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Bacon EK, Donnelly CG, Bellone RR, Haase B, Finno CJ, Velie BD. Preliminary investigation of potential links between pigmentation variants and opioid analgesic effectiveness in horses during cerebrospinal fluid centesis. BMC Vet Res 2024; 20:311. [PMID: 38997753 PMCID: PMC11245827 DOI: 10.1186/s12917-024-04139-z] [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: 03/25/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The pleiotropic effects of the melanocortin system show promise in overcoming limitations associated with large variations in opioid analgesic effectiveness observed in equine practice. Of particular interest is variation in the melanocortin-1-receptor (MC1R) gene, which dictates pigment type expression through its epistatic interaction with the agouti signalling protein (ASIP) gene. MC1R has previously been implicated in opioid efficacy in other species; however, this relationship is yet to be explored in horses. In this study, analgesic effectiveness was scored (1-3) based on noted response to dura penetration during the performance of cerebrospinal fluid centisis after sedation and tested for association with known genetic regions responsible for pigmentation variation in horses. RESULTS The chestnut phenotype was statistically significant (P < 0.05) in lowering analgesic effectiveness when compared to the bay base coat colour. The 11bp indel in ASIP known to cause the black base coat colour was not significant (P>0.05); however, six single nucleotide polymorphisms (SNPs) within the genomic region encoding the ASIP gene and one within MC1R were identified as being nominally significant (P<0.05) in association with opioid analgesic effectiveness. This included the location of the known e MC1R variant resulting in the chestnut coat colour. CONCLUSIONS The current study provides promising evidence for important links between pigmentation genes and opioid effectiveness in horses. The application of an easily identifiable phenotype indicating variable sensitivity presents a promising opportunity for accessible precision medicine in the use of analgesics and warrants further investigation.
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Affiliation(s)
- Elouise K Bacon
- Equine Genetics and Genomics Group, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia.
| | - Callum G Donnelly
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithica, NY, 14850, USA
| | - Rebecca R Bellone
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
- Veterinary Genetics Laboratory, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
| | - Bianca Haase
- School of Veterinary Science, University of Sydney, Sydney, NSW, Australia
| | - Carrie J Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
| | - Brandon D Velie
- Equine Genetics and Genomics Group, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
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Kilcoyne I, Nieto J, Nottle BF, Flynn H, Knych HK. Morphine synovial fluid concentrations after intravenous regional limb perfusion in horses during standing sedation. Equine Vet J 2024. [PMID: 38887833 DOI: 10.1111/evj.14114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/16/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Addition of morphine to the perfusate while performing intravenous regional limb perfusion (IVRLP) may be helpful in treating painful infectious orthopaedic conditions of the distal limb. OBJECTIVES The main objective of this study was to determine synovial morphine concentrations following IVRLP with morphine alone or in combination with amikacin. STUDY DESIGN Randomised cross-over in vivo experiment. METHODS Six horses underwent IVRLP with 0.1 mg/kg morphine sulphate diluted to 60 mL using 0.9% NaCl (M group) or combined with 2 g amikacin and 0.9% NaCl (MA group) with a 2-week washout period between treatments. Synovial fluid was collected from the radiocarpal joint (RCJ) at 10, 20, 30, 120, 240, 480, 720 and 1440 min after IVRLP. The tourniquet was removed after the 30-min sample was collected. Synovial concentrations of morphine and major metabolites were measured using liquid chromatography-tandem mass spectrometry. Amikacin concentrations were quantified by a fluorescence polarisation immunoassay. RESULTS Measurable concentrations of morphine were apparent in the RCJ of all horses. Median CMAX of morphine in the M group was 4753.1 (2115.7-14 934.5) ng/mL and 4477 (3434.3-7363) ng/mL in the MA group (p = 0.5). Median CMAX of synovial amikacin was 322.6 (157.5-1371.6 μg/mL). MAIN LIMITATIONS Limitations include small sample size. Investigators were not blinded to the treatments and a third treatment group where amikacin alone was administered via IVRLP to the study population was not included. CONCLUSIONS IVRLP using morphine is a feasible technique and synovial morphine concentrations were measurable following IVRLP and were not affected when used concurrently with amikacin. Administration of morphine via IVRLP may be beneficial as an analgesic technique for orthopaedic conditions of the distal limb while limiting potential serious systemic side-effects.
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Affiliation(s)
- Isabelle Kilcoyne
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Jorge Nieto
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Bridget F Nottle
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Harriet Flynn
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Heather K Knych
- K.L. Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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Haralambus R, Juri M, Mokry A, Jenner F. The impact of opioid administration on the incidence of postanaesthetic colic in horses. FRONTIERS IN PAIN RESEARCH 2024; 5:1347548. [PMID: 38440199 PMCID: PMC10910105 DOI: 10.3389/fpain.2024.1347548] [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: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
Effective management of postoperative pain is essential to ensure patient welfare, reduce morbidity and optimize recovery. Opioids are effective in managing moderate to severe pain in horses but concerns over their adverse effects on gastrointestinal (GI) motility and associated increased colic risk limit their widespread use. Studies investigating the impact of systemic opioids on both GI motility and colic incidence in horses have yielded inconclusive outcomes. Therefore, this retrospective study aims to assess the influence of systemic administration of butorphanol, morphine, and methadone on post-anaesthetic colic (PAC) incidence. Horses undergoing general anaesthesia for non-gastrointestinal procedures that were hospitalized for at least 72 h post-anaesthesia were included in this study. Anaesthetised horses were stratified by procedure type into horses undergoing diagnostic imaging without surgical intervention, emergency or elective surgery. In addition, patients were grouped by opioid treatment regime into horses receiving no opioids, intraanaesthetic, short- (<24 h) or long-term (>24 h) postoperative opioids. Administered opioids encompassed butorphanol, morphine and methadone. The number of horses showing signs of colic in the 72 h after anaesthesia was assessed for each group. A total of 782 horses were included, comprising 659 undergoing surgical procedures and 123 undergoing diagnostic imaging. The overall PAC incidence was 15.1%. Notably, horses undergoing diagnostic imaging without surgery had a significantly lower PAC rate of 6.5% compared to those undergoing surgery (16.7%, p = 0.0146). Emergency surgeries had a significantly lower PAC rate of 5.8% compared to elective procedures (18%, p = 0.0113). Of the 782 horses, 740 received intraoperative opioids and 204 postoperative opioids, 102 of which long-term (≥24 h). Neither intraoperative (p = 0.4243) nor short-term postoperative opioids (p = 0.5744) increased PAC rates. Notably, only the long-term (≥24 h) administration of morphine significantly increased PAC incidence to 34% (p = 0.0038). In contrast, long-term butorphanol (5.3% PAC, p = 0.8482) and methadone (18.4% PAC, p = 0.6161) did not affect PAC rates. In summary, extended morphine administration was the only opioid treatment associated with a significantly increased risk of PAC.
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Affiliation(s)
- Rhea Haralambus
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | | | - Florien Jenner
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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Maney JK, Dzikiti BT, Escobar A, Knych HK, Bennett RC. Morphine in donkeys: Antinociceptive effect and preliminary pharmacokinetics. Equine Vet J 2023; 55:1086-1093. [PMID: 36537849 DOI: 10.1111/evj.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/01/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Morphine is the prototypical μ-opioid receptor agonist used to provide analgesia in veterinary species. Its effects are well-described in horses but not donkeys. OBJECTIVES To determine the antinociceptive effects of two doses of morphine in donkeys. To describe preliminary pharmacokinetic parameters of morphine in donkeys. STUDY DESIGN In vivo experiment. METHODS Eight adult castrated male donkeys were given intravenous (IV) 0.9% saline, morphine 0.1 mg/kg bwt (LDM), or morphine 0.5 mg/kg bwt (HDM) in a randomised order with a minimum 1-week washout period. Mechanical nociceptive thresholds (MNTs) were determined by a blinded investigator pre-injection and 15, 30, 45, 60, 90, 120, 150, 180, 210, 240, 300, and 360 min post-injection. Venous blood samples were collected pre-injection and 2, 5, 10, 15, 30, 45, 60, 90, and 120 min post-injection. Data were analysed using Friedman's test with Dunn's post hoc test for multiple comparisons. Pharmacokinetic parameters were calculated for the HDM treatment. RESULTS Baseline MNT was [median (interquartile range)] 8.9 (7.1-10.3) N and did not differ between treatments. Peak MNTs occurred at 60 min for both LDM (16.2 N) and HDM (25.0 N) treatments. MNTs after HDM treatment were higher than saline (p < 0.04) at 15, 60, 90, 120, 150, 180, 240, and 300 min post-injection. MNTs after LDM treatment were higher than baseline (p < 0.05) at 45 and 60 min post-injection. Terminal half-life for HDM was (mean ± SD) 51.0 ± 10.7 min, the volume of distribution at steady-state 2.07 ± 0.33 L/min and clearance 49.2 ± 4.16 ml * min/kg using noncompartmental analysis. The concentration of morphine-3-glucuronide (M3G) was higher than morphine-6-glucuronide (M6G) at all sampled time points. MAIN LIMITATIONS Short duration of plasma sampling for pharmacokinetic analysis; lack of objective measure of gastrointestinal function. CONCLUSIONS The HDM treatment provided mechanical antinociception in donkeys with no significant adverse effects.
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Affiliation(s)
- Jill K Maney
- Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Brighton T Dzikiti
- Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Andre Escobar
- Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Heather K Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, California, USA
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Tueshaus T, McKemie DS, Kanarr K, Kass PH, Knych HK. Pharmacokinetics and effects of codeine in combination with acetaminophen on thermal nociception in horses. J Vet Pharmacol Ther 2023; 46:311-325. [PMID: 37021661 DOI: 10.1111/jvp.13126] [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: 11/14/2022] [Revised: 02/22/2023] [Accepted: 03/21/2023] [Indexed: 04/07/2023]
Abstract
Codeine and acetaminophen in combination have proven to be an effective analgesic treatment for moderate-to-severe and postoperative pain in humans. Studies have demonstrated that codeine and acetaminophen, when administered as sole agents, are well tolerated by horses. In the current study, we hypothesized that administration of the combination of codeine and acetaminophen would result in a significant thermal antinociceptive effect compared with administration of either alone. Six horses were administered oral doses of codeine (1.2 mg/kg), acetaminophen (20 mg/kg), and codeine plus acetaminophen (1.2 mg/kg codeine and 6-6.4 mg/kg acetaminophen) in a three-way balanced crossover design. Plasma samples were collected, concentrations of drug and metabolites determined via liquid chromatography-mass spectrometry, and pharmacokinetic analyses were performed. Pharmacodynamic outcomes, including effect on thermal thresholds, were assessed. Codeine Cmax and AUC were significantly different between the codeine and combination group. There was considerable inter-individual variation in the pharmacokinetic parameters for codeine, acetaminophen, and their metabolites in horses. All treatments were well tolerated with minimal significant adverse effects. An increase in the thermal threshold was noted at 1.5 and 2 h, from 15 min through 6 h and 0.5, 1, 1.5, and 3 h in the codeine, acetaminophen, and combination groups, respectively.
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Affiliation(s)
- Tisa Tueshaus
- K.L Maddy Equine Analytical Pharmacology Laboratory, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Daniel S McKemie
- K.L Maddy Equine Analytical Pharmacology Laboratory, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Kirsten Kanarr
- K.L Maddy Equine Analytical Pharmacology Laboratory, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Philip H Kass
- Department of Medicine and Epidemiology, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Heather K Knych
- K.L Maddy Equine Analytical Pharmacology Laboratory, University of California Davis, School of Veterinary Medicine, Davis, California, USA
- Department of Molecular Biosciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
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Poth MKM, McKemie DS, Traynham M, Kass PH, Knych HK. Concentrations, pharmacokinetics and selected pharmacodynamics of morphine and its active metabolites following oral administration to horses. J Vet Pharmacol Ther 2023. [PMID: 36883679 DOI: 10.1111/jvp.13122] [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: 10/15/2022] [Revised: 01/25/2023] [Accepted: 02/18/2023] [Indexed: 03/09/2023]
Abstract
The metabolism and pharmacokinetics of intravenous (i.v.) morphine in the horse have been described; however, administration of therapeutic doses has also been associated with neuroexcitation and adverse gastrointestinal effects. In this study, we hypothesized that oral administration would lead to comparable concentrations of morphine and its presumed active metabolite, morphine 6-glucuronide (M6G) without the adverse effects associated with i.v. administration. Eight horses were administered a single i.v. dose of 0.2 mg/kg morphine and oral doses of 0.2, 0.6, and 0.8 mg/kg of morphine in a four-way balanced crossover design, with a 2-week washout period between doses. Concentrations of morphine and metabolites were determined, and pharmacokinetic parameters determined. Physiologic and behavioral outcomes including the number of steps taken, changes in heart rate, and gastrointestinal borborygmi were assessed. Oral administration of morphine resulted in higher concentrations of morphine metabolites, including M6G (Cmax : 11.6-37.8 ng/mL (0.6 mg/kg); 15.8-42.6 ng/mL (0.8 mg/kg)), compared with i.v. Bioavailability was 36.5%, 27.6% and 28.0% for 0.2, 0.6 and 0.8 mg/kg, respectively. Behavioral and physiologic changes were noted in all groups but were less prominent with oral compared with i.v. administration. Results of the current study are encouraging for further study, specifically anti-nociceptive effects of morphine following oral administration.
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Affiliation(s)
- Meghan K M Poth
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Daniel S McKemie
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Megan Traynham
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Philip H Kass
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Heather K Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, California, USA.,Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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Knych HK, Kanarr K, Fang Y, McKemie DS, Kass PH. Characterization of the pharmacokinetics, behavioral effects and effects on thermal nociception of morphine 6-glucuronide and morphine 3-glucuronide in horses. Vet Anaesth Analg 2022; 49:634-644. [DOI: 10.1016/j.vaa.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 10/16/2022]
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Bacon EK, Donnelly CG, Bellone RR, Finno CJ, Velie BD. Melanocortin‐1 receptor influence in equine opioid sensitivity. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Elouise K. Bacon
- Equine Genetics and Genomics Group School of Life and Environmental Sciences University of Sydney Sydney New South Wales Australia
| | - Callum G. Donnelly
- Department of Population Health and Reproduction School of Veterinary Medicine University of California Davis California USA
| | - Rebecca R. Bellone
- Department of Population Health and Reproduction School of Veterinary Medicine University of California Davis California USA
- Veterinary Genetics Laboratory School of Veterinary Medicine University of California Davis California USA
| | - Carrie J. Finno
- Department of Population Health and Reproduction School of Veterinary Medicine University of California Davis California USA
| | - Brandon D. Velie
- Equine Genetics and Genomics Group School of Life and Environmental Sciences University of Sydney Sydney New South Wales Australia
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Knych HK, Stucker K, Gretler SR, Kass PH, McKemie DS. Pharmacokinetics, adverse effects and effects on thermal nociception following administration of three doses of codeine to horses. BMC Vet Res 2022; 18:196. [PMID: 35614473 PMCID: PMC9131543 DOI: 10.1186/s12917-022-03299-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/16/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In humans, codeine is a commonly prescribed analgesic that produces its therapeutic effect largely through metabolism to morphine. In some species, analgesic effects of morphine have also been attributed to the morphine-6-glucuronide (M6G) metabolite. Although an effective analgesic, administration of morphine to horses produces dose-dependent neuroexcitation at therapeutic doses. Oral administration of codeine at a dose of 0.6 mg/kg has been shown to generate morphine and M6G concentrations comparable to that observed following administration of clinically effective doses of morphine, without the concomitant adverse effects observed with morphine administration. Based on these results, it was hypothesized that codeine administration would provide effective analgesia with decreased adverse excitatory effects compared to morphine. Seven horses received a single oral dose of saline or 0.3, 0.6 or 1.2 mg/kg codeine or 0.2 mg/kg morphine IV (positive control) in a randomized balanced 5-way cross-over design. Blood samples were collected up to 72 hours post administration, codeine, codeine 6-glucuronide, norcodeine morphine, morphine 3-glucuronide and M6G concentrations determined by liquid chromatography- mass spectrometry and pharmacokinetic analysis performed. Pre- and post-drug related behavior, locomotor activity, heart rate and gastrointestinal borborygmi were recorded. Response to noxious stimuli was evaluated by determining thermal threshold latency. RESULTS Morphine concentrations were highest in the morphine dose group at all times post administration, however, M6G concentrations were significantly higher in all the codeine dose groups compared to the morphine group starting at 1 hour post drug administration and up to 72-hours in the 1.2 mg/kg group. With the exception of one horse that exhibited signs of colic following administration of 0.3 and 0.6 mg/kg, codeine administration was well tolerated. Morphine administration, led to signs of agitation, tremors and excitation. There was not a significant effect on thermal nociception in any of the dose groups studied. CONCLUSIONS The current study describes the metabolic profile and pharmacokinetics of codeine in horses and provides information that can be utilized in the design of future studies to understand the anti-nociceptive and analgesic effects of opioids in this species with the goal of promoting judicious and safe use of this important class of drugs.
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Affiliation(s)
- Heather K Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA.
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
| | - Kristen Stucker
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
| | - Sophie R Gretler
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
| | - Philip H Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Daniel S McKemie
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA
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Ruíz-López P, Morgaz J, Quirós-Carmona S, Navarrete-Calvo R, Domínguez JM, Gómez-Villamandos RJ, Granados MM. Parasympathetic Tone Changes in Anesthetized Horses after Surgical Stimulation, and Morphine, Ketamine, and Dobutamine Administration. Animals (Basel) 2022; 12:ani12081038. [PMID: 35454284 PMCID: PMC9027407 DOI: 10.3390/ani12081038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary A parasympathetic tone activity (PTA) monitor has been developed similar to the analgesia nociception index (ANI) used in human medicine to evaluate the changes in the autonomic nervous system based on heart rate variability. The autonomic nervous system acts unconsciously and regulates body functions (autonomic response). Examples of autonomic response are decreases of heart rate or/and blood pressure due to an increase of parasympathetic tone activity. It is important to know how stimuli and medication may affect the autonomic nervous system since they can modify heart rate and blood pressure. This study attempts to find how a surgical nociceptive stimulus, along with the administration of medication frequently used in horses, can affect mean parasympathetic tone activity (PTAm) (one of the values of the PTA monitor), heart rate and blood pressure in clinically anesthetized horses. Values of the PTAm, heart rate, and blood pressure were registered before and after surgical incision and after the administration of morphine, ketamine, and dobutamine at defined time points. No changes were found after the incision or the administration of morphine and dobutamine. It seems that only ketamine affects the autonomic nervous system by decreasing PTAm. Abstract Autonomic nervous system (ANS) activity can modify cardiovascular parameters in response to nociceptive stimuli or drugs in anesthetized animals. The aim of this study was to determine if a surgical nociceptive stimulus and morphine, ketamine, and dobutamine administration would modify ANS activity observed as a change in the mean parasympathetic tone activity (PTAm) in anesthetized horses. In 20 anesthetized horses, heart rate (HR), mean arterial pressure (MAP), and PTAm were monitored before and 1, 3, and 5 min after surgical incision, and before and 10 min after the administration of morphine (0.2 mg/kg IV). If nystagmus or spontaneous ventilation was observed, ketamine (0.5 mg/kg IV) was given, and the three variables were registered before and 3 and 5 min afterward. If MAP reached ≤62 mmHg, a dobutamine infusion was administered, and the three variables were recorded before and 5 min after starting/increasing the infusion (0.25 μg/kg/min IV every 5 min). The three variables were registered before and 1, 3, and 5 min after a PTAm decrease of ≥20%, HR increase of ≥10%, or MAP increase of ≥20%. The PTAm decreased 3 min after the administration of ketamine and 1 min after a PTA event. The surgical incision, dobutamine, and morphine did not modify PTAm. The absence of changes in ANS activity after the nociceptive stimulus and lack of correlation between PTAm and HR or MAP suggest that PTAm is a poor indicator of sympathetic activation under the study conditions. Ketamine seems to affect ANS activity by decreasing PTAm.
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Affiliation(s)
- Patricia Ruíz-López
- Department of Surgery and Anesthesia of Domestic Animals, Faculty of Veterinary Medicine, University of Ghent, 9820 Merelbeke, Belgium
- Correspondence: (P.R.-L.); (J.M.)
| | - Juan Morgaz
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
- Correspondence: (P.R.-L.); (J.M.)
| | - Setefilla Quirós-Carmona
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - Rocío Navarrete-Calvo
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - Juan Manuel Domínguez
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - Rafael Jesús Gómez-Villamandos
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - M. M. Granados
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
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Hopster K, Watkins AR, Hurcombe SD. Comparison of cervical epidural morphine with intravenous morphine administration on antinociception in adult horses using thermal threshold testing. Vet Anaesth Analg 2022; 49:417-422. [DOI: 10.1016/j.vaa.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 11/28/2022]
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Tallon R, McMillan M, Ho N, Dunkel B. Presumed generalised seizure following caudal epidural administration of morphine and detomidine in a pony. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Tallon
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - M. McMillan
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - N. Ho
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - B. Dunkel
- Department of Clinical Science and Services The Royal Veterinary College Hatfield UK
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Duke-Novakovski T, Jimenez CP, Fujiyama M, Beazley SG. Plasma histamine concentrations in horses administered sodium penicillin, guaifenesin-xylazine-ketamine and isoflurane with morphine or butorphanol. Vet Anaesth Analg 2020; 48:17-25. [PMID: 33229232 DOI: 10.1016/j.vaa.2020.10.003] [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: 07/29/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Various drugs administered to horses undergoing surgical procedures can release histamine. Histamine concentrations were evaluated in horses prepared for surgery and administered butorphanol or morphine intraoperative infusions. STUDY DESIGN Prospective studies with one randomized. ANIMALS A total of 44 client-owned horses. METHODS In one study, anesthesia was induced with xylazine followed by ketamine-diazepam. Anesthesia was maintained with guaifenesin-xylazine-ketamine (GXK) during surgical preparation. For surgery, isoflurane was administered with intravenous (IV) morphine (group M: 0.15 mg kg-1 and 0.1 mg kg-1 hour-1; 15 horses) or butorphanol (group B: 0.05 mg kg-1 and 0.01 mg kg-1 hour-1; 15 horses). Histamine and morphine concentrations were measured using enzyme-linked immunoassay before opioid injection (time 0), and after 1, 2, 5, 30, 60 and 90 minutes. In a subsequent study, plasma histamine concentrations were measured in 14 horses before drug administration (baseline), 15 minutes after IV sodium penicillin and 15 minutes after starting GXK IV infusion. Statistical comparison was performed using anova for repeated measures. Pearson correlation compared morphine and histamine concentrations. Data are presented as mean ± standard deviation. Significance was assumed when p ≤ 0.05. RESULTS With histamine, differences occurred between baseline (3.2 ± 2.4 ng mL-1) and GXK (5.2 ± 7.1 ng mL-1) and between baseline and time 0 in group B (11.9 ± 13.4 ng mL-1) and group M (11.1 ± 12.4 ng mL-1). No differences occurred between baseline and after penicillin or between groups M and B. Morphine concentrations were higher at 1 minute following injection (8.1 ± 5.1 ng mL-1) than at 30 minutes (4.9 ± 3.1 ng mL-1) and 60 minutes (4.0 ± 2.5 ng mL-1). Histamine correlated with morphine at 2, 30 and 60 minutes. CONCLUSIONS AND CLINICAL RELEVANCE GXK increased histamine concentration, but concentrations were similar with morphine and butorphanol.
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Affiliation(s)
- Tanya Duke-Novakovski
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Sakatoon, SK, Canada
| | - Carolina Palacios Jimenez
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Sakatoon, SK, Canada
| | - Masako Fujiyama
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Sakatoon, SK, Canada
| | - Shannon G Beazley
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Sakatoon, SK, Canada
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Gretler SR, Finno CJ, McKemie DS, Kass PH, Knych HK. Metabolism, pharmacokinetics and selected pharmacodynamic effects of codeine following a single oral administration to horses. Vet Anaesth Analg 2020; 47:694-704. [PMID: 32654915 PMCID: PMC7872472 DOI: 10.1016/j.vaa.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe the pharmacokinetics and selected pharmacodynamic variables of codeine and its metabolites in Thoroughbred horses following a single oral administration. STUDY DESIGN Prospective experimental study. ANIMALS A total of 12 Thoroughbred horses, nine geldings and three mares, aged 4-8 years. METHODS Horses were administered codeine (0.6 mg kg-1) orally and blood was collected before administration and at various times until 120 hours post administration. Plasma and urine samples were collected and analyzed for codeine and its metabolites by liquid chromatography-mass spectrometry, and plasma pharmacokinetics were determined. Heart rate and rhythm, step counts, packed cell volume and total plasma protein were measured before and 4 hours after administration. RESULTS Codeine was rapidly converted to the metabolites norcodeine, codeine-6-glucuronide (C6G), morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G). Plasma codeine concentrations were best represented using a two-compartment model. The Cmax, tmax and elimination t½ were 270.7 ± 136.0 ng mL-1, 0.438 ± 0.156 hours and 2.00 ± 0.534 hours, respectively. M3G was the main metabolite detected (Cmax 492.7 ± 35.5 ng mL-1), followed by C6G (Cmax 96.1 ± 33.8 ng mL-1) and M6G (Cmax 22.3 ± 4.96 ng mL-1). Morphine and norcodeine were the least abundant metabolites with Cmax of 3.17 ± 0.95 and 1.42 ± 0.79 ng mL-1, respectively. No significant adverse or excitatory effects were observed. CONCLUSIONS AND CLINICAL RELEVANCE Following oral administration, codeine is rapidly metabolized to morphine, M3G, M6G, C6G and norcodeine in horses. Plasma concentrations of M6G, a presumed active metabolite of morphine, were comparable to concentrations reported previously following administration of an analgesic dose of morphine to horses. Codeine was well tolerated based on pharmacodynamic variables and behavioral observations.
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Affiliation(s)
- Sophie R Gretler
- K.L. Maddy Equine Analytical Pharmacology Laboratory, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Carrie J Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Daniel S McKemie
- K.L. Maddy Equine Analytical Pharmacology Laboratory, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Philip H Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Heather K Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA; Department of Veterinary Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
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15
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Hamamoto-Hardman BD, Baden RW, McKemie DS, Knych HK. Equine uridine diphospho-glucuronosyltransferase 1A1, 2A1, 2B4, 2B31: cDNA cloning, expression and initial characterization of morphine metabolism. Vet Anaesth Analg 2020; 47:763-772. [PMID: 32933848 DOI: 10.1016/j.vaa.2020.07.033] [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: 02/24/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Uridine diphospho-glucuronosyltransferases (UGTs) are membrane-bound enzymes that catalyze the conjugation of glucuronic acid onto a diverse set of xenobiotics. Horses efficiently and extensively glucuronidate a number of xenobiotics, including opioids, making UGTs an important group of drug-metabolizing enzymes for the clearance of drugs. Recombinant enzymes have allowed researchers to characterize the metabolism of a variety of drugs. The primary objective was to clone, express and characterize equine UGTs using drugs characterized as UGT substrates in other species. A secondary objective was to characterize the in vitro metabolism of morphine in horses. STUDY DESIGN In vitro drug metabolism study using liver microsomes and recombinant enzyme systems. ANIMALS Liver microsomes and RNA from tissue collected from two Thoroughbred mares euthanized for other reasons. METHODS Based on homology to the human UGT2B7, four equine UGT variants were expressed: UGT1A1, UGT2A1, UGT2B31 and UGT2B4. cDNA sequences were cloned and resulting protein expressed in a baculovirus expression system. Functionality of the enzymes was assessed using 4-methylumbelliferone, testosterone, diclofenac and ketoprofen. Recombinant enzyme, control cells, equine liver microsomes and human UGT2B7 supersomes were then incubated with morphine. Concentrations of metabolites were measured using liquid chromatography-tandem mass spectrometry and enzyme kinetics determined. RESULTS 4-Methylumbelliferone was glucuronidated by all expressed equine UGTs. Testosterone glucuronide was not produced by any of the expressed enzymes, and diclofenac glucuronide and ketoprofen glucuronide were produced by UG2A1 and UGT1A1, respectively. UGT2B31 metabolized morphine to morphine-3-glucuronide and low concentrations of morphine-6-glucuronide. CONCLUSIONS AND CLINICAL RELEVANCE This is the first successful expression of functional recombinant equine UGTs. UGT2B31 contributes to the glucuronidation of morphine; however, it is probably not the main metabolizing enzyme. These results warrant further investigation of equine UGTs, including expression of additional enzymes and further characterization of UGT2B31 as a contributor to morphine metabolism.
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Affiliation(s)
- Briana D Hamamoto-Hardman
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Russell W Baden
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Dan S McKemie
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Heather K Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California Davis, Davis, CA, USA; Department of Veterinary Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.
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16
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Martins FC, Keating SC, Clark-Price SC, Schaeffer DJ, Lascola KM, DiMaio Knych H. Pharmacokinetics and pharmacodynamics of hydromorphone hydrochloride in healthy horses. Vet Anaesth Analg 2020; 47:509-517. [PMID: 32409257 DOI: 10.1016/j.vaa.2020.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine the physiologic and behavioral effects and pharmacokinetic profile of hydromorphone administered intravenously (IV) to horses. STUDY DESIGN Prospective, randomized, crossover study. ANIMALS A group of six adult healthy horses weighing 585.2 ± 58.7 kg. METHODS Each horse was administered IV hydromorphone (0.025 mg kg-1; treatment H0.025), hydromorphone (0.05 mg kg-1; treatment H0.05) or 0.9% saline in random order with a 7 day washout period. For each treatment, physiologic, hematologic, abdominal borborygmi scores and behavioral data were recorded over 5 hours and fecal output was totaled over 24 hours. Data were analyzed using repeated measures anova with significance at p < 0.05. Blood samples were collected in treatment H0.05 for quantification of plasma hydromorphone and hydromorphone-3-glucuronide and subsequent pharmacokinetic parameter calculation. RESULTS Hydromorphone administration resulted in a dose-dependent increase in heart rate (HR) and systolic arterial pressure (SAP). HR and SAP were 59 ± 17 beats minute-1 and 230 ± 27 mmHg, respectively, in treatment H0.05 at 5 minutes after administration. No clinically relevant changes in respiratory rate, arterial gases or temperature were observed. The borborygmi scores in both hydromorphone treatments were lower than baseline values for 2 hours. Fecal output did not differ among treatments and no evidence of abdominal discomfort was observed. Recorded behaviors did not differ among treatments. For hydromorphone, mean ± standard deviation for volume of distribution at steady state, total systemic clearance and area under the curve until the last measured concentration were 1.00 ± 0.29 L kg-1, 106 ± 21 mL minute-1 kg-1 and 8.0 ± 1.5 ng hour mL-1, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Hydromorphone administered IV to healthy horses increased HR and SAP, decreased abdominal borborygmi and did not affect fecal output.
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Affiliation(s)
- Felipe C Martins
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Stephanie Cj Keating
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - Stuart C Clark-Price
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - David J Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Kara M Lascola
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Heather DiMaio Knych
- Department of Molecular Biosciences, University of California Davis School of Veterinary Medicine, Davis, CA, USA
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Mirra A, Birras J, Diez Bernal S, Spadavecchia C. Morphine plasmatic concentration in a pregnant mare and its foal after long term epidural administration. BMC Vet Res 2020; 16:19. [PMID: 31959188 PMCID: PMC6971975 DOI: 10.1186/s12917-020-2242-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background Epidural administration of morphine has been shown to be an effective analgesic strategy in horses; however, the possible occurrence of side effects limits its usage. In order to decrease their frequency, it is important to target the minimal effective plasma concentration and avoid overdosing. As to date species-specific pharmacokinetics data are not available for epidural morphine, the dosing regimen is usually established on the basis of clinical reports and personal experience. In certain physiological conditions, like gestation, the outcome of an empirical dosing scheme can be unpredictable. The aim of this case report is to describe the pharmacological profile of morphine and its metabolites after prolonged epidural administration in a pregnant mare and her foal. Case presentation A 20 years old pregnant mare was presented to our hospital because of severe lameness, 2 months before delivery. Following an ineffective systemic pain treatment, an epidural catheter was inserted and morphine administered (initial dose 0.1 mg/kg every 8 h). Due to its efficacy in controlling pain, it was continued until end of gestation. Plasmatic concentration of morphine and its metabolites were assessed in the mare 6 weeks after starting the treatment, and in both the mare and foal during the first days after delivery. Plasmatic values similar to those previously reported in the literature following morphine short term administration through various routes and not accompanied by side effects were found in the mare, except during an excitatory period. Moreover, no evidence of dangerous drug accumulation or significant milk passage was noticed in the foal. Mild reduction of feces production with no signs of colic and two self-limiting episodes of excitement occurred during treatment in the mare. No side effects occurred during gestation and first phases of life in the foal. Conclusion Prolonged epidural administration of morphine in a pregnant mare allowed good pain control in absence of clinically relevant side effects, in both the mare and her foal. Sudden increase in morphine plasmatic concentration can occur and side effects appear; careful treatment to the lowest effective dose and continuous monitoring of the clinical condition of the treated horse should be performed.
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Affiliation(s)
- Alessandro Mirra
- Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland.
| | - Jasmin Birras
- Swiss Institute for Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland
| | - Sabina Diez Bernal
- Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland
| | - Claudia Spadavecchia
- Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland
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Reed RA, Knych HK, Barletta M, Sakai DM, Ruch MM, Smyth CA, Ryan CA. Pharmacokinetics and pharmacodynamics of hydromorphone after intravenous and intramuscular administration in horses. Vet Anaesth Analg 2019; 47:210-218. [PMID: 31959534 DOI: 10.1016/j.vaa.2019.08.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/15/2019] [Accepted: 08/22/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To compare the pharmacokinetics and pharmacodynamics of hydromorphone in horses after intravenous (IV) and intramuscular (IM) administration. STUDY DESIGN Randomized, masked, crossover design. ANIMALS A total of six adult horses weighing [mean ± standard deviation (SD))] 447 ± 61 kg. METHODS Horses were administered three treatments with a 7 day washout. Treatments were hydromorphone 0.04 mg kg⁻1 IV with saline administered IM (H-IV), hydromorphone 0.04 mg kg⁻1 IM with saline IV (H-IM), or saline IV and IM (P). Blood was collected for hydromorphone plasma concentration at multiple time points for 24 hours after treatments. Pharmacodynamic data were collected for 24 hours after treatments. Variables included thermal nociceptive threshold, heart rate (HR), respiratory frequency (fR), rectal temperature, and fecal weight. Data were analyzed using mixed-effects linear models. A p value of less than 0.05 was considered statistically significant. RESULTS The mean ± SD hydromorphone terminal half-life (t1/2), clearance and volume of distribution of H-IV were 19 ± 8 minutes, 79 ± 12.9 mL minute⁻1 kg⁻1 and 1125 ± 309 mL kg⁻1. The t1/2 was 26.7 ± 9.25 minutes for H-IM. Area under the curve was 518 ± 87.5 and 1128 ± 810 minute ng mL⁻1 for H-IV and H-IM, respectively. The IM bioavailability was 217%. The overall thermal thresholds for both H-IV and H-IM were significantly greater than P (p < 0.0001 for both) and baseline (p = 0.006). There was no difference in thermal threshold between H-IV and H-IM. No difference was found in physical examination variables among groups or in comparison to baseline. Fecal weight was significantly less than P for H-IV and H-IM (p = 0.02). CONCLUSIONS AND CLINICAL RELEVANCE IM hydromorphone has high bioavailability and provides a similar degree of antinociception to IV administration. IM hydromorphone in horses provides a similar degree and duration of antinociception to IV administration.
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Affiliation(s)
- Rachel A Reed
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA.
| | - Heather K Knych
- K.L. Maddy Equine Analytical Chemistry Laboratory, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Michele Barletta
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA
| | - Daniel M Sakai
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA
| | - Melanie M Ruch
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA
| | - Carly A Smyth
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA
| | - Clare A Ryan
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA
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Hertzsch R, Richter A. Systematic analysis to assess the scientific validity of the international residue limits for caffeine and theophylline in horse-racing. Vet Rec 2019; 185:230. [PMID: 31409753 DOI: 10.1136/vr.105404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/17/2019] [Accepted: 07/09/2019] [Indexed: 11/04/2022]
Abstract
Based on their performance-enhancing potential, caffeine and theophylline are prohibited substances in equine sports. Residues in horses can be caused by wilful application or by unintended uptake of contaminated feed. The International Federation of Horseracing Authorities recently introduced international residue limits (IRLs) to facilitate the discrimination between pharmacological relevant and irrelevant concentrations in doping samples. The objective of this study was to investigate the scientific validity of these IRLs. A systematic analysis was performed to assess the IRLs by different statistical approaches using published pharmacokinetic data. 31 out of 218 potentially relevant publications met the inclusion criteria. Thereby, both IRLs were found to be appropriate for the exclusion of the presence of a relevant pharmacological effect after a wilful application. The IRL of theophylline was also determined to be suitable for the prevention of positive doping tests caused by the ingestion of contaminated feed. In contrast, the IRL of caffeine is not suitable to prevent positive doping test caused by the ingestion of more than 10 mg caffeine per day per horse with contaminated feed. The lack of corresponding regulation for paraxanthine, a major active metabolite of caffeine and theophylline, was recognised as a substantial shortcoming of the current system, rendering both IRLs incomplete.
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Affiliation(s)
- Robert Hertzsch
- Institute of Pharmacology, Pharmacy and Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Angelika Richter
- Institute of Pharmacology, Pharmacy and Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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20
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Tessier C, Pitaud JP, Thorin C, Touzot-Jourde G. Systemic morphine administration causes gastric distention and hyperphagia in healthy horses. Equine Vet J 2019; 51:653-657. [PMID: 30835841 DOI: 10.1111/evj.13090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are no data investigating the effect of systemic morphine on the size of the stomach or the food consumption in horses. OBJECTIVES To evaluate gastrointestinal side effects of morphine administered systemically in healthy horses by the means of clinical and ultrasonographic evaluations. STUDY DESIGN In vivo experiment. METHODS On day 1 of the experiment, six healthy French Trotter mares were evaluated clinically and an abdominal ultrasonography was performed three times 4 h apart to record the size of the stomach, the number of contractions per minute of the duodenum, jejunum, caecum, left and right ventral colons. On Day 2, morphine was administered three times 4 h apart at the dose of 0.1 mg/kg i.v. and the same ultrasonographic examinations performed. On Day 3, only clinical and ultrasonographic examinations were performed as on Day 1. Amounts of hay and water ingested, frequency and weight of faeces were recorded throughout the study. RESULTS Number of contractions of the duodenum, caecum, left and right ventral colons were significantly decreased after morphine administration. Size of the stomach was increased significantly with a cumulative effect of repeated doses of morphine. Hay (+0.4 kg/h, P<0.001) and water (+1.1 L/h, P<0.001) consumption were significantly increased. MAIN LIMITATIONS The study was performed in healthy horses. CONCLUSIONS Systemic morphine administration causes gastrointestinal depression, gastric distention and hyperphagia in horses. Clinical and ultrasonographical examinations are valuable tools to identify side effects of morphine administration in horses. Further studies are needed to assess side effects and monitoring in clinically painful cases. Horses receiving systemic morphine administration should be closely monitored for signs of gastric distention and, specifically, the amount of food given while receiving treatment should be controlled to avoid complications.
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Affiliation(s)
- C Tessier
- ONIRIS-Ecole Nationale Vétérinaire de Nantes, Equine Hospital, Nantes Cedex, France
| | - J-P Pitaud
- Clinique Vétérinaire des Faluns, Saint Grégoire, France
| | - C Thorin
- Department of Animal Physiopathology and Physiology, ONIRIS-Ecole Nationale Vétérinaire de Nantes, Nantes Cedex, France
| | - G Touzot-Jourde
- Department of Anesthesia and Analgesia, ONIRIS-Ecole Nationale Vétérinaire de Nantes, Nantes Cedex, France
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Hamamoto-Hardman BD, Steffey EP, Weiner D, McKemie DS, Kass P, Knych HK. Pharmacokinetics and selected pharmacodynamics of morphine and its active metabolites in horses after intravenous administration of four doses. J Vet Pharmacol Ther 2019; 42:401-410. [PMID: 30919469 DOI: 10.1111/jvp.12759] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/07/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022]
Abstract
The objective of the current study was to describe and characterize the pharmacokinetics and selected pharmacodynamic effects of morphine and its two major metabolites in horses following several doses of morphine. A total of ten horses were administered a single intravenous dose of morphine: 0.05, 0.1, 0.2, or 0.5 mg/kg, or saline control. Blood samples were collected up to 72 hr, analyzed for morphine, and metabolites by LC/MS/MS, and pharmacokinetic parameters were determined. Step count, heart rate and rhythm, gastrointestinal borborygmi, fecal output, packed cell volume, and total protein were also assessed. Morphine-3 glucuronide (M3G) was the predominant metabolite detected, with concentrations exceeding those of morphine-6 glucuronide (M6G) at all time points. Maximal concentrations of M3G and M6G ranged from 55.1 to 504 and 6.2 to 28.4 ng/ml, respectively, across dose groups. The initial assessment of morphine pharmacokinetics was done using noncompartmental analysis (NCA). The volume of distribution at steady-state and systemic clearance ranged from 9.40 to 16.9 L/kg and 23.3 to 32.4 ml min-1 kg-1 , respectively. Adverse effects included signs of decreased gastrointestinal motility and increased central nervous excitation. There was a correlation between increasing doses of morphine, increases in M3G concentrations, and adverse effects. Findings from this study support direct administration of purified M3G and M6G to horses to better characterize the pharmacokinetics of morphine and its metabolites and to assess pharmacodynamic activity of these metabolites.
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Affiliation(s)
- Briana D Hamamoto-Hardman
- K.L Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, California
| | - Eugene P Steffey
- K.L Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, California.,Department of Veterinary Surgery and Radiology, School of Veterinary Medicine, University of California, Davis, California
| | - Daniel Weiner
- Department of Pharmacotherapy and Experimental Therapeutics, School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina
| | - Daniel S McKemie
- K.L Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, California
| | - Philip Kass
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Heather K Knych
- K.L Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, California.,Department of Veterinary Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California
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22
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Reed R, Barletta M, Mitchell K, Hanafi A, Bullington A, Knych H, Quandt J, Ryan C, Giguère S. The pharmacokinetics and pharmacodynamics of intravenous hydromorphone in horses. Vet Anaesth Analg 2018; 46:395-404. [PMID: 30930095 DOI: 10.1016/j.vaa.2018.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/19/2018] [Accepted: 11/01/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Describe the pharmacokinetics and pharmacodynamics of intravenous hydromorphone in healthy horses. STUDY DESIGN Masked, randomized, cross-over, Latin square design. ANIMALS A group of eight healthy adult horses METHODS: Horses were administered each of four treatments with an 8 day washout. Treatments groups included intravenous hydromorphone 0.02 mg kg-1 (LD), 0.04 mg kg-1 (MD), 0.08 mg kg-1 (HD) and saline (P). Blood samples for hydromorphone analysis were obtained for 24 hours after treatment. Plasma hydromorphone was quantified and pharmacokinetic parameters were determined using non-compartmental analysis. Pharmacodynamic data collected for 24 hours after treatment included thermal nociceptive threshold, heart rate (HR), respiratory rate (fR) and rectal temperature, and analyzed using mixed-effects linear models. RESULTS Mean (± standard deviation) hydromorphone terminal half-life (t1/2), systemic clearance and apparent volume of distribution at steady state (Vdss) were 18.1 ± 18.6, 34.0 ± 12.8, and 41.3 ± 32.5 minutes, 66.6 ± 5.3, 550.0 ± 76.4, and 92.7 ± 13.9 mL kg-1 minute-1, and 1118 ± 369, 1460 ± 325 and 2242 ± 950 mL kg-1 for treatments LD, MD and HD, respectively. Thermal threshold increased significantly compared to baseline for all treatments for up to 12 hours. HR was elevated above baseline in treatments LD, MD and HD, extending to 30, 15 and 105 minutes after treatment, respectively. Respiratory rate was elevated above baseline in treatments MD and HD from 30 to 195 minutes and from 45 to 480 minutes after treatment, respectively. Temperature was elevated above baseline in treatment HD until 255 minutes after treatment. CONCLUSIONS Hydromorphone exhibited a short t1/2, rapid clearance and large Vdss in horses. It also provided a dose-dependent increase in thermal threshold with associated increases in HR, fR and rectal temperature. CLINICAL RELEVANCE Hydromorphone 0.04 mg kg-1 provided clinically relevant thermal antinociception with minimal adverse effects.
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Affiliation(s)
- Rachel Reed
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA.
| | - Michele Barletta
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Krista Mitchell
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Amanda Hanafi
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Annie Bullington
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Heather Knych
- Department of Molecular Biosciences, University of California Davis School of Veterinary Medicine, Davis, CA, USA
| | - Jane Quandt
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Clare Ryan
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | - Steeve Giguère
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA
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Hamamoto BD, Steffey EP, Knych HK. Pharmacokinetics and Pharmacodynamics of Morphine and its Major Metabolites Following Intravenous Administration of Four Doses to Horses. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.683.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Briana D. Hamamoto
- K.L Maddy Equine Analytical Chemistry LaboratoryCalifornia Animal Health and Food Safety LaboratorySchool of Veterinary MedicineUniversity of CaliforniaDavisDavisCA
| | - Eugene P. Steffey
- K.L Maddy Equine Analytical Chemistry LaboratoryCalifornia Animal Health and Food Safety LaboratorySchool of Veterinary MedicineUniversity of CaliforniaDavisDavisCA
| | - Heather K. Knych
- K.L Maddy Equine Analytical Chemistry LaboratoryCalifornia Animal Health and Food Safety LaboratorySchool of Veterinary MedicineUniversity of CaliforniaDavisDavisCA
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Gordon E, Stang BV, Heidel J, Poulsen KP, Cebra CK, Schlipf JW. Pharmacokinetic evaluation and safety of topical 1% morphine sulfate application on the healthy equine eye. Vet Ophthalmol 2018; 21:516-523. [PMID: 29350477 DOI: 10.1111/vop.12541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine if corneal epithelial cell integrity is detrimentally affected by short-term administration of 1.0% morphine sulfate. Additionally, we sought to determine if topical 1.0% morphine applied to the equine cornea would result in ocular or systemic absorption. ANIMAL STUDIED Six healthy horses. PROCEDURE Morphine sulfate (1.0%) was applied topically to one eye every four hours for 72 h before horses were euthanized. Serum samples were collected at varying time points during the study and aqueous and vitreous humor were collected immediately after euthanasia. Morphine quantification in serum, aqueous, and vitreous humor was performed by ELISA. Treated and control corneas were submitted for histopathology. Horses were monitored for adverse ocular and systemic effects throughout the study period. RESULTS All horses developed mild mucoid ocular discharge in the treated eye. One horse developed a fever during treatment. Morphine was detected in the aqueous humor of the treated eye for all horses with mean ± standard deviation of 165.18 ng/mL ± 87.69 ng/mL. Morphine was detected in vitreous humor of the treated eye of 5 of 6 horses with mean ± standard deviation of 4.87 ± 4.46 ng/mL. Morphine was detected in the serum of 5 of 6 horses at varying time points. Maximum systemic concentration reached in a single horse was 6.98 ng/mL. Corneal histopathology revealed no difference in microscopic appearance between morphine-treated and control corneas. CONCLUSIONS Topical administration of 1.0% morphine sulfate did not appear to cause any significant ocular or systemic adverse effects. Topical ophthalmic morphine application resulted in both ocular and systemic absorption.
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Affiliation(s)
- Emma Gordon
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Bernadette V Stang
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Jerry Heidel
- Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Keith P Poulsen
- Department of Medical Sciences, School of Veterinary Medicine and Wisconsin Veterinary Diagnostic Laboratory, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher K Cebra
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - John W Schlipf
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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26
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Potter JJ, MacFarlane PD, Love EJ, Tremaine H, Taylor PM, Murrell JC. Preliminary investigation comparing a detomidine continuous rate infusion combined with either morphine or buprenorphine for standing sedation in horses. Vet Anaesth Analg 2016; 43:189-94. [DOI: 10.1111/vaa.12316] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 03/19/2015] [Indexed: 01/18/2023]
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27
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Fischer B, Clark-Price S. Anesthesia of the Equine Neonate in Health and Disease. Vet Clin North Am Equine Pract 2015; 31:567-85. [DOI: 10.1016/j.cveq.2015.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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28
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Wong JKY, Chan GHM, Leung DKK, Tang FPW, Wan TSM. Generation of phase IIin vitrometabolites using homogenized horse liver. Drug Test Anal 2015; 8:241-7. [DOI: 10.1002/dta.1850] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/22/2015] [Accepted: 07/05/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Jenny K. Y. Wong
- Racing Laboratory; The Hong Kong Jockey Club; Sha Tin Racecourse, Sha Tin N.T. Hong Kong China
| | - George H. M. Chan
- Racing Laboratory; The Hong Kong Jockey Club; Sha Tin Racecourse, Sha Tin N.T. Hong Kong China
| | - David K. K. Leung
- Racing Laboratory; The Hong Kong Jockey Club; Sha Tin Racecourse, Sha Tin N.T. Hong Kong China
| | - Francis P. W. Tang
- Racing Laboratory; The Hong Kong Jockey Club; Sha Tin Racecourse, Sha Tin N.T. Hong Kong China
| | - Terence S. M. Wan
- Racing Laboratory; The Hong Kong Jockey Club; Sha Tin Racecourse, Sha Tin N.T. Hong Kong China
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29
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Sanchez LC, Robertson SA. Pain control in horses: What do we really know? Equine Vet J 2014; 46:517-23. [DOI: 10.1111/evj.12265] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 03/07/2014] [Indexed: 01/15/2023]
Affiliation(s)
- L. C. Sanchez
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville USA
| | - S. A. Robertson
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; Michigan State University; East Lansing USA
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