Therapeutic Review: Deslorelin Acetate Subcutaneous Implant

Hormonal Suppression in Female Rhesus Macaques (Macaca mulatta) Implanted Subcutaneously with Deslorelin

Providing effective contraception for nonhuman primates (NHP) is challenging. Deslorelin acetate is a commercially available gonadotropin-releasing hormone (GnRH) agonist that may provide a relatively noninvasive, long-lasting, and potentially reversible alternative to standard NHP contraception methods. This study evaluated the duration of suppression of progesterone and estradiol in 6 adult female rhesus macaques (Macaca mulatta) that received a single subcutaneous 4.7 mg deslorelin implant. We hypothesized that deslorelin would suppress production of these hormones for 6 mo with a correspond- ing cessation of menses. Prior to implantation, blood was collected over 1 mo for baseline hormone analyses. Macaques were sedated at the onset of the next menstrual cycle and a 4.7 mg deslorelin implant was placed in the interscapular region. Blood was collected over the subsequent month at the same intervals used for the baseline collection schedule, and then every 7 d thereafter. Results showed that estradiol and progesterone transiently increased 1 to 3 d after implantation, then fell to basal levels within 6 d of implantation. The duration of hormone suppression (progesterone <0.5 ng/mL) varied among animals. Two macaques returned to cyclicity by 96 d and 113 d after implantation, while hormones remained suppressed in the other 4 macaques at 6 mo after implantation. Cessation of menses correlated with hormone suppression except in 1 animal that continued to have sporadic vaginal bleeding despite progesterone remaining below 0.5 ng/mL. This study indicates that deslorelin is a noninvasive and long-lasting contraceptive method in female rhesus macaques. However, individual variation should be considered when determining reimplantation intervals.

Overview of Drug Delivery Methods in Exotics, Including Their Anatomic and Physiologic Considerations

Drug delivery to exotic animals may be extrapolated from domestic animals, but some physiologic and anatomic differences complicate treatment administration. Knowing these differences enables one to choose optimal routes for drug delivery. This review provides practitioners with a detailed review of the currently reported methods used for drug delivery of various medications in the most common exotic animal species. Exotic animal peculiarities that are relevant for drug administration are discussed in the text and outlined in tables and boxes to help the reader easily find targeted information.

Reproductive Medicine in Lizards

Common reproductive problems in captive male lizards are hemipenile plugs in hemipenial sac, unilateral prolapse of hemipenis, or bilateral prolapse of hemipene. Although the orchiectomy is performed as a treatment for testicular disease, the effectiveness in reducing aggressive behavior is unclear. Female captive lizards suffer from cloacal prolapse, preovulatory follicular stasis, or dystocia. The veterinarian must differentiate between the disorders because the treatment differs. Mating, physical, or visual contact with the male stimulates ovulation and prevents preovulatory follicular stasis. Surgical intervention is usually required for dystocia. This article discusses selected procedures and use of ultrasonography and diagnostic endoscopy.

Long-term contraception in a small implant: A review of Suprelorin (deslorelin) studies in cats

Rationale:

Deslorelin (Suprelorin®; Virbac) is a gonadotropin-releasing hormone (GnRH) agonist licensed in select countries for the long-term suppression of fertility in adult male dogs and male ferrets. This article summarizes studies investigating the use of deslorelin implants for the long-term suppression of fertility in male and female domestic cats.

Evidence base:

Slow-release deslorelin implants have been shown to generate effective, safe and reversible long-term contraception in male and female cats. In pubertal cats, a 4.7 mg deslorelin implant suppressed steroid sex hormones for an average of approximately 20 months (range 15–25 months) in males and an average of approximately 24 months (range 16–37 months) in females. Reversibility has been demonstrated by fertile matings approximately 2 years post-treatment in both male and female adult cats. In prepubertal female cats of approximately 4 months of age, puberty was postponed to an average of approximately 10 months of age (range 6–15 months) by a 4.7 mg deslorelin implant.

Challenges:

The large variability in the duration of suppression of gonadal activity makes the definition of the optimal time for reimplantation quite challenging. In addition, the temporary stimulation phase occurring in the weeks following deslorelin implantation can induce in adult female cats a fertile estrus that needs to be managed to avoid unwanted pregnancy. Longer duration and larger scale controlled field studies implementing blinding, a negative control group and a carefully controlled randomization to each group are needed. Furthermore, the effects of repeated treatment need to be investigated. Finally, the effect of treatment on growth and bone quality of prepubertal cats needs to be assessed. However, the ease of use, long-lasting effects and reversibility of deslorelin implants are strong positive points supporting their use for controlling feline reproduction.