The editors Tom Doherty, MVB, MSc, Dip ACVAA, is Professor (retired) at the College of Veterinary Medicine, University of Tennessee in Knoxville, Tennessee, USA. Alex Valverde, DVM, DVSc, Dip ACVAA, is Professor at Ontario Veterinary College, University of Guelph in Guelph, Ontario, Canada. Rachel A. Reed, DVM, DACVAA, is Clinical Associate Professor at the College of Veterinary Medicine, University of Georgia in Athens, Georgia, USA.

• List of Contributors xiPreface xvAcknowledgments xvi1 Preoperative Evaluation and Patient Preparation 1The Risk of Equine Anesthesia 1Tanya Duke-NovakovskiPatient Preparation 5Tanya Duke-Novakovski2 Serum Chemistry and Hematology 8Carla Sommardahl3 The Cardiovascular System 19Physiology of the Cardiovascular System 19Tamara GrubbEvaluation of the Cardiovascular System 36Daniel G. Kenney4 The Respiratory System 50Anatomy of the Equine Respiratory System 50Robert ReedPhysiology of the Respiratory System 55Carolyn KerrEvaluation of the Respiratory System 67Tom DohertyAirway Management 68Tom DohertyTracheostomy 78Tanner Snowden and Jim Schumacher5 The Renal System 86Natalie S. Chow6 Neurophysiology and Neuroanesthesia 98Tanya Duke-Novakovski7 The Autonomic Nervous System 110Christine Egger8 Electrolyte and Fluid Therapy 119Electrolytes 119Rachel A. ReedFluid Therapy 125Christopher K. Smith9 Acid-Base Physiology 137Traditional Approach 137Alex Valverde and Tom DohertyPhysicochemical Approach 147Diego E. Gomez and Alex Valverde10 Hemostasis and Hemotherapy 155Hemostasis 155Kira L. EpsteinHemotherapy 162Kira L. Epstein11 Thermoregulation 173Chiara E. Hampton12 Pharmacology of Drugs Used in Equine Anesthesia 184Phenothiazines 184Alicia SkeldingButyrophenones 186Alicia Skeldingα2-Adrenergic Agonists 188Alicia SkeldingOpioids 196Alicia SkeldingTrazadone 205Alicia SkeldingBenzodiazepines 206Alicia SkeldingGuaifenesin 209Alicia SkeldingKetamine 210Alicia SkeldingTiletamine and Zolazepam (TZ) 213Alicia SkeldingAlfaxalone 214Alicia SkeldingPropofol 216Alicia SkeldingBarbiturates 218Alicia SkeldingIntravenous lidocaine 219Patricia Queiroz-WilliamsHorse-related drug Regulations in Europe 222Regula Bettschart-Wolfensberger and Simone K. Ringer13 Inhalational Anesthetics 223Rachel A. Reed14 Local Anesthetics 232Catherine M. Creighton and Leigh Lamont15 Neuromuscular Blocking Agents in Horses 244Manuel Martin-Flores and Daniel M. Sakai16 Non-steroidal Anti-Inflammatory Drugs and Corticosteroids 250Non-steroidal Anti-Inflammatory Drugs 250Stephanie KleineCorticosteroids 259Stephanie Kleine17 Anesthetic Machines and Equipment 266Rachel A. Reed18 Positioning the Anesthetized Horse 287Hui Chu Lin19 Monitoring the Anesthetized Horse 294Monitoring the Central Nervous System 294Joanna C. MurrellCardiovascular Monitoring 300Alanna N. JohnsonRespiratory Monitoring 310Alanna N. JohnsonAnesthetic Agent Monitoring 323Alanna N. JohnsonMonitoring Temperature 324Chiara E. HamptonMonitoring Neuromuscular Function 328Manuel Martin-Flores and Daniel M. Sakai20 Standing Sedation 333Catherine M. Creighton21 General Anesthesia Techniques 339Regula Bettschart-Wolfensberger and Simone K. Ringer22 Anesthesia of the Head and Neck 352Anesthesia of the Head 352Jim Schumacher, John Schumacher, and Ray WilhiteMaxillary Nerve Block in Donkeys 358Usama HagagCervical Plexus Block 363Luis Campoy23 Anesthesia of the Eye 369Daniel S. Ward24 Anesthesia of the Limbs 376Jim Schumacher, John Schumacher, and Ray Wilhite25 Anesthesia of the Perineum and Testicle 396Pudendal Nerve Block – Electrostimulation Technique 396Kirsty Gallacher and Luiz SantosPudendal Nerve Block – Blind Approach 399Jim SchumacherLocal Anesthesia for Castration 400Philip D. Jones26 Anesthesia of the Abdominal Wall 404Thoracolumbar Paravertebral Block (TPVB) – Electrostimulation Technique 404Luiz Santos and Kirsty GallacherParavertebral Nerve Block – Blind Technique 406Alex ValverdeTransversus Abdominis Plane Block 409Alex Valverde and Flavio SA. FreitagCaudal Intercostal Block for Abdominal Surgery (CIBAS) 413Benjamin Gingold27 Epidural Analgesia and Anesthesia 416Alex Valverde28 Pathophysiology of Pain 425Rachel A. Reed29 Pain Recognition in Horses 431Karina B. Gleerup, Casper Lindegaard, and Pia Haubro Andersen30 Management of Pain 450The Pharmacologic Approach to Pain Management 450Rachel A. ReedRehabilitation Modalities for Acute and Chronic Pain in Horses 456Tena L. UrsiniEquine Acupuncture 462Neal Valk31 Anesthesia of Foals 472Tom Doherty and Alex Valverde32 Anesthesia of Horses with Intestinal Emergencies (Colic) 494Tom Doherty33 Anesthesia of the Geriatric Horse 501Reza M. Seddighi34 Anesthesia and Pregnancy 511Lydia Donaldson35 Anesthesia for Equine Imaging 522Carrie A. Davis36 Anesthesia of Donkeys and Mules 543Anatomic, Physiologic, and Behavioral Differences 543Suzanne L. BurnhamSedation and Anesthesia of Donkeys and Mules 548Tom DohertyDonkey Pain Assessment Scales 552Machteld van Dierendonck and Thijs van Loon37 Remote Capture of Equids 565Nigel Caulkett38 Complications 573Intraoperative Hypotension 573Christopher K. Smith and Tom DohertyIntraoperative Hypertension 580Tom DohertyHypoxia and Hypoxemia 582Rachel A. ReedHypercarbia 588Tom DohertyPulmonary Edema as a Consequence of Airway Obstruction 590Tom DohertyEndotoxemia 592Tom DohertyPostanesthetic Myopathy 594Krista B. MitchellNeuropathy 599Rachel A. ReedHyperkalemic Periodic Paralysis (HYPP) 604Alanna N. Johnson and Rachel A. ReedMalignant Hyperthermia 609Alanna N. Johnson and Rachel A. ReedDelayed Awakening and Recovery 611Tom DohertyParaphimosis and Priaprism 614Meggan Graves and Jim SchumacherAnaphylactic and Anaphylactoid Reactions 621Rachel A. ReedIntra-carotid and Perivascular Injections 624Rachel A. ReedEquine Cardiopulmonary Resuscitation 627Genevieve Bussieres39 Recovery from Anesthesia 633Bernd Driessen40 Euthanasia 653Ron Jones and Tom DohertyIndex 661

The editors Tom Doherty, MVB, MSc, Dip ACVAA, is Professor (retired) at the College of Veterinary Medicine, University of Tennessee in Knoxville, Tennessee, USA. Alex Valverde, DVM, DVSc, Dip ACVAA, is Professor at Ontario Veterinary College, University of Guelph in Guelph, Ontario, Canada. Rachel A. Reed, DVM, DACVAA, is Clinical Associate Professor at the College of Veterinary Medicine, University of Georgia in Athens, Georgia, USA.

• List of Contributors xiPreface xvAcknowledgments xvi1 Preoperative Evaluation and Patient Preparation 1The Risk of Equine Anesthesia 1Tanya Duke-NovakovskiPatient Preparation 5Tanya Duke-Novakovski2 Serum Chemistry and Hematology 8Carla Sommardahl3 The Cardiovascular System 19Physiology of the Cardiovascular System 19Tamara GrubbEvaluation of the Cardiovascular System 36Daniel G. Kenney4 The Respiratory System 50Anatomy of the Equine Respiratory System 50Robert ReedPhysiology of the Respiratory System 55Carolyn KerrEvaluation of the Respiratory System 67Tom DohertyAirway Management 68Tom DohertyTracheostomy 78Tanner Snowden and Jim Schumacher5 The Renal System 86Natalie S. Chow6 Neurophysiology and Neuroanesthesia 98Tanya Duke-Novakovski7 The Autonomic Nervous System 110Christine Egger8 Electrolyte and Fluid Therapy 119Electrolytes 119Rachel A. ReedFluid Therapy 125Christopher K. Smith9 Acid-Base Physiology 137Traditional Approach 137Alex Valverde and Tom DohertyPhysicochemical Approach 147Diego E. Gomez and Alex Valverde10 Hemostasis and Hemotherapy 155Hemostasis 155Kira L. EpsteinHemotherapy 162Kira L. Epstein11 Thermoregulation 173Chiara E. Hampton12 Pharmacology of Drugs Used in Equine Anesthesia 184Phenothiazines 184Alicia SkeldingButyrophenones 186Alicia Skeldingα2-Adrenergic Agonists 188Alicia SkeldingOpioids 196Alicia SkeldingTrazadone 205Alicia SkeldingBenzodiazepines 206Alicia SkeldingGuaifenesin 209Alicia SkeldingKetamine 210Alicia SkeldingTiletamine and Zolazepam (TZ) 213Alicia SkeldingAlfaxalone 214Alicia SkeldingPropofol 216Alicia SkeldingBarbiturates 218Alicia SkeldingIntravenous lidocaine 219Patricia Queiroz-WilliamsHorse-related drug Regulations in Europe 222Regula Bettschart-Wolfensberger and Simone K. Ringer13 Inhalational Anesthetics 223Rachel A. Reed14 Local Anesthetics 232Catherine M. Creighton and Leigh Lamont15 Neuromuscular Blocking Agents in Horses 244Manuel Martin-Flores and Daniel M. Sakai16 Non-steroidal Anti-Inflammatory Drugs and Corticosteroids 250Non-steroidal Anti-Inflammatory Drugs 250Stephanie KleineCorticosteroids 259Stephanie Kleine17 Anesthetic Machines and Equipment 266Rachel A. Reed18 Positioning the Anesthetized Horse 287Hui Chu Lin19 Monitoring the Anesthetized Horse 294Monitoring the Central Nervous System 294Joanna C. MurrellCardiovascular Monitoring 300Alanna N. JohnsonRespiratory Monitoring 310Alanna N. JohnsonAnesthetic Agent Monitoring 323Alanna N. JohnsonMonitoring Temperature 324Chiara E. HamptonMonitoring Neuromuscular Function 328Manuel Martin-Flores and Daniel M. Sakai20 Standing Sedation 333Catherine M. Creighton21 General Anesthesia Techniques 339Regula Bettschart-Wolfensberger and Simone K. Ringer22 Anesthesia of the Head and Neck 352Anesthesia of the Head 352Jim Schumacher, John Schumacher, and Ray WilhiteMaxillary Nerve Block in Donkeys 358Usama HagagCervical Plexus Block 363Luis Campoy23 Anesthesia of the Eye 369Daniel S. Ward24 Anesthesia of the Limbs 376Jim Schumacher, John Schumacher, and Ray Wilhite25 Anesthesia of the Perineum and Testicle 396Pudendal Nerve Block – Electrostimulation Technique 396Kirsty Gallacher and Luiz SantosPudendal Nerve Block – Blind Approach 399Jim SchumacherLocal Anesthesia for Castration 400Philip D. Jones26 Anesthesia of the Abdominal Wall 404Thoracolumbar Paravertebral Block (TPVB) – Electrostimulation Technique 404Luiz Santos and Kirsty GallacherParavertebral Nerve Block – Blind Technique 406Alex ValverdeTransversus Abdominis Plane Block 409Alex Valverde and Flavio SA. FreitagCaudal Intercostal Block for Abdominal Surgery (CIBAS) 413Benjamin Gingold27 Epidural Analgesia and Anesthesia 416Alex Valverde28 Pathophysiology of Pain 425Rachel A. Reed29 Pain Recognition in Horses 431Karina B. Gleerup, Casper Lindegaard, and Pia Haubro Andersen30 Management of Pain 450The Pharmacologic Approach to Pain Management 450Rachel A. ReedRehabilitation Modalities for Acute and Chronic Pain in Horses 456Tena L. UrsiniEquine Acupuncture 462Neal Valk31 Anesthesia of Foals 472Tom Doherty and Alex Valverde32 Anesthesia of Horses with Intestinal Emergencies (Colic) 494Tom Doherty33 Anesthesia of the Geriatric Horse 501Reza M. Seddighi34 Anesthesia and Pregnancy 511Lydia Donaldson35 Anesthesia for Equine Imaging 522Carrie A. Davis36 Anesthesia of Donkeys and Mules 543Anatomic, Physiologic, and Behavioral Differences 543Suzanne L. BurnhamSedation and Anesthesia of Donkeys and Mules 548Tom DohertyDonkey Pain Assessment Scales 552Machteld van Dierendonck and Thijs van Loon37 Remote Capture of Equids 565Nigel Caulkett38 Complications 573Intraoperative Hypotension 573Christopher K. Smith and Tom DohertyIntraoperative Hypertension 580Tom DohertyHypoxia and Hypoxemia 582Rachel A. ReedHypercarbia 588Tom DohertyPulmonary Edema as a Consequence of Airway Obstruction 590Tom DohertyEndotoxemia 592Tom DohertyPostanesthetic Myopathy 594Krista B. MitchellNeuropathy 599Rachel A. ReedHyperkalemic Periodic Paralysis (HYPP) 604Alanna N. Johnson and Rachel A. ReedMalignant Hyperthermia 609Alanna N. Johnson and Rachel A. ReedDelayed Awakening and Recovery 611Tom DohertyParaphimosis and Priaprism 614Meggan Graves and Jim SchumacherAnaphylactic and Anaphylactoid Reactions 621Rachel A. ReedIntra-carotid and Perivascular Injections 624Rachel A. ReedEquine Cardiopulmonary Resuscitation 627Genevieve Bussieres39 Recovery from Anesthesia 633Bernd Driessen40 Euthanasia 653Ron Jones and Tom DohertyIndex 661

The editors Tom Doherty, MVB, MSc, Dip ACVAA, is Professor (retired) at the College of Veterinary Medicine, University of Tennessee in Knoxville, Tennessee, USA. Alex Valverde, DVM, DVSc, Dip ACVAA, is Professor at Ontario Veterinary College, University of Guelph in Guelph, Ontario, Canada. Rachel A. Reed, DVM, DACVAA, is Clinical Associate Professor at the College of Veterinary Medicine, University of Georgia in Athens, Georgia, USA.

• List of Contributors xiPreface xvAcknowledgments xvi1 Preoperative Evaluation and Patient Preparation 1The Risk of Equine Anesthesia 1Tanya Duke-NovakovskiPatient Preparation 5Tanya Duke-Novakovski2 Serum Chemistry and Hematology 8Carla Sommardahl3 The Cardiovascular System 19Physiology of the Cardiovascular System 19Tamara GrubbEvaluation of the Cardiovascular System 36Daniel G. Kenney4 The Respiratory System 50Anatomy of the Equine Respiratory System 50Robert ReedPhysiology of the Respiratory System 55Carolyn KerrEvaluation of the Respiratory System 67Tom DohertyAirway Management 68Tom DohertyTracheostomy 78Tanner Snowden and Jim Schumacher5 The Renal System 86Natalie S. Chow6 Neurophysiology and Neuroanesthesia 98Tanya Duke-Novakovski7 The Autonomic Nervous System 110Christine Egger8 Electrolyte and Fluid Therapy 119Electrolytes 119Rachel A. ReedFluid Therapy 125Christopher K. Smith9 Acid-Base Physiology 137Traditional Approach 137Alex Valverde and Tom DohertyPhysicochemical Approach 147Diego E. Gomez and Alex Valverde10 Hemostasis and Hemotherapy 155Hemostasis 155Kira L. EpsteinHemotherapy 162Kira L. Epstein11 Thermoregulation 173Chiara E. Hampton12 Pharmacology of Drugs Used in Equine Anesthesia 184Phenothiazines 184Alicia SkeldingButyrophenones 186Alicia Skeldingα2-Adrenergic Agonists 188Alicia SkeldingOpioids 196Alicia SkeldingTrazadone 205Alicia SkeldingBenzodiazepines 206Alicia SkeldingGuaifenesin 209Alicia SkeldingKetamine 210Alicia SkeldingTiletamine and Zolazepam (TZ) 213Alicia SkeldingAlfaxalone 214Alicia SkeldingPropofol 216Alicia SkeldingBarbiturates 218Alicia SkeldingIntravenous lidocaine 219Patricia Queiroz-WilliamsHorse-related drug Regulations in Europe 222Regula Bettschart-Wolfensberger and Simone K. Ringer13 Inhalational Anesthetics 223Rachel A. Reed14 Local Anesthetics 232Catherine M. Creighton and Leigh Lamont15 Neuromuscular Blocking Agents in Horses 244Manuel Martin-Flores and Daniel M. Sakai16 Non-steroidal Anti-Inflammatory Drugs and Corticosteroids 250Non-steroidal Anti-Inflammatory Drugs 250Stephanie KleineCorticosteroids 259Stephanie Kleine17 Anesthetic Machines and Equipment 266Rachel A. Reed18 Positioning the Anesthetized Horse 287Hui Chu Lin19 Monitoring the Anesthetized Horse 294Monitoring the Central Nervous System 294Joanna C. MurrellCardiovascular Monitoring 300Alanna N. JohnsonRespiratory Monitoring 310Alanna N. JohnsonAnesthetic Agent Monitoring 323Alanna N. JohnsonMonitoring Temperature 324Chiara E. HamptonMonitoring Neuromuscular Function 328Manuel Martin-Flores and Daniel M. Sakai20 Standing Sedation 333Catherine M. Creighton21 General Anesthesia Techniques 339Regula Bettschart-Wolfensberger and Simone K. Ringer22 Anesthesia of the Head and Neck 352Anesthesia of the Head 352Jim Schumacher, John Schumacher, and Ray WilhiteMaxillary Nerve Block in Donkeys 358Usama HagagCervical Plexus Block 363Luis Campoy23 Anesthesia of the Eye 369Daniel S. Ward24 Anesthesia of the Limbs 376Jim Schumacher, John Schumacher, and Ray Wilhite25 Anesthesia of the Perineum and Testicle 396Pudendal Nerve Block – Electrostimulation Technique 396Kirsty Gallacher and Luiz SantosPudendal Nerve Block – Blind Approach 399Jim SchumacherLocal Anesthesia for Castration 400Philip D. Jones26 Anesthesia of the Abdominal Wall 404Thoracolumbar Paravertebral Block (TPVB) – Electrostimulation Technique 404Luiz Santos and Kirsty GallacherParavertebral Nerve Block – Blind Technique 406Alex ValverdeTransversus Abdominis Plane Block 409Alex Valverde and Flavio SA. FreitagCaudal Intercostal Block for Abdominal Surgery (CIBAS) 413Benjamin Gingold27 Epidural Analgesia and Anesthesia 416Alex Valverde28 Pathophysiology of Pain 425Rachel A. Reed29 Pain Recognition in Horses 431Karina B. Gleerup, Casper Lindegaard, and Pia Haubro Andersen30 Management of Pain 450The Pharmacologic Approach to Pain Management 450Rachel A. ReedRehabilitation Modalities for Acute and Chronic Pain in Horses 456Tena L. UrsiniEquine Acupuncture 462Neal Valk31 Anesthesia of Foals 472Tom Doherty and Alex Valverde32 Anesthesia of Horses with Intestinal Emergencies (Colic) 494Tom Doherty33 Anesthesia of the Geriatric Horse 501Reza M. Seddighi34 Anesthesia and Pregnancy 511Lydia Donaldson35 Anesthesia for Equine Imaging 522Carrie A. Davis36 Anesthesia of Donkeys and Mules 543Anatomic, Physiologic, and Behavioral Differences 543Suzanne L. BurnhamSedation and Anesthesia of Donkeys and Mules 548Tom DohertyDonkey Pain Assessment Scales 552Machteld van Dierendonck and Thijs van Loon37 Remote Capture of Equids 565Nigel Caulkett38 Complications 573Intraoperative Hypotension 573Christopher K. Smith and Tom DohertyIntraoperative Hypertension 580Tom DohertyHypoxia and Hypoxemia 582Rachel A. ReedHypercarbia 588Tom DohertyPulmonary Edema as a Consequence of Airway Obstruction 590Tom DohertyEndotoxemia 592Tom DohertyPostanesthetic Myopathy 594Krista B. MitchellNeuropathy 599Rachel A. ReedHyperkalemic Periodic Paralysis (HYPP) 604Alanna N. Johnson and Rachel A. ReedMalignant Hyperthermia 609Alanna N. Johnson and Rachel A. ReedDelayed Awakening and Recovery 611Tom DohertyParaphimosis and Priaprism 614Meggan Graves and Jim SchumacherAnaphylactic and Anaphylactoid Reactions 621Rachel A. ReedIntra-carotid and Perivascular Injections 624Rachel A. ReedEquine Cardiopulmonary Resuscitation 627Genevieve Bussieres39 Recovery from Anesthesia 633Bernd Driessen40 Euthanasia 653Ron Jones and Tom DohertyIndex 661