Dose-related effects of detomidine on autonomic responses in the horse

Renal replacement therapy in healthy adult horses

BACKGROUND

Renal replacement therapy (RRT) has been implemented extensively in people to facilitate recovery from acute renal failure (ARF). RRT has not been explored in horses, but might provide a further treatment option in horses with ARF.

OBJECTIVE

To investigate efficacy and safety of RRT in horses.

ANIMALS

Five healthy adult horses.

METHODS

A prospective study was performed on horses restrained in stocks and intravenously connected to a commercial RRT machine to allow continuous venovenous hemodiafiltration to be performed for 6 hours. The RRT machine was set at the following flow rates: blood flow rate 250 mL/min; dialysate rate 3,000 mL/h; prefilter replacement pump 3,000 mL/h; and postfilter replacement pump rate 2,000 mL/h. Balanced electrolyte solution was used as dialysate and replacement fluid. Heart rate, respiratory rate, body temperature, direct arterial blood pressure, urine output, and various clinicopathologic parameters were measured over the study period.

RESULTS

Renal replacement therapy was successfully performed in horses, resulting in a mean creatinine clearance of 0.127 mL/kg/min (68.9 mL/min) and urea reduction ratio of 24%. No adverse effects were detected although a significant decrease in rectal temperature was observed (P ≤ .007). A significant increase in serum phosphorus (P ≤ .001) and decrease in BUN (P < .001) were also noted. A significant prolongation of prothrombin (P < .01) and partial thromboplastin time (P < .0001) were observed along with a decrease in platelet count (P ≤ .04).

CONCLUSIONS AND CLINICAL IMPORTANCE

Renal replacement therapy can safely and effectively be used in adult horses.

Bioavailability of detomidine administered sublingually to horses as an oromucosal gel

The objective of the study was to determine the absorption, bioavailability and sedative effect of detomidine administered to horses as an oromucosal gel compared to intravenous and intramuscular administration of detomidine injectable solution. The study was open and randomized, with three sequences crossover design. Nine healthy horses were given 40 μg/kg detomidine intravenously, intramuscularly or administered under the tongue with a 7-day wash-out period between treatments. Blood samples were collected before and after drug administration for the measurement of detomidine concentrations in serum. The effects of the route of administration on heart rate and rhythm were evaluated and the depth of sedation assessed. Mean (±SD) bioavailability of detomidine was 22% (±5.3%) after sublingual administration and 38.2% (±7.9%) after intramuscular administration. The sedative effects correlated with detomidine concentrations regardless of the route of administration. We conclude that less detomidine is absorbed when given sublingually than when given intramuscularly, because part of it does not reach the circulation. Sublingual administration of detomidine oromucosal gel at 40 μg/kg produces safe sedation in horses. Slow absorption leads to fewer and less pronounced adverse effects than the more rapid absorption after intramuscular injection.

Tachypnea and antipyresis in febrile horses after sedation with alpha-agonists

BACKGROUND

Signs of tachypnea after sedation of febrile horses with alpha2-agonists have been noted previously but have not been further investigated.

OBJECTIVES

To examine the effects of xylazine and detomidine on respiratory rate and rectal temperature in febrile horses and to investigate if either drug would be less likely than the other to cause changes in these variables.

ANIMALS

Nine febrile horses and 9 healthy horses were included in the study.

METHODS

Horses were randomly assigned to sedation with xylazine 0.5 mg/kg or detomidine 0.01 mg/kg. Heart rate and respiratory rate were recorded before sedation and at 1, 3, and 5 minutes after injection. Hourly measurements of rectal temperature were performed starting before sedation.

RESULTS

All febrile horses experienced an episode of tachypnea and antipyresis after sedation. Rectal temperature in the febrile group was significantly lower at 1, 2, and 3 hours after sedation. In several measurements, the decrease was >1 degrees C. Respiratory rate in the febrile group was significantly increased after sedation. All febrile horses were breathing>40 breaths/min and 3 horses>100 breaths/min 5 minutes after sedation. No differences were noted between the 2 treatments. No significant changes in respiratory rate or temperature were noted in the reference group.

CONCLUSIONS AND CLINICAL IMPORTANCE

Febrile horses can become tachypneic after sedation with detomidine or xylazine. The antipyretic properties of alpha2-agonists need consideration when evaluating patients that have been sedated several hours before examination.

Cardiovascular effects of insufflation of the abdomen with carbon dioxide in standing horses sedated with detomidine

OBJECTIVE

To determine the cardiovascular effects of 60 minutes of abdominal insufflation with CO2 to an intra-abdominal pressure of 15 mm Hg in standing horses receiving a constant rate infusion of detomidine.

ANIMALS

5 horses.

PROCEDURE

Horses were randomly allocated into treatment or control groups. A washout period of a minimum of 7 days separated the 2 experimental periods of the crossover study. Catheters were placed into the right atrium, pulmonary artery, jugular vein, and right transverse facial artery after lidocaine infiltration. All horses were sedated with detomidine (8.54 microg/kg/h, i.v.). Horses in the treatment group received abdominal insufflation with CO2 via a laparoscopic cannula to a final and constant intra-abdominal pressure of 15 mm Hg for 60 minutes. Systemic arterial pressure, right atrial pressure, heart rate, cardiac output, core body temperature, and the pH and gas tensions of arterial and mixed venous blood were obtained. Cardiac index and systemic vascular resistance were calculated. Data were collected in 3 stages: preinsufflation (-10 and -5 minutes), insufflation (0, 15, 30, 45, and 60 minutes), and postinsufflation (70 and 80 minutes). The quality of sedation and level of analgesia were determined.

RESULTS

The PaO2 of horses in the treatment group was significantly higher after 60 minutes of pneumoperitoneum than in the control group. Core body temperature decreased significantly from baseline in both groups.

CONCLUSIONS AND CLINICAL RELEVANCE

A 60-minute period of abdominal insufflation to an intra-abdominal pressure of 15 mm Hg did not induce significant cardiovascular abnormalities in healthy horses.

Intoxicações natural e experimental por amitraz em eqüídeos: aspectos clínicos

A administração oral e a aspersão com amitraz reproduziram experimentalmente em 17eqüinos e um asinino um quadro de intoxicação muito similar a outro que vinha ocorrendo em cavalos no Estado do Rio de Janeiro. O início dos sintomas após a administração oral variou entre 15min. e 2h05min., na aplicação por aspersão variou entre 6h28min. e 8h38min. A evolução nos casos de administração oral foi de 4 a 9 dias, nos de aspersão de 5 a 6 dias. Somente morreram animais que receberam a administração oral. Um animal aspergido com o amitraz foi sacrificado. Por via oral foram usadas dosagens de 5,5 mg/kg (uma administração), 5,8 mg/kg (duas administrações) e num terceiro animal, doses que variaram entre 7,2 e 36,4 mg/kg (cinco administrações). Nas aplicações por aspersão, a intoxicação foi reproduzida com soluções nas concentrações de 0,1 e 0,2%. Com relação ao sistema nervoso, os principais sinais observados foram apatia, sonolência, ptoses palpebral e auricular, dificuldade de apreensão, mastigação e deglutição do alimento, arrastar das pinças dos cascos no solo, exposição do pênis, sensibilidade cutânea diminuída/ausente, instabilidade em estação, abdução dos membros, cabeça baixa, incoordenação, bocejos, flacidez labial, exposição da língua, cruzamento dos membros ao caminhar, resposta postural diminuída após cruzar e abduzir os membros, reflexos do lábio superior, palatal, lingual, de deglutição e flexor diminuídos/ausentes, reflexos auricular, palpebral e de ameaça diminuídos e resposta ambulatória diminuída ao teste de girar em círculo de pequeno raio. No que se refere ao sistema digestivo, foram evidenciados, principalmente, hipomotilidade/atonia intestinal, edema dos lábios, distensão abdominal, deitar e levantar com freqüência, rolar no solo, olhar para o flanco, gemer e impactação do intestino grosso. Observaram-se ainda taquicardia, aumento do tempo de preenchimento capilar e mucosas congestas, estridor, taquipnéia, dispnéia, secreção nasal, bradipnéia e respiração abdominal. Todos os três casos naturais ocorreram após aspersão do amitraz. Os primeiros sintomas foram observados 2 e 3 dias após o banho. A evolução foi de 6, 7 e 17 dias. Um animal manifestou a maioria dos sinais referentes ao sistema nervoso observados nos experimentos, com exceção dos sinais de cruzamento dos membros ao caminhar, bocejos, lábios flácidos e exposição do pênis. Outro animal, intoxicado espontaneamente, manifestou somente sintomas digestivos como rolar, ''patear'', hipomotilidade/atonia intestinal e impactação do intestino grosso. Um terceiro animal, inicialmente manifestou sintomas digestivos caracterizados por patear, rolar, atonia intestinal e impactação do intestino grosso, com conseqüente desenvolvimento de laminite; na fase final exibiu acentuada sintomatologia nervosa mostrando compressão da cabeça contra obstáculos, incoordenação motora com cruzamento dos membros ao caminhar e relutância em se movimentar. Baseados no quadro clínico observado, são sugeridos possíveis locais de lesão no sistema nervoso.

Analgesic, sedative and haemodynamic effects of spinally administered romifidine in female goats

The present study was designed to evaluate the analgesic, sedative and haemodynamic effects of spinally administered romifidine in goats. Ten female healthy goats weighing 14-18 kg were randomly divided into two groups, I and II, of five animals each. Romifidine was administered spinally at rates of 50 and 75 microg/kg body weight in the animals of groups I and II, respectively, into the lumbosacral space. The treatments were compared based on their effects on analgesia, sedation, ataxia, heart rate, respiratory rate, rectal temperature, mean arterial pressure, central venous pressure, electrocardiogram and haemato-biochemical parameters. The objective parameters were analysed statistically using paired t-test and Duncan's multiple range test. Depth of analgesia was measured by recording the response to pin prick at different regions and was graded on a scale from 0 to 3. Moderate to complete analgesia was recorded at perineum and flank in both groups. Sedation was moderate in both groups. Ataxia was observed in all the animals but it was more pronounced in group II. Heart rate decreased significantly (P < 0.01) in both groups. A decrease in respiration rate was also recorded in both groups but it was more significant (P < 0.01) and for longer duration in group II as compared to group I. A slight increase in rectal temperature was also observed in both groups. Mean arterial pressure decreased and central venous pressure increased significantly (P < 0.01) in both groups but changes were more pronounced in group II. Electrocardiogram changes in group I included bradycardia, increased QT interval and increased or biphasic T wave but in animals of group II, in addition to these changes, occasional sinus dysrhythmia, increased PR interval and second-degree heart block were also recorded. Haemoglobin and packed cell volume decreased non-significantly in both groups. A significant (P < 0.01) increase in blood glucose and non-significant changes in plasma proteins, urea nitrogen and creatinine were recorded in both groups. The results of the study revealed that romifidine at the rate of 50 microg/kg could produce moderate to complete analgesia of perineum and flank after spinal administration into the lumbosacral space in goats. The analgesia could not be enhanced further by increasing the dose of romifidine up to 75 microg/kg, however, ataxia and cardiopulmonary and haemodynamic side-effects became more apparent.

Alpha 2 adrenoceptor agonists in the horse--a review

In recent years the usefulness of the alpha 2 adrenoceptor agonist drugs has been recognized in equine practice. Several agents have become available and are now licensed for use in a number of countries. The principle actions of all alpha 2 adrenoceptor agonists are similar, in that they produce a reduction in heart rate and alteration of heart rhythm, an initial hypertension followed by a prolonged hypotension, a decrease in the cardiac output and respiratory depression. For clinical purposes, these agents produce sedation and analgesia, they are useful for premedication and markedly potentiate the effects of other sedative/analgesic agents. Differences in receptor specificity between the alpha 2 adrenoceptor agonists results in the distinguishing characteristics of the individual agents, particularly with respect to their duration of action, sedative effect and analgesic properties; their cardiopulmonary effects are however similar, when equipotent sedative doses are administered. When used in combination with other agents, the alpha 2 adrenoceptor agonists all appear to act in a similar manner, with the greatest difference being related to their duration of action.

Total intravenous anaesthesia in ponies using detomidine, ketamine and guaiphenesin: pharmacokinetics, cardiopulmonary and endocrine effects

Pharmacokinetics and some pharmacological effects of anaesthesia induced by a combination of detomidine, ketamine and guaiphenesin were investigated in eight ponies. Cardiopulmonary function was studied and plasma met-enkephalin, dynorphin, beta-endorphin, arginine vasopressin, adrenocorticotrophin, cortisol, 11-deoxycortisol and catecholamine concentrations were measured. The combination produced slight cardiorespiratory depression, hyperglycaemia and a reduction in haematocrit. There were no changes in plasma opioids, pituitary peptides or catecholamines. Plasma cortisol concentration decreased and plasma 11-deoxycortisol increased indicating a suppression of steroidogenesis. Steady state ketamine and guaiphenesin concentrations were attained during the infusion period, and ketamine concentrations likely to provide adequate analgesia for surgical operations were achieved (more than 2.2 micrograms ml-1). Steady state detomidine concentration was not attained. The ponies took on average 68 minutes to recover to standing and the recovery was uneventful.