kg and ivermectin at 5 mg/kg were effective, rapid methods for euthanasia of anesthetized blue crabs.}, number={4}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Mones, Alissa B. and Heniff, Ashlyn C. and Harms, Craig A. and Balko, Julie A.}, year={2022}, month={Dec}, pages={689–695} }
 @article{knutson_petritz_thomson_robertson_balko_2022, title={Effects of Intramuscular Alfaxalone and Midazolam Compared With Midazolam and Butorphanol in Rhode Island Red Hens (Gallus gallus domesticus)}, volume={36}, ISSN={["1938-2871"]}, DOI={10.1647/20-00087}, abstractNote={Abstract: Chickens (Gallus gallus domesticus) often undergo veterinary procedures requiring sedation; however, there is little published research evaluating the efficacy of sedation protocols in this species. The objective of this study was to assess the effects of intramuscular alfaxalone and midazolam compared with intramuscular butorphanol and midazolam in chickens. In a complete crossover study, 11 healthy adult hens were randomly administered midazolam 2.5 mg/kg IM combined with either alfaxalone 15 mg/kg IM (AM, n = 11) or butorphanol 3 mg/kg IM (BM, n = 11), with a 35-day washout period between groups. Time to first effects, recumbency, standing, and recovery were recorded. Physiologic parameters and sedation scores were recorded every 5 minutes by 2 blinded investigators. Fifteen minutes after injection, positioning for sham whole body radiographs was attempted. At 30 minutes, flumazenil 0.05 mg/kg IM was administered to all hens. Peak total sedation score was significantly higher for AM compared with BM (P < 0.001). Mean ± SD or median (range) time to initial effects, recumbency, standing, and recovery in AM and BM were 1.9 ± 0.6 and 2.6 ± 0.9 (P = 0.02), 3.5 (1.6–7.6) and 4.8 (2.2–13.0) (P = 0.10), 40.3 (28.0–77.8) and 33.2 (5.2–41.3) (P = 0.15), and 71.2 (45.7–202.3) and 39.9 (35.9–45.9) minutes (P = 0.05), respectively. Radiographic positioning was successful in 6 of 11 (54.5%) and 0 of 11 (0%) birds in the AM and BM groups at 15 minutes, respectively. Heart and respiratory rates remained within acceptable clinical limits for all birds. Intramuscular AM resulted in significantly faster onset of sedative effects, significantly longer duration of recumbency, significantly higher peak sedation, and improved success of radiographic positioning compared with intramuscular BM. Intramuscular AM produces clinically effective sedation in chickens without clinically significant cardiorespiratory effects.}, number={3}, journal={JOURNAL OF AVIAN MEDICINE AND SURGERY}, author={Knutson, Kyra A. and Petritz, Olivia A. and Thomson, Andrea and Robertson, James and Balko, Julie A.}, year={2022}, month={Sep}, pages={287–294} }
 @article{knutson_petritz_thomson_balko_2022, title={Intramuscular Alfaxalone-Butorphanol-Midazolam Compared with Ketamine-Butorphanol- Midazolam in New Zealand White Rabbits}, volume={61}, ISSN={["1559-6109"]}, DOI={10.30802/AALAS-JAALAS-22-000038}, abstractNote={Rabbits are a common companion animal and research subject and frequently require sedation to facilitate procedures. The objective of this study was to compare the effects of intramuscular butorphanol and midazolam combined with either alfaxalone or ketamine in rabbits. In a complete crossover study, healthy New Zealand white rabbits (n = 9; age, 6 mo) randomly received midazolam (1 mg/kg IM) and butorphanol (1 mg/kg IM) combined with either alfaxalone (2 mg/kg IM; ABM) or ketamine (5 mg/kg IM; KBM). Time to first effects, recumbency, and standing (recovery) were recorded. Every 5 min during recumbency, an investigator who was blind to treatment group collected serial physiologic parameters and sedation scores. At 5 min after rabbits became recumbent, manipulations were performed to mimic 2-view radiography and a cephalic intravenous catheter was placed. At 30 min after drug injection, flumazenil (0.05 mg/kg IM) was administered for reversal. Food consumption and fecal output were measured for 3 d after each study day. Time to standing and duration of recumbency differed significantly between groups. The median (range) of the total sedation score for ABM was 10 (8 to 10) and for KBM was 10 (6 to 10). Sham radiographs were successful in all rabbits in both groups. Physiologic parameters were not significantly different between groups over time. At 24 h after drug treatment, KBM-treated rabbits showed reduced food intake and both groups showed reduced fecal output. Total sedation scores decreased significantly over time in KBM rabbits (P < 0.001) but not in ABM rabbits (P = 1). The duration of recumbency was significantly longer in ABM rabbits than in KBM rabbits. Both protocols produced sufficient sedation for radiograph acquisition without clinically significant adverse effects.}, number={5}, journal={JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE}, author={Knutson, Kyra A. and Petritz, Olivia A. and Thomson, Andrea E. and Balko, Julie A.}, year={2022}, month={Sep}, pages={475–481} }
 @article{wang_lynch_balko_duffy_robertson_posner_2022, title={Point-of-care viscoelastic coagulation assessment in healthy dogs during the perianesthetic period}, volume={18}, ISSN={["1746-6148"]}, DOI={10.1186/s12917-022-03442-x}, abstractNote={The viscoelastic coagulation monitor (VCM Vet) is a novel, portable device that provides a global assessment of hemostasis. The study aims were to evaluate serial viscoelastic analysis during the perianesthetic period in healthy dogs and to compare the agreement between two VCM Vet devices. Twenty healthy dogs undergoing orthopedic surgery were enrolled. Whole blood samples were collected from an intravenous catheter at four time points: baseline, 15 min after premedication, 60 min after inhalant initiation, and 60 min after inhalant termination. Viscoelastic tests were performed in duplicate on different devices, providing: clot time (CT; seconds), clot formation time (CFT; seconds), alpha angle (α; degrees), amplitude (units) at 10 (A10) and 20 (A20) minutes post clot time, maximum clot firmness (MCF; units), and lysis index (%) at 30 (Li30) and 45 (Li45) minutes post maximum clot formation.One hundred sixty samples were analyzed. The speed of CT and CFT significantly decreased an average of 25.5 s (95% confidence interval [CI]15.9-35.0) and 6.9 s (95% CI 3.1-10.7) per time point, respectively. There were no significant changes in clot strength or lysis variables. The Bland-Altman style plot shows an acceptable rate of agreement for all variables with intra-class correlation ranging from 0.64-0.94.The rate of clot formation (CT and CFT) decreased over the perianesthetic period in healthy dogs undergoing surgery. These changes were small and occurred without changes in clot strength or fibrinolysis rate, thus were not clinically relevant. There was clinically acceptable consistency between devices.}, number={1}, journal={BMC VETERINARY RESEARCH}, author={Wang, Wen H. and Lynch, Alex M. and Balko, Julie A. and Duffy, Daniel J. and Robertson, James B. and Posner, Lysa P.}, year={2022}, month={Sep} }
 @article{balko_fogle_stuska_fogle_posner_2021, title={Retrospective and prospective assessment of butorphanol, azaperone and medetomidine (BAM (TM)) for immobilisation of feral horses (Equus ferus caballus)}, volume={7}, ISSN={["2042-3306"]}, DOI={10.1111/evj.13490}, abstractNote={BACKGROUND
Butorphanol-azaperone-medetomidine (BAM™) has not been evaluated in horses.


OBJECTIVES
To evaluate BAM™ for chemical restraint of feral horses.


STUDY DESIGN
Retrospective and prospective descriptive studies.


METHODS
Data was collected retrospectively from medical records of 28 feral horses immobilised with BAM™ over a six-year period. Prospectively, 0.0125 ml/kg bwt of BAM™ (butorphanol 27.3 mg/mL, azaperone 9.1 mg/mL, medetomidine 10.9 mg/mL) intramuscularly (IM) was administered to 8 stallions via dart and, once recumbent, 1.0 mg/kg bwt ketamine was given intravenously (IV). Induction and recovery time and quality via a standardised rubric (1 = very poor, 5 = excellent) and visual analog scale (VAS), need for additional darts, weight tape measurement, and serial physiological parameters were recorded. Serial arterial blood gas analysis was performed during recumbency. Following castration, horses were given 0.1 mg/kg bwt atipamezole (25% IV, 75% IM) and allowed to recover unaided.


RESULTS
Retrospectively, twenty-eight horses were successfully immobilised with BAM™ without a major complication. Prospectively, eight horses were given a median (range) actual BAMTM dose of 0.0143 (0.0127-0.0510) mL/kg bwt. Three of eight horses needed 1, 2, or 5 additional darts. Median (range) time to recumbency was 11 (2-44) min. Median (range) induction (n=4) and recovery (n=6) scores via rubric and VAS were 5 (4-5) and 5 (5-5) and 92 (86-93) and 98 (92-99) cm, respectively. Four of seven horses were hypoxaemic at ≥1 time point with otherwise acceptable physiological parameters. Following atipamezole, median (range) time to sternal recumbency and standing was 12 (2-18) and 17 (11-52) min, respectively (n=6).


MAIN LIMITATIONS
The sample size was small. Data could not be collected before darting or after recovery. Some data were missing from retrospective analysis.


CONCLUSIONS
Intramuscular BAM™ with IV ketamine provided chemical restraint suitable for field castration of feral horses with no mortality. Hypoxaemia occurred in the majority of horses.}, journal={EQUINE VETERINARY JOURNAL}, author={Balko, Julie A. and Fogle, Callie and Stuska, Susan J. and Fogle, Jonathan E. and Posner, Lysa P.}, year={2021}, month={Jul} }
 @article{louis_houck_lewbart_posner_balko_2020, title={EVALUATION OF POTASSIUM CHLORIDE ADMINISTERED VIA THREE ROUTES FOR EUTHANASIA OF ANESTHETIZED KOI (CYPRINUS CARPIO)}, volume={51}, ISSN={["1937-2825"]}, DOI={10.1638/2019-0207}, abstractNote={Abstract: Immersion in tricaine methanesulfonate (MS-222) is insufficient for euthanasia in at least one species of fish. The current study investigated the effectiveness of potassium chloride (KCl) to euthanize anesthetized koi (Cyprinus carpio). Twenty-eight healthy koi were anesthetized via immersion in 500 mg/L of buffered MS-222 for 10–12 min, manually removed to room air, and randomly administered 10 mEq/kg KCl (333 mg/ml) via one of three routes—intracardiac injection (IC) (n = 7), intracoelomic injection (ICe) (n = 7), or topical instillment over the gill filaments bilaterally (T) (n = 7)—or received no treatment (control, C) (n = 7). A Doppler ultrasonic flow detector was placed over the heart, and sounds were assessed continuously from immediately prior to treatment until 5 min posttreatment and every 5 min thereafter until Doppler sound cessation, resumption of operculation, or 30 min. Time to Doppler sound cessation or resumption of operculation was recorded. Doppler sound cessation occurred in 7/7 fish in IC (median 0.08, range 0–2.75 min) and 1/7 fish in T (10 min). In T, ICe, and C, 6/7, 7/7, and 7/7 fish, respectively, maintained Doppler sounds to 30 min. All fish in ICe (7/7) and C (7/7) resumed operculation with median (range) times of 22 (7–30) min and 16 (9–29) min from treatment, respectively. Intracardiac KCl at 10 mEq/kg rapidly ceases Doppler sounds and is a successful technique for euthanasia of anesthetized koi. Intracoelomic and topical KCl at 10 mEq/kg were not effective for euthanasia of koi.}, number={3}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Louis, Meghan M. and Houck, Emma L. and Lewbart, Gregory A. and Posner, Lysa P. and Balko, Julie A.}, year={2020}, month={Sep}, pages={485–489} }
 @article{duffy_chang_balko_moore_2020, title={Effect of presurgical storage conditions on leakage pressures of enterotomy sites closed with unidirectional barbed suture material in fresh, chilled, and frozen-thawed cadaveric canine jejunal specimens}, volume={81}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.81.3.220}, abstractNote={OBJECTIVE
To evaluate the effect of presurgical storage conditions on leakage pressures of enterotomy sites closed with unidirectional barbed suture material in fresh, chilled, and frozen-thawed cadaveric canine jejunal specimens.


SAMPLE
36 grossly normal jejunal segments obtained from 4 dog cadavers.


PROCEDURES
9 jejunal segments were harvested immediately from each euthanized dog and randomly assigned to be tested within 4 hours after collection (fresh segments), stored at 4°C for 24 hours before testing (chilled segments), or stored at -20°C for 7 days and thawed at 21°C for 6 hours before testing (frozen-thawed segments). For leakage pressure testing, a 3-cm-long antimesenteric enterotomy was performed and repaired with 3-0 unidirectional barbed suture material in a simple continuous pattern in each segment. Time to complete the enterotomy, initial leakage pressure, maximum intraluminal pressure, and leakage location were recorded for each segment.


RESULTS
Mean ± SD initial leakage pressure for fresh, chilled, and frozen-thawed segments was 52.8 ± 14.9 mm Hg, 51.8 ± 11.9 mm Hg, and 33.3 ± 7.7 mm Hg, respectively. Frozen-thawed segments had significantly lower mean initial leakage pressure, compared with findings for fresh or chilled segments. Time to complete the enterotomy, maximum intraluminal pressure, and leakage location did not differ among groups.


CONCLUSIONS AND CLINICAL RELEVANCE
Leak pressure testing of cadaveric jejunal segments that are fresh or chilled at 4°C for 24 hours is recommended for enterotomy studies involving barbed suture material in dogs. Freezing and thawing of cadaveric jejunal tissues prior to investigative use is not recommended because leak pressure data may be falsely low.}, number={3}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Duffy, Daniel J. and Chang, Yi-Jen and Balko, Julie A. and Moore, George E.}, year={2020}, month={Mar}, pages={220–226} }
 @article{duffy_chang_balko_moore_2020, title={Ex vivo comparison of the effect of storage temperature on canine intestinal leakage pressures}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13339}, abstractNote={OBJECTIVE
To determine the effect of storage temperature on cadaveric small intestinal leakage pressures after enterotomy.


STUDY DESIGN
Experimental ex vivo study.


ANIMALS
Grossly normal jejunal segments from four canine cadavers.


METHODS
Thirty-six jejunal segments (n = 12 segments/group) were harvested immediately after euthanasia and assigned to a fresh group (tested within 4 hours), chilled group (stored for 24 hours at 4°C before testing), or freeze-thaw group (frozen at -20°C for 7 days and thawed at 21°C for 6 hours before testing). A 2-cm antimesenteric enterotomy was performed and repaired with 4-0 monofilament suture in a simple-continuous pattern. Initial leakage pressure (ILP), maximal intraluminal pressure (MIP), and leakage location were recorded, with testing performed at room temperature.


RESULTS
Mean ± SD ILP for fresh, chilled, and frozen-thawed specimens was 52.9 ± 8.4, 51.8 ± 11.9 and 29.8 ± 4.4 mm Hg, respectively. There was a difference in ILP among groups (P < .003), with freeze-thaw samples demonstrating lower ILP compared with other groups. There was no difference in MIP between groups (P = .186) There was a difference in leakage location among groups (P = .004), with the majority of chilled and freeze-thaw samples leaking at the suture holes compared with the incisional line in fresh samples.


CONCLUSION
Freezing and subsequent thawing prior to specimen testing reduced ILP compared with use of fresh and chilled specimens but did not affect MIP among experimental groups.


CLINICAL SIGNIFICANCE
Cadaveric canine intestinal specimens tested immediately after collection or after chilling for 24 hours should be recommended for ex vivo burst pressure assessment in dogs. Additional studies to evaluate loss in testing viability of chilled intestinal specimens are warranted to help govern experimental methodologies.}, number={3}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Balko, Julie A. and Moore, George E.}, year={2020}, month={Apr}, pages={496–501} }
 @article{sheldon_adkesson_allender_balko_bailey_langan_chinnadurai_2020, title={OBJECTIVE GAIT ANALYSIS IN HUMBOLDT PENGUINS (SPHENISCUS HUMBOLDTI) USING A PRESSURE-SENSITIVE WALKWAY}, volume={50}, ISSN={["1937-2825"]}, DOI={10.1638/2019-0054}, abstractNote={Abstract: Assessment of pododermatitis, osteoarthritis, and other causes of lameness in penguins can be challenging. Subjective gait analysis using visual observation and response to analgesic therapy can be affected by observer variation and caregiver placebo bias. A pressure-sensitive walkway (PSW), however, allows for objective gait analysis and assessment of analgesic therapeutic response. In this study, a 3-m-long PSW was used to analyze gait in 21 adult Humboldt penguins (Spheniscus humboldti). Medical record reviews and comprehensive examinations were performed on all penguins; five penguins were considered abnormal, with either right-sided (n = 3) or bilateral historical lameness-causing disease (n = 2) and were analyzed separately from the normal data set. All penguins walked across the PSW four times and gait parameters (step and stride distances and velocities, maximum force, impulse, and peak pressure) were calculated for each foot in each penguin. Statistical comparisons were made between right and left feet, sexes, and normal and abnormal penguins for each gait parameter. Among normal penguins, there were no significant differences between feet or sex. Left step width was shorter in abnormal penguins than that of normal penguins. Study results established baseline values for Humboldt penguins. This will allow objective monitoring of progression and response to therapy in penguin lameness cases, both current and future. The data also provide a foundation to compare gait parameters with other penguin populations and species.}, number={4}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Sheldon, Julie D. and Adkesson, Michael J. and Allender, Matthew C. and Balko, Julie A. and Bailey, Ryan S. and Langan, Jennifer N. and Chinnadurai, Sathya K.}, year={2020}, month={Jan}, pages={910–916} }
 @article{milloway_posner_balko_2020, title={SEDATIVE AND CARDIORESPIRATORY EFFECTS OF INTRAMUSCULAR ALFAXALONE AND BUTORPHANOL AT TWO DOSAGES IN FERRETS (MUSTELA PUTORIUS FURO)}, volume={51}, ISSN={["1937-2825"]}, DOI={10.1638/2019-0241}, abstractNote={Abstract: Veterinary care of ferrets often requires chemical restraint. This study hypothesized that IM alfaxalone and butorphanol would result in clinically useful sedation without clinically relevant cardiorespiratory effects. Twelve healthy 15-mo-old ferrets of equal sexes weighing 0.75 to 1.66 kg were enrolled. Using a prospective, blinded design, ferrets randomly received either IM alfaxalone 2.5 mg/kg and butorphanol 0.2 mg/kg (low dose [LD]) or IM alfaxalone 5 mg/kg and butorphanol 0.2 mg/kg (high dose [HD]) (n = 6/group). Sedation times and induction and recovery scores were recorded by a blinded observer. Anesthetic monitor placement was attempted in all recumbent ferrets, and physiologic parameters and reflexes were recorded every 5 min until return of spontaneous movement. Data were assessed for normality using a Shapiro-Wilk normality test and analyzed by two-sample t test or Mann-Whitney U test; one ferret in HD was excluded. Ferrets in LD and HD exhibited moderate and marked sedation, with one of six and four of five ferrets tolerating monitor placement, respectively. Mean ± SD time to first effects, recumbency, and recovery in LD and HD was 2.30 ± 1.13 and 2.054 ± 1.12 (P = 0.7240), 2.87 ± 1.25 and 2.72 ± 1.41 (P = 0.8529), and 65.43 ± 32.43 and 52.30 ± 13.19 (P = 0.4212), respectively. Median (range) duration of recumbency in LD and HD was 31.12 (25.58–115.72) and 35.47 (28.27–44.42) min (P = 0.3290), respectively. Among monitored ferrets, transient mild hypotension and hypoxemia were observed. Intramuscular alfaxalone 5 mg/kg with butorphanol 0.2 mg/kg provided clinically useful sedation in ferrets with mild transient cardiorespiratory derangements.}, number={4}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Milloway, Matthew C. and Posner, Lysa P. and Balko, Julie A.}, year={2020}, month={Dec}, pages={841–847} }
 @article{balko_lindemann_allender_chinnadurai_2019, title={Evaluation of the anesthetic and cardiorespiratory effects of intramuscular alfaxalone administration and isoflurane in budgerigars (Melopsittacus undulatus) and comparison with manual restraint}, volume={254}, ISSN={["1943-569X"]}, DOI={10.2460/javma.254.12.1427}, abstractNote={OBJECTIVE To evaluate the anesthetic and cardiorespiratory effects of IM alfaxalone and isoflurane administration in budgerigars (Melopsittacus undulatus) and compare use of these agents with use of manual restraint. ANIMALS 42 healthy budgerigars. PROCEDURES For dose comparison, birds received alfaxalone (5 or 10 mg/kg [2.27 or 4.54 mg/lb], IM; groups A5 and A10, respectively; n = 6/group). For treatment comparison, birds received alfaxalone (10 mg/kg, IM) or isoflurane (via face mask) or were manually restrained (groups A, I, and M, respectively; n = 10/group). Data were obtained on onset, degree, and duration of sedation or anesthesia; heart and respiratory rates; and recovery times. Birds in the treatment comparison underwent physical examination and blood gas analysis. RESULTS All group A5 birds became sedate, but not recumbent. In group A10, 5 of 6 birds lost the righting reflex; however, none lost the noxious stimulus response. Median time to initial effects was significantly shorter and mean time to complete recovery was significantly longer in group A10 than in group A5. Heart and respiratory rates in group A10 remained clinically acceptable; however, some birds had signs of excitement during induction and recovery. Times to initial effects, recumbency, and complete recovery were significantly longer, yet clinically practical, in group A than in group I. Plasma lactate concentrations were significantly higher in group M than in groups A and I. CONCLUSIONS AND CLINICAL RELEVANCE Alfaxalone administered IM at 10 mg/kg produced effective sedation in healthy budgerigars and may be a viable alternative to isoflurane and manual restraint for brief, minimally invasive procedures. Brief manual restraint resulted in a significant increase in plasma lactate concentration.}, number={12}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Balko, Julie A. and Lindemann, Dana M. and Allender, Matthew C. and Chinnadurai, Sathya K.}, year={2019}, month={Jun}, pages={1427–1435} }
 @article{balko_posner_chinnadurai_2019, title={IMMERSION IN TRICAINE METHANESULFONATE (MS-222) IS NOT SUFFICIENT FOR EUTHANASIA OF SMOKEY JUNGLE FROGS (LEPTODACTYLUS PENTADACTYLUS)}, volume={50}, ISSN={["1937-2825"]}, DOI={10.1638/2018-0033}, abstractNote={Abstract: Although tricaine methanesulfonate (MS-222) immersion has historically been standard of care for fish and anuran euthanasia, recent research has proven it insufficient for euthanasia of goldfish. To assess appropriateness for humane euthanasia of anurans, this study evaluated the efficacy of MS-222 in Smokey Jungle Frogs (Leptodactylus pentadactylus). Eighteen frogs (21–33 g) were exposed to one of three MS-222 concentrations via partial immersion: 2.5 g/L for 90 min (M2.5/90), 5 g/L for 60 min (M5/60), or 10 g/L for 60 min (M10/60). Physiologic parameters and times to loss of spontaneous movement, righting reflex, and noxious stimulus response were recorded. Following exposure, frogs were rinsed with dechlorinated water, and time to cessation of heart beat was recorded. Survival in M2.5/90, M5/60, and M10/60 was one of six, zero of six, and zero of six, respectively. In M2.5/90, three of six frogs had continued purposeful, spontaneous movement throughout exposure. In M5/60 and M10/60, median (range) time to initial loss of movement was 14.3 (5.5–30.0) and 7.6 (4.8–19.7) min, respectively. Twelve of 18 frogs among all groups demonstrated a median (range) of two (one to six) episodes of regained consciousness with purposeful, spontaneous movement following loss of noxious stimulus response. Median (range) time to heart beat cessation in M2.5/90, M5/60, and M10/60 was 150 (135–210), 157.5 (60–225), and 90 (75–210) min, respectively. Although death was achieved in 17 of 18 frogs, given the repeated events of regained consciousness, MS-222 immersion when used at concentrations ≤10 g/L did not result in rapid and distress-free death and is not sufficient for humane euthanasia in this species.}, number={1}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Balko, Julie A. and Posner, Lysa P. and Chinnadurai, Sathya K.}, year={2019}, month={Mar}, pages={89–95} }
 @article{curto_griffith_posner_walsh_balko_gilger_2018, title={Factors associated with postoperative complications in healthy horses after general anesthesia for ophthalmic versus non-ophthalmic procedures: 556 cases (2012–2014)}, volume={252}, ISSN={["1943-569X"]}, DOI={10.2460/javma.252.9.1113}, abstractNote={OBJECTIVE To compare complications between healthy horses undergoing general anesthesia for ophthalmic versus non-ophthalmic procedures and identify potential risk factors for the development of complications. DESIGN Retrospective case series. ANIMALS 502 horses (556 anesthetic procedures). PROCEDURES Medical records from January 2012 through December 2014 were reviewed to identify horses undergoing general anesthesia. Signalment, body weight, drugs administered, patient positioning, procedure type (ophthalmic, orthopedic, soft tissue, or diagnostic imaging), specific procedure, procedure time, anesthesia time, recovery time, recovery quality, and postoperative complications were recorded. RESULTS Patients underwent general anesthesia for ophthalmic (n = 106), orthopedic (246), soft tissue (84), diagnostic imaging (110), or combined (10) procedures. Mean procedure, anesthesia, and recovery times were significantly longer for patients undergoing ophthalmic versus non-ophthalmic procedures. Excluding diagnostic imaging procedures, there was a significant positive correlation between surgery time and recovery time. Within ophthalmic procedures, surgery time, anesthesia time, and recovery time were significantly greater for penetrating keratoplasty versus other ophthalmic procedures. There was a significantly higher rate of postoperative colic following penetrating keratoplasty, compared with all other ophthalmic procedures. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in healthy horses, duration of general anesthesia should be minimized to decrease the risk of postanesthetic complications. Judicious use of orally administered fluconazole is recommended for horses undergoing general anesthesia. For horses undergoing a retrobulbar nerve block during general anesthesia, use of the lowest effective volume is suggested.}, number={9}, journal={Journal of the American Veterinary Medical Association}, publisher={In press}, author={Curto, E.M. and Griffith, E.H. and Posner, L.P. and Walsh, K.T. and Balko, J.A. and Gilger, B.C.}, year={2018}, month={May}, pages={1113–1119} }
 @article{balko_gatson_cohen_griffith_harms_bailey_2018, title={INHALANT ANESTHETIC RECOVERY FOLLOWING INTRAMUSCULAR EPINEPHRINE IN THE LOGGERHEAD SEA TURTLE (CARETTA CARETTA)}, volume={49}, ISSN={["1937-2825"]}, url={https://doi.org/10.1638/2017-0182.1}, DOI={10.1638/2017-0182.1}, abstractNote={Abstract Prolonged anesthetic recovery time is a common complication of chelonian inhalant anesthesia and may be exacerbated by right-to-left intracardiac shunting of blood. Epinephrine may decrease intracardiac shunting, which may shorten anesthetic recovery time. The study objective was to assess inhalant anesthetic recovery time following intramuscular epinephrine compared with saline in the loggerhead sea turtle (Caretta caretta). With the use of a prospective, randomized, blinded, crossover design with a 1-wk washout period, six turtles were anesthetized with intravenous (IV) alfaxalone 3 mg/kg, orotracheally intubated, manually ventilated with 3.5% isoflurane inhalant in 100% oxygen for 90 min, and administered either intramuscular (IM) epinephrine 0.1 mg/kg or IM saline 0.1 ml/kg. Isoflurane administration was immediately discontinued and turtles were manually ventilated with room air until extubation. Physiologic variables, sedation scores, end-tidal carbon dioxide (ETCO2) and isoflurane (ETISO) concentrations, time to first movement, and time to extubation were recorded and two-time-point venous blood gas analyses performed. Data were compared with the use of paired t-tests and repeated-measures analyses of variance (ANOVA) (P < 0.05). No morbidity, mortality, or adverse events occurred. ETCO2 and ETISO did not significantly change over time during the isoflurane delivery period (P = 0.990). Mean time to first movement was significantly faster following epinephrine (69.24 ± 12.28 min) compared with saline (87.71 ± 27.05 min, P = 0.047). Although differences were not statistically significant (P = 0.133), time to extubation was at least 30 min faster (31–123 min) in 4/6 turtles following epinephrine compared with saline. Intramuscular epinephrine significantly reduces time to first movement during isoflurane anesthetic recovery in loggerhead sea turtles.}, number={3}, journal={JOURNAL OF ZOO AND WILDLIFE MEDICINE}, author={Balko, Julie A. and Gatson, Bonnie J. and Cohen, Eli B. and Griffith, Emily H. and Harms, Craig A. and Bailey, Kate M.}, year={2018}, month={Sep}, pages={680–688} }
 @article{balko_oda_posner_2018, title={Use of tricaine methanesulfonate or propofol for immersion euthanasia of goldfish (Carassius auratus)}, volume={252}, DOI={10.2460/javma.252.12.1555}, abstractNote={OBJECTIVE To substantiate current AVMA guidelines for immersion euthanasia of goldfish (Carassius auratus) with tricaine methanesulfonate (TMS), determine whether immersion in propofol at 5 times its immersion anesthesia concentration for 30 minutes is sufficient for euthanasia of goldfish, and quantify the duration of myocardial contraction following immersion of goldfish in TMS and decapitation. DESIGN Prospective clinical trial. ANIMALS 36 healthy, adult goldfish. PROCEDURES Goldfish were randomly assigned to be immersed in 1 of 6 test solution treatments (n = 6/treatment): TMS (500 mg/L) for 15 minutes followed by placement in anesthetic agent-free water (T15W), placement out of water (T15A), or decapitation (T15D); TMS (1,000 mg/L) for 15 minutes followed by placement in anesthetic agent-free water (T15XW); TMS (500 mg/L) for 30 minutes followed by placement in anesthetic agent-free water (T30W); or propofol (25 mg/L) for 30 minutes followed by placement in anesthetic agent-free water (P30W). Any fish that resumed operculation in group T15A was returned to anesthetic agent-free water. Times from onset of immersion to induction of anesthesia, cessation and resumption of operculation, and recovery (T15W, T15A, T15XW, T30W, P30W) or cessation of Doppler ultrasounds (T15D) were recorded. RESULTS Overall, 5 of 6, 6 of 6, 6 of 6, 6 of 6, and 5 of 6 fish survived in the T15W, T15A, T15XW, T30W, and P30W groups, respectively. Median time to cessation of Doppler ultrasounds in group T15D was 77.5 minutes (range, 30 to 240 minutes). CONCLUSIONS AND CLINICAL RELEVANCE Timed immersion in test solutions (TMS at 500 mg/L or 1,000 mg/L or propofol at 25 mg/L) resulted in death in only 7% (2/30) of immersed goldfish. Myocardial contractions continued for up to 4 hours in decapitated goldfish.}, number={12}, journal={Journal of the American Veterinary Medical Association}, author={Balko, J. A. and Oda, A. and Posner, L. P.}, year={2018}, pages={1555–1561} }