Effects of peripheral active warming and passive insulation on core body temperature during feline ovariohysterectomy: a multi-arm randomized clinical trial

Abstract

Objectives: Hypothermia is a common complication of anesthesia, particularly in cats. Some veterinarians insulate the extremities of cats as a preventive measure, and there is evidence that heating the extremities of dogs decreases the rate of heat loss from the core. This study investigated whether active warming or passive insulation of the extremities of cats resulted in a slower decrease in rectal temperature during anesthesia.

Methods: Female cats were assigned via block randomization to passive (cotton toddler socks), active (heated toddler socks) or control group (uncovered extremities). Rectal temperature was monitored every 5 mins from induction through return to trap/carrier (final temperature). Multivariable linear regression models were used to compare temperature (rate change and final) between groups.

Results: There were 164 cats with 1757 temperature readings. Mean total duration of anesthesia was 53 ± 13 mins. The temperature of all groups decreased linearly over time (all P <0.0001), with the rates of temperature decrease being -0.039°F/min (95% confidence interval [CI] -0.043 to -0.035)/-0.022°C (95% CI -0.024 to -0.019), -0.039°F/min (95% CI -0.042 to -0.035)/-0.022°C (95% CI -0.023 to -0.019) and -0.029°F/min (95% CI -0.032 to -0.025)/-0.016°C (95% CI -0.018 to -0.014) for the control, passive and active groups, respectively. The control, passive and active groups had median final temperatures of 98.4°F (interquartile range [IQR] 97.6-99.4)/36.9°C (IQR 36.4-37.4), 98.0°F (IQR 97.2-98.7)/36.7°C (IQR 36.2-37.1) and 99.1°F (IQR 97.7-100.0)/37.3°C (IQR 36.5-37.8), respectively. After controlling for weight, postinduction temperature and duration of anesthesia, and as compared with controls, the final temperature of the active group was predicted to be 0.54°F (95% CI 0.03-1.01)/0.3°C (95% CI 0.02-0.56) greater (P = 0.023), while the passive group was not significantly different (P = 0.130).

Conclusions and relevance: The rate of rectal temperature decrease was significantly slower for the active group compared with the other groups. Although the cumulative difference in final temperature reading was modest, superior materials might enhance performance. Cotton toddler socks alone did not slow the rate of temperature decrease.

Keywords: Anesthesia; anaesthesia; high-quality high-volume spay–neuter; hypothermia; shelter medicine; surgery; trap–neuter–vaccinate–return.

Figure 1

Sock placement and radiant heat imaging for (a,d) control, (b,e) passive and (c,f) active groups

Figure 2

Frequency distribution of final temperature reading for (a) control, (b) passive and (c) active groups overlaid with kernel density estimate (solid green line) and normal curve (dashed blue line)

Figure 3

Scatterplot of temperature over time for each of the groups overlaid with Lowess lines. Lowess was constrained to 60 mins due to comparatively few data points after 60 mins (n = 101/1757 temperature readings)