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2013 - 20168
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Subject: Veterinary Surgery and Radiology × End date: 2016 × Start date: 2010 × Type: Thesis ×
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    ThesisItemOpen Access
    SURGICAL AFFECTIONS IN PIGS WITH SPECIAL REFERENCE TO UMBILICAL HERNIA
    (Assam Agricultural University, Khanapara, Guwahati, 2016-07) BUCHEM, Y. BAUAN; Gogoi, Dimbeswar
    The survey work on pigs were carried out at AICRP, MSP and 30 Sow Teaching Unit of C.V.Sc. pig farms and places of ambulatory classes viz. Kamalpur Veterinary Dispensary, Hajo Veterinary Hospital and Halogaon Veterinary Dispensary from 1st February 2015 to 31st January 2016 to study the incidence of different surgical problems in pigs. A total of 2,820 numbers of pigs were surveyed and out of which 77 numbers (2.73 %) of pigs were affected with various surgical affections. Age group between 0-3 months 44 (57.14 %) recorded the highest incidence rate and the lowest 1 year and above 6 (7.80 %), male had higher incidence rate 44 (57.14 %) to female 33 (42.86 %). Breed wise incidence of different surgically affected pigs were found to be non-significant as all the animals surveyed were of only cross breeds. On the basis of different surgical affections, umbilical hernia recorded the highest incidence rate 27 (35.07%), while wound and inguinal hernia were the lowest with 5 (6.49%). Summer season recorded the highest incidence 32 (41.56%) and winter the lowest 8 (10.39%). C.V.Sc pig farms recorded higher incidence rate 36 (46.75 %) in comparison to the other three surveyed places. From the surveyed animals, 12 numbers of pigs affected with umbilical hernia were selected for the present study and were divided into 2 groups irrespective of the age, sex and breed. Group I animals, where the hernial ring was less than 4 cm (approximately 2 fingers breadth) were rendered herniorrhaphy with prolene suture while Group II animals, where the hernial ring was more than 4 cm (approximately 4 fingers breadth) hernioplasty with prolene mesh was carried out. The clinical parameters viz. pulse rate, respiration rate and rectal temperature and haematological parameters viz. Hb, PCV, TEC, TLC and DLC were recorded on the day before the surgery and on 3rd, 7th and 14th post-operative days to evaluate the efficacy of the surgical procedure. The recorded parameters did not show any significant changes. There was slight increase or decrease in their values during the recorded days which were within the physiological range. The rendered surgical procedure of herniorrhaphy with polypropylene suture in group I and hernioplasty with polypropylene mesh in group II to the pigs affected with umbilical hernia were found to be effective without any post-operative complications. Evaluation of healing was done on the 3rd, 7th and 14th post-operative days to record the changes. There were peripheral swelling and exudation during the initial stage of wound healing which were followed by scab formation on the 7th day and complete healing was noticed in both the groups by 14th day. These were normal phenomenon characterized in the course of wound healing. The healing process of wound in both the groups were found to be good with no untoward complications.
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    ThesisItemOpen Access
    SURVEILLANCE OF FOOT AFFECTIONS IN STALL FED DAIRY CATTLE AND THEIR SURGICO-MEDICAL MANAGEMENT
    (Assam Agricultural University, Khanapara, Guwahati, 2016-07) BHAGABATI, KRISHANU KR.; Sarma, Kushal Konwar
    Bovines are the productive animals. Any sort of disease or discomfort of these sensitive animals may lead to decreased production and corresponding economic losses to the farmers. Healthy feet and legs are of utmost concern for dairy cows’ well-being and performance, but the same is intimately related to the management conditions and floor patterns. Feet affections occur when the integrity of climate and structure of floor where animals are kept is rendered defective. Challanges of diseases are also increasing with the increase of the cross bred dairy animal population to meet up the increasing demand and needs of milk augments. Many cases of foot affections in the stall fed dairy cows in and around Khanapara, Guwahati city have been noticed by the practitioners but a systematic study and record of the diseases is still lacking. So the present experiment was undertaken to study incidence of the affections, haematological and biochemical changes in foot affections in relation to clinically healthy animals and to evaluate few prevailing therapeutic measures. Incidence was studied in terms of type of affections, age, season, flooring pattern, lactation number, foot affected and feeding practices. Five animals affected in each summer and winter season with feet affections were considered for investigation. A total of 1760 (one thousand seven hundred and sixty) dairy cows were surveyed in the present investigation out of which 98 (5.568%) animals were found to be affected with various foot lesions. Different types of foot affections were Hoof overgrowth (59.184%), Scissor Claw (30.612%), Heel Erosion (6.122%) and Interdigital Hyperplasia (4.082%). Highest incidence of foot affections were found in the age group of 4-6 years (55.102%) and lowest for 0-2 year’s age group (1.020%). Out of three different floor patterns observed in the area of survey, highest incidence was found for those animals which were maintained in brick floor (65.307%), second highest for wooden floor (23.469%) and lowest for concrete floor (11.224%). Seasonal variation was also found for the incidence of the affections. Highest for summer (60.204%) followed by winter (39.796%). Out of total affected animals fore foot affections were comparatively high than hind foot (50% and 32.653% respectively). In 17.347 percent animals foot affections could be noted on both fore and hind limbs. Highest incidence of the disease was found in animals of 3rd lactation (51.020%). Out of total affected animals foot affections were comparatively high in those that were provided high concentrate ration (67.347%). Haematological investigation showed that mean values of Hb, Lymphocyte and Monocyte did not differ significantly between normal and affected animals in both summer and winter season. Mean values of RBC, WBC and PMN in affected animals were significant in summer with values being 5.74±0.623, 5.97±1.692 and 33.6±1.435 compared to the mean values of normal animals. Mean value of TLC in affected animals were significant in winter with value being 9±1.048. While the mean values of PCV, Neutrophil, Eosinophil and Basophil were significant between normal and affected animals in both the two seasons. Biochemical test revealed that mean values of ALP and Creatinine were significant in winter with values being 211.6±52.384 and 1.0044±0.173 respectively compared to the mean values of normal animals. While the mean values of AST and Creatine Kinase were significant between normal and affected animals in both the two seasons. Bacteriological investigation revealed both Gram positive and Gram negative organisms from infected hoof lesions. Three samples out of ten showed Streptococcus and Staphylococcus organisms and rest of the samples showed Gram negative coccobacilli. Sensitivity test of samples showed resistance to Enrofloxacin, Erythromycin, Ampicillin and Amoxicillin but sensitive to Gentamicin and Tetracycline. Four samples out of ten showed sensitivity to ceftiofur but 6 samples were resistance to ceftiofur. Affected animals were treated according to the type of affections. Secondary bacterial infection as seen in bacterial culture and sensitivity test were treated with specific antibiotics. Meloxicam @15ml/375 kg b.w was administered intra muscularly in cases where pain was evidenced. Hoof trimming was done under sedation with Xylazine Hydrochloride @0.05-0.22mg/kg b.w in cases of hoof overgrowth and scissor claw. Cases of inter-digital hyperplasia with associated wound were treated with local application of antiseptic and antibiotic powder followed by a course of systemic antibiotic. Animals with heel horn erosion condition were managed by reducing both the heels to the same height.
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    ThesisItemOpen Access
    COMPARATIVE EVALUATION OF NANOSILVER, UNPASTEURIZED HONEY AND TURMERIC IN THE TREATMENT OF FULL THICKNESS CONTAMINATED CUTANEOUS WOUND IN RABBITS
    (Assam Agricultural University, Khanapara, Guwahati, 2016-07) PRADHAN, EKTA; Sarma, K. K.
    The present study was carried out on experimentally created full-thickness contaminated cutaneous wounds in New Zealand White rabbits with an aim to evaluate the healing efficacy of nanosilver, unpasteurized honey and turmeric. The experiment was carried out on 15 apparently healthy New Zealand White rabbits of either sex, divided into 3 equal groups. Full-thickness cutaneous wounds of 4x4 cm were created on the thoraco-lumbar region on either sides of the vertebral column under general anaesthesia and were left unattended for 48 hours to render it contaminated. Group A, Group B and Group C were subjected to ‘Silverkind Nanofine’ (nanosilver), unpasteurized honey and turmeric paste respectively. The rate of wound healing and macroscopic changes were recorded on the 3rd, 7th, 10th, 15th and 20th days of post wound creation. The bacteriological and biochemical investigation were performed on the 3rd, 5th, 7th and 10th days of post-wound creation and the histopathological investigations on the 3rd, 10th and 28th days of experiment. The rate of wound healing was found to be the fastest in nanosilver treated group, followed by the ones with unpasteurized honey and turmeric till the 28th day of experiment. Various macroscopic changes were observed during the course of treatment viz. peripheral swelling, serous exudation, dry casts over the wound, proliferating pinkish granulation tissue and fast contracting wound edges with re-epithelialization. However, clinically complete wound healing was observed on the 20th day of post-wound creation in Group A. The bacteriological investigation revealed presence of coagulase positive Staphylococcus spp., coagulase negative Staphylococcus spp. and Escherichia coli at the initial stages and eventually became a sterile wound by the 10th day of post-wound creation in both nanosilver based ointment and unpasteurized honey. Higher levels of total protein and carbohydrate were observed in Group B and Group C while the enzymatic investigations revealed decreasing levels of creatine kinase and aspartate aminotransferase which was more significant in Group A (P<0.01). The histopathological studies on the 28th day of post-wound creation revealed clinically complete healing in Group A with regeneration of all the epidermal layers and associated adnexa and better reorganization of the thick collagen bundles. From the above findings, it could be drawn that use of nanosilver based ointment was found to more effective in terms of wound healing of contaminated cutaneous wounds compared to the other two treatment regimes.
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    ThesisItemOpen Access
    COMPARATIVE STUDY BETWEEN INTERLOCKING NAILING (ILN) AND INTRAMEDULLARY PINNING FOR THE TREATMENT OF FRACTURE OF FEMUR IN CANINE
    (Assam Agricultural University, Khanapara, Guwahati, 2016-07) BAPAT, CHANDRASHEKHAR GIRISH; Sarma, K. K.
    The present study was undertaken to compare the use of Interlocking nailing (ILN) and Intramedullary Pinning for the treatment of canine femur fracture cases. A total of 773 cases were presented in the Teaching Veterinary Clinical Complex (Surgery Unit) and Department of Veterinary Surgery and Radiology, College of Veterinary Science, A.A.U., Khanapara during the period of 1st April, 2015 to 31st March, 2016. Out of 265 orthopedic cases 197 (74.34%) were found in canine. According to the distribution of the canine cases with signs of lameness, it was found that fracture incidences were the highest (65.48%) followed by dislocations (18.27%) and neurological disorders (16.24%). Further, fracture distribution in bones was recorded and highest was in femur (44.19%) followed by tibia/fibula (13.18%) and radius/ulna (10.85%). Ten clinical cases of canine diphyseal fracture of femur irrespective of age and sex were randomly divided into two groups. In Group A and Group B, correction of fracture was done by using intramedullary pinning and interlocking nailing respectively. Hematological and biochemical analysis were done on 0 day, 5th, 10th and 20th days post-operatively while radiographic evaluation and weight bearing test were done on 0 day, 10th, 20th, 30th and 60th days post-operatively. The cost of surgery and time taken for surgery were compared. Hematological estimation of Hb, TEC, TLC, ESR and PCV were done. Biochemical estimation of Alkaline phosphatase, Creatine kinase, Serum Calcium, Serum Phosphorous and total protein were done. Haematological parameters and Biochemical parameters showed non-significant alterations for both the groups except ALP levels showed significant difference within normal limits. Radiographic evaluation revealed secondary healing with hard callus formation in group A and primary healing with negligible callus formation in group B. Weight Bearing Test revealed 100% recovery in 2 out of 5 cases (40%) and 4 out of 5 cases (80%) in group A and group B respectively. Cost of implants was lesser in group A (Rs. 276/-) than group B (Rs. 1440/-). Time required for surgery was longer in group B (101 minutes) than group A (42 minutes). Based on the present findings, interlocking nailing was considered better than intramedullary pinning.
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    ThesisItemOpen Access
    ROMIFIDINE AND ITS COMBINATION WITH KETAMINE IN DOG
    (Assam Agricultural University, Khanapara, Guwahati, 2016-07) SAIKIA, ANANGSHA; Sarma, B.
    Fifteen clinically affected dogs of either sex and different age groups were divided into three groups consisting of five dogs in each. Intramuscular injection of romifidine @ 40 µg/kg b. wt. was injected to group I; romifidine @ 30 µg/kg b. wt. and ketamine @ 5 mg/kg b. wt. to group II and romifidine @ 40 µg/kg b. wt. along with ketamine @ 5mg/kg b. wt. to group III. The induction time of 12.80 ± 0.80, 8.40 ± 0.24 and 5.80 ± 0.37 mins; duration of anaesthesia of 50.20 ± 1.11, 64.40 ±0.81 and 76.20 ± 0.96 mins and recovery time of 69.40 ± 2.29, 86.40 ± 0.74 and 94.40 ± 0.67 mins were recorded in group I, II and III. Complete analgesia was present in group III. All the animals exhibited muscle relaxation, cessation of tail movement and salivation. Smooth induction and recovery were recorded in all the groups. In dogs of all the groups heart rate, respiration rate, rectal temperature, tidal volume, minute volume and oxygen saturation decreased significantly (p < 0.05). Mean arterial pressure increased significantly (p < 0.05) in all three groups. Haemoglobin and total erythrocyte count decreased significantly (p < 0.05) in all the groups. Non-significant (p > 0.05) reduction of packed cell volume was recorded in group I while significant (p < 0.05) decreased level was recorded in group II and III. Total protein decreased non-significantly (p>0.05) in group I but significant (p<0.05) decrease of total protein was recorded in other two groups. GGT, blood glucose, alkaline phosphatase, BUN, creatinine and cortisol increased significantly (p<0.05) in all the groups. Based on the observation, romifidine @ 40 g/kg b. wt. and ketamine @ 5 mg/kg b. wt. could be recommended for surgical procedures. Romifidine @ 30 g/kg b. wt. and ketamine @ 5mg/kg b. wt. is suggestive for minor surgical procedure while romifidine @ 40g /kg b. wt. is not recommended for clinical use.
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    ThesisItemOpen Access
    EVALUATION OF BALANCED ANAESTHESIA IN PIGS (Sus scrofa domesticus)
    (Assam Agricultural University, Khanapara, Guwahati, 2013-07) CHHAKCHHUAK, ROSANGZUALI; Sarma, Kushal Konwar
    Thirty (30) clinically healthy weaned mixed breed male piglets (2 to 3 months of age weighing 7 to 14 kg) were used for the experiment and randomly divided into five (5) anaesthetic groups (Groups I, II, III, IV and V) consisting of six (6) piglets in each group. The anaesthetic combinations were administered intramuscularly in quick succession as follows :- Group I : Xylazine-Ketamine @ 2 mg/kg and 15 mg/kg b. wt. IM, respectively. Group II : Medetomidine-Ketamine @ 80 µg/kg and 15 mg/kg b. wt. IM, respectively. Group III : Azaperone-Ketamine @ 4 mg/kg and15 mg/kg b. wt. IM, respectively. Group IV : Acepromazine-Ketamine @ 0.1 mg/kg and 15 mg/kg b. wt IM, respectively. Group V : Triflupromazine-Ketamine @ 2 mg/kg and 15 mg/kg b. wt. IM, respectively. The various observations of the present research work could be summarized as follows: CLINICAL OBSERVATIONS • Induction time was shortest in Group II and longest in Group I. Groups III, IV and V exhibited similar intermediate induction time. • The duration of anaesthesia, initial recovery and absence of righting reflex was the longest in Group II followed by Group IV, Group I, Group III and Group V, respectively. • The clinical recovery was the longest in Group II followed by Group I, Group IV, Group III and Group V, respectively. • The induction was smooth and rapid, and recovery uneventful in all the anaesthetic combination groups. • Analgesia was excellent in Group II, good in Groups I and III, and fair in Groups IV & V. • Muscle relaxation was maximum and of the longest duration in Group II piglets. • Moderate to profuse salivation was observed in Groups III, IV and V. • The palpebral reflex, pupillary light reflex and corneal reflex were present with varying intensity during the entire study period in all groups, except in Group II. • In Groups I, II and III, the pedal and pin-prick reflexes were abolished at certain period of observation during the study whereas it remained positive with varying degree during the entire period of observation in Groups IV and V. • Muscle tremor, occasional limb paddling and mild opisthotonus condition were observed in Groups III, IV and V, but were absent in Groups I and II. • The eyeball position was central with negative palpebral reflex at 30th and 45th minutes of observation in Group II piglets indicating a deep plane of surgical anaesthesia. • Breathing pattern indicated light to medium plane of surgical anaesthesia in Groups IV and V, medium to deep plane of surgical anaesthesia in Groups I and III, and deep plane of surgical anaesthesia in Group II. • Vocalization (grunting) was observed with varying degree and at different time in all the anaesthetic groups. • Urination was absent in all piglets, except in 3 animals of Group II. PHYSIOLOGICAL PARAMETERS • Rectal temperature – Except for an initial rise from baseline value in Group II, there were steady decline in all the groups till the end of the study period. Cardio-respiratory parameters • Heart rate and pulse rate decreased in all groups, except in Group V. • Systolic Pressure decreased in Groups I, III, IV and V, except in Group II. • Diastolic Pressure, MAP and RTV decreased in all the anaesthetic groups. • Respiration rate increased in all groups, except in Group III. • RMV decreased in Groups I, II & III, whereas it increased in Groups IV and V. • SPO2 increased in Groups I & II, whereas it decreased in Groups III, IV & V. • Mild cardiac and respiratory depression was observed during anaesthesia in all the anaesthetic groups. HAEMATO-BIOCHEMICAL FINDINGS • There were transient intermittent fluctuations within physiological limits for the different haemato-biochemical parameters in all the anaesthetic groups studied under the experiment which indicated that there was no marked adverse effect of the drug combinations used on the general status of the piglets during the study period. HORMONAL ANALYSIS • In Groups I, II and III, the cortisol levels decreased at 30th minute and subsequently increased towards base values at the end of the observation period. In Groups IV and V, the cortisol levels increased at 30th minute and subsequently decreased at the end of study period. The serum cortisol values showed transient fluctuations within their physiological limits in all the anaesthetic groups during the experiment indicating that there might not be any serious alteration in the basal metabolic rate and stress level in the body. This could be summarized as that the physiological homeostasis was maintained in the anaesthetized piglets. The clinical, physiological, haemato-biochemical and hormonal parameters in all the five anaesthetic combination groups were variable, but well within the physiological limits and almost all the parameters returned to their pre-anaesthetic values towards the end of the study period. Conclusion : On the basis of score card, as Group II scored the highest it can be concluded that Medetomidine-Ketamine combination (@80µg/kg & 15mg/kg body weight IM, respectively) administered intramuscularly in quick succession produced the best balanced anaesthesia in post-weaned piglets characterized by adequate Central Nervous System (CNS) depression, excellent analgesia and complete muscle relaxation. This was followed by Azaperone-Ketamine, Xylazine-Ketamine, Acepromazine-Ketamine and Triflupromazine-Ketamine combinations, respectively. The sedative, analgesic and muscle relaxant properties of both Azaperone and Xylazine in combination with Ketamine were comparable.
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    ThesisItemOpen Access
    INTEGRATED SURGICO-THERAPEUTIC MANAGEMENT OF CANINE MAMMARY TUMOUR
    (Assam Agricultural University, Khanapara, Guwahati, 2013-07) DEURI, BITUPONA; Sarma, K. K.
    The present study was conducted on clinical canine patients presented to the College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati-22 for five calendar years starting from 1st April 2008 to 31st March 2013. Of the total 5760 cases registered, 330 were various neoplasm cases and 114 (34.55%) were confirmed as mammary gland tumours. Incidence study revealed that the age groups between 9-12 years (41.23%) were mostly affected and German Spitz (49.09%) breed and females (97%) were more susceptible and the inguinal pair (68.42%) of gland was mostly affected. Among 53% malignant and 47% benign tumours, papillary adenocarcinoma and fibroadenoma (24.57%) were highest. Clinical study revealed that the intact bitches were mostly affected and were also associated with other diseases like pyometra etc. The mammary tumour cases were further divided into three groups having six animals in each group. The animals of Gr-I were treated with regional mastectomy alone, Gr-II with chemotherapy (Capecitabine ‘Xabine’500mg oral tablets) and that of Gr-III were treated with mastectomy followed by the use of capacitabine. In GR-I, after regional mastectomy, the benign tumours didn’t show and reoccurrence where as two malignant tumours reoccurred after 1 year. In GR-II, after capecitabine therapy, the tumour less than 3cm size regressed after second round of chemotherapy but the tumours above 3cm size didn’t show any regression. In GR-III, there was no incidence of recurrence till one and half year of treatment. The hematological parameters revealed no adverse effects on the animal’s health except mild leucopaenia, neutropenia, thrombocytopaenia, lymphocytosis and monocytosis for a transient time in GR-II and GR-III as a result of chemotherapy. Whereas, the biochemical parameters revealed significant difference in BUN, Serum creatinine, AST, ALT and ALP levels within groups as well as between groups. But the effects were not long lasting to hamper the animal’s general health. The estradiol, progesterone and cortisol levels were significantly higher in mammary tumour cases which subsided in due course of treatment. Complications were minimal except mild anorexia and discharges from the tumour site.
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    ThesisItemOpen Access
    TOTAL INTRAVENOUS ANAESTHESIA WITH PROPOFOL AND KETAMINE IN ATROPINE AND XYLAZINE PREMEDICATED DOGS
    (AAU, 2016) SAIKIA, BASANTA; Sarma, K.K.
    The study was conducted in eighteen clinical cases of dogs of either sex. The animals were randomly divided into three groups with six animals in each group. Atropine sulphate @ 0.04mg/kg b.wt. i.m. and xylazine HCl @ 0.5mg/kg b.wt. i.m. route were administered as premedicants in all the three groups. In group-I, propofol @ 5mg/kg body weight, in group-II, ketamine @ 5mg/kg body weight and in group-III, ketofol @ 4mg/kg body weight was administered intravenously for induction after 15 minutes of preanaesthetic administration. Surgical anaesthesia was maintained for 90 minutes in all three groups viz. group-I, group-II and group-III with propofol @ 2.5mg/kg. b.w., ketamine @ 2.5mg/kg b.wt. and ketofol @ 2mg/kg b.wt. respectively by intermittent bolus injection ( IBI) technique. Clinical studies like induction time, quality of induction, duration of analgesia, degree of analgesia, duration of recumbency and quality of recovery showed better results in ketofol group than propofol and ketamine group. Physiological parameters like rectal temperature, heart rate, respiratory rate, blood pressure and spO2 were evaluated before administration of anaesthetic agent (0 minute) then at 15, 30, 60 and 90 minutes during and after administration of anaesthetic agents. The heart rate initially increased and then decreased gradually towards pre-anaesthetic level in all the three groups. The respiratory rate initially decreased and then increased towards pre-anaesthetic level in all the three groups. Both diastolic pressure and systolic pressure remained in a comfortable zone in group-III animals whereas, high blood pressure was recorded in group-II animals and low blood pressure was recorded in group-I animals. Haemato-biochemical and hormonal changes were evaluated before administration of anaesthetic agent (0 minute) then at 15, 30, 60 and 90 minutes during and after administration of anaesthetic agents. The all thee anaesthetic protocols did not bring about any drastic change in the haematological parameters. In all the three groups, group-I, group –II and group-III, initial significant declination was observed in Hb, PCV, TEC which steadily returned to the pre- anaesthetic level at the end of the observation. The values of TLC, neutrophils, lymphocyte, monocyte and eosinophil count did not register any significant change throughout the experiment in all three groups. In biochemical parameters significant increased glucose, BUN, creatinine ALT, AST and GGT values were recorded in all the groups in early phase of observation then showed a declining trend towards the pre- anaesthetic level at the end of the experiment. The magnitude of increasing trend of glucose was higher whereas increasing trend of creatinine, BUN, ALT, AST and GGT was lesser in group-III than group-I and group-II animals. In all the groups, the LDH, sodium and chloride values insignificantly increased but values were found to be within the physiological limits. A decrease in serum potassium level was observed in all the groups but these values were within normal physiological limit. In hormonal parameters significant increased cortisol values were recorded in all the groups The cortisol values in group-III animals also increased with time but the magnitude of these changes were least compared to group-I and group-II animals. In the present study, triiodothyronine (T3) and thyroxine (T4) values showed a non-significant fluctuation trend within their physiological limits at different time interval of TIVA in all three groups. The cost of the anaesthesia was least only Rs. 4.68/kg in group-II followed by Rs. 8.30/kg in group-III animals. The cost of the anaesthesia was Rs. 20.02/kg in group-I animals which was found to be highest among the all three groups. Key words: Dog, Propofol, Ketamine, Ketofol, Xylazine, Atropine, TIVA