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Ioannis Savvas
Companion Animal Clinic
Faculty of Veterinary Medicine
Aristotle University of Thessaloniki
Greece
isavas@vet.auth.gr
Assistant Professor of Veterinary Anaesthesia

Journal articles

2008
 
DOI   
PMID 
Tilemahos L Anagnostou, Ioannis Savvas, George M Kazakos, Dimitris Raptopoulos, Haralabos Ververidis, Nikolaos Roubies (2008)  Thiopental and halothane dose-sparing effects of magnesium sulphate in dogs.   Vet Anaesth Analg 35: 2. 93-99 Mar  
Abstract: OBJECTIVE :To evaluate the effect of pre- and intraoperatively administered magnesium sulphate (MgSO(4)) on the induction dose of thiopental and of halothane for maintenance of anaesthesia in dogs undergoing ovariohysterectomy (OHE). STUDY DESIGN: Prospective, double-blind, randomized, placebo-controlled study. ANIMALS: Forty-six healthy, ASA physical status 1 dogs, scheduled for elective OHE. METHODS: The dogs were randomly assigned to receive a bolus of 50 mg kg(-1) MgSO(4) intravenously (IV), just before induction of anaesthesia, followed by a constant rate infusion (CRI) of 12 mg kg(-1) hour(-1) MgSO(4) intraoperatively (group Mg, n = 27) or a placebo bolus and CRI of 0.9% sodium chloride (NaCl) (group C, n = 19), approximately 30 minutes after premedication with acepromazine (0.05 mg kg(-1), intramuscularly, IM) and carprofen (4 mg kg(-1), subcutaneously, SC). Anaesthesia was induced with thiopental administered to effect and maintained with halothane in oxygen. End-tidal halothane (ET(hal)) was adjusted to achieve adequate depth of anaesthesia. Blood samples were obtained pre- and postoperatively for measurement of total serum magnesium concentration. RESULTS: The mean dose of thiopental was statistically lower (p < 0.0005) and the mean standardized ET(hal) concentration and end-tidal carbon dioxide partial pressure (Pe'CO(2)) areas under the curve were statistically smaller (p < 0.0005 and 0.014 respectively) in group Mg. Postoperatively the mean total serum magnesium concentration was statistically higher than the preoperative value (p < 0.0005) in group Mg, but not in group C. Nausea, associated with the MgSO(4) bolus injection, was observed in six dogs in group Mg, two of which vomited prior to induction of anaesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Magnesium sulphate administration reduced the induction dose of thiopental and ET(hal) concentration for maintenance of anaesthesia in dogs undergoing OHE. Observed side effects were nausea and vomiting.
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PMID 
Ioannis Savvas, Lysimachos G Papazoglou, George Kazakos, Tilemahos Anagnostou, Vassiliki Tsioli, Dimitris Raptopoulos (2008)  Incisional block with bupivacaine for analgesia after celiotomy in dogs.   J Am Anim Hosp Assoc 44: 2. 60-66 Mar/Apr  
Abstract: A blind, placebo-controlled clinical trial was performed to evaluate the postoperative analgesic effect of preoperative infiltration of the incision site with bupivacaine in dogs undergoing celiotomy. Sixty dogs were randomly allocated into four groups: preoperative bupivacaine, postoperative bupivacaine, preoperative saline, and postoperative saline. All dogs were premedicated with acepromazine and meperidine; then they were anesthetized with thiopentone and isoflurane. Each group received either bupivacaine or normal saline before midline incision or just before skin closure. After surgery, pain scores were assigned using a numerical rating scale. Preoperative bupivacaine was associated with significantly lower pain scores and a significantly lower need for opioid administration. The authors conclude that a preoperative incisional block with bupivacaine seems to be a useful adjunct for controlling pain after celiotomy in dogs.
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2007
 
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Konstantinos Tsalis, Konstantinos Blouhos, Konstantinos Vasiliadis, Stavros Kalfadis, Theodoros Tsachalis, Ioannis Savvas, Dimitrios Betsis (2007)  Bloodless laparoscopic liver resection using radiofrequency thermal energy in the porcine model.   Surg Laparosc Endosc Percutan Tech 17: 1. 22-25 Feb  
Abstract: The aim of this study was to assess the feasibility and safety of laparoscopic hepatectomy using radiofrequency (RF) thermal energy in a porcine model. Fifteen female domestic pigs weighing 29.3 kg (range 25 to 35 kg) were used. Five transversal abdominal incisions (3 of 1 cm and 2 of 0.5 cm) were made for the introduction of the video camera and the other laparoscopic instruments. With the porta hepatis not clamped, the liver was inspected and the preferred lobe each time was divided using RF (cool-tip electrode 3 cm) with minimum bleeding. Serum liver enzymes and blood counts were drawn pre and postoperatively. All animals were killed after 1 week. The mean time of the procedures was 119 minutes (range 100 to 155 min). There were no intraoperative complications. Mean blood loss was 27 mL (range 5 to 60 mL), and the mass of the resected specimen was 132.5 g (range 65 to 305 g). There were no postoperative complications or deaths. Bloodless laparoscopic hepatectomy was technically feasible and safe in the porcine model using cool-tip electrode and 500-kHz RF Generator.
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G M Kazakos, I Savvas, Raptopoulos (2007)  Pain management in cat   Journal of the Hellenic Veterinary Medical Society 58: 257-269  
Abstract: Although cats are very popular pets, pain in this species is often underestimated. The reasons for this may include difficulties in pain recognition, unfamiliarity with the use of opioids or non-steroidal analgesic drugs, and with the application of local analgesic techniques. Proper pain management should always be undertaken mainly for medical and humane purposes. Pre-emptive and multimodal analgesia can aid significantly in postoperative pain alleviation. Nowadays, the veterinarian’s armamentarium is equipped with a variety of agents in order to alleviate pain in cats. Non-steroidal anti-inflammatory drugs are often as effective as opioids. The latter are now used successfully for pain management in cats. Both classes provide safe analgesia, taking into account the differences in metabolism between cats and other species. Adjunctive analgesic therapy may be provided with the use of ketamine or 945;2-adrenergic receptor agonists. Loco-regional analgesic techniques can be used to effectively manage pain in a variety of clinical settings.
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George M Kazakos, Tilemahos Anagnostou, Ioannis Savvas, Dimitris Raptopoulos, Dimitra Psalla, Irene M Kazakou (2007)  Use of the laryngeal mask airway in rabbits: placement and efficacy.   Lab Anim (NY) 36: 4. 29-34 Apr  
Abstract: The laryngeal mask airway (LMA) has been used in various animal species anesthetized for the purpose of device evaluation, but the device has not been evaluated in rabbits during surgery. The authors tested the feasibility and potential advantages of using the LMA in 50 rabbits undergoing surgery under spontaneous-breathing inhalational anesthesia, focusing mainly on the technique of insertion and its efficacy. The LMA was easily inserted and no air leakage at the larynx was detected. Although four rabbits developed lingual cyanosis, this was reversible and most likely due to lingual vascular compression by the LMA. The authors conclude that the LMA is an attractive alternative to endotracheal intubation, as the mask can be inserted easily and rapidly and its correct placement is easily confirmed.
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2006
 
PMID 
K Plevraki, A F Koutinas, H Kaldrymidou, N Roumpies, L G Papazoglou, M N Saridomichelakis, I Savvas, L Leondides (2006)  Effects of allopurinol treatment on the progression of chronic nephritis in Canine leishmaniosis (Leishmania infantum).   J Vet Intern Med 20: 2. 228-233 Mar/Apr  
Abstract: Forty dogs with canine leishmaniosis (CL) participated in this study, which was designed to investigate the effect of allopurinol on the progression of the renal lesions associated with this disease. The animals were allocated into 5 groups. Group A dogs (n = 12) had neither proteinuria nor renal insufficiency, group B dogs (n= 10) had asymptomatic proteinuria, and group C dogs (n = 8) were proteinuric and azotemic. Two more groups, CA and CB, comprising 5 dogs each, served as controls for groups A and B, respectively. Group A, B, and C dogs received allopurinol PO (10 mg/kg q12h) for 6 months, whereas group CA and CB dogs were placebo-treated. Serum biochemistry profile, urinalysis, urine protein/creatinine ratio, and glomerular filtration rate (GFR) measurements were carried out at the beginning of the study, the 3rd month, and the 6th month, whereas renal biopsies were carried out only at the beginning and the end of the trial. Membranoproliferative glomerulonephritis was the most common cause of chronic renal failure. Mesangioproliferative and tubulointerstitial nephritis were detected even in group A and CA dogs. Allopurinol not only lowered proteinuria in group B dogs but also prevented the deterioration of GFR and improved the tubulointerstitial, but not the glomerular, lesions in both group A and group B dogs. Further, it resolved the azotemia in 5 of the 8 dogs admitted with 2nd stage chronic renal failure (group C). Consequently, treatment with allopurinol is advisable in CL cases with asymptomatic proteinuria or 1st-2nd stage chronic renal failure.
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I Savvas (2006)  Seizure activity after xylazine administration in a horse   Journal of the Hellenic Veterinary Medical Society 57: 116-121 June 2006  
Abstract: A vicious stallion, schedule for castration, became very stressed during the attempts to place a jugular catheter. Finally, xylazine was injected directly from the syringe into the jugular vein and immediately the animal fell down and developed seizures. Acepromazine and fluids were administered to successfully treat the condition. No evidence of haematoma formation was noticed. Xylazine in stressed animals may activate a1-adrenoceptors, resulting to central neural system excitement and seizures. Moreover, xylazine may had sensitized the myocardium to endogenous catecholamines, resulting to cardiac arrhythmias, cerebral hypoxia and seizures. Xylazine administration in stressed animals may increase the incidence of adverse reactions.
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Ioannis Savvas, Tilemahos Anagnostou, Lysimachos G Papazoglou, Dimitris Raptopoulos (2006)  Successful resuscitation from cardiac arrest associated with extradural lidocaine in a dog.   Vet Anaesth Analg 33: 3. 175-178 May  
Abstract: BACKGROUND: Extradural lidocaine exerts several adverse effects which are seldom fatal. While cardiac arrest following extradural lidocaine injection has been reported in human beings, it has not hitherto been reported in dogs. OBSERVATIONS: The emergency management of a dog with complete urethral obstruction is described. We intended to perform vaginoscopy and cystostomy under extradural lidocaine anaesthesia, but cardiac asystole occurred a few minutes after injection. Resuscitation was successful. About 20 minutes later cardiac arrest recurred, and was treated successfully. The dog remained hypothermic for approximately 7 hours. Complete recovery without neurological deficit occurred the next day and the dog remained normal for at least 3 months. The probable cause of the problem was cranial lidocaine dispersion causing a drop in cardiac preload and cardiac arrest. The successful neurological outcome was attributed to early diagnosis and effective treatment. Hypothermia may have conferred cerebral protection during ischemia. CONCLUSIONS: Extradural local anaesthetic administration is not without risk and the technique should be tailored to individual animals. Constant monitoring is required to detect potentially fatal complications and increase the likelihood of successful outcome.
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2005
 
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PMID 
Ioannis Savvas, Katerina Plevraki, Dimitris Raptopoulos, Alexandros F Koutinas (2005)  Blood gas and acid-base status during tiletamine/zolazepam anaesthesia in dogs.   Vet Anaesth Analg 32: 2. 94-100 Mar  
Abstract: OBJECTIVE: To evaluate the effect of the tiletamine/zolazepam (TZ) combination (Zoletil 100; Virbac, Carros, France) with and without atropine on blood gas values and acid-base status in dogs. STUDY DESIGN: Randomized cross-over experimental study. ANIMALS: Six healthy adult cross-bred dogs, weighing 11.0-18.5 kg. MATERIALS AND METHODS: Each dog received four different drug treatments at intervals of at least 15 days: (i) 5 mg kg(-1) intravenous (IV) TZ (TZ.IV); (ii) 10 mg kg(-1) intramuscular (IM) TZ (TZ.IM); (iii) atropine, 20 microg kg(-1) IV, followed 5 minutes later by 5 mg kg(-1) TZ IV (A.TZ.IV); and (IV) atropine (same dose) given 5 minutes before 10 mg kg(-1) TZ IM (A.TZ.IM). Arterial blood samples were collected from each dog before drug administration (baseline) at induction of anaesthesia (time 0) and 2, 5, 10 and 30 minutes thereafter. RESULTS: Transient hypoxaemia and respiratory acidosis were observed just after induction. PaO(2) and SaO(2) dropped, while H(+) concentration and PaCO(2) rose significantly above baseline values. In groups TZ.IV and A.TZ.IV, PaO(2) values as low as 6.0-6.4 kPa (45-48 mm Hg) were recorded. However, there was no significant difference in blood gas variables among the groups encountered during the evaluation period. The overall change in [HCO(3) (-)] and base excess (BE) was not significant among groups. Atropine did not affect the above variables. CONCLUSIONS AND CLINICAL RELEVANCE: Tiletamine/zolazepam injection may induce transient hypoxaemia and respiratory acidosis, but acid-base status changes are clinically unimportant. Particularly, close observation of dogs is recommended during the first 5-10 minutes after induction with TZ, especially in animals with cardiopulmonary disease. TZ should perhaps not be used in animals intolerant of tachycardia.
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A Th Komnenou, I Georgopoulou, I Savvas, A Dessiris (2005)  A retrospective study of presentation, treatment, and outcome of free-ranging raptors in Greece (1997-2000).   J Zoo Wildl Med 36: 2. 222-228 Jun  
Abstract: A retrospective study was conducted on free-ranging raptors (n = 402) presented to the Veterinary Medical Teaching Hospital, School of Veterinary Medicine, Aristotle University of Thessaloniki, Greece, during a 3-yr period (1997-2000). Representatives of 19 species were admitted from taxonomic orders Accipitriformes (n = 295), Falconiformes (n = 35), and Strigiformes (n = 72). Traumatic injuries (n = 305, 75.8%) were the most common cause of presentation in all raptors. Starvation (n = 38 birds, 9.4%) was the second most common reason, whereas toxicoses (n = 28, 6.9%) were suspected in a limited number of birds. Orphans (n = 31, 7.7%) were presented during breeding season primarily because of inappropriate human intervention. Surgical and medical treatment was given to all birds when necessary. In total, 229 (56.9%) of the presented raptors were successfully rehabilitated and released, 121 (30%) were rehabilitated but nonreleasable, whereas 52 (12.9%) of them died despite treatment. Human intervention (79.2%) plays the most important role in birds of prey morbidity and mortality.
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2004
2003
 
PMID 
M N Patsikas, L G Papazoglou, N G Papaioannou, I Savvas, G M Kazakos, A K Dessiris (2003)  Ultrasonographic findings of intestinal intussusception in seven cats.   J Feline Med Surg 5: 6. 335-343 Dec  
Abstract: The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a 'kidney' configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.
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PMID 
A Th Komnenou, G K Georgiades, I Savvas, A Dessiris (2003)  Surgical treatment of gastric impaction in farmed ostriches.   J Vet Med A Physiol Pathol Clin Med 50: 9. 474-477 Nov  
Abstract: Partial or complete impaction of the proventriculus and/or the ventriculus is usually seen in juvenile ostriches. Common impaction materials include stones, sand, hay stems and leaves, and even plastic and metallic objects. Six live ostriches showing signs of impaction and three dead ones suspected to have impacted stomachs were presented to the Department of Clinical Sciences of the Faculty of Veterinary Medicine of the Aristotle University of Thessaloniki. The birds manifested anorexia, whitish and decreased urine output, scant defecation, unwillingness to rise and consume water. Clinical examination revealed distended and firm proventriculi, while radiographs showed foreign objects in the proventriculi of all birds and the ventriculus of one of them. The living birds were successfully treated surgically and medically. Autopsy of the three dead ostriches revealed severe dehydration and impaction of the stomachs. Bacteriological and parasitological examination was negative. Amendments in management practices were important to minimize losses caused by impaction of the stomachs in ostriches, while proventriculotomy remains the most effective approach to the problem.
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2001
 
PMID 
A D Galatos, I Savas, N N Prassinos, D Raptopoulos (2001)  Gastro-oesophageal reflux during thiopentone or propofol anaesthesia in the cat.   J Vet Med A Physiol Pathol Clin Med 48: 5. 287-294 Jun  
Abstract: Lower oesophageal pH was monitored in 50 cats anaesthetized with either thiopentone or propofol. Gastro-oesophageal reflux, as evidenced by a decrease in lower oesophageal pH to less than 4.0 or an increase to more than 7.5, occurred in 16% (4/25) and 12% (3/25) of the cats anaesthetized with thiopentone and propofol, respectively, the difference between the two groups being non-significant. Reflux usually occurred shortly after the induction of anaesthesia and had a mean duration of about 23 min. The refluxate was always acidic (pH < 4.0). Gastric contents of pH below 2.5 were refluxed on three occasions, two in the thiopentone group and one in the propofol group. Regurgitation and flow of gastric contents from the mouth occurred in only one cat anaesthetized with propofol. None of the cats that exhibited reflux developed any signs of postanaesthetic oesophagitis or stricture formation.
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