Effects of Anesthetic Management in Dogs with Hypoalbuminemia for Gastro-Intestinal Endoscopy

Abstract

Hypoalbuminemia is commonly observed in canine inflammatory bowel disease with protein-losing enteropathy. Tissue perfusion injury, increasing vascular permeability, hypotension and dysfunction of blood coagulation system by losing blood clotting factors can occur following the hypoalbuminemia. Histopathological examination of intestinal mucosa by endoscopic sampling is useful as a diagnostic method of inflammatory bowel disease. In the other hand, general anesthesia is required for endoscopy. In this study, we investigated whether the severity of hypoalbuminemia affected heart rate and blood pressure in anesthetized dogs for gastrointestinal endscopy. The medical records of the Animal Medical Center, Nihon University, were investigated retrospectively from June, 2014 to Septenber, 2016 in dogs for gastrointestinal endoscopy examination. Dogs were able to assign to three groups: S-Alb group defined as serum albumin < 2.0 g/dl, M-Alb group defined as serum albumin 2.0 to 2.5 g/dl, and N-Alb group defined as > 2.5 g/dl. Following pre-medication with atropine, midazolam and butorphanol, anesthesia was induced by slowly titrating propofol until obtain the desired effect. After endotracheal intubation, anesthesia was maintained with isoflurane in oxygen. Despite the significant difference among 3 groups in the colloid osmotic pressure calculated from serum total protein concentration, there were no significant difference in heart rate, mean arterial blood pressure, the total dose of propofol, end tidal isoflurane concentration, and dopamine and fluid infusion rate required for maintaining circulation. In this anesthetic technique, it was suggested that heart rate and mean blood pressure did not differed clinically in the range of serum albumin from 1.0 to 3.2 g/dl in dogs during anesthesia for gastrointestinal endoscopy but dopamine infusion was useful for dogs with hypoalbuminemia.