Does Alfaxan change your cardiac measurement?

The effects of alfaxalone on cardiac and pulmonary vascular size in cats evaluated by thoracic radiography and echocardiography

Michael Schettler, Merrilee Holland, Erik Hofmeister, Randolph Winter

Background
This study investigates the effects of alfaxalone, a neuroactive steroid sedative, on the radiographic and echocardiographic appearance of cardiac and pulmonary vascular structures in cats. Alfaxalone has gained popularity as a sedative agent due to its minimal impact on cardiovascular function compared to other sedatives, such as dexmedetomidine, which can artificially enlarge the cardiac silhouette.

Methods
This prospective, partially blinded, randomized study included 11 healthy adult cats from a research colony. Baseline thoracic radiographs (four views) and echocardiograms were obtained without sedation. Following intramuscular administration of 5 mg/kg alfaxalone, the same imaging studies were repeated. Vertebral heart score (VHS) and pulmonary vascular measurements were assessed by blinded observers. Echocardiographic parameters, including left atrial diameter and pulmonary artery dimensions, were measured by a nonblinded echocardiographer. Statistical comparisons were made using paired t-tests and ANOVA.

Results
No significant changes were observed in vertebral heart scores or pulmonary vascular measurements after alfaxalone administration. Echocardiographic parameters, including left ventricular dimensions, fractional shortening, and pulmonary artery and vein ratios, also showed no significant differences. Minor side effects of alfaxalone included transient muscle rigidity, twitching, and arrhythmia in a few cats. These effects resolved after recovery.

Limitations
The study's small sample size may limit the detection of minor changes. The lack of electrocardiographic monitoring precluded detailed arrhythmia characterization. Observer variability in VHS measurements and challenges in delineating certain pulmonary vascular structures introduced potential measurement bias.

Conclusions
Alfaxalone does not significantly affect cardiac or pulmonary vascular size on radiography or echocardiography in healthy cats. These findings support its use as a suitable sedative for cardiovascular imaging in cats, offering reliable diagnostic outcomes without altering the appearance of cardiovascular structures.

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