Lomax etal 2010lamb castration AVJ

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Topicalanaesthesiaalleviatesshort-termpainofcastrationandtaildockinginlambs avj_54667..74 SLomax,aHDickson,aMSheila,bandPAWindsora* ObjectiveToinvestigatetheeffectofatopicalanaestheticfor-mulationonpainalleviation,woundhealingandsystemiclevelsof localanaestheticactivesinlambsundergoingcastrationandtail docking.DesignThreeplacebo-controlledand/orrandomisedexperi-mentswereconductedusingthreegroupsofMerinolambs(n=62,68and19)undergoingroutinecastrationandtaildocking.ProcedureSurgicalcastration,witheithersurgicalorhot-irontaildocking,wasperformedwithandwithouttheapplicationoftopical anaesthetic(Tri-Solfen®)orplacebo.Theeffectsofthisprocedurewerecomparedwiththoseofrubberringcastrationandtail docking,andofthehandledbutunmarkedcontrols.Woundpain wasassessedusingcalibratedVon-Freymonofilamentsovera4-h period,pain-relatedbehaviourwasassessedover5h,wound healingwasassessedat14and28days,andtheplasmalevelsof lignocaineandbupivacaineweredetermined.ResultsRapidandupto4hprimaryhyperalgesiadevelopedfol-lowingsurgicalcastrationandtaildockingintheuntreatedand placebo-treatedlambs.Itwasabsentinthecastrationwounds,and significantlyreducedinthetail-dockingwounds,ofthetreated lambs.Hot-irondockingwasassociatedwithmildandtransient secondaryhyperalgesia,whichwasabolishedbythetopicalanaes- thesia.Therewasasignificantreductioninpain-relatedbehaviours intreatedlambs,whichwerenotsignificantlydifferentintheir behaviourtothesham-operationhandledcontrols.Plasma lignocaineandbupivacainelevelswerebelowthetoxicthresholds inalltestedlambs.ConclusionTopicalanaesthesiaalleviateswoundpainandsig-nificantlyreducespain-relatedbehavioursinlambsundergoing surgicalcastrationplussurgicalorhot-irontaildocking,withouta negativeeffectonwoundhealingorariskofsystemictoxicity.

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-relatedbehavioursinlambsundergoing surgicalcastrationplussurgicalorhot-irontaildocking,withouta negativeeffectonwoundhealingorariskofsystemictoxicity. Keywordsanalgesia;castration;lambs;pain;taildocking;topicalanaesthesia;welfareAbbreviationsHI,hotiron;LT,lighttouchsensation;NRS,numericalratingscale;P,painsensationAustVetJ2010;88:67–74doi:10.1111/j.1751-0813.2009.00546.x L ambmarking,whichincludescastrationofmalelambsandtaildockingofmaleandfemalelambsisaroutinehusbandry proceduresperformedannuallyonbetween31and34millionlambsinAustralia,1andmanymorethroughouttheworld.Althoughtheseprocedurescauseacutepainandstress,2–7theyareroutinelyconductedwithoutanalgesia.Despitetheirjustificationforanimal health,productionandmanagementreasons,thereisgrowing concernforthewelfareofanimalsundergoingtheseprocedures.In theEuropeanUnion,forexample,somecountrieshavepassedlegis- lationbanningpigletorlambcastrationunlessanalgesiaisused.In othercountries,supermarketchainsarerefusingtotakeproducts frompigsunlesstheywerecastratedwithanalgesia.IntheUnited Kingdom,theFarmAnimalWelfareCouncilhasreleasedanewreport callingforurgentactiontodevelopeffectiveanalgesiaforlambs undergoingcastrationandtaildocking.8Thesedevelopmentsreflectthegrowingdemandforhumanemanagementoflivestockthrough- outtheworldandsetachallengetodevelopeffectivemethodsofpain alleviationthatarepracticalandapplicabletofarmingoperations. Tri-Solfen®(BayerAnimalHealth,Gordon,NSW,Australia)isa‘farmerapplied’spray-ontopicalanaestheticformulationof lignocaine(asthehydrochloride:40.6g/L),bupivacaine(asthehydro- chloride:4.5g/L),adrenalin(asatartrate:24.8mg/L)andcetrimide (5.0g/Linagelbase).Ithasbeenreportedthattopicalanaesthesia withTri-Solfenishighlyeffectiveinalleviatingpainassociatedwith

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artrate:24.8mg/L)andcetrimide (5.0g/Linagelbase).Ithasbeenreportedthattopicalanaesthesia withTri-Solfenishighlyeffectiveinalleviatingpainassociatedwith mulesingandimproveswoundhealing.9Inthepresentstudiesweinvestigatedthepotentialfortopicalanaesthesiatoalleviatethepain associatedwithcastrationandtaildockinginsheep.MaterialsandmethodsTwoexperimentswereperformedonramlambsundergoingroutinetaildockingandcastrationincommercialflocksintheCentralTable- landsandSouthernHighlandsofNewSouthWales,Australia.Lambs wereaged6to12weekswithameaninitialbodyweightof14.48kg ( 2.8kg)andconsistedof62F1Merino¥SouthAfricanMuttonMerinolambs(CentralTablelandsflock)and68finewoolMerino lambs(SouthernHighlandsflock)borninthewinterof2007.Lambs weredividedintoeighttreatmentgroupstoexaminesurgicalcastra- tionplussurgicalorhot-iron(HI)taildocking,(performedwithout Tri-SolfenorwithTri-Solfenorplacebo),rubberringcastrationand taildocking,andshamprocedureinwhichlambswerehandledonly butremaineduncastratedortail-docked(Table1).Inathirdexperi- ment,fordeterminingtheplasmalevelsoflignocaineandbupivacaine aftertreatmentwiththetopicalanaesthetic,bloodsampleswerecol- lectedfromfinewoolMerinolambsaged6to12weeksfromacom- mercialflockintheSouthernHighlands,NSW,undergoingroutine taildockingandcastration(n=15)ormulesing,taildockingandcastration(n=4).GeneralmanagementandmarkingOnthedayofeachexperimentlambsfromeachflockwereyardedanddraftedintoaholdingyard.Theywerethenselectedatrandom, weighed,ear-taggedandplacedinmarkingcradles.Inexperiments1 *Correspondenceauthor.aFacultyofVeterinaryScience,UniversityofSydney,PMB3,Camden,NewSouthWales2570,Australia; pwindsor@camden.usyd.edu.au bAnimalEthicsPtyLtd,YarraGlen,Victoria,Australia PRODUCTIONANIMALSPRODUCTIONANIMALS

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B3,Camden,NewSouthWales2570,Australia; pwindsor@camden.usyd.edu.au bAnimalEthicsPtyLtd,YarraGlen,Victoria,Australia PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201067

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and2,lambswereallocatedsequentiallytothetreatmentgroupslistedinTable1,buttheorderoftreatmentswasreversedinexperiment2.Methodofsurgicalcastrationandtopicalanaestheticorplaceboapplication Surgicalcastrationwasperformedusingaclean,sharpsurgicalknife.Thedistalskinofthescrotumwasexcised,exposingthetestes,which wereindividuallyextractedfromthescrotumbytraction,exposing thespermaticcord.Eachtestiswasremovedbyincisingthespermatic cordapproximately10cmproximaltotheheadoftheepididymis.In groupsreceivingtopicalanaestheticorplacebotreatment,Tri-Solfen orplacebogel(whichconsistedofthebasegelwithoutlocalanaes- theticorvasoconstrictorcompounds)wasappliedtoeachofthe exposedspermaticcordsproximaltothesiteofincision,priorto removalofthetestis,byinsertingthenozzleofthespraygunalongthe lengthofthecordasfarintothescrotalwoundaspossibleandapply- ing1.5mLoftheTri-Solfenorplacebotoliberallycoatthespermatic cordastheapplicatorwaswithdrawn.Anadditional1.5mLofTri- Solfenorplacebowasappliedtothecutedgeoftheskinwoundand thescrotalsac.Thetechniqueensuredthatboththecordtissuethat retractedintothewoundafterremovalofthetestisandtheskinofthe scrotalwoundwerewellcoatedwiththeanaestheticorplaceboagent.MethodofsurgicalandHItaildockingSurgicaltaildockingwasperformedusingacleaned,sharpenedsur-gicallamb-markingknife,incisingattherecommendedposition betweencoccygealvertebrae2and3.TheHItechniquefortaildockingusedagastail-dockingknifethathadbeenpreheatedtothecorrecttemperaturetoefficientlysealthe coccygealbloodvessels.Theskinofthetailwaspushedtowardsthe lamb’sbodytolocatethecorrectpositionbetweencoccygealvertebrae 2and3andthetailelevatedtoavoidburningoftheperineum.The

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eskinofthetailwaspushedtowardsthe lamb’sbodytolocatethecorrectpositionbetweencoccygealvertebrae 2and3andthetailelevatedtoavoidburningoftheperineum.The leveroftheknifewassqueezedandafter2sthetailwassevered.MethodofrubberringcastrationandtaildockingDetailsofallproceduralandtreatmentstrategiesareshowninTable1.Ringcastrationinvolvedtheapplicationofanelastratorrubberringaroundtheneckofthescrotumproximaltothetestesinorderto obstructbloodflowtothetestesandcauseischaemicnecrosis.Asecondelastratorringwasappliedtothetailattherecommendedpositionbetweencoccygealvertebrae2and3.Thefirst35to38lambsoneachpropertyonthedayoftheexperimentwereassignedtobehaviouralobservations.Theywereallocatedtoa treatmentgroup,treatedaccordingly,thenweretransferredintheir treatmentgroupsto5-m2outdoorpasturedobservationyardsawayfromvisualandauditorystimuli.Pain-relatedbehaviourassessments wereperformedbyatrainedobserver,whowasunawareofthetreat- mentgroupstrategy,usinganumericalratingscale(NRS)at5and 30minand1,2,3,4and5haftertheprocedures.Thenext27to30lambsonthedayoftheexperimentwereallocatedtowoundpainassessments.Theywereassignedtotreatmentgroups andpriortocastrationandtaildockingtheirresponsestolighttouch (LT)andpain(P)stimulationoftheintactskinonthescrotumandtail wasassessedusingVon-Freymonofilamentsaspreviouslydescribed.9Aftercastrationanddocking,(withorwithoutTri-Solfenorplacebo application),lambsremainedinthecradlefor1minandtheir responsestoLTandPstimulationofthetailandscrotalwoundswere assessedbytwoobserverswhowereunawarewhichtreatmentstrategy (Tri-Solfenorplacebo)hadbeenused.Lambswerethentransferredto asmallholdingyardinamixedtreatmentgroupandreturnedtothe lambcradleforrepeatassessmentsat2and4hfollowingtheproce-dures.Aftercompletionofassessments,lambswerereturnedtotheir

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ixedtreatmentgroupandreturnedtothe lambcradleforrepeatassessmentsat2and4hfollowingtheproce-dures.Aftercompletionofassessments,lambswerereturnedtotheir damsatpasture.Woundhealingwasassessedat2and4weeks.Lambswerere-yarded,weighedandplacedinthecradlewheretheirwoundswereinspected andpalpatedbyaregisteredspecialistveterinarian(pathobiology).Assessmentofpain-relatedbehaviourPain-relatedbehaviourwasassessedusingtheNRSdevelopedprevi-ously9andmodifiedbyacombinationoffieldobservationsandpub-lishedreportsofbehaviouralchangesinresponsetocastrationand/or taildocking.6–11Atrainedobserver(animalscientistblindedtotreat-ment)observedthelambsatvarioustimepointsaftermarking.Indi- viduallambsweregivenascorebetween0and3:0=nopain-relatedbehaviour;1=mildlyabnormalposture,gaitorbehaviour,suchasmildkyphosiswithouthyperextensionofhindlegs,ventralrecum- bencywithhindlegspartiallyextendedormildstiffeningofgait Table1. Treatmentgroupsandtotalnumbersoflambsineachgroupinexperiments1and2 GroupCastrationmethodTail-dockingmethodTreatmentDirectwoundsensoryassessment(n)Pain-relatedbehaviourassessment(n)1KnifeKnifeUntreated11112KnifeKnifeTri-Solfen11113KnifeKnifePlacebo11114KnifeHotironUntreated885KnifeHotironTri-Solfen886KnifeHotironPlacebo807RubberringRubberringUntreated0128ControlControlUntreated012 PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201068

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withoutovertlimpingorlegdragging;2=moderatelyabnormalposture,gaitorbehaviour,suchas‘statuestanding’withheaddown andprominentkyphosis,moderatestiffeningorslowingofgaitor hyperextensionand/orabductionofhindlegs,ventralrecumbency withhindlegsfullyextended;3=displayingseverelyabnormalposture,gaitorbehaviour,suchasmarkedagitationwithtwistingor writhing,highfrequencyofposturalchangefromlyingtokneelingor standing,distressedvocalisation,lateralorprostratelying,kneeling, dogsittingortremors,shakingorlipcurling.DirectwoundsensoryassessmentVon-FreymonofilamentsarecalibratedtobendatpredeterminedpressurestoproviderepeatableLT(10N)orP(75N)stimulation,as previouslydescribed.9Theywereusedtoperformdirectsensorytestingatsevenpredeterminedsitesonthecutskinedgeofthescrotal andtailwoundsandatfoursitesontheintactskinsurroundingthe woundstodeterminethelambs’responsestoLTandPstimulation beforeandupto4haftercastrationandtaildocking.Evidenceoflocalanaesthesia(diminishedresponsetoLTandPstimu-lation),allodynia(heightenedresponsetoLTstimuli)and/orprimary andsecondaryhyperalgesia(heightenedresponsetoPstimulus directlyinthedamagedtissueorinsurroundingundamagedtissue, respectively)wasassessedateachsite.Responseswerescoredby monitoringinducedinvoluntarymotorreflexesintherumpandhead, whichweregradedbyvigour.Rumpresponsescoresweregradedas: 0=noresponse;1=minorinvoluntarymotorresponsessuchaslocalskintwitch,subcutaneousmuscletwitchoranalcontraction;2=partialrumpwithdrawalreflex,suchasmultiplesubcutaneousmuscle groupcontractionand/orliftingofthetail;3=fullrumpwithdrawalreflexwithliftingoftherumpoffthecradle.Facialresponsescores

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,suchasmultiplesubcutaneousmuscle groupcontractionand/orliftingofthetail;3=fullrumpwithdrawalreflexwithliftingoftherumpoffthecradle.Facialresponsescores weregradedas:0=noresponse;1=minorfacial‘awareness’,suchaseyewideningorblinkingornasalflaring;2=partialstartlereflexofthehead,suchasslightliftingofthesnoutorpartialheadrotation; 3=fullstartlereflexofthehead,resultinginamajormovementsuchasliftingheadoffthecradle,fullheadjerkorfullheadrotation.Scores foreachsitewereaddedtoachieveatotalscoreforeachlamb.Total scoreswerecalculatedoutof24forperi-woundsensitivityandoutof 42fordirectwoundsensitivity.PlasmalignocaineandbupivacaineanalysesInexperiment3,lambswereselectedatrandom,placedinthecradleand10mLofbloodwascollectedviadirectjugularvenouspuncture. Lambswerethensurgicallycastratedandtail-docked.Fourlambsalso underwentmulesingbyanaccreditedpractitionerusingtheindustry standardtechnique.AllwoundsweretreatedwithTri-Solfenaccord- ingtolabelrecommendationsorasoutlinedearlier.Thelambswere thentransferredtoholdingpensandbloodsampleswerecollectedby repeatjugularvenouspunctureat30,90and120minfollowingthe procedure,afterwhichtheywerereturnedtotheirdamsatpasture.Thebloodsampleswerecentrifuged,theplasmawasfrozenandthentransferredtoAgrisearchAnalytical®(Rozelle,NSW)foranalysis.Lignocaineandbupivacainelevelsweredeterminedusingreverse- phasehigh-performanceliquidchromatographywithtandemmass spectrometricdetection.StatisticalanalysisDatawereanalysedusingSPSSversion14.0®(SPSSInc.,Chicago,IL,USA),andGenstat®version10.0(VSNInternational,UK2007).Box-plotswereexaminedandone-wayanalysisofvariancewasusedto measuretheshort-termeffectsoftreatmentgroupsforwhichthere wasvariation.Residualmaximumlikelihoodestimationlinearmixed modelsanalyseswereusedtoanalyseNRSscoresfrombehavioural

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ectsoftreatmentgroupsforwhichthere wasvariation.Residualmaximumlikelihoodestimationlinearmixed modelsanalyseswereusedtoanalyseNRSscoresfrombehavioural andsensitivity-testingobservations.Post-hocpair-wisecomparisons wereperformedforanalysesinwhichthebetweengroupcomparison wassignificant.Forallstatisticalcalculations,P<0.005wasconsid-eredstatisticallysignificant.ThisresearchprogramwasapprovedbytheAnimalEthicsCommitteeoftheUniversityofSydneyandconformedtotheprovisionsofthe DeclarationofHelsinki(2000).ResultsWeatherconditionsDuringexperiment1theweatherwascoolandovercast,withanaveragetemperatureof13°C,duringexperiment2itwascoolandfine, withanaveragetemperatureof10°Candnoflyactivityandforexperi- ment3itwaswarmanddryat19°C,withmoderateflyactivity.Morbidity,mortalityandwoundinspectionClinicalsignsoftetanuswerenotobservedandnoneofthelambsdied.Directinspectionandwoundpalpationidentified3lambswith abscessformationinthescrotalsacand13lambswithincreased firmnessandthickeningofthecord,interpretedasasubacuteto chronicinflammatoryorscirrhouscordreactionat14daysafterthe surgicalprocedure.Therewasnosignificantdifferenceinabscess formationandscirrhouscordreactionaccordingtotreatment.Evenat 4weeksthemajorityofthelambstreatedwithrubberringsstillhad theirscrotumsandtailsattached,althoughthetissueswerecold, shrunkenandfirm,indicativeofischaemicnecrosis.Inmanycases therewasreddeningandswellingoftheskinimmediatelyproximalto thering,accompaniedbyasmallamountofyellowtogreenish exudate,suggestingfocalinflammationandminorinfection.DirectsensorytestingofthecastrationwoundandsurroundingskinBeforesurgicalcastration.TherewaslittleresponsetoLTorPstimulationoftheintactskinofthescrotalareapriortocastration.Meanresponsefromthefourtestingsites(maximumpossiblescore

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tion.TherewaslittleresponsetoLTorPstimulationoftheintactskinofthescrotalareapriortocastration.Meanresponsefromthefourtestingsites(maximumpossiblescore 24)was 0.44 1.04forLTand 1.03 1.6forP.Therewerenosignificantdifferencesbetweengroupswithineachtrial.Aftersurgicalcastration.TherewasasignificantelevationintheresponsetoPstimulationofthewoundovertime(P<0.0001),withasignificanttreatmenteffect(P<0.0001).Primaryhyperalgesiadevel-opedwithin1minofcastrationintheuntreatedandplacebo-treated lambs,butnotintheTri-Solfen-treatedlambs.Responsescoresinthe Tri-Solfen-treatedlambsweresignificantlybelowthoseofthe untreatedandplacebo-treatedlambsatalltimepointspostprocedure (P 0.002)(Figure1).ResponsetoPstimulationoftheskinsur-roundingthecastrationwounddidnotchangeovertimeinthegroup asawhole.ResponsescoresweresignificantlylowerintheTri-Solfen- treatedlambsthaninuntreatedandplacebo-treatedlambsat1min(P =0.005)and4h(P=0.02)(Figure2). PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201069

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ResponsetoLTstimulationofthecastrationwound.TherewasnosignificantoverallchangeintheresponsetoLTovertime.However,therewasasignificanttreatmenteffect(P=0.008),withLTresponsesoftheTri-Solfen-treatedlambssignificantlylessthanthose oftheuntreatedlambsat1min(P=0.003)and2h(P=0.05).Placebo-treatedlambswerenotsignificantlydifferenttountreatedlambs (Figure3).ThereappearedtobeamilddecreaseintheresponsetoLT stimulationoftheskinsurroundingthecastrationwoundbetween beforetreatmentand1minafterinbothuntreatedandTri-Solfen- treatedlambs,butnotinplacebo-treatedlambs,andtherewasamild increaseintheresponsetoLTstimulationoftheskinsurroundingthe castrationwoundbetween1minand2haftersintheuntreated,but notintheplacebo-orTri-Solfen-treated,lambs(P=0.001)(Figure4).Directsensorytestingofthetail-dockingwoundandsurroundingskin TherewasasignificantchangeintheresponsetoPovertime(P<0.0001),withsignificanttreatmenteffect.LambsdockedwithaHIhad responsescoressignificantlybelowthoseofthesurgicallydocked lambs(P<0.0001).Surgicallytail-dockedlambs.Therewasevidenceofprimaryhype-ralgesia,withasignificantelevationinresponsetoPstimulationbetween1minand2h(P<0.0001).Therewasasignificanttreatmenteffect(P=0.034):Tri-Solfen-treatedlambshadPresponsescoresthatwerelessthanthoseoftheuntreatedlambsatalltimepoints(P=0.008at4h).ThePresponsescoresfortheplacebo-treatedand untreatedlambswerenotsignificantlydifferent(Figure5).Therewas nosignificantchangeovertimetoPstimulationaroundthewound. However,therewasasignificanttreatmenteffect(P=0.018),withTri-Solfen-treatedlambsdisplayingresponsescoresbelowthoseof untreatedlambsatalltimepoints,whichwasstatisticallysignificantat

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reatmenteffect(P=0.018),withTri-Solfen-treatedlambsdisplayingresponsescoresbelowthoseof untreatedlambsatalltimepoints,whichwasstatisticallysignificantat 4h(P=0.005)(Figure6).HItail-dockedlambs.Therewasnoevidenceofprimaryhyperal-gesiaandnosignificanttreatmenteffect.However,thePresponsescoresweresignificantlyloweratthe4-htimepointinthetreated lambscomparedwiththeuntreated(P=0.03)andplacebo-treatedlambs(P=0.008)(Figure5).Therewasevidenceofearlysecondaryhyperalgesia,withamildbutsignificantchangeovertimeinresponse toPstimulationaroundthewound(P=0.02),within1minofHI Figure1. Meanpain(P)responsescoresoflambsfollowingstimulationofthesurgicalcastrationwoundcomparinguntreated,placeboonlyand topicalanaesthesiatreatments. Figure2. Meanresponsetopain(P)stimulationoftheskinsurroundingthecastrationwoundcomparinguntreated,placeboonlyandtopical anaesthesiatreatments. Figure3. Meanresponsetolighttouch(LT)stimulationofthecastrationwoundcomparinguntreated,placeboonlyandtopicalanaesthesia treatments. Figure4. Responsetolighttouch(LT)stimulationoftheskinsurroundingthecastrationwound. PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201070

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dockingandmostprominentintheuntreatedandplacebo-treatedlambs(Figure6).ResponsetoLTstimulationofthetail-dockingwound.TherewasasignificantincreaseinLTresponsescoresovertime(P=0.01)withasignificanttreatmenteffect(P=0.009).Thegreatestincreaseinresponseoccurredbetweenthe2-and4-htimepointsinsurgically docked,untreatedlambs(P=0.01),whichwasnotapparentinsurgi-callydockedTri-Solfen-treatedlambsorthosethatweredockedwith aHI.Placebo-treatedsurgicallydockedlambsdisplayedintermediate values(Figure7).TherewasminimalresponsetoLTstimulationof skinsurroundingthewoundinalltreatmentgroups(Figure8).Pain-relatedbehaviourTherewasasignificantchangeinlambbehavioursovertime(P<0.001),withlambsexhibitingthegreatestabnormalitiesinposture,gait orbehaviourwithinthefirst4haftermarking.Treatmenttypewas showntobehighlysignificant(P<0.001),withring-castratedlambsdisplayingsignificantlyhigherpain-relatedbehaviourscoresthanthe lambsinthesurgicalknifeandHItreatmentgroups.Lambstreated withtopicalanaesthesiadisplayedsignificantlylesspain-relatedbehav- ioursthantheuntreated,ring-castratedandplacebo-treatedlambs(P<0.001)andwerenotsignificantlydifferentfromthehandledcontrols(Figure9).PlasmalignocaineandbupivacaineanalysesMeanplasmalignocainelevelswere0.17( 0.09),0.12( 0.06)and0.1( 0.06)mg/Lat30,90and120minposttreatment,respectively.Themaximumrecordedlevelatanytimepointinanyofthelambs was0.39mg/Lat30minposttreatment.Meanplasmabupivacainelevelswerebelowthelevelofdetection(<0.0025mg/L)orquantification(<0.01mg/L)in5lambs,withameanvalue SDof0.014 0.003mg/Lintheremaininglambsat30minaftertreatment.Thereafter,bupivacainelevelsat90and 120minwereeitheratorbelowthelevelofquantificationin10lambs,

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0.014 0.003mg/Lintheremaininglambsat30minaftertreatment.Thereafter,bupivacainelevelsat90and 120minwereeitheratorbelowthelevelofquantificationin10lambs, with0.013 0.003mg/Lintheremaininganimals.DiscussionTherearerapidlyemergingcommercialandethicalimperativestofindpracticalmethodsofalleviatingthepainandstressinflictedon farmanimalsduringroutinehusbandryproceduressuchascastration andtaildocking.Ourstudypresentsevidencethatalleviationofpain Figure5. Meanresponsetopain(P)stimulationofthetailwoundovertimecomparing6differenttreatmentgroupsoflambs. Figure6. Meanresponsetopain(P)stimulationaroundthetailwoundovertimecomparing6differenttreatmentgroupsoflambs. Figure7. Meanresponsetolighttouch(LT)stimulationofthetailwoundovertimecomparing6differenttreatmentgroupsoflambs. Figure8. Meanresponsetolighttouch(LT)stimulationoftheskinsur-roundingthetailwoundovertimecomparing6differenttreatment groupsoflambs. PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201071

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upto4hisachievedforlambsundergoingsurgicalcastrationplussurgicalorHItaildockingusingafarmer-applied,spray-ontopical anaestheticformulation.Thisfindinghasmajorwelfareimplications foralllivestockundergoingsuchprocedures.Localanaestheticagents,suchaslignocaine,wheninjectedarehighlyeffectiveinalleviatingthepainassociatedwithcastrationandtail docking,2,12–14andthesafetyandefficacyprofilesoflocalanaestheticagentsarewelldescribedinsheep.15–18Despitethis,localanaestheticinjectionsarerarelyusedduringroutinehusbandryprocedures becauseofthepracticalandeconomicconstraints.Topicalanaesthe- sia,appliedduringand/orimmediatelyaftertheprocedure,offersa practicalalternativethatmaystillbehighlyeffectiveforsurgicalpro- cedures.Localanaestheticagentsactdirectlyonnervetissuetoelicitarevers-ibleblockoftheconductionofsignalsresponsibleforthesensationof pain.Whenappliedtoopenwoundstheycaneffectrapidandpro- foundlocalanaesthesia.9,19–24Theycanalsopreventorreducethesubsequentpainescalationresponse.25–27Althoughitmayseemcoun-terintuitivetoapplylocalanaestheticafteraprocedure,therearesig- nificantadvantagestothisapproachinthesheepfarmsetting.Firstly, foreconomicreasons,on-farmsurgicalproceduresareperformed veryquickly,takingamatterofseconds;thepaininvolvedmaywellbe lessthanthatofalocalanaestheticinjection,particularlyifawell- sharpenedbladeisusedfortheprocedure.Secondly,bynothavingto waitfortheanaestheticagenttotakeeffectbeforeperformingthe procedure,double-handlingofthelambisavoidedanditispromptly returnedtoitsdam,minimisingthestressofhandlingandseparation. Thirdly,theagentscanbeappliedbythefarmer,withoutdirectvet- erinaryintervention.Further,postoperativepainmaybemoreeffec- tivelyaddressedastheactivesaredelivereddirectlytothetraumatised

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hefarmer,withoutdirectvet- erinaryintervention.Further,postoperativepainmaybemoreeffec- tivelyaddressedastheactivesaredelivereddirectlytothetraumatised nervefibresandtissuesthatarethesourceofpain,andcanbedeliv- eredinformulationsdesignedformaximaladhesionanddurationof effect.Finally,theanaestheticagentscanalsobedeliveredincombi- nationswithotheragents,suchasvasoconstrictorsandantiseptics, withpossiblesynergisticandadjunctivewoundcareeffects.OurstudiesoftopicalanaesthesiaforlivestockhusbandryhaveusedTri-Solfenbecausethelignocaine,bupivacaineandadrenalininthe delivereddoseshaveproveneffectiveforanaesthesiaandhaemostasis ofopenwoundsinhumanpatients,19–24andbecauseitcontainsaviscousgelbasethatcanbesprayedontoandadherestoopenwounds. Previousstudieshavedemonstratedthattopicalanaesthesiaishighly effectiveinalleviatingthepainandimprovingthehealingofmulesing woundsinsheep,withloweracutecortisolresponsesandreduced woundpainandpain-relatedbehaviourforuptoandincluding8h afterward.9,28Ourcurrentresultsextendthesefindingsbydocument-ingthattopicalanaesthesiaisalsohighlyeffectiveinalleviatingthepain associatedwithsurgicalcastrationplussurgicalorHItaildocking.Itcanbedifficulttoquantifypaininanimalsandmostauthorsuseacombinationoftechniques.Weelectedtousebehaviouralanalysis togetherwithdirectsensorytesting.Quantitativesensorytestingisa widelyused,validatedtechnique,29–32whichwehavepreviouslyusedinlambstorecordtheonset,evolutionanddistributionofpainfrom mulesingwoundsandtheirresponsetoatopicallocalanaesthetic.9Ourcurrentfindingsofalleviationofwoundpainandpreventionof primaryandsecondaryhyperalgesiainthefirstminuteandupto4h aftersurgicalcastrationinTri-Solfen-treatedlambsissupportedby findingthatpain-relatedbehaviourwasalsosignificantlyreducedin

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esiainthefirstminuteandupto4h aftersurgicalcastrationinTri-Solfen-treatedlambsissupportedby findingthatpain-relatedbehaviourwasalsosignificantlyreducedin theTri-Solfen-treatedlambs.WefoundlittleevidenceofdirectwoundpainafterHItaildocking,asidentifiedinpreviousstudies.6,10,11TheHIisbelievedtocauteriseanddestroythenervoussensorytissueinthetail,resultinginasubsequent lossofsensation.6,33,34Mildandtransientsecondaryhyperalgesiadevelopedinthesurroundingtissues,butwaspreventedbytreatment withTri-Solfen.Wedidnotfindanyevidenceofdelayedwound healingintheHIdockedlambs,withorwithouttreatment.Surgicaltaildockingresultedinlessimmediatesecondaryhyperalge-sia.However,therewasescalatingprimaryallodyniaandprimaryand secondaryhyperalgesiaovertheensuing4h,consistentwiththepain escalationphenomenon.Asignificant,butincomplete,analgesiceffect wasapparentwiththeuseofTri-Solfenanditwasconsideredthat Figure9. Meanscoresforpain-relatedbehav-iourof6differenttreatmentgroupsoflambs comparedwithcontrollambs,usinganumeri- calratingscale. PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201072

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arterialbleedingfromthetailmayhavedilutedtheanaestheticagentandpreventeditfromadheringeffectivelytothecutskinedgesofthe tailwound.Nevertheless,theuseofanalgesiawasstillassociatedwith asignificantreductioninpain-relatedbehaviour.Bloodplasmalignocaineandbupivacainelevelswerewellbelowthetoxicthresholdof6mg/L(humans)andthetoxicconvulsiveplasma levelof40mg/Linsheep.Woundhealingwasunimpairedandwe concludethatapplicationofTri-Solfenattherecommendedrateto lambmarkingwoundswillnotbedetrimentaltotheirhealth.Rubberringcastrationandtaildockingiswidelyusedbecauseofitseaseandpracticality.Itislessamenabletopainalleviationwithtopical anaesthesiabecauseofthepoorskinpenetrabilityoflocalanaesthetic agents.Weincludedarubberringtreatmentgroupforbehavioural comparison,asmanyconsiderthistobethemosthumanemethodof castrationanddocking.However,thatopinionisnotsupportedbyour results.Lambsundergoingringcastrationanddockinginourtrials exhibitedagitation,bleating,lateralandventralrecumbency,lip curling,kneeling,kneewalking,writhingandotherabnormalpostures indicativeof‘intensepain’and‘markeddistress’.Thesebehaviours persistedbeyond2hafterapplicationoftheringsandisconsistent withpreviousreports.3,13Thenatureoftheirdistress‘dominatedtheirexperience’35andrenderedthemoblivioustoexternalenvironmentalstimulation,totheextentthattheywereunsuitablefordirectwound sensorytesting.OurresultsconcurwithGrant,6whodeterminedahierarchyofpainassociatedwithdifferentmarkingmethods,with rubberringcastrationandtaildockingbeingthemostpainful(andear taggingastheleastmostpainfulintervention),andnotedthat‘All treatmentsinvolvingtheuseoftightrubberringsresultedinsignifi-

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kingbeingthemostpainful(andear taggingastheleastmostpainfulintervention),andnotedthat‘All treatmentsinvolvingtheuseoftightrubberringsresultedinsignifi- cantabnormalpostureandactivepainbehaviourdisplays.’Argumentsthatrubberringscauselesspainandstressaregenerallybasedoninterpretationofbiochemicalmeasurements,withgreater elevationandpersistenceofthecortisolresponsefollowingsurgical procedures.However,isitappropriatetocomparesurgicalandnon- surgicalproceduresusingthecortisolresponseasameasureofpain? Surgicalwounding(breachingtheskin)promptsauniquephysiologi- calresponsethatisdesignedtomaintainbloodvolumeandinstitute bodydefencesandwoundhealing.Cortisolsecretionisanimportant partofthisphysiologicalresponse,36whichoccurseveninthecompleteabsenceofpain,suchaswhenpatientsareunconsciousand/orunder fullgeneralanaesthesia.37–40Amoreprotractedcortisolresponsefol-lowingsurgicalcastrationdoesnotnecessarilyindicategreaterormore protractedpaincomparedwithrubberringcastration.Itmaysimply indicatethattherehasbeenagreaterbreachoftheskin.Ourresultsindicatethatcastrationandtaildockinginlambscanbeachievedwithminimalpainanddistressusingsurgicalcastration,HI taildockingandintra-/postoperativelyappliedtopicalanaesthetic. Thistechniqueoffersthesheepindustryawelfare-appropriatealter- nativetoboththecurrentlyusedmethods:surgerywithoutanalgesia andrubberrings.Inouropinion,investigationsofothermethodsof analgesiaarerequiredtoaddresstheconsiderablewelfareconcerns thatoccurwiththeroutineuseofrubberringsforcastrationonlyor forcombinedcastrationandtaildocking.Tri-Solfeniscurrentlyonlyavailableunderarestrictedusepermitthroughveterinariansforuseinalleviatingpost-mulesingpaininlambsinAustralia.However,theuseoftopicalanaestheticformula-tionshasthepotentialtoprovideapracticalandeconomicmeansof

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seinalleviatingpost-mulesingpaininlambsinAustralia.However,theuseoftopicalanaestheticformula-tionshasthepotentialtoprovideapracticalandeconomicmeansof reducingthepainassociatedwithcastrationandtaildockingand improvethewelfareofmillionsofyounglambsannually,bothin Australiaandinternationally.Investigationsastowhetheritissimi- larlyeffectiveincattleandpigshavecommenced.AcknowledgmentsSLomaxwassupportedbyaJeanWalkerFellowshipFundFacultyofVeterinarySciencescholarship,andHDicksonbytheAustralianWool EducationTrust.WearegratefulforstatisticaladvicefromDrsP ThomsonandNDhandfromtheUniversityofSydneyandlogistical supportfromMrCOlssonandstaffat‘RoyalOak’,Goulburn,NSW andMrLMacsmithandfamilyat‘Corroboree’,Cudal,NSW.References1.AustralianBureauofStatistics.7111.0:PrincipalAgriculturalCommodities,Aus-tralia,Preliminary,2007–09; http://www.abs.gov.au/AUSSTATS/abs@.nsf/Latestproducts/7111.0Main%20Features42008-09?opendocument&tabname=Summary&prodno=7111.0&issue=2008-09&num=&view= .RetrievedDecember2009 2.DinnissAS,MellorDJ,StaffordKJetal.Acutecortisolresponsesoflambsto castrationusingarubberringand/oracastrationclampwithorwithoutlocal anaesthetic.NZVetJ1997;45:114–121.3.MellorDJ,MurrayL.Effectsoftaildockingandcastrationonbehaviourand plasmacortisolconcentrationsinyounglambs.ResVetSci1989;46:387–391.4.ThorntonPD,Waterman-PearsonAE.Quantificationofthepainanddistress responsestocastrationinyounglambs.ResVetSci1999;66:107–118.5.RhodesRC,NippoMM,GrossWA.Stressinlambs(Ovisaries)duringaroutinemanagementprocedure:evaluationofacuteandchronicresponses.CompBiochemPhysiol1994;107A:181–185.6.GrantC.Behaviouralresponsesoflambstocommonpainfulhusbandrypro- cedures.ApplAnimBehavSci2004;87:255–273.7.FellLR,ShuttDA.Behaviouralandhormonalresponsestoacutesurgicalstress

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onsesoflambstocommonpainfulhusbandrypro- cedures.ApplAnimBehavSci2004;87:255–273.7.FellLR,ShuttDA.Behaviouralandhormonalresponsestoacutesurgicalstress insheep.ApplAnimBehavSci1989;22:283–294.8.FarmAnimalWelfare.Reportontheimplicationsofcastrationanddockingfor thewelfareoflambs.CrowncopyrightMay2008. http://www.fawc.org.uk/pdf/report-080630.pdf .AccessedSeptember2009.9.LomaxS,SheilM,WindsorPA.Impactoftopicalanaesthesiaonpainalleviation andwoundhealinginlambsaftermulesing.AustVetJ2008;86:159–168.10.GrahamMJ,KentJE,MolonyV.Effectsoffouranalgesictreatmentsonthe behaviouralandcortisolresponsesof3-week-oldlambstotaildocking.VetJ1997;153:87–97. 11.LesterSJ,MellorDJ,HolmesRJetal.Behaviouralandcortisolresponsesof lambstocastrationandtailingusingdifferentmethods.NZVetJ1996;44:45–54.12.WoodGN,MolonyV,Fleetwood-WalkerSMetal.Effectsoflocalanesthesia andintravenousnaloxoneonthechangesinbehaviourandplasmaconcentra- tionsofcortisolproducedbycastrationandtaildockingwithtightrubberrings inyounglambs.ResVetSci1991;51:193–199.13.DinnissAS,StaffordKJ,MellorDJetal.Thebehaviourpatternoflambsafter castrationusingarubberringand/orcastratingclampwithorwithoutlocal anaesthetic.NZVetJ1999;47:198–203.14.MellorDJ,StaffordKJ.Acutecastrationand/ortailingdistressanditsallevia- tioninlambs.NZVetJ2000;48:33–43.15.MorishimaHO,PedersenH,FinsterMetal.Toxicityoflidocaineinadult, newborn,andfetalsheep.Anesthesiology1981;55:57–61.16.RuttenA,NancarrowC,MatherLetal.Hemodynamicandcentralnervous systemeffectsofintravenousbolusdosesoflidocaine,bupivacaine,andropiv- acaineinsheep.AnesthAnalg1989;69:291–299.17.FeldmanH,DvoskinS,HalldinMetal.Comparativelocalanestheticefficacy andpharmacokineticsofepidurallyadministeredropivacaineandbupivacainein

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9;69:291–299.17.FeldmanH,DvoskinS,HalldinMetal.Comparativelocalanestheticefficacy andpharmacokineticsofepidurallyadministeredropivacaineandbupivacainein thesheep.RegionAnesth1997;22:451–460.18.HuangY,PryorM,MatherLetal.Cardiovascularandcentralnervoussystem effectsofintravenouslevobupivacaineandbupivacaineinsheep.AnesthAnalg1998;86:797–804. PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010UniversityofSydneyAustralianVeterinaryJournalVolume88,No3,March201073

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19.BrofeldtB,CornwellP,DohertyDetal.Topicallidocaineinthetreatmentofpartial-thicknessburns.JBurnCareRehabil1989;10:63–68.20.JellishWS,GamelliRL,FurryPAetal.Effectoftopicallocalanestheticappli- cationtoskinharvestsitesforpainmanagementinburnpatientsundergoing skin-graftingprocedures.AnnSurg1999;229:115–120.21.KokinskyE,CassutoJ,SinclairRetal.Topicalwoundanaesthesiainchildren:a temporarypostoperativepainrelief.ActaAnaesthiolScand1999;43:225–229.22.SinclairR,CassutoJ,HogstromS.TopicalAnaesthesiawithlidocaineaerosolin thecontrolofpostoperativepain.Anaesthesiology1988;68:895–901.23.SmithGA,StrausbaughSD,Harbeck-WeberCetal.Comparisonoftopical anestheticswithoutcocainetotetracaine-adrenaline-cocaineandlidocaineinfil- trationduringrepairoflacerations:bupivacaine-norepinephrineisaneffectivenewtopicalanestheticagent.Pediatrics1996;97:301–307.24.StewartA,SimpsonP,RosenbergN.Useoftopicallidocaineinpediatric lacerationrepair:Areviewoftopicalanaesthetics.PediatrEmergCare1998;14:419–423. 25.DahlJB,BrennumJ,Arendt-NielsenLetal.theeffectofpre-versuspost-injury infiltrationwithlidocaineonthermalandmechanicalhyperalgesiaafterheat injurytotheskin.Pain1993;53:43–51.26.LamKW,PunTC,NgEHetal.Efficacyofpreemptiveanalgesiaforwoundpain afterlaproscopicoperationsininfertilewomen:arandomised,doubleblindand placebocontrolstudy.BrJObstetGynaecol2004;111:340–344.27.PogatzkiEM,VandermeulenEP,BrennanTJ.Effectofplantarlocalanaesthetic injectionondorsalhornneuronactivityandpainbehaviourscausedbyincision. Pain2002;97:151–161.28.PaullDR,LeeC,ColditzIGetal.Theeffectoftopicalanaestheticformulation, systemicflunixinandcarprofen,singlyorincombination,oncortisolandbehav-

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7:151–161.28.PaullDR,LeeC,ColditzIGetal.Theeffectoftopicalanaestheticformulation, systemicflunixinandcarprofen,singlyorincombination,oncortisolandbehav- iouralresponsesofMerinolambstomulesing.AustVetJ2007;85:98–106.29.RolkeR,MagerlW,CampbellKAetal.Quantitativesensorytesting:acompre- hensiveprotocolforclinicaltrials.EurJPain2006;10:77–88.30.HardieEM.RecognitionofpainbehaviourinanimalsIn:HellebrekersL,editor.Animalpain.Vanderwees,Utrecht,TheNetherlands,2000;51–69.31.KawamataM,TakahashiT,KozukaYetal.Experimentalincision-inducedpain inhumanskin:effectsofsystemiclidocaineonflareformationandhyperalgesia. Pain2002;100:77–89.32.DuarteA,PospisilovaE,ReillyEetal.Reductionofpostincisionalallodyniaby subcutaneousbupivacaine:findingswithanewmodelinthehairyskinoftherat. Anaesthesiology2005;103:113–125.33.GroerMW,ShekletonME.Basicpathophysiology:Aconceptualapproach.Mosby,StLouis,1983;643. 34.JohnstonD.Burns:electrial,chemicalandcoldinjuries.In:SlatterDH, editor.Textbookofsmallanimalsurgery.WBSaunders,Philadelphia,1985;516–533. 35.WoodG,MolonyV.Welfareaspectsofcastrationandtaildockingoflambs.InPract1992;14:2–7.36.GroseR,WernerS,KesslerDetal.Aroleforendogenousglucocorticoidsin woundrepair.EMBORep2002;3:575–582.37.MalatinskyJ,VigasM,JurcovicovaJ,JezovaD,GarayovaS,MinarikovaM.The patternsofendocrineresponsetosurgicalstressduringdifferenttypesofanes- thesiaandsurgeryinman.ActaAnaesthesiolBelg1986;37:23–32.38.FoxSM,MellorDJ,FirthECetal.Changesinplasmacortisolconcentrations before,duringandafteranalgesia,anaesthesiaandanaesthesiaplusovariohys- terectomyinbitches.ResVetSci1994;57:110–118.39.HughanSC,LooseJM,CaddyDJetal.Combinedxylazineandketamineasan analgesicregimeninsheep.AustVetJ2001;79:207–211.40.BaldiniG,BagryH,CarliF.Depthofanesthesiawithdesfluranedoesnot

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DJetal.Combinedxylazineandketamineasan analgesicregimeninsheep.AustVetJ2001;79:207–211.40.BaldiniG,BagryH,CarliF.Depthofanesthesiawithdesfluranedoesnot influencetheendocrine-metabolicresponsetopelvicsurgery.ActaAnaesthesiolScand2008;52:99–105.(Acceptedforpublication5August2009) BOOKREVIEW avj_55174..81 WheretoseebirdsinVictoria.EditedbyTimDolby,PennyJohnsandSallySymonds.PublishedforBirdsAustraliabyJacanaBooks,AllenandUnwin,NSW,Australia,2009.192pages.AUD$35.00.ISBN9781741757361.ThebookispublishedtoassistpeoplefindthespecialbirdsofVictoriawhichfromthephotographsmeanvisitingvery beautifulplacesacrossVictoria.Victoriaisdividedinto8regionsmakingiteasiertoidentifyoneofthe43placestogoand seeinterestingnativebirdsnearyouarelocated.Places,ascloseas 4kmtotheMelbourneGPO,arereliablesitesforseeingawide varietyofbirdsinhabitatrangingfromforests,wetlands,open woodlandstograsslands.Thebookoutlinesthebestseasonin whichtoseethebirdsateachofthe43locations.BeingaBirdsAustraliapublication,thebookissupportedbyregularsurveysofbirdpopulationsrecordedbyenthusiastmembers makingthelikelihoodofseeingthedescribedspecieshighlylikely.Thebookalsocontainsanannotatedlistofbirdspeciesandwherethelesscommonspecieswillbelikelyobservedinthewild.Acom- prehensiveindexprovidesforeasysearching.Picturesofthegeneralhabitatandsomebirdslikelytobeseenateachlocationareincludedandareofexcellentquality.Thebookis ofasizesuitableforhandcarriagewhilebirdspottingandkeeping inthegloveboxofthecarreadyforanothertwitchingsession.AndrewTurnerPrincesHillVictoria.doi:10.1111/j.1751-0813.2010.00551.x PRODUCTIONANIMALSPRODUCTIONANIMALS ©2010TheAuthorsJournalcompilation©2010AustralianVeterinaryAssociationAustralianVeterinaryJournalVolume88,No3,March201074