Clinical Analgesia in Reptiles

Macroscopic, microscopic, and immunofluorescent characterization of the Greek tortoise (Testudo graeca graeca) oropharyngeal floor with concern to its feed adaptation as a herbivorous land reptile

The current investigation focuses on gross anatomy, light, and scanning electron microscopy (SEM) of the Testudo graeca oropharyngeal floor, with particular reference to the immunofluorescence technique to examine its tongue. The T. graeca oropharyngeal floor showed many anatomical structures: the lower rhamphotheca, paralingual ridge, lower alveolar ridge, tongue, laryngeal mound, and glottis. The lower rhamphotheca appeared as a V-shaped jaw line with a highly serrated edge and a median tomium (beak). SEM observations of the lingual apex and the lingual body showed rectangular and conical filiform papillae with porous surfaces and taste pores. Meanwhile, the lingual root had two wings that carried papillae with different shapes: dagger-shaped, conical, bifurcated, and leaf-like papillae, and these papillae lacked taste pores. The laryngeal mound had openings for the laryngeal mucus gland and its secretions. Light microscopy findings showed mucous glands in the propria submucosa and near the mucosal surface of the lingual apex. The lingual root had lingual papillae and two hyaline cartilaginous skeletons between skeletal muscles, and the lingual papillae were elongated filiform, rectangular filiform papillae, and fungiform papillae. The lamina propria constituted the core of the lingual papillae and the mucous gland, they had a positive reaction with the periodic acid schiff (PAS) reagent. The apical surface of the fungiform papillae had taste pores. Under immunofluorescence, the vimentin was detected in taste bud cells, and synaptophysin reacted to the taste buds and nerve bundles. The current study of the Greek tortoise oropharyngeal floor investigated its herbivorous eating habits using its serrated lower rhamphotheca, a large tongue with differently shaped papillae, and numerous mucous glands. RESEARCH HIGHLIGHTS: The Greek tortoise (T. graeca graeca) oropharyngeal floor showed many anatomical structures: lower rhamphotheca, paralingual ridge, lower alveolar ridge, tongue, laryngeal mound, and glottis. SEM and light microscopy observations of the tongue revealed varied types and shapes of lingual papillae with a porous surface on the tongue apex (rectangular or conical filiform papillae), on the tongue body (filiform and fungiform papillae), and on the tongue root (dagger-shaped, conical, bifurcated, and leaf-like papillae). Light microscopy findings: the lamina propria constituted the core of the lingual papillae and had numerous mucous glands that had a slightly magenta-red color with PAS reagent. The apical surface of the fungiform papillae had taste pores. Vimentin and synaptophysin gave a reaction to the taste buds.

PHARMACOKINETICS OF TRAMADOL AND O-DESMETHYLTRAMADOL IN GIANT TORTOISES (CHELONOIDIS VANDENBURGHI, CHELONOIDIS VICINA)

The objective of this study was to determine the pharmacokinetics of two orally administered doses of tramadol (1 mg/kg and 5 mg/kg) and its metabolite, O-desmethyltramadol (M1) in giant tortoises (Chelonoidis vandenburghi, Chelonoidis vicina). Eleven giant tortoises (C. vandenburghi, C. vicina) received two randomly assigned, oral doses of tramadol (either 1 mg/kg or 5 mg/kg), with a washout period of 3 wk between each dose. The half-life (t½) of orally administered tramadol at 1 mg/kg and 5 mg/kg was 11.9 ± 4.6 h and 13.2 ± 6.1 h, respectively. After oral administration of tramadol at 1 mg/kg and 5 mg/kg, the maximum concentration (Cmax) was 125 ± 69 ng/ml and 518 ± 411 ng/ml, respectively. There were not enough data points to determine pharmacokinetic (PK) parameters for the M1 metabolite from either dose. Tramadol administered orally to giant tortoises at both doses provided measurable plasma concentrations of tramadol for approximately 48 h with occasional transient sedation. Oral tramadol at 5 mg/kg, on average, achieves concentrations of >100 ng/ml, the reported human therapeutic threshold, for 24 h. Based on the low levels of M1 seen in this study, M1 may not be a major metabolite in this taxon.

Surgical removal of an atypical histiocytic cell proliferation in a bearded dragon (Pogona vitticeps)

A 4-year-old female bearded dragon (Pogona vitticeps) was referred to the Clinic for Small Mammals, Reptiles and Birds of the University of Veterinary Medicine, Hannover, Germany for diagnostics and treatment of a growing mass in the right cervical region. The owner reported that the mass had grown over the past 4 weeks with only little alteration in the lizard´s behavior when the animal started rubbing its neck against the cage equipment. Physical examination as well as ultrasonographic and computed tomographic diagnostics revealed a highly vascularized mass, which allowed for the hypothesis of an aneurysm or a neoplasia. Complete surgical resection of the mass could be performed uneventfully. The bearded dragon recovered well from anesthesia and the surgical procedure. The microbiological sample of the excised mass revealed Group F-67 Salmonella. Histopathological examination of the excised mass revealed a histiocytic cell proliferation with centrally located blood filled cavities, hemorrhages and granulation tissue resembling features of a pseudoaneurysm. This report describes the diagnosis of an atypical growing mass in a bearded dragon and its successful removal.

Antinociceptive effects of nortriptyline and desipramine hydrochloride in Speke's hinge-back tortoise (Kinixys Spekii)

Some of the most commonly used analgesic drugs in animals are of questionable efficacy or present adverse side effects among the various species of reptiles. Tricyclic antidepressants have been demonstrated to have antinociceptive effects in several animal models of pain and could be a good alternative for use in reptiles. The aim of the study was to investigate the antinociceptive effects of nortriptyline and desipramine hydrochloride in Speke's hinge-back tortoise. A total of 24 animals weighing 600-1000 g were used for nociceptive tests, i.e., formalin, capsaicin, and hot plate tests. Drugs were administered intracoelomically 30 min before starting the tests. The time spent in nocifensive behavior and the associated observable effects during the tests were recorded. Only the highest dose of 40 mg/kg of nortriptyline hydrochloride caused statistically significant decrease in nocifensive behavior in both the formalin and the capsaicin test. Desipramine hydrochloride at doses of 20 and 40 mg/kg caused statistically significant decrease in nocifensive behavior in the formalin test. Also, desipramine hydrochloride at doses of 15, 20, and 60 mg/kg caused statistically significant decrease in nocifensive behavior in the capsaicin test. None of the doses used for both drugs had any statistically significant effect on nocifensive behavior in the hot plate test. The results show that nortriptyline and desipramine hydrochloride have significant antinociceptive effects in the chemical but not thermal inflammatory pain-related behavior in the Speke's hinge-back tortoise. The most common associated side effect following administration of the higher doses of either of the drugs is excessive salivation.

A Critical Review on the Pharmacodynamics and Pharmacokinetics of Non-steroidal Anti-inflammatory Drugs and Opioid Drugs Used in Reptiles

Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are analgesics used for moderate to severe pain in many animals, including reptiles. However, reptilian dosing regimens are often extrapolated from other animal species. This is not ideal as inter- and intra-species variability in physiology may result in varied drug disposition. Therefore, this critical review aims to collate data from pharmacological studies of selected NSAIDs and opioids performed in reptile and provide an analysis and discussion on the existing pharmacodynamic knowledge and pharmacokinetic data of NSAIDs and opioids use in reptiles. Additionally, key pharmacokinetic trends that may aid dosing of NSAIDs and opioids in reptiles will also be highlighted. Most of the existing reports of NSAID used in reptiles did not observe any adverse effects directly associated to the respective NSAID used, with meloxicam being the most well-studied. Despite the current absence of analgesic efficacy studies for NSAIDs in reptiles, most reports observed behavioural improvements in reptiles after NSAID treatment. Fentanyl and morphine were studied in the greatest number of reptile species with analgesic effects observed with the doses used, while adverse effects such as sedation were observed most with butorphanol use. While pharmacokinetic trends were drug- and species-specific, it was observed that clearance (CL) of drugs tended to be higher in squamates compared to chelonians. The half-life (t_1/2) of meloxicam also appeared to be longer when dosed orally compared to other routes of drug administration. This could have been due to absorption-rate limited disposition. Although current data provided beneficial information, there is an urgent need for future research on NSAID and opioid pharmacology to ensure the safe and effective use of opioids in reptiles.

Evaluation of a dexmedetomidine-midazolam-ketamine combination administered intramuscularly in captive ornate box turtles (Terrapene ornata ornata)

OBJECTIVE

To characterize the effects of a combination protocol of dexmedetomidine-midazolam-ketamine (DMK) administered intramuscularly (IM) in ornate box turtles (Terrapene ornata ornata).

STUDY DESIGN

Prospective experimental trial.

ANIMALS

A total of 16 apparently clinically healthy adult ornate box turtles (eight male, eight female).

METHODS

Each turtle was treated with dexmedetomidine (0.1 mg kg^-1), midazolam (1 mg kg^-1) and ketamine (10 mg kg^-1) administered IM. Time to first response, time to maximal effect, the plateau phase and time to recovery from reversal administration were recorded. Physiologic variables, muscle tone, reflexes and the ability to perform endotracheal intubation were recorded at 5 minute intervals. Movement in response to an IM injection of 0.1 mL sterile 0.9% NaCl administered in the left pelvic limb, using a 25 gauge needle to a depth of just past the bevel of the needle, was assessed every 15 minutes. Atipamezole (0.5 mg kg^-1) IM and flumazenil (0.05 mg kg^-1) SC were administered 60 minutes after the initial DMK injections.

RESULTS

The mean time to first response, time to maximal effect, the plateau phase and time to recovery were 2.1, 14.9, 38.7 and 7.8 minutes, respectively. A respiratory rate was not observed in most turtles. The body temperature significantly increased over time. The palpebral reflex was persistent in 43% of turtles and the tail pinch reflex remained intact in 13% of turtles. All turtles recovered with no observed adverse effects.

CONCLUSIONS AND CLINICAL RELEVANCE

In this study, this DMK protocol administered to ornate box turtles resulted in a rapid-onset, light anesthesia lasting approximately 40 minutes and a smooth recovery with no adverse effects noted.

Circulating miRNome of Trachemys scripta after elective gonadectomy under general anesthesia

Post-surgical management is an important issue in veterinary medicine, requiring biomarkers with high sensitivity and specificity for timely and effective treatment. Emerging evidence suggests that miRNAs are promising stress- and pain-related markers. The aims were to profile the circulating miRNA signature in plasma of turtles (Trachemysscripta) and point out potential candidate biomarkers to assess the status of the animal. The plasma of female turtles underwent surgical gonadectomy were collected 24 h pre-surgery, and 2.5 h and 36 h post-surgery. The expression of miRNAs was profiled by Next Generation Sequencing and the dysregulated miRNAs were validated using RT-qPCR. The diagnostic value of miRNAs was calculated by ROC curves. The results showed that 14 miRNAs were differentially expressed over time. RT-qPCR validation highlighted that 2-miR-499-3p and miR-203-5p-out of 8 miRNAs tested were effectively modulated. The Area Under the Curve (AUC) of miR-203-5p was fair (AUC 0.7934) in discriminating pre- and 36 h post-surgery samples and poor for other time points; the AUC of miR-499-3p was excellent (AUC 0.944) in discriminating pre-surgery and 2.5 h post-surgery samples, and fair in discriminating pre-surgery and 36 h post-surgery (AUC 0.7292) and 2.5 h and 36 h post-surgery (AUC 0.7569) samples. In conclusion, we demonstrated for the first time that miRNAs profile changes in plasma of turtles underwent surgical oophorectomy and identified miR-203-5p and miR-499-3p as potential candidate biomarkers to assess animals' status. Further studies are necessary to confirm their diagnostic value and to investigate functional and mechanistic networks to improve our understanding of the biological processes.

Evaluating the efficacy of alfaxalone in corn snakes (Pantherophis guttatus)

OBJECTIVE

Alfaxalone is a popular veterinary anesthetic; however, research on this anesthetic in snakes has been limited to ball pythons, garter snakes and several Australian species. The objective was to evaluate the anesthetic effects of alfaxalone in corn snakes (Pantherophis guttatus), a popular pet snake.

STUDY DESIGN

Prospective, randomized crossover study.

ANIMALS

A total of eight corn snakes.

METHODS

In phase I, snakes were subcutaneously administered three doses of alfaxalone (5, 10 and 15 mg kg^-1) in the cranial third of the body to determine the most effective dose. In phase II, a dose of 15 mg kg^-1 was administered in the cranial and caudal thirds of the snakes to determine if injection site affected anesthesia duration. Heart rate (HR), respiratory rate (f_R), righting reflex, escape response, tail pinch, needle prick and tongue flick were monitored at baseline and 5 minute intervals until the snakes fully recovered.

RESULTS

Duration of anesthesia differed significantly, with higher doses lasting longer than lower doses: 5 mg kg^-1 [23.8 ± 4.4 (15-30) minutes]; 10 mg kg^-1 [40.6 ± 9.4 (25-55) minutes]; and 15 mg kg^-1 [56.9 ± 8.4 (50-70) minutes], mean ± standard deviation (range). The tail pinch reflex was not completely lost in phase 1. There was a significant change in f_R over time, but this was not related to dose. HR was not different by time or dose. Duration of anesthesia was not different after administration of alfaxalone (15 mg kg^-1) in the cranial third versus the caudal third of the body; however, there was a significant decrease in HR and f_R at this dose, regardless of injection site.

CONCLUSIONS AND CLINICAL RELEVANCE

Based on these results, alfaxalone (15 mg kg^-1) provides adequate anesthesia for brief procedures or intubation; however, additional analgesia is required for painful procedures.

Modulation of nociception by amitriptyline hydrochloride in the Speke's hinge-back tortoise (Kiniskys spekii)

BACKGROUND

There are limited studies on the utilization of analgesics in testudines. Management of pain in reptiles is by use of analgesics generally used in other vertebrate species. Evidently, some analgesics considered to be generally effective in reptiles are not effective in certain reptile species.

OBJECTIVE

The purpose of this study was to examine the effect of amitriptyline hydrochloride on nociceptive behaviour in Speke's hinge-back tortoise.

METHODS

Twenty-four adult Speke-hinged tortoises weighing 500-700 g were used. The effects of amitriptyline hydrochloride on nociception were evaluated using the formalin, capsaicin and hot plate nociceptive tests. Amitriptyline was administered intracoelomically at doses of 0.5, 1.0 and 3.0 mg/kg.

RESULTS

The higher doses of amitriptyline hydrochloride caused an increase in nociceptive behaviour (time spent in hindlimb withdrawal) on the formalin and capsaicin nociceptive tests, suggesting a potentiating effect. However, the doses used had no significant change in nociceptive behaviour on withdrawal response in the hot plate test.

CONCLUSIONS

The study showed that amitriptyline hydrochloride which is widely used in management of neuropathic pain potentiates nociceptive effects in the formalin and capsaicin nociceptive tests in the Speke's hinge-back tortoise. The hot plate test, which previously has not been reported in these animals, gave results not in line with the other tests and therefore more testing and validation of the test is required. Amitriptyline modulates chemical and thermal pain differently.

Respiratory and antinociceptive effects of dexmedetomidine and doxapram in ball pythons (Python regius)

OBJECTIVE

To determine the effects of dexmedetomidine, doxapram, and dexmedetomidine plus doxapram on ventilation ([Formula: see text]e), breath frequency, and tidal volume (Vt) in ball pythons (Python regius) and of doxapram on the thermal antinociceptive efficacy of dexmedetomidine.

ANIMALS

14 ball pythons.

PROCEDURES

Respiratory effects of dexmedetomidine and doxapram were assessed with whole-body, closed-chamber plethysmography, which allowed for estimates of [Formula: see text]e and Vt. In the first experiment of this study with a complete crossover design, snakes were injected, SC, with saline (0.9% NaCl) solution, dexmedetomidine (0.1 mg/kg), doxapram (10 mg/kg), or dexmedetomidine and doxapram, and breath frequency, [Formula: see text]e, and Vt were measured before and every 30 minutes thereafter, through 240 minutes. In the second experiment, antinociceptive efficacy of saline solution, dexmedetomidine, and dexmedetomidine plus doxapram was assessed by measuring thermal withdrawal latencies before and 60 minutes after SC injection.

RESULTS

Dexmedetomidine significantly decreased breath frequency and increased Vt but did not affect [Formula: see text]e at all time points, compared with baseline. Doxapram significantly increased [Formula: see text]e, breath frequency, and Vt at 60 minutes after injection, compared with saline solution. The combination of dexmedetomidine and doxapram, compared with dexmedetomidine alone, significantly increased [Formula: see text]e at 30 and 60 minutes after injection and did not affect breath frequency and Vt at all time points. Thermal withdrawal latencies significantly increased when snakes received dexmedetomidine or dexmedetomidine plus doxapram, versus saline solution.

CONCLUSIONS AND CLINICAL RELEVANCE

Concurrent administration of doxapram may mitigate the dexmedetomidine-induced reduction of breathing frequency without disrupting thermal antinociceptive efficacy in ball pythons.

Evaluation of subcutaneous administration of alfaxalone-midazolam and dexmedetomidine-midazolam for sedation of ball pythons (Python regius)

OBJECTIVE

To evaluate SC administration of alfaxalone-midazolam and dexmedetomidine-midazolam for sedation of ball pythons (Python regius).

ANIMALS

12 healthy juvenile ball pythons.

PROCEDURES

In a randomized crossover study, each snake was administered a combination of alfaxalone (5 mg/kg [2.3 mg/lb]) and midazolam (0.5 mg/kg [0.23 mg/lb]) and a combination of dexmedetomidine (0.05 mg/kg [0.023 mg/lb]) and midazolam (0.5 mg/kg), SC, with a washout period of at least 7 days between protocols. Respiratory and heart rates and various reflexes and behaviors were assessed and compared between protocols. Forty-five minutes after protocol administration, sedation was reversed by SC administration of flumazenil (0.05 mg/kg) alone or in combination with atipamezole (0.5 mg/kg; dexmedetomidine-midazolam protocol only). Because of difficulties with visual assessment of respiratory effort after sedative administration, the experiment was repeated for a subset of 3 ball pythons, with plethysmography used to assess respiration.

RESULTS

Both protocols induced a similar level of moderate sedation with no adverse effects aside from transient apnea. Cardiopulmonary depression was more profound, but time to recovery after reversal was significantly shorter, for the dexmedetomidine-midazolam protocol than for the alfaxalone-midazolam protocol. Plethysmographic findings were consistent with visual observations and suggested that snakes compensated for a decrease in respiratory rate by increasing tidal volume amplitude.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that both protocols induced clinically relevant sedation in ball pythons and should be useful for minor procedures such as venipuncture and diagnostic imaging. However, caution should be used when sedating snakes with compromised cardiopulmonary function. (J Am Vet Med Assoc 2020;256:573-579.

Pain in dinosaurs: what is the evidence?

How far back can we trace behaviour associated with pain? Behaviour is not preserved in the palaeontological record, so, for dinosaurs, we are restricted to what we can deduce from fossilized bones and tracks. This review is a thought experiment using circumstantial evidence from dinosaur fossils and from the behaviour of their extant relatives to describe probable responses of dinosaurs to serious injuries. Searches yielded 196 papers and chapters with: reports of healed serious injuries, and limping gait and injured feet in trackways; information about physiology and behaviour relevant to healing; evidence of evolutionary connections with birds and crocodilians, and their behaviour; and information about relevant aspects of evolution. Clearly, many dinosaurs survived injuries that would have seriously hampered mobility, impairing hunting or escape from predators, and affecting social interactions. Recovery from severe injuries implies pain-mediated responses. Rates of healing seem faster than for other reptiles, possibily aided by warm-bloodedness. Nesting was often communal, raising the possibility of parental and group protection for injured young. The existence of family groups, packs or herds raises the possibility of protection or feeding from pack kills. This is the first study, to our knowledge, of possible pain behaviour and responses to injury in dinosaurs. This article is part of the Theo Murphy meeting issue 'Evolution of mechanisms and behaviour important for pain'.

A systematic study of injectable anesthetic agents in the brown anole lizard (Anolis sagrei )

Anolis lizards have served as important research models in fields ranging from evolution and ecology to physiology and biomechanics. However, anoles are also emerging as important models for studies of embryo development and tissue regeneration. The increased use of anoles in the laboratory has produced a need to establish effective methods of anesthesia, both for routine veterinary procedures and for research procedures. Therefore, we tested the efficacy of different anesthetic treatments in adult female Anolis sagrei. Alfaxalone, dexmedetomidine, hydromorphone, ketamine and tribromoethanol were administered subcutaneously (SC), either alone or combined at varying doses in a total of 64 female anoles. Drug induction time, duration, anesthesia level and adverse effects were assessed. Differences in anesthesia level were observed depending on injection site and drug combination. Alfaxalone/dexmedetomidine and tribromoethanol/dexmedetomidine were the most effective drug combinations for inducing a surgical plane of anesthesia in anoles. Brown anoles injected SC with alfaxalone (30 mg/kg) plus dexmedetomidine (0.1 mg/kg) or with tribromoethanol (400 mg/kg) plus dexmedetomidine (0.1 mg/kg) experienced mean durations of surgical anesthesia levels of 31.2 ± 5.3 and 87.5 ± 19.8 min with full recovery after another 10.9 ± 2.9 and 46.2 ± 41.8 min, respectively. Hydromorphone given with alfaxalone/dexmedetomidine resulted in deep anesthesia with respiratory depression, while ketamine/hydromorphone/dexmedetomidine produced only light to moderate sedation. We determined that alfaxalone/dexmedetomidine or tribromoethanol/dexmedetomidine combinations were sufficient to maintain a lizard under general anesthesia for coeliotomy. This study represents a significant step towards understanding the effects of anesthetic agents in anole lizards and will benefit both veterinary care and research on these animals.

Antinociceptive efficacy and respiratory effects of dexmedetomidine in ball pythons (Python regius)

OBJECTIVE To determine antinociceptive efficacy, behavioral patterns, and respiratory effects associated with dexmedetomidine administration in ball pythons (Python regius). ANIMALS 12 ball pythons. PROCEDURES Antinociception was assessed by applying an infrared heat stimulus to the cranioventral surface of snakes during 2 experiments. Thermal withdrawal latency was measured at 0, 2, and 24 hours after SC injections of dexmedetomidine (0.1 or 0.2 mg/kg) or saline (0.9% NaCl) solution and at 0 to 60 minutes after injection of dexmedetomidine (0.1 mg/kg) or saline solution. Behaviors were recorded at 0, 2, and 24 hours after administration of dexmedetomidine (0.1 mg/kg) or saline solution. Tongue flicking, head flinch to the approach of an observer's hand, movement, and righting reflex were scored. Respiratory frequency was measured by use of plethysmography to detect breathing-related movements after injection of dexmedetomidine (0.1 mg/kg) or saline solution. RESULTS Mean baseline withdrawal latency was 5 to 7 seconds; saline solution did not alter withdrawal latency. Dexmedetomidine increased withdrawal latency by 18 seconds (0.2 mg/kg) and 13 seconds (0.1 mg/kg) above baseline values at 2 hours. Increased withdrawal latency was detected within 15 minutes after dexmedetomidine administration. At 2 hours after injection, there were few differences in behavioral scores. Dexmedetomidine injection depressed respiratory frequency by 55% to 70%, compared with results for saline solution, but snakes continued to breathe without prolonged apnea. CONCLUSIONS AND CLINICAL RELEVANCE Dexmedetomidine increased noxious thermal withdrawal latency without causing excessive sedation. Therefore, dexmedetomidine may be a useful analgesic drug in ball pythons and other snake species.

Evaluation of sedative and antinociceptive effects of dexmedetomidine, midazolam and dexmedetomidine-midazolam in tegus (Salvator merianae)

OBJECTIVE

To evaluate dexmedetomidine, midazolam and dexmedetomidine-midazolam for sedation and antinociception in tegus.

STUDY DESIGN

Prospective, crossover, randomized, blinded study.

ANIMALS

Six healthy tegus (Salvator merianae) weighing 1.6±0.3 kg.

METHODS

Tegus were administered intramuscularly saline (0.5 mL; CON), dexmedetomidine (0.2 mg kg^-1; DX), midazolam (1 mg kg^-1; MZ) and dexmedetomidine-midazolam (same doses; DM). Heart rate (HR) and respiratory frequency (f_R) were recorded before treatment (baseline) and 15, 30 minutes, 1, 2, 3, 4, 6, 8, 12 and 24 hours after the treatments. Sedation scores were recorded according to resistance to manual restraint, posture and response to noxious stimulus, at baseline and 5, 10, 15, 30 minutes, 1, 2, 3, 4, 6, 8, 12 and 24 hours after the treatments. Antinociception was evaluated by measurement of latency of limb withdrawal reflex (LWR) to thermal stimulus, recorded at baseline and 15 minutes, 1, 2, 4, 8, 12 and 24 hours after the treatments.

RESULTS

Lower HR (DX and DM) and f_R (MZ, DX and DM) than CON were measured 15 minutes after the treatment and for up to 6 hours. Sedation was mild to moderate in MZ, deep in DM and absent in DX, although animals showed behavioral changes in DX, with increase in aggressiveness. Median (interquartile range) duration of sedation were 170 (50; 235) minutes in MZ and 230 (115; 235) minutes in DM. Recovery period was prolonged in both treatments, surpassing the duration of the experiment. Higher LWR than CON was detected from 15 minutes until 12 hours in DX and DM.

CONCLUSIONS AND CLINICAL RELEVANCE

Midazolam provided sedation without antinociception, and dexmedetomidine provided antinociception without sedation. Drug combination increased the duration of sedation but not antinociception. Due to increased duration of sedation, reversal of effects with flumazenil and atipamezole should be considered after conclusion of clinical procedures.

Antinociceptive and respiratory effects following application of transdermal fentanyl patches and assessment of brain μ-opioid receptor mRNA expression in ball pythons

OBJECTIVE To quantify plasma fentanyl concentrations (PFCs) and evaluate antinociceptive and respiratory effects following application of transdermal fentanyl patches (TFPs) and assess cerebrospinal μ-opioid receptor mRNA expression in ball pythons (compared with findings in turtles). ANIMALS 44 ball pythons (Python regius) and 10 turtles (Trachemys scripta elegans). PROCEDURES To administer 3 or 12 μg of fentanyl/h, a quarter or whole TFP (TFP-3 and TFP-12, respectively) was used. At intervals after TFP-12 application in snakes, PFCs were measured by reverse-phase high-pressure liquid chromatography. Infrared heat stimuli were applied to the rostroventral surface of snakes to determine thermal withdrawal latencies after treatments with no TFP (control [n = 16]) and TFP-3 (8) or TFP-12 (9). Breathing frequency was measured in unrestrained controls and TFP-12-treated snakes. μ-Opioid receptor mRNA expression in brain and spinal cord tissue samples from snakes and turtles (which are responsive to μ-opioid receptor agonist drugs) were quantified with a reverse transcription PCR assay. RESULTS Mean PFCs were 79, 238, and 111 ng/mL at 6, 24, and 48 hours after TFP-12 application, respectively. At 3 to 48 hours after TFP-3 or TFP-12 application, thermal withdrawal latencies did not differ from pretreatment values or control treatment findings. For TFP-12-treated snakes, mean breathing frequency significantly decreased from the pretreatment value by 23% and 41% at the 24- and 48-hour time points, respectively. Brain and spinal cord tissue μ-opioid receptor mRNA expressions in snakes and turtles did not differ. CONCLUSIONS AND CLINICAL RELEVANCE In ball pythons, TFP-12 application resulted in high PFCs, but there was no change in thermal antinociception, indicating resistance to μ-opioid-dependent antinociception in this species.

Radio Transmitter Implantation and Movement in the Wild Timber Rattlesnake ( Crotalus horridus )

Radiotelemetry transmitters have become critical to studies of wildlife ecology. However, little is known about how transmitter implantation surgery affects the mobility of some species, including the timber rattlesnake, Crotalus horridus . Tracking snake movement can provide insights into the effects of transmitter implantation. During 2007-11, 71 radio transmitters were surgically implanted intracoelomically in 47 timber rattlesnakes. Over 20 of these snakes underwent surgery at least twice in 5 yr to replace old transmitters. Surgeries were performed under general anesthesia with a local nerve block at the site of implantation, 20 cm cranial to the cloaca. Snakes were also administered postsurgical meloxicam and enrofloxacin every 24 h for three doses. Two to five days after surgery, snakes were released at their original locations and radiotracked regularly during the active seasons (April-October 2007-11). Average daily movement data (distance traveled) were compiled for each snake. Snakes undergoing transmitter surgery in a given year did not differ significantly in distance traveled compared to snakes that had transmitters but did not have surgery in that year. Distance traveled for each snake did not differ before or after surgery or between weeks 1 and 2 postsurgery, indicating that the transmitter implantation did not alter snake movement.

Approach to Reptile Emergency Medicine

This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients.

Wildlife Emergency and Critical Care

Wildlife patients often present as emergencies. For veterinarians who do not typically treat wildlife, it is important to be able to stabilize and determine the underlying cause of the animal's signs. This article discusses initial assessment, stabilization, and treatment of common emergency presentations in wild birds, reptiles, and mammals.