Clinical Pharmacology in Donkeys and Mules

Gastric habronematidosis in mules: Gastroscopy and histopathology-based diagnosis

This cross-sectional study aimed to describe the presence of gastric habronematidosis using gastroscopy and histopathology as diagnostic methods, in addition to evaluating the relationship between the parasite presence and concurrent gastric diseases. Numerous studies have been carried out with equines, mules not being targeted even though these are representative species because of number and the various agricultural tasks they perform worldwide. To fill this gap in the literature, this study evaluated a population of 97 male and female mules over two years old using two diagnostic methods. Samples were taken from the gastric mucosa of mules presenting lesions compatible with Squamous Gastric Disease (SGD) or Glandular Gastric Disease (GGD). The Spearman's test was used to determine the correlation coefficients between the outcomes and explanatory variables of the study, i.e., parasites with gastritis/equine gastric ulcer syndrome (EGUS)/GGD/SGD/age/sex/body condition score (BCS). Gastroscopy evidenced the presence of nematodes morphologically compatible with Habronema spp. in 11.3 % of the individuals, and histopathology showed that 5.6 % of the mules had inflammatory processes associated with chronic eosinophilic gastritis with intralesional parasites. No correlation (p > 0,05) was found between the presence of parasites and the variables studied. These results confirm the presence of gastric habronematidosis in mules, which has not been reported for this species.

Hemodynamic Response to Lipopolysaccharide Infusion and Effect of Meloxicam Administration on Cardiac Function in Donkeys

Systemic inflammatory response syndrome (SIRS) in donkeys is observed to be secondary to colic, diarrhea or pleuropneumonia, among other disorders. Horses with SIRS develop secondary disturbances such as hyperlipemia, laminitis, disseminated intravascular coagulopathy, and hemodynamic and cardiac derangements, which impair their prognosis and increase the mortality rate. In donkeys, no information is available on the effect of experimentally induced endotoxemia in the cardiovascular system. Acute experimental endotoxemia was induced by lipopolysaccharide (LPS) infusion in six healthy adult non-pregnant jennies. Physical signs, arterial (systolic, diastolic and mean) and central venous pressure were monitored during 360 min. Cardiac troponin I (cTnI) concentrations were measured in blood samples, and echocardiography was performed. LPS infusion caused an increase in cTnI, hypotension and diminution of central venous pressure, cardiac dysfunction, with a decrease in stroke volume (SV), cardiac output (CO) and cardiac index, and impairment of ultrasonographic ventricular function parameters. Intravenous meloxicam administration prevented the cTnI increase, hypotension, diminution of SV and CO, and changes in ultrasonographic parameters related to ventricular dysfunction. Thus, meloxicam could be proposed as an effective therapeutical option to control the hemodynamic and cardiac derangements observed in donkeys with SIRS.

New insights in the diagnosis and treatment of equine piroplasmosis: pitfalls, idiosyncrasies, and myths

Equine piroplasmosis (EP) is a global tick-borne disease of equids caused by the intraerythrocytic apicomplexan parasites Theileria equi and Babesia caballi, and the more recently discovered Theileria haneyi. These parasites can be transmitted by several tick species, including Dermacentor, Hyalomma, and Rhipicephalus, but iatrogenic and vertical transmission are also common. Clinical signs of EP include poor performance, fever, icterus, abortions, among others, and peracute or acute forms of infection are associated with high mortality in non-endemic areas. EP is a reportable disease and represents an important barrier for the international trade of horses and other equids, causing disruption of international equine sports. Tick control measures, serological and molecular diagnostic methods, and parasiticidal drugs are currently used against EP, while vaccines remain unavailable. Since most acaricides used in equids are non-environmentally friendly and linked to drug resistances, this is considered as an unsustainable approach. Imidocarb dipropionate (ID) and buparvaquone (BPQ) are currently the main drugs used to control the disease. However, while ID has several side and toxic effects and recurrent failures of treatment have been reported, BPQ is less effective in the clearance of T. equi infection and not available in some countries. Thus, novel alternative and effective therapeutics are needed. While current trade regulations require testing equids for EP before exportation, the lack of standardized PCR tests and limitations of the currently recommended serological assays entail a risk of inaccurate diagnosis. Hereby, we propose a combination of standardized PCR-based techniques and improved serological tests to diminish the risks of exporting EP-infected animals making equid international trade safer. In addition, this review discusses, based on scientific evidence, several idiosyncrasies, pitfalls and myths associated with EP, and identifies weaknesses of current methods of control and gaps of research, as initial steps toward developing novel strategies leading to control this disease.

Pharmacokinetics of Enrofloxacin in Plasma, Urine, and Feces of Donkey (Equus asinus) after a Single Intragastric Administration

Enrofloxacin is a broad-spectrum antimicrobial agent, but the study of its pharmacokinetics/pharmacodynamics (PKs/PDs) in donkeys is rarely reported. The present study aimed to investigate the pharmacokinetics of enrofloxacin administered intragastrically, and to study the pharmacokinetics of enrofloxacin and its metabolite ciprofloxacin in plasma, urine, and feces, and the PK/PD parameters were investigated to provide a rationale for enrofloxacin treatment in donkeys. A total of five healthy donkeys were selected for intragastric administration of 7.5 mg·kg-1 BW of enrofloxacin by gavage, and blood, urine, and fecal samples were collected. The results showed that the elimination half-life of plasma enrofloxacin was 11.40 ± 6.40 h, Tmax was 0.55 ± 0.12 h, Cmax was 2.46 ± 0.14 mg·L-1, AUC0-∞ was 10.30 ± 3.37 mg·L-1·h, and mean residence time (MRT) was 7.88 ± 1.26 h. The Tmax of plasma ciprofloxacin was 0.52 ± 0.08 h, Cmax was 0.14 ± 0.03 mg·L-1, and AUC0-∞ was 0.24 ± 0.16 mg·L-1·h. Urinary Cmax was 38.18 ± 8.56 mg·L-1 for enrofloxacin and 15.94 ± 4.15 mg·L-1 for ciprofloxacin. The total enrofloxacin and ciprofloxacin recovered amount in urine was 7.09 ± 2.55% of the dose for 144 h after dosing. The total enrofloxacin and ciprofloxacin recovered amount in feces was 25.73 ± 10.34% of the dose for 144 h after dosing. PK/PD parameters were also examined in this study, based on published MICs. In conclusion, 7.5 mg/kg BW of enrofloxacin administered intragastrically to donkeys was rapidly absorbed, widely distributed, and slowly eliminated in their bodies, and was predicted to be effective against bacteria with MICs < 0.25 mg·L-1.

Morphine in donkeys: Antinociceptive effect and preliminary pharmacokinetics

BACKGROUND

Morphine is the prototypical μ-opioid receptor agonist used to provide analgesia in veterinary species. Its effects are well-described in horses but not donkeys.

OBJECTIVES

To determine the antinociceptive effects of two doses of morphine in donkeys. To describe preliminary pharmacokinetic parameters of morphine in donkeys.

STUDY DESIGN

In vivo experiment.

METHODS

Eight adult castrated male donkeys were given intravenous (IV) 0.9% saline, morphine 0.1 mg/kg bwt (LDM), or morphine 0.5 mg/kg bwt (HDM) in a randomised order with a minimum 1-week washout period. Mechanical nociceptive thresholds (MNTs) were determined by a blinded investigator pre-injection and 15, 30, 45, 60, 90, 120, 150, 180, 210, 240, 300, and 360 min post-injection. Venous blood samples were collected pre-injection and 2, 5, 10, 15, 30, 45, 60, 90, and 120 min post-injection. Data were analysed using Friedman's test with Dunn's post hoc test for multiple comparisons. Pharmacokinetic parameters were calculated for the HDM treatment.

RESULTS

Baseline MNT was [median (interquartile range)] 8.9 (7.1-10.3) N and did not differ between treatments. Peak MNTs occurred at 60 min for both LDM (16.2 N) and HDM (25.0 N) treatments. MNTs after HDM treatment were higher than saline (p < 0.04) at 15, 60, 90, 120, 150, 180, 240, and 300 min post-injection. MNTs after LDM treatment were higher than baseline (p < 0.05) at 45 and 60 min post-injection. Terminal half-life for HDM was (mean ± SD) 51.0 ± 10.7 min, the volume of distribution at steady-state 2.07 ± 0.33 L/min and clearance 49.2 ± 4.16 ml * min/kg using noncompartmental analysis. The concentration of morphine-3-glucuronide (M3G) was higher than morphine-6-glucuronide (M6G) at all sampled time points.

MAIN LIMITATIONS

Short duration of plasma sampling for pharmacokinetic analysis; lack of objective measure of gastrointestinal function.

CONCLUSIONS

The HDM treatment provided mechanical antinociception in donkeys with no significant adverse effects.

Development of the Chromatographic Method for Simultaneous Determination of Azaperone and Azaperol in Animal Kidneys and Livers

A precise and accurate method for the simultaneous determination of azaperone and azaperol in meat tissues has been developed. This paper describes the first method to be so fast, simple, and useful, especially for many laboratories that do not have sophisticated equipment. This method is based on LC separation and UV-Vis detection. During the sample preparation, the meat tissue was homogenized in acetonitrile at a ratio of 1:4 (tissue weight:acetonitrile volume). The homogenate was centrifuged, the supernatant was evaporated in a lyophilizator, and then the evaporation residue was dissolved in 20 µL of ethanol. For deproteinization, 15 µL of perchloric acid was added, and the sample prepared in this way was injected into a chromatographic column and analyzed using reversed-phased HPLC. The mobile phase consisted of 0.05 mol/L phosphate buffer pH 3.00 (component A) and acetonitrile (component B). UV detection was conducted at 245 nm. The experimentally determined LOQs were 0.25 µg/kg for azaperone and 0.12 µg/kg for azaperol. For both analytes, the calibration curves showed linearity in the tested concentration range from 50 to 300 µg/kg of tissue. The accuracy of the presented method did not exceed 15%, and the recovery was in the range of 85-115%. A validated analytical procedure was implemented for the analysis of various animal tissues for their content of azaperone and azaperol.

Pharmacokinetics of butorphanol following intravenous and intramuscular administration in donkeys: A preliminary study

The pharmacokinetics of butorphanol after intravenous (IVB) and intramuscular (IMB) administration in donkeys were determined in this preliminary study. Healthy male gelded donkeys (n = 5), aged 6–12 years old, were administered 0.1 mg/kg butorphanol IV or IM in a randomized, crossover design. Blood samples were obtained at predetermined intervals for 24 h (IVB) and 48 h (IMB) after administration. Plasma butorphanol concentrations were determined by high performance liquid chromatography and pharmacokinetic parameters were calculated. Following IVB administration, mean (± SE) apparent volume of distribution, elimination half-life, total body clearance, and area under the plasma concentration time curve from time 0 to infinity (AUC_0−∞) were 322 ± 50 mL/kg, 0.83 ± 0.318 h, 400 ± 114 mL/h/kg, 370 ± 131 h·ng/mL, respectively. After IMB administration, a maximum plasma drug concentration of 369 ± 190 ng/mL was reached at 0.48 ± 0.09 h. The IMB AUC_0−∞ was 410 ± 60 h·ng/mL. Bioavailability of IMB was 133 ± 45%. The pharmacokinetics of butorphanol in healthy donkeys was characterized by faster elimination half-life compared to values from the equine literature.

Characterisation of the oral glucose and sugar tolerance tests and the enteroinsular axis response in healthy adult donkeys

BACKGROUND

Insulin dysregulation (ID) is diagnosed in horses and ponies using oral glucose (OGTT) and oral sugar (OSTT) tolerance tests. The enteroinsular axis plays a major role in postprandial glucose disposal and insulin response in horses, ponies and foals. The insulin and incretin response to oral carbohydrate challenges has not been characterised in donkeys.

OBJECTIVES

(a) To characterise OGTT and OSTT, and (b) to assess the plasma incretin response to OGTT and OSTT in healthy donkeys.

STUDY DESIGN

In vivo experiments.

METHODS

Six healthy adult female Andalusian donkeys were challenged with OGTT (1 g/kg glucose, 20% solution by nasogastric tube) and OSTT (0.45 mL/kg corn syrup orally by syringe) with a 1-week washout. Blood samples were collected for glucose (spectrophotometry), insulin (radioimmunoassay), glucose-dependent insulinotropic polypeptide (GIP, ELISA) and active glucagon-like peptide-1 (aGLP-1, ELISA) determination over 6 hours. Curves were analysed and proxies calculated.

RESULTS

Glucose and insulin concentrations peaked at 180 minutes in OGTT, but at 300 and 150 minutes in OSTT, respectively. Plasma GIP concentrations increased in the OGTT and OSTT (peaked at 180 and 360 minutes, respectively), but aGLP-1 increased only in OGTT (240 minutes).

MAIN LIMITATIONS

Single breed, narrow age and sample, diet, season and not having donkeys with evidence of ID to provide clinical validation.

CONCLUSIONS

Donkeys have a functional enteroinsular axis that is activated by enteral carbohydrates. Donkeys have evident endocrine differences with horses, supporting the validation of the OSTT and OGTT to assess insulin sensitivity in this species to avoid extrapolation from horses.

Analgesic Effect of Butorphanol during Castration in Donkeys under Total Intravenous Anaesthesia

Pain management is necessary for all surgical procedures. Little scientific evidence about drug efficacy in donkeys is available. The aim of this study was to evaluate the analgesic effect of butorphanol in donkeys undergoing orchiectomy under total intravenous anaesthesia with guaifenesin-ketamine-detomidine. A randomized blinded prospective clinical trial (Protocol n. 2021/0000338), was carried out on 18 clinically healthy donkeys undergoing bilateral orchiectomy. Patients were assigned to Group D (n = 8) or Group DB (n = 10) if receiving intravenous detomidine or detomidine-butorphanol respectively, before induction of general anaesthesia with ketamine-diazepam. Intraoperative muscle relaxation, nystagmus, palpebral reflex, heart and respiratory rate, and non-invasive blood pressure were evaluated every 2 min; time to prepare the patient, duration of surgery and anaesthesia and recovery score were recorded. Group D had significantly longer surgical time, higher heart rate, higher systolic and mean blood pressure (p < 0.05; repeated measure ANOVA), increased muscle rigidity and expression of palpebral reflex (p < 0.05; Mann-Whitney U test) than group DB. Top-ups with thiopental were statistically higher in Group D. Butorphanol and detomidine together produced a more stable anaesthetic plan. The low dosage of opioid and alpha-2-agonists and reduced rescue anaesthesia are responsible for a safer and more superficial anaesthesia, which is mandatory under field conditions.

Emergency Management for Donkeys and Mules

This article provides an overview of initial assessment and management of common emergency presentations in donkeys and mules. The principles are similar to those in horses (and ponies), but clinicians must be aware of differences in recognition of signs of pain/disease, approach to handling, pharmacology of some drugs, and subtle differences in the physiology and local anatomy in donkeys and mules. The epidemiology of common disease presentations will vary between pet/companion or working/farmed donkeys and mules. Regular dental checks, deworming, vaccination, and monitoring of behavior and quality of life are important aspects of preventive care.

Nonlinear Mixed-Effect Pharmacokinetic Modeling and Distribution of Doxycycline in Healthy Female Donkeys after Multiple Intragastric Dosing-Preliminary Investigation

Doxycycline (DXC) is a broad-spectrum antibacterial antimicrobial administered to horses for the treatment of bacterial infections which may also affect donkeys. Donkeys have a different metabolism than horses, leading to differences in the pharmacokinetics of drugs compared to horses. This study aimed to describe the population pharmacokinetics of DXC in donkeys. Five doses of DXC hyclate (10 mg/kg) were administered via a nasogastric tube, q12 h, to eight non-fasted, healthy, adult jennies. Serum, urine, synovial fluid and endometrium were collected for 72 h following the first administration. Doxycycline concentration was measured by competitive enzyme immunoassay. Serum concentrations versus time data were fitted simultaneously using the stochastic approximation expectation-maximization algorithm for nonlinear mixed effects. A one-compartment model with linear elimination and first-order absorption after intragastric administration, best described the available pharmacokinetic data. Final parameter estimates indicate that DXC has a high volume of distribution (108 L/kg) as well as high absorption (10.3 h^-1) in donkeys. However, results suggest that oral DXC at 10 mg/kg q12 h in donkeys would not result in a therapeutic concentration in serum, urine, synovial fluid or endometrium by comparison to the minimum inhibitory concentration of common equine pathogens. Further studies are recommended to identify appropriate dosage and dosing intervals of oral DXC in donkeys.

Pharmacokinetic properties of tramadol and M1 metabolite in Northeast Brazilian donkeys (Equus asinus)

There is currently little information available on the pharmacokinetics and pharmacodynamics of the analgesic opioid tramadol when used in the veterinary medicine of domestic species. In this study, we aimed to determine the pharmacokinetics of tramadol and its active metabolite M1 following intravenous administration of 2 (T2) and 4 (T4) mg/kg to Northeast Brazilian donkeys. Tramadol and M1 plasma levels were quantified using a validated liquid chromatography-tandem mass spectrometry method. We found that plasma levels of tramadol and M1 were higher than those reported as clinically meaningful in humans for at least 3 hr. However, the pharmacokinetic parameter calculation corrected by dose analysis identified no proportional increase with dose for the AUC of tramadol (T2: 2,663 ± 1,827 vs. T4: 2,964 ± 1,038 ng*h/ml) and M1 (T2: 378 ± 237 vs. T4: 345 ± 142 ng*h/ml). This finding appears to be attributable to a significant increase in clearance and a reduction in the terminal half-life of tramadol. The frequency of adverse effects observed at the higher dose indicates that 2 mg/kg administered intravenously would be suitable for donkeys. Clinical studies are required to determine the implications of these observations regarding the pharmacodynamic response to tramadol in Northeast Brazilian donkeys.