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Dzikiti TB, Maney JK, Thorogood J, Segabinazzi L, Peterson E, Dzikiti LN, Escobar A. Sedation with dexmedetomidine-butorphanol or xylazine-butorphanol continuous intravenous infusions during unilateral ovariectomy in standing donkeys. Equine Vet J 2024; 56:1243-1250. [PMID: 38173139 DOI: 10.1111/evj.14052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Intravenous infusions of alpha-2 adrenoceptor sedatives and opioids can potentially facilitate surgery in donkeys while standing. Literature on this subject matter is scant. OBJECTIVES Evaluation of efficacy of sedation from α2-adrenoceptors (dexmedetomidine or xylazine) and butorphanol during ovariectomy in standing donkeys. STUDY DESIGN Randomised, masked in vivo experiment. METHODS Thirteen female donkeys were sedated with butorphanol (0.05 mg/kg bwt followed by 0.05 mg/kg bwt/h) IV. Concomitantly, 6 of the 13 jennies were sedated with dexmedetomidine 2.5 mcg/kg bwt followed by 2.5 mcg/kg bwt/h (Dex-B group), while seven jennies were sedated with xylazine 0.5 mg/kg bwt followed by 0.5 mg/kg bwt/h (Xyl-B group). A line block of the left flank and an infiltration block around uterine ligament were performed with lidocaine. While the jennies underwent ovariectomies standing, sedation scores and head height above ground were assessed at 2 and 10 min after sedative boluses and every 10 min thereafter. If sedation was too light or too deep, the dose of dexmedetomidine or xylazine was increased or decreased by 25% of the original infusion rate, while butorphanol infusion rate was constant. Physiological parameters were measured. Normally distributed data were compared using the two-sample t test while repeatedly measured data were tested for differences between and within groups using repeated measures analysis of variance (ANOVA) by ranks followed by a Wilcoxon test with Tukey Honest Significant Difference for multiple testing. Statistical significance was set at p < 0.05. RESULTS Both Dex-B and Xyl-B caused moderate to marked sedation adequate for ovariectomy in donkeys. Evident sedation was absent by 60 min of termination of infusions. No adverse physiological effects were observed. MAIN LIMITATIONS Study on ovariectomy cases only, no pharmacokinetic profiling. CONCLUSIONS Dexmedetomidine or xylazine and butorphanol sedation is feasible for ovariectomy in standing donkeys.
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Affiliation(s)
- Tarisai B Dzikiti
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Jill K Maney
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Jemma Thorogood
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Lorenzo Segabinazzi
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Erik Peterson
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Loveness N Dzikiti
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - André Escobar
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
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Cuypers C, Alonso B, Devreese M, Schauvliege S. Dose titration of intravenously administered gamma-hydroxybutyric acid for sedation in Holstein-Friesian calves. Vet J 2024; 308:106246. [PMID: 39276849 DOI: 10.1016/j.tvjl.2024.106246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 09/11/2024] [Accepted: 09/11/2024] [Indexed: 09/17/2024]
Abstract
Gamma-hydroxybutyric acid (GHB) is a short-chain fatty acid that can potentially provide safe, prolonged sedation with minimal cardiorespiratory effects. This preliminary trial, performed in 10 three-week-old male Holstein-Friesian calves, investigated the effects of GHB administered intravenously over 5 min at a dose of 100 (G100, n=2), 150 (G150, n=4) or 200 mg/kg (G200, n=4). Once lateral recumbency was achieved, scores for sedation depth (range: 0 = no sedation to 3 = marked) and response to noxious stimulation (range: 0 = strong to 3 = absent), heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP) and arterial blood gases were monitored every 15 min until sternal recumbency. Times from end of administration to lateral recumbency and return to sternal/standing positions were recorded. Dose G100 resulted in mild sedation and ataxia without decubitus. Doses G150 and G200 respectively resulted in time to lateral recumbency 8 ± 2 and 9 ± 3 min, lasting 189 ± 41 and 283 ± 29 min, while overall median (range) scores for sedation were 3 (1-3) and 3 (2-3) respectively and response to noxious stimulation 0 (0-3) and 0 (0-3) respectively. The mean ± SD for HR was 110 ± 10 and 106 ± 11 bpm respectively; for MAP 87±9 and 94±5 mmHg respectively; and for RR 28 ± 5 and 26 ± 5 bpm respectively. The mean ± SD for arterial partial pressure of oxygen (PaO2) at these two dose rates was 74 ± 6 and 74 ± 2 mmHg respectively, while the arterial partial pressure of carbon dioxide oxygen (PaCO2) was 53 ± 3 and 47 ± 0.8 mmHg respectively. Based on these preliminary results we conclude that GHB has the potential to be used as a long-acting sedative in calves. Further studies are needed to confirm this.
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Affiliation(s)
- C Cuypers
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke 9820, Belgium.
| | - B Alonso
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke 9820, Belgium
| | - M Devreese
- Department of Pathobiology, Pharmacology and Zoological Medicine, Ghent University, Merelbeke 9820, Belgium
| | - S Schauvliege
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke 9820, Belgium
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Izquierdo-Moreno J, de Paz MI, Manso-Díaz G, Villalba-Orero M, López-Sanromán J. Correlation between kinematic parameters, ataxia and ground-to-lip distance in detomidine sedated horses. Equine Vet J 2024. [PMID: 39140154 DOI: 10.1111/evj.14207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/13/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND An accurate evaluation of the degree of sedation is mandatory to adjust the dosage of sedative drugs. OBJECTIVES To determine the correlation between head height above the ground and ataxia degree in horses sedated with detomidine and the correlation existing between accelerometric variables and both parameters. STUDY DESIGN Retrospective study. METHODS Twelve horses were given 0.01 mg/kg of detomidine hydrochloride iv. Measured accelerometric parameters, with one accelerometer positioned between both sacral tuberosities, included speed, stride frequency and length, regularity, dorsoventral, longitudinal, mediolateral and total accelerometric activities, relative force index and dorsoventral, longitudinal and mediolateral parts of the accelerometric activities. Head height above the ground (cm) and subjective ataxia degree were also measured. Baseline values (-15 min) and values measured 5 and 15 min after the injection and then every 15 min for a period of 2 h were obtained. RESULTS There was a negative and strong correlation between head height above the ground and ataxia degree (Pearson r = -0.78, p < 0.001), particularly during the first 45 min. A significant correlation was found between head height above the ground and almost all accelerometric parameters. This correlation was very strong with stride frequency, regularity and dorsoventral and total accelerometric activities in both cases, but for ataxia, also with total accelerometric activity. MAIN LIMITATIONS Experimental conditions may not represent real clinical situations. CONCLUSIONS Stride frequency and regularity are the most reliable parameters to determine degree of sedation and are related to the sedation produced. Ataxia should not be considered a separate property of sedation and does not need to be assessed separately to the depth of sedation.
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Affiliation(s)
- Jorge Izquierdo-Moreno
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Marta Illán de Paz
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Gabriel Manso-Díaz
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - María Villalba-Orero
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Javier López-Sanromán
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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Giambrone G, Catone G, Marino G, Gugliandolo E, Miloro R, Vullo C. Loco-Regional Anaesthesia during Standing Laparoscopic Ovariectomy in Equids: A Systematic Review (2003-2023) of the Literature. Animals (Basel) 2024; 14:2306. [PMID: 39199841 PMCID: PMC11350817 DOI: 10.3390/ani14162306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/30/2024] [Accepted: 08/05/2024] [Indexed: 09/01/2024] Open
Abstract
Laparoscopic ovariectomy is generally performed with equids in the standing position, with the animals heavily sedated and restrained in stocks. This procedure may be quite painful, and it is essential first to manage intraoperative pain to complete the surgery, respecting the animal's welfare and, at the same time, ensuring the safety of the operators. Laparoscopy requires multiple small incisions to introduce the instruments, with one to two incisions enlarged sufficiently to remove the ovary. The surgical procedure must be associated with effective pain control, usually obtained with loco-regional anaesthesia, mesovarian injection, mesovaric or ovarian topical anaesthesia, and epidural anaesthesia. This systematic review aims to discuss articles published from 2003 to 2023 on treating loco-regional anaesthesia in standing laparoscopic ovariectomy in association with an evaluation of pain. The literature review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines on three databases (NCBI-PubMed, Web of Science, and SciVerse Scopus). Despite the collected papers numbering 36, we identified only five eligible papers, demonstrating that few studies are performed in order to evaluate the quality of analgesia with loco-regional anaesthesia in standing laparoscopic ovariectomy in equids. The authors of this systematic review agree that the association of injectable and epidural anaesthesia is the best solution to manage intraoperative pain in standing laparoscopic ovariectomy in equids.
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Affiliation(s)
- Giada Giambrone
- Department of Veterinary Sciences, University of Messina, Polo SS. Annunziata, 98169 Messina, Italy; (G.G.); (G.C.); (G.M.); (E.G.); (R.M.)
| | - Giuseppe Catone
- Department of Veterinary Sciences, University of Messina, Polo SS. Annunziata, 98169 Messina, Italy; (G.G.); (G.C.); (G.M.); (E.G.); (R.M.)
| | - Gabriele Marino
- Department of Veterinary Sciences, University of Messina, Polo SS. Annunziata, 98169 Messina, Italy; (G.G.); (G.C.); (G.M.); (E.G.); (R.M.)
| | - Enrico Gugliandolo
- Department of Veterinary Sciences, University of Messina, Polo SS. Annunziata, 98169 Messina, Italy; (G.G.); (G.C.); (G.M.); (E.G.); (R.M.)
| | - Renato Miloro
- Department of Veterinary Sciences, University of Messina, Polo SS. Annunziata, 98169 Messina, Italy; (G.G.); (G.C.); (G.M.); (E.G.); (R.M.)
| | - Cecilia Vullo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D’Alcontres, 31, 98166 Messina, Italy
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Hubbell JAE, Muir WW, Gorenberg E, Hopster K. A review of equine anesthetic induction: Are all equine anesthetic inductions "crash" inductions? J Equine Vet Sci 2024; 139:105130. [PMID: 38879096 DOI: 10.1016/j.jevs.2024.105130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/29/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
Horses are the most challenging of the common companion animals to anesthetize. Induction of anesthesia in the horse is complicated by the fact that it is accompanied by a transition from a conscious standing position to uncconconscious recumbency. The purpose of this article is to review the literature on induction of anesthesia with a focus on the behavioral and physiologic/pharmacodynamic responses and the actions and interactions of the drugs administered to induce anesthesia in the healthy adult horse with the goal of increasing consistency and predictability.
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Affiliation(s)
| | - William W Muir
- College of Veterinary Medicine, Lincoln Memorial University, Harrogate, Tennessee, USA
| | - Emma Gorenberg
- School of Veterinary Medicine, University of Pennsylvania. Kennett Square, PA, USA
| | - Klaus Hopster
- School of Veterinary Medicine, University of Pennsylvania. Kennett Square, PA, USA
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Leps A, Korsos S, Clarysse M, Vlaminck L. Dental sectioning for intraoral equine cheek teeth extractions: 29 cases. Front Vet Sci 2024; 11:1367861. [PMID: 38425840 PMCID: PMC10901997 DOI: 10.3389/fvets.2024.1367861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
The objectives of this retrospective study were to describe cheek teeth extraction by the sectioning technique, the decision making to use this technique and its potentially associated complications. Sectioning for dental extraction purpose was used in 29/461 (6.3%) of cases. Oro-sinusal fistula was the main post-operative complication, with 4/29 (13.7%) cases developing a macroscopic communication between the alveolus of the tooth extracted and the adjacent sinus compartment. All teeth where sectioning was attempted were successfully extracted. Sectioning for dental extraction appears to be a safe technique that can be used instead of or in addition too other minimal invasive cheek teeth extraction techniques. Thorough preoperative planning including oroscopic examination and medical imaging modalities are required to help in decision making, as well as excellent sedation and analgesia and horse compliance.
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Affiliation(s)
- Alexis Leps
- Department of Large Animal Surgery, Anesthesiology and Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Eichler F, Ehrle A, Machnik M, Jensen KC, Wagner S, Baudisch N, Bolk J, Pötzsch M, Thevis M, Bäumer W, Lischer C, Wiegard M. Behavioral observations, heart rate and cortisol monitoring in horses following multiple oral administrations of a cannabidiol containing paste (part 2/2). Front Vet Sci 2024; 10:1305873. [PMID: 38234983 PMCID: PMC10791836 DOI: 10.3389/fvets.2023.1305873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/10/2023] [Indexed: 01/19/2024] Open
Abstract
As a remedy against stress and anxiety, cannabidiol (CBD) products are of increasing interest in veterinary medicine. Limited data is available describing the actual effectiveness of CBD in horses. The aim of this study (part 2 of 2) was to analyze stress parameters via behavioral observation, heart rate monitoring and assessment of blood and saliva cortisol levels in healthy horses treated repeatedly with a CBD containing paste. Twelve horses were randomly assigned to a treatment or a control group. Two pastes were orally administered in a double-blinded study design, one paste containing CBD and one paste without active ingredient. Both pastes were administered twice daily over 15 days (dose: 3 mg CBD/kg). Behavioral observations were conducted daily using a sedation score and a rating of facial expressions, based on the previously described facial sedation scale for horses (FaceSed) and the Horse Grimace Scale. Blood and saliva samples were obtained regularly to determine cortisol levels throughout the study. Cortisol levels were analyzed by means of liquid chromatography/tandem mass spectrometry (LC/MS/MS). Behavioral observations and cortisol levels were compared between groups. Prior to paste administration, a novel object test was performed and the horses' reaction to loading on a trailer was recorded. Both tests were repeated after 13 days of paste application. Movement patterns such as different gaits during the novel object test were evaluated and an ethogram was designed to assess exhibited behavioral traits. Cardiac beat-to-beat (R-R) intervals were recorded throughout and evaluated using heart rate (HR) and heart rate variability (HRV) parameters. Blood and saliva samples for cortisol analysis were taken before and after the tests. Daily behavioral observations and cortisol levels did not differ between the treatment and the control group. Similarly, analysis of movement patterns, HR, HRV and cortisol levels during the novel object test and trailer test did not identify significant differences between the groups. Regularly administered oral CBD (3 mg/kg BID over 15 days) had no statistically significant effect on behavioral observations, cortisol levels, HR and HRV in horses. Further research is required to establish adequate doses and indications for the use of CBD in horses.
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Affiliation(s)
- Fabienne Eichler
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Anna Ehrle
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Marc Machnik
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Katharina Charlotte Jensen
- Institute of Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Sabrina Wagner
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Natalie Baudisch
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Julia Bolk
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Magdalena Pötzsch
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Mario Thevis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Wolfgang Bäumer
- Institute of Pharmacology and Toxicology, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Christoph Lischer
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Mechthild Wiegard
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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Eichler F, Ehrle A, Jensen KC, Baudisch N, Petersen H, Bäumer W, Lischer C, Wiegard M. Behavioral observations, heart rate and heart rate variability in horses following oral administration of a cannabidiol containing paste in three escalating doses (part 1/2). Front Vet Sci 2023; 10:1305868. [PMID: 38149295 PMCID: PMC10750369 DOI: 10.3389/fvets.2023.1305868] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/06/2023] [Indexed: 12/28/2023] Open
Abstract
Cannabidiol (CBD) products have been proposed to exert stress- and anxiety-relieving effects in animals. Despite the increasing popularity of CBD for veterinary use, the available research detailing the effects of CBD in horses is limited. The aim of this study (part 1 of 2) was to analyze stress parameters via behavioral observations and heart rate monitoring in healthy horses following single oral administration of a CBD containing paste in different doses. Study products were two pastes for oral administration, one containing CBD and one containing no active ingredient. Pastes were applied as single administrations in consecutive trials with escalating dosages (doses: 0.2, 1.0, 3.0 mg CBD/kg) to a treatment (trial 1: n = 3, trial 2: n = 3, trial 3: n = 5 horses) and a control group (trial 1: n = 3, trial 2: n = 3, trial 3: n = 6 horses) with minimum wash-out periods of seven days in between. Behavioral parameters were evaluated using video recordings to score the levels of sedation including the horses' reactions to acoustic and visual stimuli. Facial expression was assessed using photographs. Evaluation was based on the previously described facial sedation scale for horses (FaceSed) and the Horse Grimace Scale. For baseline values, identical observations were recorded on the day before each paste administration. Both paste administration and behavioral evaluation were performed double blinded. Cardiac beat-to-beat (R-R) intervals were continuously recorded throughout the trial and assessed using heart rate and heart rate variability parameters. Statistical analysis included comparison between treatment and control group over escalating doses and time points using linear mixed models. The CBD paste was well tolerated, and no side effects were observed. Analysis of sedation scores and facial expressions did not indicate significant differences between treatment and control group over the escalating doses. The heart rate was neither reduced, nor were significant changes in heart rate variability observed compared to the control group. Main limitation of this study is the small sample size. Further research is required to determine adequate doses and indications for the use of CBD products in horses.
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Affiliation(s)
- Fabienne Eichler
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Anna Ehrle
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Katharina Charlotte Jensen
- Institute of Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Natalie Baudisch
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Hannah Petersen
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Wolfgang Bäumer
- Institute of Pharmacology and Toxicology, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Christoph Lischer
- Equine Clinic, Veterinary Hospital Freie Universität Berlin, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Mechthild Wiegard
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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Cock G, Blakeney Z, Hernandez JA, DeNotta S. Opioid-free sedation for atlantoaxial cerebrospinal fluid collection in adult horses. J Vet Intern Med 2022; 36:1812-1819. [PMID: 35639966 PMCID: PMC9511061 DOI: 10.1111/jvim.16450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Atlantoaxial (AA) cerebrospinal fluid (CSF) collection in standing horses utilizes the controlled narcotic morphine, thereby limiting feasibility in field practice settings. OBJECTIVES To compare AA CSF collection time and reaction scores in horses sedated with morphine-containing and opioid-free sedation protocols: detomidine + morphine (DM), detomidine + xylazine (DX), detomidine + detomidine (DD), detomidine alone (D0); To develop a novel method for assessing sedation in standing horses using open-source motion-tracking software. ANIMALS Six healthy adult horses. METHODS Randomized crossover. Atlantoaxial CSF collections were performed weekly for 4 weeks. Horses received sedation protocols in random order. Procedure time and procedure reaction scores were compared between groups using Friedman test. Associations between procedure reaction scores and motion tracking variables (total distance and farthest excursion traveled by horse's head) were examined using scatter diagrams. RESULTS Procedure times were D0 (median = 120 seconds, range XXXX), DM (48, range xxx to yy), DX (36 range), or DD (49, range); (P = .25). Procedure reaction scores were lower in horses sedated with DX (median score = 1.0, range xx to yy), compared to DD (2.8; range cc to vv, P = .04) or DO (3.0 range; P = .01). Reactions to dura mater puncture were recorded in 3 of 6 horses in D0 and DD groups, and 0 of 6 horses in DX and DM groups. Positive associations were observed between reaction score vs total distance or farthest excursion distance from baseline. CONCLUSIONS AND CLINICAL IMPORTANCE Both opioid-free and morphine-containing sedation protocols are acceptable for AA CSF collection. Motion-tracking software represents a novel method for assessing sedation in standing horses.
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Affiliation(s)
- Gemma Cock
- Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Zachary Blakeney
- Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Jorge A Hernandez
- Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Sally DeNotta
- Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
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Gold JR, Grubb TL, Cox S, Malavasi L, Villarino NL. Pharmacokinetics and pharmacodynamics of repeat dosing of gabapentin in adult horses. J Vet Intern Med 2022; 36:792-797. [PMID: 35150014 PMCID: PMC8965223 DOI: 10.1111/jvim.16386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/26/2022] Open
Abstract
Background The repeated administration of high doses of gabapentin may provide better analgesia in horses than current clinical protocols. Hypothesis and Objectives Administration of gabapentin at 40 and 120 mg/kg PO q 12 h for 14 days will not alter serum biochemistry findings or cause adverse effects. Our objectives were to evaluate the effect of gabapentin on serum biochemistry, physical examination, and plasma pharmacokinetics of gabapentin. Animals Six healthy adult mares. Methods Horses received 40 and 120 mg/kg of gabapentin orally q 12 h for 14 days. Horses were examined and scored for ataxia and sedation daily. Serum biochemistry variables were analyzed before treatment and days 7 and 14 after gabapentin administration. Plasma disposition of gabapentin was evaluated after the first and last drug administration. Pharmacokinetic parameters were estimated using noncompartmental analysis. Results No changes occurred in physiologic or biochemical variables. Median (range) maximal plasma gabapentin concentrations (μg/mL) after the last dose (day 15) were 7.6 (6.2‐11) and 22 (14‐33) for 40 mg/kg and 120 mg/kg doses respectively. Maximal concentration of gabapentin was reached within 1 hour after drug administration. Repeated administration of gabapentin resulted in a median (range) area under the curve (AUC0‐12 hours) last/first dose ratio of 1.5 (1.00‐2.63) and 2.92 (1.4‐3.8) for the 40 and 120 mg/kg regimens, respectively. Conclusion and Clinical Importance Our results suggest that horses tolerate gabapentin up to 120 mg/kg PO q 12 h for 14 days. The analgesic effect of the dosage regimens evaluated in our study warrants further research.
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Affiliation(s)
- Jenifer R Gold
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
| | - Tamera L Grubb
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
| | - Sherry Cox
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Lais Malavasi
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
| | - Nicholas L Villarino
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
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Leigh H, Gozalo-Marcilla M, Esteve V, Gutiérrez Bautista ÁJ, Martin Gimenez T, Viscasillas J. Description of a novel ultrasound guided peribulbar block in horses: a cadaveric study. J Vet Sci 2021; 22:e22. [PMID: 33774938 PMCID: PMC8007447 DOI: 10.4142/jvs.2021.22.e22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). OBJECTIVE To describe a technique for USG PB in horse cadavers. METHODS Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naïve to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. RESULTS Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). CONCLUSIONS The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.
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Affiliation(s)
- Hannah Leigh
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, The University of Edinburgh, Bush Farm, Roslin. EH25 9RG, Scotland, UK.
| | - Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, The University of Edinburgh, Bush Farm, Roslin. EH25 9RG, Scotland, UK
| | - Vicente Esteve
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia 46115, Spain
| | | | - Tamara Martin Gimenez
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia 46115, Spain
| | - Jaime Viscasillas
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia 46115, Spain
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Analgesic and Sedative Effects of Epidural Lidocaine-Xylazine in Elective Bilateral Laparoscopic Ovariectomy in Standing Mule Mares. Animals (Basel) 2021; 11:ani11082419. [PMID: 34438877 PMCID: PMC8388800 DOI: 10.3390/ani11082419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/18/2022] Open
Abstract
Simple Summary Elective bilateral ovariectomy in mule mares is recommended to correct undesirable behaviour effects related to oestrus and also in order to improve work performance. This procedure is usually carried out in a standing position with a combination of sedative and analgesic drugs along with local anaesthesia of the ovarian pedicles. The aim of the study was to evaluate the effects of epidural lidocaine-xylazine in sedated standing mules undergoing elective bilateral laparoscopic ovariectomy. The findings suggest that no significant changes were found in heart rate, respiratory rate, rectal temperature with respect to baseline values. Sedation and analgesia were satisfactory in six out of the eight mules. Epidural analgesia with lidocaine-xylazine may be a good alternative to local anaesthetics infiltration of the ovarian pedicle for elective bilateral laparoscopic ovariectomy in standing mule mares, but further studies should be performed. Abstract The purpose of this study was to determine the analgesic efficacy and safety of epidural lidocaine-xylazine administration in standing mules undergoing elective bilateral laparoscopic ovariectomy in order to suppress unwanted behaviour. Eight mule mares were sedated with intramuscular 0.05 mg/kg acepromazine followed by 1.3 mg/kg of xylazine and 0.02 mg/kg of butorphanol intravenously. Sedation was maintained by a constant rate infusion of 0.6 mg/kg/h of xylazine. The paralumbar fossae were infiltrated with 30 mL of 2% lidocaine. Epidural anaesthesia was performed at the first intercoccygeal space with 0.2 mg/kg of lidocaine and 0.17 mg/kg of xylazine. After 15 min, bilateral laparoscopic ovariectomy was performed. Heart rate, respiratory rate, rectal temperature, invasive arterial blood pressure, degree of analgesia, sedation and ataxia were evaluated during surgery. The laparoscopic ovariectomy was successfully completed in all animals. Sedation and analgesia were considered satisfactory in six out of the eight mules. In conclusion, caudal epidural block allowed surgery to be easily completed in six out of eight. The animals did not show any signs of discomfort associated with nociception and were mostly calm during the procedures, however additional studies are needed to establish epidural doses of xylazine and lidocaine that result in reliable abdominal pain control in mules for standing ovariectomy.
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Troya-Portillo L, López-Sanromán J, Villalba-Orero M, Santiago-Llorente I. Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both. Animals (Basel) 2021; 11:ani11072081. [PMID: 34359209 PMCID: PMC8300393 DOI: 10.3390/ani11072081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Standing surgery and diagnostic procedures in equine patients under deep sedation reduce the risk associated with general anesthesia. Sedation protocols must be safe, provide a good quality of sedation without producing cardiorespiratory depression and severe ataxia. The use of adrenergic alpha-2 receptors agonist in combination with opioids and/or ketamine can achieve an adequate sedation and provide sufficient analgesia for surgical procedures. Medetomidine and medetomidine with morphine in intravenous constant rate infusion have been evaluated for standing sedation but have not been compared directly. Although ketamine has been combined with other alpha-2 agonists successfully, it has not been evaluated in combination with medetomidine. The objective of this study was to compare four medetomidine-based protocols with the addition of morphine and/or ketamine, including cardiorespiratory, sedative and mechanical antinociceptive variables. All four protocols produced a similar degree of sedation and mechanical antinociception without clinically relevant impact on cardiorespiratory variables. Abstract Standing surgery under sedation reduces anesthetic-related mortality in horses. Medetomidine, alone and combined with morphine in a constant rate infusion (CRI), has been described for standing surgery but their cardiorespiratory, sedative and antinociceptive effects have never been compared. The addition of ketamine could improve analgesia in these procedures with minimal cardiorespiratory consequences. The objectives were to compare the cardiorespiratory effects, quality of sedation, antinociception and ataxia produced by administration of a medetomidine-based CRI with morphine, ketamine or both, in standing horses. A prospective, blind, randomized crossover, experimental design with six healthy adult horses was performed, in which four treatments were administered to all horses with at least two weeks of washout period: medetomidine (M); medetomidine and ketamine (MK); medetomidine and morphine (MMo); and medetomidine, morphine and ketamine (MMoK). Dosages were the same in all treatment groups: medetomidine at 5 µg/kg bwt followed by 5 µg/kg bwt/h, ketamine at 0.4 mg/kg/h and morphine at 50 µg/kg bwt, followed by morphine 30 µg/kg bwt/h. Drug infusions were maintained for 120 min. Cardiorespiratory variables, sedation degree and antinociceptive effects were evaluated during the procedure. All combinations produced similar sedation and antinociceptive effects and no clinically relevant alterations in cardiorespiratory variables occurred. Medetomidine CRI combined with morphine, ketamine or both are suitable and safe protocols for standing sedation in horses and the addition of morphine and/or ketamine did not cause any negative effect but no improving effect on sedation and antinociception was detected.
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Affiliation(s)
- Lucas Troya-Portillo
- Departamento de Medicina y Cirugía Animal, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.L.-S.); (M.V.-O.)
- Correspondence:
| | - Javier López-Sanromán
- Departamento de Medicina y Cirugía Animal, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.L.-S.); (M.V.-O.)
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - María Villalba-Orero
- Departamento de Medicina y Cirugía Animal, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.L.-S.); (M.V.-O.)
| | - Isabel Santiago-Llorente
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, 28040 Madrid, Spain;
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de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Esteves Trindade PH, Prospero Puoli Filho JN, Luna SPL. Development and validation of the facial scale (FaceSed) to evaluate sedation in horses. PLoS One 2021; 16:e0251909. [PMID: 34061878 PMCID: PMC8168851 DOI: 10.1371/journal.pone.0251909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 05/05/2021] [Indexed: 01/12/2023] Open
Abstract
Although facial characteristics are used to estimate horse sedation, there are no studies measuring their reliability and validity. This randomised controlled, prospective, horizontal study aimed to validate a facial sedation scale for horses (FaceSed). Seven horses received detomidine infusion i.v. in low or high doses/rates alone (DL 2.5 μg/kg+6.25 μg/kg/h; DH 5 μg/kg+12.5 μg/kg/h) or combined with methadone (DLM and DHM, 0.2 mg/kg+0.05 mg/kg/h) for 120 min, or acepromazine boli i.v. in low (ACPL 0.02 mg/kg) or high doses (ACPH 0.09 mg/kg). Horses' faces were photographed at i) baseline, ii) peak, iii) intermediate, and iv) end of sedation. After randomisation of moments and treatments, photos were sent to four evaluators to assess the FaceSed items (ear position, orbital opening, relaxation of the lower and upper lip) twice, within a one-month interval. The intraclass correlation coefficient of intra- and interobserver reliability of FaceSed scores were good to very good (0.74-0.94) and moderate to very good (0.57-0.87), respectively. Criterion validity based on Spearman correlation between the FaceSed versus the numerical rating scale and head height above the ground were 0.92 and -0.75, respectively. All items and the FaceSed total score showed responsiveness (construct validity). According to the principal component analysis all FaceSed items had load factors >0.50 at the first dimension. The high internal consistency (Cronbach´s α = 0.83) indicated good intercorrelation among items. Item-total Spearman correlation was adequate (rho 0.3-0.73), indicating homogeneity of the scale. All items showed sensitivity (0.82-0.97) to detect sedation, however only orbital opening (0.79) and upper lip relaxation (0.82) were specific to detect absence of sedation. The limitations were that the facial expression was performed using photos, which do not represent the facial movement and the horses were docile, which may have reduced specificity. The FaceSed is a valid and reliable tool to assess tranquilisation and sedation in horses.
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Affiliation(s)
- Alice Rodrigues de Oliveira
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Midlothian, United Kingdom
| | - Simone Katja Ringer
- Department of Clinical Diagnostics and Services, Section Anaesthesiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Stijn Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Mariana Werneck Fonseca
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Pedro Henrique Esteves Trindade
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - José Nicolau Prospero Puoli Filho
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Stelio Pacca Loureiro Luna
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
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15
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de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Trindade PHE, Puoli Filho JNP, Luna SPL. Development, Validation, and Reliability of a Sedation Scale in Horses (EquiSed). Front Vet Sci 2021; 8:611729. [PMID: 33665216 PMCID: PMC7921322 DOI: 10.3389/fvets.2021.611729] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/15/2021] [Indexed: 12/11/2022] Open
Abstract
The lack of standardization of sedation scales in horses limits the reproducibility between different studies. This prospective, randomized, blinded, horizontal and controlled trial aimed to validate a scale for sedation in horses (EquiSed). Seven horses were treated with intravenous detomidine in low/high doses alone (DL 2.5 μg/kg + 6.25 μg/kg/h; DH 5 μg/kg +12.5 μg/kg/h) or associated with methadone (DLM and DHM, 0.2 mg/kg + 0.05 mg/kg/h) and with low (ACPL 0.02 mg/kg) or high (ACPH 0.09 mg/kg) doses of acepromazine alone. Horses were filmed at (i) baseline (ii) peak, (iii) intermediate, and (iv) end of sedation immediately before auditory, visual and pressure stimuli were applied and postural instability evaluated for another study. Videos were randomized and blindly evaluated by four evaluators in two phases with 1-month interval. Intra- and interobserver reliability of the sum of EquiSed (Intraclass correlation coefficient) ranged between 0.84-0.94 and 0.45-0.88, respectively. The criterion validity was endorsed by the high Spearman correlation between the EquiSed and visual analog (0.77), numerical rating (0.76), and simple descriptive scales (0.70), and average correlation with head height above the ground (HHAG) (-0.52). The Friedman test confirmed the EquiSed responsiveness over time. The principal component analysis showed that all items of the scale had a load factor ≥ 0.50. The item-total Spearman correlation for all items ranged from 0.3 to 0.5, and the internal consistency was good (Cronbach's α = 0.73). The area under the curve of EquiSed HHAG as a predictive diagnostic measure was 0.88. The sensitivity of the EquiSed calculated according to the cut-off point (score 7 of the sum of the EquiSed) determined by the receiver operating characteristic curve, was 96% and specificity was 83%. EquiSed has good intra- and interobserver reliabilities and is valid to evaluate tranquilization and sedation in horses.
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Affiliation(s)
- Alice Rodrigues de Oliveira
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Simone Katja Ringer
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zürich, Zurich, Switzerland
| | - Stijn Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Mariana Werneck Fonseca
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Pedro Henrique Esteves Trindade
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - José Nicolau Prospero Puoli Filho
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Stelio Pacca Loureiro Luna
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
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16
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Shane SE, Langston VC, Wills RW, Denney WS, Knych H, Fontenot RL, Meyer RE, Natalini CC. Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses. J Vet Pharmacol Ther 2021; 44:533-543. [PMID: 33576078 DOI: 10.1111/jvp.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/04/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
An ideal dexmedetomidine protocol has yet to be determined for standing sedation in horses. It was hypothesized that an IV bolus followed by CRI dexmedetomidine would have a quicker increase in plasma concentrations compared with repeated IM injections. In a crossover design, eight adult, female horses were randomly placed into two groups: the CRI group (IV bolus dexmedetomidine at 0.005 mg/kg followed by a CRI at 0.01 mg/kg/h for 15 min then 0.005 mg/kg/h for 60 min) and the IM group (dexmedetomidine at 0.01 mg/kg, followed by 0.005 mg/kg in 30-min intervals for 60 min). Clearance and elimination half-life were 134 ± 67.4 ml/kg/min and 44.3 ± 26.3 min, respectively, in the CRI group, and apparent clearance and half-life were 412 ± 306 ml/kg/min (Cl/F) and 38.9 ± 18.6 min, respectively, in the IM group. Analgesia was evaluated using mechanical pressure threshold. Intravenous dexmedetomidine produced faster onset of sedation and increased pressure threshold compared with IM administration. Individual horses had a large variability in dexmedetomidine plasma concentrations between CRI and IM administration. The odds of a decreased GI motility following IV administration was 12.34 times greater compared with IM administration.
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Affiliation(s)
- Sarah E Shane
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Vernon C Langston
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Robert W Wills
- Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | | | - Heather Knych
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Robin L Fontenot
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Robert E Meyer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Claudio C Natalini
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
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17
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Kim A, Sasaki N, Lee I, Seo JP. Comparison of intraoperative cardiorespiratory and behavioral responses to medetomidine combined with tramadol or butorphanol during standing laparoscopic ovariectomy in horses. J Vet Med Sci 2021; 83:643-647. [PMID: 33583912 PMCID: PMC8111346 DOI: 10.1292/jvms.20-0397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to assess the cardiorespiratory and behavioral responses to
the combination of medetomidine and tramadol (M-T) or butorphanol (M-B) in standing
laparoscopic ovariectomy in horses. One ovary was removed under M-T and the contralateral
ovary was removed under M-B with at least 4 weeks between operations at random. Horses
were sedated using intravenous medetomidine (5 µg/kg) followed by tramadol (1 mg/kg) or
butorphanol (10 µg/kg) after 5 min. Sedation was maintained through the repeated injection
of medetomidine (1 µg/kg) and tramadol (0.4 mg/kg) or medetomidine (1 µg/kg) and
butorphanol (4 µg/kg) every 15 min. Cardiorespiratory function and behavioral responses,
including, sedation, ataxia, and analgesia, were assessed during the surgery. There were
no significant differences in cardiorespiratory values and sedation and analgesia scores
between M-T and M-B. Ataxia scores were significantly lower in M-T than in M-B. This
result suggests that M-T could maintain smooth and stable standing surgery with minimal
cardiorespiratory changes in horses.
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Affiliation(s)
- Ahram Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Naoki Sasaki
- Department of Clinical Veterinary Science, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Jong-Pil Seo
- Department of Veterinary Clinical Sciences, Jeju National University, Jeju 63243, Republic of Korea
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Schumacher SA, Toribio RE, Scansen B, Lakritz J, Bertone AL. Pharmacokinetics of magnesium and its effects on clinical variables following experimentally induced hypermagnesemia. J Vet Pharmacol Ther 2020; 43:577-590. [PMID: 32525571 DOI: 10.1111/jvp.12883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 03/22/2020] [Accepted: 05/07/2020] [Indexed: 12/16/2022]
Abstract
The objectives of this study were to describe pharmacokinetic and pharmacodynamic changes as a result of a single intravenous administration of magnesium sulfate (MgSO4 ) to healthy horses. MgSO4 is a magnesium salt that has been used to calm horses in equestrian competition and is difficult to regulate because magnesium is an essential constituent of all mammals. Six healthy adult female horses were administered a single intravenous dose of MgSO4 at 60 mg/kg of body weight over 5 min. Blood, urine, and cerebrospinal fluid (CSF) samples were collected, and cardiovascular parameters were monitored and echocardiograms performed at predetermined times. Noncompartmental pharmacokinetic analysis was applied to plasma concentrations of ionized magnesium (Mg2+ ). Objective data were analyzed using the Wilcoxon rank-sum test with p < .05 used as a determination for significance. Plasma concentrations of Mg2+ increased nearly fivefold, ionized calcium (Ca2+ ) decreased by nearly 10%, and the Ca2+ to Mg2+ ratio declined more than 3.5-fold and remained different than baseline until 24 hr (p < .05). Significant changes were seen with urinary fractional excretion of electrolytes, cardiovascular parameters, and echocardiographic measurements. No changes were detected in CSF electrolyte concentrations. The decrease in Ca2+ result of hypermagnesemia supports the interaction between these cations. Alterations detected in plasma electrolyte concentrations and urinary fractional excretion of electrolytes may serve as biomarkers for regulatory control for the nefarious administration of MgSO4 .
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Affiliation(s)
- Stephen A Schumacher
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Ramiro E Toribio
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Brian Scansen
- College of Veterinary Medicine & Biomedical Services, Colorado State University, Fort Collins, CO, USA
| | - Jeffrey Lakritz
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Alicia L Bertone
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
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Blohm KO, Tichy A, Nell B. Clinical utility, dose determination, and safety of ocular contrast-enhanced ultrasonography in horses: A pilot study. Vet Ophthalmol 2019; 23:331-340. [PMID: 31799804 PMCID: PMC7155076 DOI: 10.1111/vop.12730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/21/2019] [Accepted: 11/08/2019] [Indexed: 12/29/2022]
Abstract
Objective To determine efficacy of contrast‐enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Procedures Ocular B‐mode and contrast‐enhanced ultrasonography were performed bilaterally in nine sedated university‐owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different dose. Qualitative blood flow and quantitative perfusion were analyzed. Heart and respiratory rates were monitored nonsedated, sedated, and during first and second minutes of CEUS. Results Qualitative contrast enhancement (CE) was visible in 7/9 animals. Quantitative CE was measurable bilaterally in four horses, unilaterally in three individuals, and not detected in two animals. In all horses with unilateral CE, the positive eye received the higher dose. Fifteen mL dose resulted in significantly shorter time to peak than 10 mL (P < .05). Peak intensity, maximum signal increase, and corresponding area under the curve were significantly higher for 15 and 20 mL doses compared with 10 mL (P < .05). Uveal and retinal tissues were enhanced frequently. Twenty‐five and 30 mL doses revealed no CE. Only sedation reduced heart rates significantly (P < .05). Clinically relevant changes in respiratory rates or adverse reactions following SF6 application were not observed. Conclusions Contrast enhancement was in most instances dose‐dependent. Fifteen mL appeared appropriate to assess equine ocular perfusion. The reliability in horses remains questionable; however, CEUS was well‐tolerated.
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Affiliation(s)
- Klaas-Ole Blohm
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Nell
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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Diez Bernal S, Studer N, Thormann W, Spadavecchia C, Levionnois O. Pharmacokinetic-pharmacodynamic modelling of the antinociceptive effect of a romifidine infusion in standing horses. Vet Anaesth Analg 2019; 47:129-136. [PMID: 31810766 DOI: 10.1016/j.vaa.2019.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/16/2019] [Accepted: 06/18/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To evaluate the effect of a romifidine infusion on antinociception and sedation, and to investigate its relationship with plasma concentration. STUDY DESIGN Prospective, experimental, nonrandomized trial. ANIMALS A total of 10 healthy adult warmblood horses. METHODS Romifidine (loading dose: 0.08 mg kg-1, infusion: 0.03 mg kg-1 hour-1) was administered intravenously over 120 minutes. Romifidine plasma concentrations were determined by capillary electrophoresis. Sedation quality and nociceptive thresholds were evaluated at regular time points before, during and after romifidine administration. The nociceptive withdrawal reflex was elicited by electrical stimulation at the thoracic limb using a dedicated threshold tracking algorithm and recorded by electromyography at the deltoid muscle. A pharmacokinetic-pharmacodynamic model was established and correlation between romifidine plasma concentration and main output variables tested. RESULTS A two compartmental model best described the romifidine pharmacokinetic profile. The nociceptive thresholds increased compared with baseline in all horses from 10 to 146 minutes after romifidine administration (p < 0.001). Peak effect reached 5.7 ± 2.3 times the baseline threshold (mean ± standard deviation). The effect/concentration relationship followed a counter-clockwise hysteresis loop. The mean plasma concentration was weakly correlated to nociceptive thresholds (p < 0.0071, r = 0.392). The sedative effects were significant until 160 minutes but variable, not correlated to plasma concentration (p = 0.067), and weakly correlated to nociceptive thresholds (p < 0.0001, r = 0.33). CONCLUSIONS AND CLINICAL RELEVANCE Romifidine elicited a marked antinociceptive effect. Romifidine-induced antinociception appeared with a delayed onset and lasted longer than sedation after discontinuing its administration.
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Affiliation(s)
- Sabina Diez Bernal
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| | - Nicole Studer
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Wolfgang Thormann
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Claudia Spadavecchia
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Olivier Levionnois
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S. Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses. Vet Anaesth Analg 2019; 46:325-334. [PMID: 30935776 DOI: 10.1016/j.vaa.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the required rate of a detomidine infusion (loading dose 5 μg kg-1; initial rate 12.5 μg kg-1 hour-1) added to a constant infusion of methadone (0.2 mg kg-1; 0.05 mg kg-1 hour-1) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. STUDY DESIGN Prospective, clinical study. ANIMALS Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. METHODS At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 minutes thereafter, ataxia, sedation and surgical condition were evaluated; each scored 0-3. These scores were used to adjust the detomidine administration rate using the Ghent Sedation Algorithm. A 10 cm visual analogue scale (VAS) was used by the main surgeon at the end of the procedure to evaluate the surgical conditions. Heart rate, systolic arterial pressure and respiratory frequency were also recorded at each time point. For statistical analysis, anova for normal, Kruskal-Wallis H-test for non-normal variables, and Mann-Whitney U test for VAS were used. RESULTS From the 42 horses/ponies included in this study, 28 underwent dental procedures and 14 other types of procedures. Overall, dental procedures required higher mean detomidine rates compared with other types of surgeries (16.9 ± 4.5 versus 9.0 ± 1.9 μg kg-1 hour-1) (p < 0.001). Dental procedures were assigned similar VAS scores, median (range), of 7.8 (5.8-10) with other procedures, 8.7 (2.8-10). Cardiovascular changes were not clinically significant. No signs or behavioural changes of abdominal pain were observed postoperatively. CONCLUSIONS AND CLINICAL RELEVANCE Satisfactory surgical conditions were achieved using a combination of detomidine and methadone infusions with locoregional anaesthesia, with no adverse effects. Dental procedures required higher detomidine dose rates compared with other surgeries.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK.
| | - Stelio Pl Luna
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Frank Gasthuys
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Elke Pollaris
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lieven Vlaminck
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ann Martens
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Stijn Schauvliege
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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