COMPARISON OF PROPOFOL CONSTANT RATE

INFUSION AND ISOFLURANE FOR MAINTENANCE OF

ANESTHESIA IN SPEKE'S GAZELLE, GAZELLA SPEKEI
Author(s): Laura M. Kleinschmidt, D.V.M., Matthew E. Kinney, D.V.M., Dipl.
A.C.Z.M, Gerardo R. Camilo, Ph.D., Tim Thier, B.S., Martha Fischer, M.A.,
Christopher S. Hanley, D.V.M., Dipl. A.C.Z.M., and Luis R. Padilla, D.V.M.,
Dipl. A.C.Z.M.
Source: Journal of Zoo and Wildlife Medicine, 49(3):722-731.
Published By: American Association of Zoo Veterinarians
https://doi.org/10.1638/2017-0212.1
URL: http://www.bioone.org/doi/full/10.1638/2017-0212.1

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 Journal of Zoo and Wildlife Medicine 49(3): 722–731, 2018
Copyright 2018 by American Association of Zoo Veterinarians

COMPARISON OF PROPOFOL CONSTANT RATE INFUSION AND

ISOFLURANE FOR MAINTENANCE OF ANESTHESIA IN SPEKE’S
GAZELLE, GAZELLA SPEKEI

Laura M. Kleinschmidt, D.V.M., Matthew E. Kinney, D.V.M., Dipl. A.C.Z.M, Gerardo R. Camilo,
Ph.D., Tim Thier, B.S., Martha Fischer, M.A., Christopher S. Hanley, D.V.M., Dipl. A.C.Z.M., and
Luis R. Padilla, D.V.M., Dipl. A.C.Z.M.

Abstract: The aims of this study were to determine if a propofol constant rate infusion (CRI) in Speke’s
gazelle, Gazella spekei, would serve as an effective alternative maintenance anesthetic, result in shorter recovery
times, and improve anesthetic recovery quality when compared with isoflurane. Eight adult gazelle were enrolled
in this complete crossover study with a minimum 3-wk washout period. All gazelle were induced with 10 mg/kg
intravenous propofol and maintained with either propofol CRI (0.4 mg/kg/min) or isoflurane (1–3%) for 45 min.
Animals were monitored for anesthetic depth and physiologic variables including heart and respiratory rates,
oxygen saturation, end-tidal carbon dioxide, indirect blood pressure, and temperature every 5 min. Blood gas
samples were analyzed within the first 10 min following anesthetic induction and within the last 10 min of
anesthesia. Recovery times were recorded. Recovery quality was classified by a residual ataxia grading scale.
Seven gazelle completed the study by undergoing both anesthetic treatments; one female (12 yr old) developed
complications 2 days after isoflurane anesthesia, consisting of seizures, azotemia, leukocytosis, hypocalcemia, and
hypomagnesemia but was treated successfully. Propofol anesthesia resulted in lower respiratory rates compared
with isoflurane and a decrease in respiratory rate over time. Propofol CRI maintained blood pressure values closer
to physiologically normal ranges compared with isoflurane for 45 min of anesthesia. Recovery times were
comparable between propofol and isoflurane treatments. While individuals receiving propofol had higher residual
ataxia scores compared with individuals receiving isoflurane, differences were not clinically important. This study
demonstrated that propofol CRI (0.4 mg/kg/min) is an effective maintenance anesthetic agent in healthy adult
Speke’s gazelle for noninvasive procedures with endotracheal intubation and intermittent positive pressure
ventilation.
Key words: Anesthesia, constant rate infusion, Gazella spekei, isoflurane, propofol, Speke’s gazelle.

INTRODUCTION related injury.17 During recovery, physical re-

straint and support by experienced staff is used
The Speke’s gazelle (Gazella spekei) is a small
to mitigate self-trauma until an animal has
antelope species classified as endangered by the regained full locomotory function. Padded stalls,
International Union for Conservation of Nature.11 crates, or stacked hay bales can also be used to
Complications associated with anesthesia, specif- protect animals during recovery.17
ically with the quality and duration of induction In addition to physical mitigation of potential
and recovery, have been a concern for the negative effects, the choice of anesthetic agents is
management of many gazelle species. Manual crucial to improving and shortening anesthetic
restraint prior to anesthetic induction with inhal- recovery. Objective documentation of species-
ant or injectable anesthetics is commonly per- specific anesthetic effects and complications are
formed in small gazelle species due to the relative limited, and clinicians often rely on personal
ease of restraint and to avoid risk of darting- experience or extrapolation from domestic spe-
cies. Inhalant anesthetics primarily eliminated
through exhalation require movement of the
From the Saint Louis Zoo, One Government Drive, inhalant down a concentration gradient leading
Saint Louis, MO 63110, USA (Kleinschmidt, Thier, to diffusion before full recovery takes place.19
Fischer, Hanley, Padilla); University of Missouri, College Propofol, an intravenously administered anesthet-
of Veterinary Medicine, 1600 East Rollins, Columbia, MO
ic agent, acts quickly and is rapidly metabolized in
65211, USA (Kleinschmidt); San Diego Zoo Safari Park,
most species, usually inducing anesthesia within 1
15500 San Pasqual Valley Road, Escondido, CA 92027,
USA (Kinney); Department of Biology, Saint Louis min of administration with a single bolus lasting
University, Saint Louis, MO 63103, USA (Camilo). only 2–5 min in domestic species.20,22 This short
Correspondence should be directed to Dr. Kleinschmidt duration allows quick return to function after
([email protected]). halting the anesthetic infusion.20–21 In domestic

722
 KLEINSCHMIDT ET AL—PROPOFOL CRI FOR ANESTHESIA OF GAZELLA SPEKEI 723

small ruminant studies, an intravenous constant tration of the maintenance agent. Endotracheal
rate infusion (CRI) of propofol at 0.2–0.6 mg/kg/ intubation was performed in all animals using a 5–
min has been used to maintain anesthesia alone or 7-mm internal diameter tube to maintain a patent
in combination with adjunct anesthetic infu- airway and provide 100% oxygen. Animals were
sions.6,8–9,13–14 supplemented with 4–6 intermittent positive pres-
This study documented the physiological ef- sure ventilation (IPPV) breaths/min independent
fects of two anesthetic regimens that can be used of treatment type to prevent atelectasis and
in Speke’s gazelle. The aims (hypotheses) of this ventilation-perfusion mismatch, ensure consistent
study were to determine if a propofol CRI in administration of inhalant anesthetic, and to
Speke’s gazelle would serve as an effective avoid this as a variable when comparing inhalant
alternative maintenance anesthetic, result in anesthesia to propofol. A 20-ga intravenous
shorter recovery times, and improve anesthetic catheter (IVC) was placed in the saphenous vein
recovery quality when compared with isoflurane. in all animals.
Cloth earplugs and blindfolds were placed on
MATERIALS AND METHODS all animals during anesthesia. The maintenance
Study subjects consisted of all the Speke’s anesthetic was started within 5 min of induction,
gazelle housed at the Saint Louis Zoo that met and consisted of either: 1) Treatment P, propofol
inclusion criteria during the study period. Eight CRI (0.4 mg/kg/min) administered with syringe
healthy, adult (.10 kg) Speke’s gazelle (five pump (Vet Pro SP 3000, Caesarea Medical
females, three males; age range 1–12 yr) were Electronics Ltd, Lichtenstein 72805, Germany)
enrolled in this complete crossover study. Health via IVC, or 2) Treatment I, isoflurane anesthetic
status was determined with history, absence of via endotracheal tube at 1–3% using a rebreathing
clinical signs, physical examination, and evalua- circuit and oxygen flow at 1.5 L/min (Isothesia,
tion of complete blood counts and serum bio- Henry Schein Animal Health, Dublin, Ohio
chemistry. Pregnant animals and those with 43017, USA; isoflurane vaporizer, Anaquest, Inc,
documented medical conditions that could influ- no current address available; universal ‘‘F’’ circuit,
ence anesthesia were excluded. Animals were Jorgensen Laboratories, Inc, Loveland, Colorado
intended to complete both anesthetic mainte- 80538, USA). A single veterinarian (LMK) mon-
nance treatments (Treatment P, propofol; Treat- itored anesthetic depth and titrated isoflurane to
ment I, isoflurane) with a minimum 3-wk washout maintain an anesthetic plane defined as lacking a
period. Animals that did not complete both conscious response to noxious stimuli (toe-pinch)
anesthetic treatments were excluded from statis- and absent palpebral and anal reflexes. Anesthesia
tical analysis. All animals were housed per was maintained for 45 min, then the maintenance
standards for this species. Animals were main- agent was stopped (vaporizer turned off or CRI
tained on a diet consisting of a commercial discontinued) and the animal was moved into the
pelleted feed (Mazurit ADF-16 herbivore diet, recovery stall while still intubated, breathing
Purina Mills, LLC, Saint Louis, Missouri 63166, ambient air.
USA), free-choice alfalfa, fresh browse, and an During anesthesia, animals were monitored for
assortment of fruits and vegetables for enrich- anesthetic depth and physiologic variables every 5
ment. No changes were made in diet or manage- min. Physiologic variables included heart rate
ment during the study period. using an electrocardiogram and thoracic auscul-
Individuals were selected for anesthesia by a tation, oxygen saturation using a pulse oximeter,
single individual (TT) and randomly assigned to indirect blood pressure using an oscillometric cuff
anesthesia maintenance Treatment P or I by a placed proximal to the carpus, respirations using
coin flip at the time of their first treatment. thoracic auscultation, chest wall excursions and
Ambient temperature and humidity at the time capnography, rectal temperature, and end-tidal
of anesthesia was recorded. Animals were CO2 using a capnograph (SurgiVet, Smiths Med-
weighed immediately prior to induction and were ical ASD, Inc, St. Paul, Minnesota 55112, USA).
manually restrained (Fig. 1) and blindfolded to Blood was collected from the median artery and
induce anesthesia using propofol (10 mg/kg blood gas samples were analyzed (iStat CG4þ,
intravenously [IV], PropoFlo 10 mg/ml, Zoetis Abbott Point of Care Inc, Abbott Park, Illinois
Inc, Kalamazoo, Michigan 49007, USA). Addi- 60064, USA) within the first 10 min following
tional boluses of propofol were administered to anesthetic induction and within the last 10 min of
some animals when necessary to allow intubation anesthesia. During anesthesia, noninvasive pro-
or intravenous catheterization prior to adminis- cedures performed included physical examina-
724 JOURNAL OF ZOO AND WILDLIFE MEDICINE

unable to rise without immediately falling or

paddling on the ground.
This study had a repeated measures (longitudi-
nal) experimental design with the anesthetic drug
as the main treatment and time as the repeated
measure (interval). Therefore, physiological pa-
rameters as well as blood gases were analyzed
with a repeated measure analysis of variance
(ANOVA) and data were transformed in order
to meet the assumptions of the test.15 Time to
recovery and ataxia data were analyzed with a
nonparametric Wilcoxon signed-rank test. For
time to recovery, either gender or anesthetic drug
were compared as the main effect, while for ataxia
only anesthetic drugs were contrasted. Nonpara-
Figure 1. Manual restraint of a Speke’s gazelle
metric tests were selected due to the small sample
during the recovery period following 45 min of
size when the sexes were separated. In order to
anesthesia using either propofol constant rate infusion
(0.4 mg/kg/min) or isoflurane (titrated 1–3%) as a ascertain if there was any relationship between
maintenance agent. recovery time and other variables, i.e., body
weight, temperature, and relative humidity, a
Spearson’s product moment correlation was used.
tion, venous blood sampling, transabdominal or
A P value less than 0.05 was considered statisti-
testicular ultrasound, manual collection of feces
cally significant. This project was approved by the
from the rectum, hoof trim, dental examination
Saint Louis Zoo Institutional Animal Care and
and floating, parenteral drug administration (anti-
Use Committee.
parasiticides, antibiotics, nonsteroidal anti-in-
flammatories, vitamin E, subcutaneous fluids), RESULTS
and radiographs (whole-body and limbs).
After 45 min of anesthesia, the animal was One male was excluded from statistical analyses
transported to the recovery stall and restrained because it died from chronic proliferative otitis
off the ground in a sternal position, with one media and suppurative meningitis approximately
keeper holding the hindlimbs, one holding the 6 wk after its first anesthesia. Most animals
included in the study analysis (four females, two
body and forelimbs, and one holding the head
males, weighing 10.9–15.8 kg) recovered from
(Fig. 1). Earplugs and blindfolds were removed
both anesthetic treatments without complications
once in the recovery stall and the animal was
and continued to do well at the time of manuscript
extubated once swallowing was noted. Total time
submission (9–19 mo postanesthesia). One female
for recovery was defined from cessation of
(12 yr old) developed complications 2 days after
anesthesia to the time the patient was capable of
isoflurane anesthesia, consisting of seizures, azo-
standing unassisted with minimal to no ataxia. A
temia, leukocytosis, hypocalcemia, and hypomag-
recovery grading scale was developed by the
nesemia, but was treated and made a complete
authors and was used to define the stages of
recovery.
recovery (Table 1). A single nonblinded individual Induction with propofol was technically chal-
(TT) determined when to attempt release based lenging in some cases, with extravasation due to
on the animal’s degree of resistance to restraint in animal movement under manual restraint despite
hand after it had reached stage 2. Recoveries were using a butterfly catheter for administration and
filmed, order of videos randomized, and a single covering the eyes with a blindfold. Supplemental
blinded reviewer (LMK) reviewed recovery qual- boluses of propofol (1.4–9 mg/kg IV) in addition
ity several months after completion of the final to the initial 10 mg/kg induction dosage were
anesthesia. The number of attempts required necessary in some animals to allow for intubation
before successful release of the animal was noted. and IVC placement within the first 5 min of
Residual ataxia after release was classified by the anesthesia.
following grading scale: 0 ¼ no ataxia; 1 ¼ mild Physiological values were clinically unremark-
ataxia, slight stumbling when walking but remain- able for both groups throughout the anesthesia
ing upright; 2 ¼ moderate ataxia, stumbling and events (Table 2, Figs. 2–4). Heart rate was
falling to carpi or into walls; 3 ¼ severe ataxia, individually variable with no significant difference
 KLEINSCHMIDT ET AL—PROPOFOL CRI FOR ANESTHESIA OF GAZELLA SPEKEI 725

Table 1. Recovery grading scale used to stage tween anesthetic treatments (P ¼ 0.2031). Body
Speke’s gazelle after 45 min of anesthesia using 10 temperature decreased over time for both anes-
mg/kg propofol IV induction followed by maintenance
thetic treatments but there was no significance
treatment of propofol constant rate infusion at 0.4 mg/
kg/min or isoflurane at 1–3%. difference between treatment groups (P ¼ 0.4813)
(Fig. 3). Systolic, diastolic, and mean blood
Recovery stage Definition pressures had no significant trends over time for
either anesthetic treatment, but were significantly
Stage 4 (light anesthesia) No conscious response
to external stimuli, lower in Treatment I compared with Treatment P
absence of palpebral independent of time (systolic, P ¼ 0.0004, Wilcox-
and anal reflexes on nonparametric W ¼ 791.5; diastolic, P ¼ 0.0001,
Stage 3 (deep sedation) No conscious response W ¼ 752; mean, P ¼ 0.001, W ¼ 744) (Fig. 4).
to external stimuli, Blood-gas data were normally distributed and
palpebral and anal clinically unremarkable (Table 3). Lactate was
reflexes present elevated above physiologic normal ranges in both
Stage 2 (light sedation) Conscious response to treatment groups, which was reflected in slight
stimuli, palpebral and
decreases in pH and base excess in all gazelle.
anal reflexes present,
unable to stand
There was no statistical difference in pH, partial
unassisted, control of pressure of oxygen, partial pressure of carbon
head dioxide, base excess, bicarbonate, total carbon
Stage 1 (recovered) Standing on own without dioxide, oxygen saturation, and lactate levels
support from staff, between treatments or time of sampling (P .
mild to no residual 0.05). Partial pressures of oxygen increased
ataxia throughout anesthesia in both treatment groups
(P ¼ 0.0072). For both treatment groups, base
excess was negative at the start of anesthesia and
between anesthetic treatments (P ¼ 0.0598). For
was closer to zero by the end of anesthesia (P ¼
both treatments, heart rate decreased over time.
0.0017). Bicarbonate and total carbon dioxide
Animals in both treatments were spontaneously were lower at the start of anesthesia and higher at
breathing in addition to supplemental IPPV the end of anesthesia for both treatment groups (P
(mean 18.9 breaths/min, Treatment P and 31 ¼ 0.0046, P ¼ 0.0056, respectively).
breaths/min, Treatment I). Treatment P had Recovery times were comparable between treat-
lower respiratory rates compared with Treatment ment groups with no statistical significance be-
I (p , 0.0001). Treatment P resulted in a tween anesthetic treatments (P ¼ 0.7426, Table 4).
decreasing respiratory rate over time of anesthe- Mean recovery time for Treatment P was 27.17 6
sia, while Treatment I showed no change (F1,8 ¼ 8.2 min. The mean recovery time for Treatment I
7.9; P , 0.0001) (Fig. 2). There was no statistical was 29.14 6 7.6 min. Recovery times were not
significance in blood oxygen saturation levels (P ¼ statistically significant by sex regardless of anes-
0.3326) or end-tidal carbon dioxide levels be- thetic treatment type (P ¼ 0.1354, Table 4).

Table 2. Aggregate data summary of physiologic parameters monitored during 45 min of anesthesia with
either propofol constant rate infusion (Treatment P, 0.4 mg/kg/min) or isoflurane (Treatment I, titrated 1–3%) as a
maintenance agent (n ¼ 7 for each anesthetic treatment type).

Treatment P Treatment I Treatment P Treatment I

Mean 6 SD Min–Max P value

HR a
151.9 6 19.2 160.2 6 24.5 102–188 113–208 0.0598
RR 18.9 6 8.3 31 6 8.1 6–56 13–46 ,0.0001
SPO2 94.1 6 2.6 94.6 6 2.5 90–99 90–99 0.3326
ETCO2 52.3 6 5.3 54 6 6.8 34–62 38–72 0.2031
Temp 101.4 6 1.3 101.6 6 1.2 98.6–104.1 99–104.2 0.4813
SysBP 121.2 6 12.9 109.5 6 25.4 91–148 54–207 0.0004
DiaBP 75.1 6 14.4 63.6 6 26 44–106 25–172 0.0001
MeanBP 90.5 6 13 78.9 6 25.2 60–117 39–184 0.001
a
HR indicates heart rate (beats/min); RR, respiratory rate (breaths/min); SPO2, peripheral capillary oxygen saturation (%);
ETCO2, end-tidal carbon dioxide (mmHg); Temp, temperature (8F); SysBP, systolic blood pressure (mmHg); DiaBP, diastolic
blood pressure (mmHg); MeanBP, mean blood pressure (mmHg).
726 JOURNAL OF ZOO AND WILDLIFE MEDICINE

Figure 2. Respiratory rate (breaths/min) of Speke’s gazelle over 45 min of anesthesia with either propofol
constant rate infusion (0.4 mg/kg/min) or isoflurane (titrated 1–3%) as a maintenance agent (n ¼ 7 for each
anesthetic treatment type): (A) isoflurane, (B) propofol constant rate infusion.

Recovery time was not affected by body weight, P ¼ 0.03; Table 4). Residual ataxia resolved within
ambient temperature, or humidity at time of several hours following the procedure in all
anesthesia (P . 0.1). animals.
The number of attempts prior to successful
release had no statistical difference between DISCUSSION
treatment groups (P ¼ 0.3924); however, two
Treatment P animals required seven attempts In this study, propofol (10 mg/kg) was used as a
before standing (mean of four attempts, Table standardized induction agent independent of
4). Residual ataxia was higher for Treatment P anesthetic maintenance treatment. Though a 5
(median residual ataxia score ¼ 2.0) than for mg/kg dosage is recommended in the litera-
Treatment I (median residual ataxia score ¼ 1.0; ture,17,20 this dosage was found to be ineffective
 KLEINSCHMIDT ET AL—PROPOFOL CRI FOR ANESTHESIA OF GAZELLA SPEKEI 727

Figure 3. Body temperature (8F) of Speke’s gazelle over 45 min of anesthesia with either propofol constant rate
infusion (0.4 mg/kg/min) or isoflurane (titrated 1–3%) as a maintenance agent (n ¼ 7 for each anesthetic treatment
type): (A) isoflurane, (B) propofol constant rate infusion.

for inducing anesthesia in this species during a tration of propofol as an induction agent. The
single attempt by these authors prior to this study. propofol induction dosage in this species may be
In addition to the initial propofol bolus, supple- decreased if adjunct induction agents or analge-
mental boluses were necessary in some animals to sics were used in combination with propofol.
allow intubation and IVC placement. In a clinical The effects from a single bolus of propofol have
setting, intramuscular anesthetic drugs could be been shown to last only 2–5 min in domestic
used as induction agents, which would require less species20 and therefore it is unlikely that the
technical expertise, but could still be followed by propofol used for induction, even when supplemen-
intravenous catheterization for propofol mainte- tal doses were given, affected recovery time 45 min
nance or supplementation. Alternatively, an IVC after administration for either maintenance treat-
could be placed under manual restraint in ad- ment. However, the use of propofol for induction
vance of the anesthesia to allow easier adminis- may have led to decreased isoflurane minimum
728 JOURNAL OF ZOO AND WILDLIFE MEDICINE

Figure 4. Mean blood pressure (mmHg) of Speke’s gazelle over 45 min of anesthesia with either propofol
constant rate infusion (0.4 mg/kg/min) or isoflurane (titrated 1–3%) as a maintenance agent (n ¼ 7 for each
anesthetic treatment type): (A) isoflurane, (B) propofol constant rate infusion. Similar trends were noted for
systolic and diastolic blood pressures.

alveolar concentration (MAC) as has been docu- As isoflurane concentrations necessary to main-
mented in domestic goats given propofol during tain anesthesia are variable per the definition of
anesthesia after induction with isoflurane, where MAC, there is inherent variability in the isoflur-
ane levels necessary for anesthetic maintenance
MAC was reduced from 1.37 to 0.55 with an
by individual. To prevent any subjective bias,
intravenous bolus of 2 mg/kg propofol followed by
isoflurane levels were titrated to the lowest
0.2 mg/kg/min propofol CRI.7 Thus, induction with
effective dosage by the same veterinarian (LMK)
propofol may have had an isoflurane-sparing effect overseeing anesthesia in order to maintain a
at the start of anesthesia maintenance, allowing similar anesthetic plane in all animals. The
titration to lower levels of isoflurane. maintained anesthetic plane was adequate for
 KLEINSCHMIDT ET AL—PROPOFOL CRI FOR ANESTHESIA OF GAZELLA SPEKEI 729

Table 3. Data summary of blood-gas parameters monitored within the first 10 min and the last 10 min of
anesthesia using either propofol constant rate infusion (0.4 mg/kg/min) or isoflurane (titrated 1–3%) as a
maintenance agent (n ¼ 7 for each anesthetic treatment type) for 45 min.

First 10 min First 10 min Last 10 min Last 10 min

Parameters propofol isoflurane propofol isoflurane

pH 7.1 6 0.1 7.2 6 0.1 7.2 6 0.1 7.3 6 0.1

PCO2a 43 6 15.2 42.7 6 6.4 52.4 6 7.5 47 6 19.7
PO2 355.1 6 154 275.2 6 128 528.8 6 92.1 408 6 137.8
BE  13.6 6 6 13.5 6 5.4  4.5 6 4.9 7 6 5.7
HCO3 15.2 6 5.7 15.4 6 4.1 22.9 6 4.1 20.2 6 5.7
TCO2 16.3 6 6.2 16.7 6 4.3 24.5 6 4 21.6 6 6.4
SO2 99.7 6 0.5 99.3 6 1 100 6 0 100 6 0
Lac 10.7 6 5.1 10.7 6 6.1 6.5 6 3.9 7.3 6 5.9
a
PCO2 indicates partial pressure of carbon dioxide (mmHg); PO2, partial pressure of oxygen (mmHg); BE, base excess (mM/
L); HCO3, bicarbonate (mM/L); TCO2, total carbon dioxide (mM/L); SO2, oxygen saturation (%); Lac, lactate (mM/L).

noninvasive procedures. If performing more inva- sion in many species, including goats.13,19 Individ-
sive or painful procedures including surgery, uals with hypotension may be treated by
analgesic drugs should be added to both propofol decreasing the anesthetic dosage, providing intra-
and isoflurane anesthesia. venous crystalloid or colloid fluid boluses, or via
All gazelle remained clinically stable during pharmaceutical management (i.e., dopamine or
anesthesia independent of treatment type. Respi- dobutamine CRI).19-20 While propofol has been
ratory rate was lower during propofol treatment documented to cause myocardial depression and
compared with isoflurane treatment, but this did resultant arterial hypotension in some cases,20
not affect the animal’s blood oxygenation and these effects did not manifest in this study. In a
peripheral perfusion when supplemented with study of goats maintained with either propofol-
100% oxygen and 4–6 supplemental IPPV ketamine CRI or sevoflurane, mean and diastolic
breaths/min. Respiratory rate decreased over blood pressure values were significantly lower in
time during propofol treatment, which is consis- the sevoflurane treatment group,13 which is con-
tent with previously reported side effects.10,16,20 sistent with the findings of this study comparing
Propofol may cause substantial respiratory de-
pression, especially if given quickly or in high Table 4. Recovery times, recovery quality scores,
dosages; therefore, ventilation support is recom- and number of attempts before successful release of
mended to be available.10,16,20 Isoflurane has also Speke’s gazelle after 45 min of anesthesia using 10 mg/
kg propofol intravenously for induction followed by
been reported to cause dosage-dependent respi-
maintenance Treatment P (propofol constant rate
ratory depression.19 Despite any respiratory de- infusion 0.4 mg/kg/min) or Treatment I (isoflurane 1–
pression produced by the anesthetic regimens, all 3%).
gazelle continued breathing spontaneously in
addition to the supplemental IPPV. Supplemental Maintenance Recovery Recovery Release
Individual sex treatment time (min) score attempts
IPPV may have affected arterial blood-gas pa-
rameters, but both treatment groups were impact- Ma I 33 0 3
ed equally. Improvements in respiratory blood- M I 32 0 5
gas parameters by the end of anesthesia despite F I 40 0 4
treatment type were likely due to supplementation F I 23 1 4
F I 26 1 3
of 100% oxygen via endotracheal tube and IPPV
F I 33 1 3
for both treatments during anesthesia. Lactate
F I 17 2 2
was likely elevated due to capture and manual M P 27 1 3
restraint during induction and likely contributed M P 41 1 6
to low pH and base excess seen in all gazelle. F P 26 2 4
Systolic, mean, and diastolic blood pressures F P 30 2 7
were all significantly lower for isoflurane com- F P 15 3 3
pared with propofol treatment. This result is F P 33 1 7
somewhat expected, as inhalant anesthetics have F P 22 3 2
well-documented dosage-dependent effects on the a
M indicates male; F, female; P, propofol constant rate
cardiopulmonary system that result in hypoten- infusion; I, isoflurane.
730 JOURNAL OF ZOO AND WILDLIFE MEDICINE

propofol CRI and isoflurane. A study comparing recoveries in domestic cats have been associated
the vascular effects of propofol and isoflurane in with the duration of propofol CRI.18 Domestic cats
dogs found that propofol better preserves aortic have also been shown to have longer propofol
pressure and increases aortic compliance.5 Final- elimination half times than other species,1 and may
ly, a study in goats determining the effects of be relatively deficient in their ability to metabolize
propofol CRI (0.05–0.2 mg/kg/min) on isoflurane phenolic compounds due to deficient hepatic glu-
MAC found that cardiovascular function was not curonidation mechanisms.20 Although prolonged
affected significantly by propofol treatment.7 recoveries have not been documented with propofol
Propofol CRI may be useful for its blood administration in any domestic ruminant species,
pressure–sparing effects for up to 45 min of there is little documentation in nondomestic species
anesthesia in this small gazelle species. regarding glucuronidation capabilities. Propofol
The differences in duration and quality of recov- recoveries have been reported as shorter or compa-
ery seen in this study are key findings with rable to alternatives in goats given propofol as an
implications to the clinical management of this induction dose or CRI due to rapid metabolism and
species. The same individual (TT) was present for high body clearance in this species.8,21–22
every anesthesia to ensure consistency and this Recovery times trended longer for males than
individual determined during recovery at which females regardless of anesthetic treatment but
point to attempt release of the animal based on the were not statistically significant. The ratio of
animal’s apparent alertness. Recovery times were females to males in this study (2.5) was biased
approximately 2 min shorter for Treatment P after dropping one male from the statistical
compared with Treatment I, but the differences analysis, thus these two males may not have been
were not statistically significant. In contrast, Treat- representative of a greater population. This trend
ment P animals had significantly higher residual of males taking longer than females to recover
ataxia scores, although none of the animals sus- despite anesthetic type merits further investiga-
tained injuries during recovery. The number of tion, as male Speke’s gazelle may react differently
attempts to release prior to successful release was to anesthetic agents than females of the same
not statistically different, although the two animals species, as has been previously reported in other
with the maximum number of attempts (seven) were species.2,4,12,23 Small sample size was a limitation of
both in the propofol treatment group. This could this study; however, all Speke’s gazelle housed at
indicate that the gazelle appeared more alert or were this institution that fit inclusion criteria during the
at a lighter plane of sedation during recovery, study period were utilized.
despite not being fully recovered or able to stand Other study limitations included isoflurane MAC
without support once released. Clinically, any level determination being outside the scope of this
residual ataxia regardless of treatment type was study; therefore, it is unknown if and for how long
considered manageable, as ataxia was transient and the induction bolus of propofol had an effect on the
resolved within hours following the procedure. As isoflurane MAC in these animals. The authors also
such, it is unlikely that this was due to any effect acknowledge that comparing a titrated inhalant
other than anesthesia. No self-trauma was noted protocol with a constant propofol protocol is a
immediately postprocedure in any animal, and the limitation of this study and likely affected the
only complication was seen in the previously physiological parameters during anesthesia; how-
mentioned 12-yr-old female who developed com- ever, it is likely not important for most clinical
plications 2 days after recovery from isoflurane applications. Because the depth of anesthesia was
anesthesia. consistent for all isoflurane treatments regardless of
The reason for apparently higher residual ataxia actual isoflurane level, and equivalent to the depth
scores in the propofol treatment group is not maintained with the propofol CRI, recovery time
known, in particular when the animals were deemed and quality should be directly comparable. There is
comparably recovered otherwise. The authors hy- not enough data on anesthetic maintenance equi-
pothesize that biotransformation of propofol via potency between intravenous (propofol) and inhal-
hepatic glucuronide conjugation and renal elimina- ant (isoflurane) maintenance agents in most species
tion may have taken longer than isoflurane elimina- and clinicians rely on parameters of anesthetic
tion via the lungs and thus propofol treatment could depth. In domestic dogs, a propofol CRI equivalent
have had residual effects during recovery.20 Al- to 0.3 mg/kg/min is physiologically equivalent to an
though generally expected to be a short-acting end-tidal isoflurane concentration of 1.4%.5 End-
agent, delayed recovery after propofol maintenance tidal isoflurane concentrations were not monitored
has been documented in some species.3,18 Prolonged in this study. Lastly, the individual (TT) who
 KLEINSCHMIDT ET AL—PROPOFOL CRI FOR ANESTHESIA OF GAZELLA SPEKEI 731

determined at which point to attempt release of the 9. Ferreira JP, Ndawana PS, Dzikiti LN, Dzikiti BT.
gazelle was not blinded to anesthetic treatment; Determination of the minimum infusion rate of propofol
while eliminating variability in how the animals required to prevent purposeful movement of the extrem-
were deemed safe to stand, it is possible that an ities in response to a standardized noxious stimulus in
unapparent subconscious bias was introduced. goats. Vet Anaesth Analg. 2016;43(5):519–527.
10. Galatos, AD. Anesthesia and analgesia in sheep
This study demonstrates that propofol CRI (0.4
and goats. Vet Clin North Am Food Anim Pract. 2011;
mg/kg/min) is an effective maintenance anesthetic
27(1):47–59.
agent in healthy adult Speke’s gazelle for noninva-
11. International Union for Conservation of Nature
sive procedures with endotracheal intubation and
(IUCN) SSC Antelope Specialist Group. Gazella spekei.
IPPV. Propofol CRI maintained blood pressure The IUCN Red List of Threatened Species 2016
values closer to physiologically normal ranges [Internet]. 2016 [cited 2017 October 2]. Available from
compared with isoflurane for 45 min of anesthesia. doi:10.2305/IUCN.UK.2016-2.RLTS.
Recovery times were comparable between propofol T8975A50187314.en.
and isoflurane treatments. While individuals recov- 12. Kest B, Sarton E, Dahan A. Gender differences
ering from propofol anesthesia had higher residual in opioid-mediated analgesia: animal and human
ataxia scores than those recovering from isoflurane, studies. Anesthesiology. 2000;93:539–547.
differences were not clinically important. 13. Larenza MP, Bergadano A, Iff I, Doherr MG,
Schatzmann U. Comparison of the cardiopulmonary
Acknowledgments: The authors would like to effects of anaesthesia maintained by continuous infu-
thank the Department of Animal Health and sion of ketamine and propofol with anaesthesia main-
Ungulate Department at the Saint Louis Zoo for tained by inhalation of sevoflurane in goats undergoing
their hard work and dedication to completion of this magnetic resonance imaging. Am J Vet Res. 2005;
66(12):2135–2141.
project.
14. Lin HC, Caldwell F, Pugh DG. Anesthetic
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