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Pisack EK, Kleine SA, Hampton CE, Smith CK, Weisent J, DeBolt R, Schumacher C, Bussières G, Seddighi R. Evaluation of the analgesic efficacy of grapiprant compared with robenacoxib in cats undergoing elective ovariohysterectomy in a prospective, randomized, masked, non-inferiority clinical trial. J Feline Med Surg 2024; 26:1098612X241230941. [PMID: 38511293 PMCID: PMC10983605 DOI: 10.1177/1098612x241230941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVES The main objective of this study was to compare the postoperative analgesic effects of grapiprant with those of robenacoxib in cats undergoing ovariohysterectomy (OVH). METHODS In total, 37 female cats (age range 4 months-10 years, weighing ⩾2.5 kg) were enrolled in a prospective, randomized, masked, non-inferiority (NI) clinical trial. Cats received oral robenacoxib (1 mg/kg) or grapiprant (2 mg/kg) 2 h before OVH. Analgesia was assessed via the Feline Grimace Scale (FGS), the Glasgow Composite Measure Pain Scale-Feline (CMPS-F), von Frey monofilaments (vFFs) and pressure algometry (ALG) 2 h before treatment administration, at extubation, and 2, 4, 6, 8, 18 and 24 hours after extubation. Hydromorphone (<8 h postoperatively) or buprenorphine (>18 h postoperatively) were administered to cats with scores of ⩾5/20 on CMPS-F and/or ⩾4/10 on FGS. NI margins for CMPS-F and vFFs were set at 3 and -0.2, respectively. A mixed-effect ANOVA was used for FGS scores (P <0.05). Data are reported as mean ± SEM. RESULTS The data from 33 cats were analyzed. The upper limit of the 95% confidence interval (CI) (0.35) was less than the NI margin of 3 for CMPS-F, and the lower limit of the 95% CI (0.055) was greater than the NI margin of -0.2 for vFFs, indicating NI of grapiprant. The FGS scores were greater than baseline at extubation for both treatments (1.65 ± 0.63; P = 0.001); however, there was no difference between treatments. There was no difference between treatments, nor treatment by time interaction, for vFFs (P <0.001). The CMPS-F scores for both treatments were higher at extubation but returned to baseline after 4 h (P <0.001). For ALG, there was no difference in treatment or treatment by time interaction. The robenacoxib group had lower pressure readings at extubation and 6 h compared with baseline. CONCLUSIONS AND RELEVANCE These results indicate that grapiprant was non-inferior to robenacoxib for mitigating postsurgical pain in cats after OVH performed via ventral celiotomy. The impact of grapiprant for analgesia in OVH via the flank is unknown.
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Affiliation(s)
- Elizabeth K Pisack
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Stephanie A Kleine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Chiara E Hampton
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Christopher K Smith
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Jennifer Weisent
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Rebecca DeBolt
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Cambrie Schumacher
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Genevieve Bussières
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Reza Seddighi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
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Pypendop BH, Stoddard S, Barter LS. Pharmacokinetics of buprenorphine and its metabolite norbuprenorphine in neutered male cats anesthetized with isoflurane. Vet Anaesth Analg 2023:S1467-2987(23)00078-8. [PMID: 37270407 DOI: 10.1016/j.vaa.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To characterize the pharmacokinetics of buprenorphine and norbuprenorphine in isoflurane-anesthetized cats. STUDY DESIGN Prospective experimental study. ANIMALS A group of six healthy adult male neutered cats. METHODS Cats were anesthetized with isoflurane in oxygen. Catheters were placed in a jugular vein for blood sampling and in a medial saphenous vein for buprenorphine and lactated Ringer's solution administration. Buprenorphine hydrochloride (40 μg kg-1 over 5 minutes) was administered intravenously. Blood samples were collected before buprenorphine administration and at various times up to 12 hours after administration. Plasma buprenorphine and norbuprenorphine concentrations were measured using liquid chromatography/tandem mass spectrometry. Compartment models were fitted to the time-concentration data using nonlinear mixed effect (population) modeling. RESULTS A five-compartment model (three compartments for buprenorphine and two compartments for norbuprenorphine) best fitted the data. Typical value (% interindividual variability) for the three buprenorphine volumes of distribution, and the metabolic clearance to norbuprenorphine, the remaining metabolic clearance and the two distribution clearances were 157 (33), 759 (34) and 1432 (43) mL kg-1, and 5.3 (33), 16.4 (11), 58.7 (27) and 6.0 (not estimated) mL minute-1 kg-1, respectively. Typical values (% interindividual variability) for the two norbuprenorphine volumes of distribution, and the norbuprenorphine metabolic and distribution clearances were 1437 (30) and 8428 (not estimated) mL kg-1 and 48.4 (68) and 235.9 (not estimated) mL minute-1 kg-1, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The pharmacokinetics of buprenorphine in isoflurane-anesthetized cats were characterized by a medium clearance.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, CA, USA.
| | - Samantha Stoddard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, CA, USA
| | - Linda S Barter
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, CA, USA
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Sypniewski LA, Knych H, Breshears M, Fang WB, Moody DE, Rudra P, Maxwell LK, Murray JK, Ritchey J, Brandão J. Pharmacokinetics, blood and urine profile effects, and injection site histopathology following three daily injections of subcutaneous high concentration buprenorphine in New Zealand white rabbits (Oryctolagus cuniculus). J Exot Pet Med 2022. [DOI: 10.1053/j.jepm.2022.09.001] [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]
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Clark TP. The history and pharmacology of buprenorphine: New advances in cats. J Vet Pharmacol Ther 2022; 45 Suppl 1:S1-S30. [DOI: 10.1111/jvp.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/19/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
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Freise KJ, Reinemeyer C, Warren K, Lin TL, Clark TP. Single-dose pharmacokinetics and bioavailability of a novel extended duration transdermal buprenorphine solution in cats. J Vet Pharmacol Ther 2022; 45 Suppl 1:S31-S39. [PMID: 35790014 DOI: 10.1111/jvp.13044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/12/2022] [Accepted: 01/22/2022] [Indexed: 11/29/2022]
Abstract
A novel transdermal buprenorphine solution (TBS) was developed for evaluation in order to make available an extended duration opioid analgesic for cats. Healthy adult cats were administered a single TBS dose of 10 mg (1.57-4.35 mg/kg), 30 mg (4.72-13.0 mg/kg), or 50 mg (7.87-21.7 mg/kg) (4 cats per group) applied topically to the unclipped dorsal cervical skin and plasma buprenorphine concentrations were evaluated through 7 days. To determine the absolute bioavailability of TBS, healthy cats were administered single TBS dose of 20 mg (3.33-4.76 mg/kg) or 0.05 mg (0.008-0.011 mg/kg) IV buprenorphine (6 cats per group). The mean ± standard deviation maximum plasma buprenorphine concentrations (Cmax ) were 10.5 ± 6.28, 18.6 ± 8.68, and 22.5 ± 4.47 ng/ml following 10, 30, and 50 mg doses, respectively, with the time of Cmax occurrence (tmax ) typically occurring at 2-12 h post-dosing. Mean plasma buprenorphine terminal half-lives ranged between 78.3 and 91.2 h. Increasing the dose threefold and fivefold from the 10 mg dose increased the exposure by 2.8- and 3.6-fold, respectively, indicating that plasma buprenorphine exposure increased in a less than proportional manner at doses >30 mg. Transient sedation, mydriasis, and euphoria were observed within 4 h post-dosing. Mean rectal temperatures were increased 0.6-0.9°C greater than baseline (37.4-37.8°C) through 168 h post-dosing. The absolute bioavailability was 16.0% (90% CI: [11.8%-21.7%]). Flip-flop pharmacokinetics were observed with a terminal elimination half-life of 0.82 ± 0.13 and 64.9 ± 15.0 h for IV buprenorphine and 20 mg of TBS, respectively. A single administration of TBS over a range of doses resulted in extended plasma buprenorphine concentrations and opioid physiological and behavioral effects.
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Affiliation(s)
| | - Craig Reinemeyer
- East Tennessee Clinical Research, Inc., Rockwood, Tennessee, USA
| | | | - Ting-Li Lin
- Nexcyon Pharmaceuticals, Inc., Madison, Wisconsin, USA
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Steagall PV, Robertson S, Simon B, Warne LN, Shilo-Benjamini Y, Taylor S. 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats. J Feline Med Surg 2022; 24:4-30. [PMID: 34937455 PMCID: PMC10845386 DOI: 10.1177/1098612x211066268] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PRACTICAL RELEVANCE Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer. CLINICAL CHALLENGES Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management. EVIDENCE BASE These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors' experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.
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Affiliation(s)
- Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montréal, Saint-Hyacinthe, Canada; and Department of Veterinary Clinical Sciences and Centre for Companion Animal Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | | | - Bradley Simon
- Department of Small Animal Clinical Sciences, Texas A&M College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Leon N Warne
- Veterinary Anaesthesia & Pain Management Australia, Perth, Western Australia; and Veterinary Cannabis Medicines Australia, Perth, Western Australia, Australia
| | - Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Cannarozzo CJ, Kirch P, Campoy L, Gleed RD, Lorenzutti AM, Martin-Flores M. Retrospective investigation of an association between high-dose buprenorphine and perpetuation of post-anesthesia hyperthermia in cats following ovariohysterectomy. J Feline Med Surg 2021; 23:777-782. [PMID: 33269621 PMCID: PMC10812187 DOI: 10.1177/1098612x20976207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We evaluated a potential association between the administration of high-dose buprenorphine and perpetuation of hyperthermia in cats following ovariohysterectomy (OVH). We hypothesized that buprenorphine 0.24 mg/kg subcutaneously (SC) would result in longer-lasting postoperative hyperthermia in cats vs a group receiving morphine 0.1 mg/kg SC. METHODS Anesthetic records from cats admitted for OVH as part of surgical exercises for second year veterinary medicine students in 2018 and 2019 were collected. All cats were sedated with dexmedetomidine 20 µg/kg and morphine 0.1 mg/kg intramuscularly. Anesthesia was induced with propofol and maintained with isoflurane in oxygen. At extubation, cats received morphine 0.1 mg/kg SC in 2018 and buprenorphine 0.24 mg/kg SC in 2019. Temperature was measured rectally prior to sedation, esophageally during anesthesia and rectally at 1, 4 and 16-20 h after extubation. Demographic data and temperature prior to administration of postoperative opioids were compared with t-tests. The effects of treatment (opioids) and time on postoperative rectal temperature and on the incidence of hyperthermia (temperature >39.2°C) were evaluated with mixed and generalized linear mixed-effect models. Significance was set at P <0.05. RESULTS There were no differences in demographic characteristics between treatment groups (all P ⩾0.2). Intraoperative esophageal temperature was lower in cats scheduled to receive morphine (mean ± SD 36.6 ± 0.2) than in those receiving buprenorphine (36.9 ± 1.0) (P <0.0001). Postoperative temperature was higher for cats receiving buprenorphine than for those receiving morphine (P <0.0001). The incidence of hyperthermia 16-20 h after opioid administration was 56% for morphine and 73% for buprenorphine (P = 0.03). CONCLUSIONS AND RELEVANCE Buprenorphine 0.24 mg/kg SC for postoperative analgesia in cats was associated with hyperthermia that persisted for 16-20 h after administration, and the incidence of hyperthermia for this group was higher than in the cats that received morphine 0.1 mg/kg SC.
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Affiliation(s)
- Cheyenne J Cannarozzo
- Cornell University Hospital for Animals, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Friendship Hospital for Animals, Washington, DC, USA
| | - Pati Kirch
- Cornell University Hospital for Animals, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Luis Campoy
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Robin D Gleed
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Augusto M Lorenzutti
- Faculty of Agricultural Sciences, Catholic University of Cordoba, Cordoba, Argentina
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Hansford J, Henao-Guerrero N, Machado ML, Pypendop BH. Pharmacokinetics of a high-concentration formulation of buprenorphine (Simbadol) in male dogs. Vet Anaesth Analg 2021; 48:509-516. [PMID: 34059460 DOI: 10.1016/j.vaa.2021.04.003] [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: 08/10/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To describe the pharmacokinetics of buprenorphine in dogs following administration of a high-concentration formulation of buprenorphine. STUDY DESIGN Prospective, randomized, crossover study. ANIMALS A total of six healthy male intact Beagle dogs, aged 9-13 months and weighing 10.3 ± 1.4 kg (mean ± standard deviation). METHODS Dogs were randomized to be administered buprenorphine (0.12 mg kg-1; Simbadol, 1.8 mg mL-1) via the intravenous (lateral saphenous) or subcutaneous (dorsal interscapular) route followed by the alternative route of administration after a 14 day interval. Blood was sampled before administration and at set times up to 72 hours after injection. Plasma buprenorphine concentration was measured using liquid chromatography-tandem mass spectrometry. RESULTS A three-compartment model with zero or biphasic rapid and slow first-order input in (intravenous or subcutaneous data, respectively) and first-order elimination from the central compartment best fitted the data. The rapid first-order input accounted for 63% of the dosage absorption. Typical values (% interindividual variability) for the three compartment volumes were 900 (33), 2425 (not estimated) and 6360 (28) mL kg-1. The metabolic and two distribution clearances were 25.7 (21), 107.5 (74) and 5.7 (61) mL minute-1 kg-1. The absorption half-life for the fast absorption phase was 8.9 minutes with a 0.7 (103) minute delay. The absorption half-life for the slow absorption phase was 347 minutes with a 226 (42) minute delay. Median (range) bioavailability calculated from noncompartmental analysis was 143 (80-239)%. Calculated terminal half-life was 963 minutes. CONCLUSIONS AND CLINICAL RELEVANCE The high-concentration formulation of buprenorphine administered subcutaneously had a large volume of distribution and a rapid absorption phase followed by slower, delayed absorption. The high estimate of bioavailability should be interpreted with caution as values above 100% are most commonly related to experimental issues.
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Affiliation(s)
- Jeremy Hansford
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Natalia Henao-Guerrero
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Marcela L Machado
- William R Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.
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Moreno KL, Scallan EM, Monteiro BP, Steagall PV, Simon BT. The thermal antinociceptive effects of a high-concentration formulation of buprenorphine alone or followed by hydromorphone in conscious cats. Vet Anaesth Analg 2021; 48:570-576. [PMID: 33926823 DOI: 10.1016/j.vaa.2021.03.008] [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: 09/23/2020] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the thermal antinociceptive effects of a high-concentration formulation of buprenorphine alone or followed by hydromorphone in conscious cats. STUDY DESIGN Randomized, blinded, placebo-controlled crossover study design. ANIMALS A total of six purpose-bred, adult female ovariohysterectomized Domestic Short Hair cats. METHODS Cats were allocated into three treatments each consisting of two injections, subcutaneous then intravenous (IV) administration, 2 hours apart: treatment SS, two injections of 0.9% saline; treatment BS, buprenorphine (0.24 mg kg-1, 1.8 mg mL-1) and saline; and treatment BH, buprenorphine (0.24 mg kg-1) and hydromorphone (0.1 mg kg-1). Skin temperature (ST) and thermal threshold (TT) were recorded before (baseline) and for 24 hours following first injection. TT data were analyzed using mixed linear models and a Benjamini-Hochberg sequential adjustment procedure (p < 0.05). RESULTS There were no significant differences among treatments for baseline ST and TT values, treatment SS over time and between treatments BS and BH. Compared with baseline, TT was significantly increased at all time points in treatments BH and BS except at 2 hours in treatment BS. TT was significantly higher than SS at 3-18 hours and 4-12 hours for treatments BS and BH, respectively. Maximal increases in TT were 47.5 °C at 2 hours, 53.9 °C at 3 hours and 52.4 °C at 6 hours in treatments SS, BS and BH, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Administration of IV hydromorphone following high-concentration buprenorphine provided no additional antinociception and decreased the duration of effect when compared with high-concentration buprenorphine alone. Alternative analgesics should be considered if additional analgesia is required after administration of high-concentration buprenorphine.
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Affiliation(s)
- Kara L Moreno
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Elizabeth M Scallan
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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Flynn H, Cenani A, Brosnan RJ, DiMaio Knych HK, de Araujo Aguiar AJ. Pharmacokinetics and pharmacodynamics of a high concentration of buprenorphine (Simbadol) in conscious horses after subcutaneous administration. Vet Anaesth Analg 2021; 48:585-595. [PMID: 33934992 DOI: 10.1016/j.vaa.2021.02.005] [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: 08/28/2020] [Revised: 01/27/2021] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics and pharmacodynamics of high-concentration formulation of buprenorphine (1.8 mg mL-1; Simbadol) following subcutaneous (SC) administration in horses. STUDY DESIGN Prospective, randomized, crossover trial. ANIMALS A group of six healthy adult horses weighing 521-602 kg. METHODS On three occasions, Simbadol (0.005 mg kg-1; treatment S5), (0.0025 mg kg-1; treatment S2.5) or saline (treatment SAL) were administered SC at least 7 days apart in random order. Electrical nociceptive threshold (ENT) measured on the neck region, physiologic variables, locomotor activity, degree of restlessness and presence of excitatory signs were measured at baseline and for up to 48 hours after injection. Blood was collected for pharmacokinetic analysis at the same time intervals and plasma buprenorphine concentration (Cp) measured using liquid chromatography-tandem mass spectrometry. RESULTS Buprenorphine was quantifiable in all horses from 15 minutes after administration up to 8-12 hours. ENT was significantly increased in treatment S2.5 compared with treatment SAL at 0.75-6 hours after treatment. Increase in locomotor activity and compulsive behavior were recorded in all horses after Simbadol, and degree of restlessness was significantly higher in treatment S5 than SAL for a sustained time. Gastrointestinal motility significantly decreased in all horses after Simbadol and returned to baseline by 16 hours after treatment. CONCLUSIONS AND CLINICAL RELEVANCE In horses, SC Simbadol was rapidly absorbed and Cp decreased rapidly. Side effects commonly seen in horses after opioids were observed in both Simbadol treatments, but degree of opioid-induced excitement lasted significantly longer in treatment S5. Simbadol (0.0025 mg kg-1) SC has the potential to be used clinically to treat pain in horses. However, at this dose, duration of antinociceptive effects was not longer than that reported for conventional buprenorphine, and side effects, including reduction in gastrointestinal motility and increased locomotor activity, were documented.
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Affiliation(s)
- Harriet Flynn
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Alessia Cenani
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.
| | - Robert J Brosnan
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Heather K DiMaio Knych
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Antonio J de Araujo Aguiar
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista - UNESP, Botucatu, SP, Brazil
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Askar R, Fredriksson E, Manell E, Hedeland M, Bondesson U, Bate S, Olsén L, Hedenqvist P. Bioavailability of subcutaneous and intramuscular administrated buprenorphine in New Zealand White rabbits. BMC Vet Res 2020; 16:436. [PMID: 33176781 PMCID: PMC7656698 DOI: 10.1186/s12917-020-02618-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Buprenorphine is one of the most used analgesics for postoperative pain in rabbits. The recommended dose in rabbits (0.01–0.05 mg/kg) is the same for intravenous (IV), intramuscular (IM), and subcutaneous (SC) administration, despite lack of pharmacokinetic data. Five male and five female New Zealand White rabbits (mean ± SD body weight 3.1 ± 0.3 kg) were administered 0.05 mg/kg buprenorphine by the IV, IM and SC routes and 0.1 mg/kg by the SC route, in a cross-over design with two-week wash-out periods between treatments. Blood was collected before, and up to 8 h post buprenorphine injection, for determination of serum levels by UPHLC-MS/MS. Results The area under the time concentration curve (AUC0-t) was lower after SC (398 ± 155 ng/mL/min) than IM (696 ± 168 ng/mL/min, p < 0.001) and IV (789 ± 189 ng/mL/min, p < 0.001) administration. The maximum serum concentration was lower after SC (2.2 ± 1.4 ng/mL) than after IM (11 ± 3.2 ng/mL) administration (p < 0.001). The bioavailability was lower after SC (50 ± 19%) than after IM (95 ± 21%) administration (p = 0.006). The elimination half-life was longer after SC (260 ± 120 min) than after IM (148 ± 26 min, p = 0.002) as well as IV (139 ± 33 min) injection (p < 0.001). An increase in the SC dose from 0.05 to 0.1 mg/kg resulted in an increase in the area under the time concentration curve of 50% in female (p = 0.022) and 165% in male rabbits (p < 0.001). The bioavailability did not change in the females (36 ± 14%, p = 0.6), whereas it increased in the males (71 ± 23%, p = 0.008). Conclusions The lower bioavailability of 0.05 mg/kg buprenorphine after SC administration could explain the lack of efficacy seen in clinical pain studies in rabbits, using this route. For immediate pain relief, IV or IM administration is therefore be recommended, whereas SC administration may be useful to sustain analgesic serum levels, once efficient pain relief has been achieved. The current data do not support an increase in dose to compensate for the lower SC bioavailability. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-020-02618-7.
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Affiliation(s)
- Raad Askar
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Elin Fredriksson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, SE-750 07, Uppsala, Sweden
| | - Elin Manell
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, SE-750 07, Uppsala, Sweden
| | - Mikael Hedeland
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden.,Department of Chemistry, Environment and Feed Hygiene, SVA, National Veterinary Institute, Uppsala, Sweden
| | - Ulf Bondesson
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden.,Department of Chemistry, Environment and Feed Hygiene, SVA, National Veterinary Institute, Uppsala, Sweden
| | - Simon Bate
- CMC Statistics, GlaxoSmithKline Medicines Research Centre, Stevenage, UK
| | - Lena Olsén
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, SE-750 07, Uppsala, Sweden
| | - Patricia Hedenqvist
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, SE-750 07, Uppsala, Sweden.
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12
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Gordon-Evans WJ, Suh HY, Guedes AG. Controlled, non-inferiority trial of bupivacaine liposome injectable suspension. J Feline Med Surg 2020; 22:916-921. [PMID: 31833793 PMCID: PMC10814399 DOI: 10.1177/1098612x19892355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Recently, a bupivacaine liposome injectable suspension (BLIS) became commercially available in the veterinary market that may provide local analgesia for 72 h. The purpose of this study was to compare a BLIS incisional block with a control protocol in cats after ovariohysterectomy (OHE). The hypothesis was that a BLIS block would provide equivalent pain relief. METHODS This study was designed as a randomized, double-blind, non-inferiority trial. Students performed an OHE followed by a two-layer incisional and body wall block with either standard bupivacaine (control) or BLIS. Postoperatively, cats in the control group received robenacoxib, whereas the BLIS cats received saline. All cats were evaluated using the feline Glasgow Composite Measure Pain Scale (GCMPS) at multiple time points postoperatively. RESULTS There were 24 control cats and 23 BLIS cats. One cat from each group required rescue medication. The mean GCMPS scores were low and the groups were equivalent at all time points (P <0.05). This study showed that BLIS was equivalent to the control group up to 42 h and pain scores remained low up to 68 h after surgery. CONCLUSIONS AND RELEVANCE BLIS incisional block is equivalent to a control pain protocol and reduces the need for continued postoperative drug administration.
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Affiliation(s)
- Wanda J Gordon-Evans
- Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
| | | | - Alonso G Guedes
- Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
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13
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Andrews DD, Fajt VR, Baker KC, Blair RV, Jones SH, Dobek GL. A Comparison of Buprenorphine, Sustained release Buprenorphine, and High concentration Buprenorphine in Male New Zealand White Rabbits. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2020; 59:546-556. [PMID: 32674750 DOI: 10.30802/aalas-jaalas-19-000132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain management in rabbits can be difficult because they are adept at hiding pain and can be stressed by handling and restraint for injection. The use of opioid analgesics with prolonged durations of activity could alleviate pain, but associated adverse effects including gastrointestinal ileus, inappetence, and tissue reactions have been reported. In this study, we compared gross tissue reactions at the site of injection, food consumption, and fecal production after single injections of buprenorphine HCl (Bup; n = 7), sustained-release buprenorphine (BupSR; n = 8), and high-concentration buprenorphine (BupHC; n = 7) during the first 3 d after minor survival surgery. We also measured plasma concentrations of the parent drug, buprenorphine, and 3 metabolites (buprenorphine-3-glucuronide (B3G), norbuprenorphine-3β-glucuronide (N3G), and norbuprenorphine (NB)). Plasma levels of buprenorphine remained above the theoretical minimal analgesic concentration for 4 h for Bup and 42 h for BupHC. For BupSR, plasma levels of buprenorphine remained above the theoretical minimal analgesic concentration for approximately 77 h, starting 15 h after administration. For all 3 formulations, N3G was the most prominent metabolite in the blood. No injection site reactions were visible grossly in any rabbit. Relative to baseline measures and compared with controls (n = 8), food consumption was suppressed on days 1 through 3 in rabbits that received BupSR and on days 2 through 3 in those given BupHC. Feces production on day 3 was reduced to a greater extent in BupSR rabbits than control animals. Two rabbits in the BupHC group exhibited neurologic signs after drug administration. These adverse effects should be considered when choosing a long-lasting buprenorphine formulation to manage pain in rabbits.
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Affiliation(s)
- David D Andrews
- Department of Comparative Medicine, Tulane University, New Orleans, Louisiana;,
| | - Virginia R Fajt
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, Texas
| | - Kate C Baker
- Divisions of Veterinary Medicine, Tulane National Primate Research Center, Covington, Louisiana
| | - Robert V Blair
- Comparative Pathology, Tulane National Primate Research Center, Covington, Louisiana
| | - Sean H Jones
- Department of Comparative Medicine, Tulane University, New Orleans, Louisiana
| | - Georgina L Dobek
- Department of Comparative Medicine, Tulane University, New Orleans, Louisiana
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14
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Steagall PV, Ruel HLM, Yasuda T, Monteiro BP, Watanabe R, Evangelista MC, Beaudry F. Pharmacokinetics and analgesic effects of intravenous, intramuscular or subcutaneous buprenorphine in dogs undergoing ovariohysterectomy: a randomized, prospective, masked, clinical trial. BMC Vet Res 2020; 16:154. [PMID: 32448336 PMCID: PMC7245774 DOI: 10.1186/s12917-020-02364-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Buprenorphine is used for canine postoperative pain management. This study aimed to describe the pharmacokinetics and evaluate the analgesic efficacy of buprenorphine (Simbadol, 1.8 mg/mL) administered by different routes in dogs undergoing ovariohysterectomy. Twenty-four dogs were included in a randomized, prospective, masked, clinical trial. Buprenorphine (0.02 mg/kg) was administered intravenously (IV), intramuscularly (IM) or subcutaneously (SC) (n = 8/group) 0.5 h before general anesthesia with propofol-isoflurane. Carprofen (4.4 mg/kg SC) was administered after anesthetic induction and before ovariohysterectomy. Pain was scored using the short-form Glasgow composite pain scale for dogs (SF-GCPS). Dogs were administered morphine (0.25 mg/kg IV) when SF-GCPS scores were ≥ 5/20. Blood sampling was performed up to 720 min after drug administration. Plasma buprenorphine and norbuprenorphine concentrations were analyzed using liquid chromatography mass spectrometry. Pharmacokinetics of buprenorphine was described using a non-compartmental model (PK Solver 2.0). Statistical analysis was performed using linear mixed models and Fisher's exact test (p < 0.05). RESULTS Pain scores were significantly higher than baseline after IV (0.5-2 h), IM (0.5-3 h) and SC (0.5-4 h) but not among groups. Prevalence of rescue analgesia was significantly higher in SC (7/8 dogs) than IV (2/8) but not different between IV and IM (3/8) or IM and SC. The frequency of rescue analgesia was not significantly different among groups (IV = 2, IM = 5 and SC = 9). Norbuprenorphine was not detected. For IV, IM and SC administration, clearance was 1.29, 1.65 and 1.40 L/hour/kg, volume of distribution was 6.8, 14.2 and 40.1 L/kg, the elimination half-life was 3.7, 5.7, 22 h, and the area under the plasma concentration-time curved extrapolated to infinity was 15.7, 12.4 and 16.4 ng/mL/hour, respectively. Bioavailability for IM and SC was 62.6 and 40%, respectively. Maximum plasma concentrations of buprenorphine were 6.2 and 1.3 ng/mL at 0.14 and 0.33 h after IM and SC administration, respectively. CONCLUSIONS The route of administration influences the analgesic efficacy of buprenorphine in dogs. SC administration of buprenorphine failed to provide clinical analgesia due to erratic drug absorption. At the doses administered, the IV and IM routes are preferred for postoperative analgesia.
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Affiliation(s)
- Paulo Vinicius Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,Diplomate American College of Veterinary Anesthesia and Analgesia, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada.
| | - Hélène Louise Marcelle Ruel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Tomoyo Yasuda
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Beatriz Paglerani Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Marina Cayetano Evangelista
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Francis Beaudry
- Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
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15
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Use of nociceptive threshold testing in cats in experimental and clinical settings: a qualitative review. Vet Anaesth Analg 2020; 47:419-436. [PMID: 32507715 DOI: 10.1016/j.vaa.2019.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/22/2019] [Accepted: 12/31/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to review the scientific articles on the use of nociceptive threshold testing (NTT) in cats and to summarize the clinical and experimental applications in this species. DATABASES USED Pertinent literature was searched with PubMed, Scopus, Web of Science, Universitätsbibliothek Basel (swissbib Basel Bern) and Google Scholar. The search was then refined manually based first on article titles and abstracts, and subsequently on full texts. CONCLUSIONS Of the four classical acute nociceptive models used for NTT, thermal and mechanical are most commonly used in cats. Thermal stimulation is applicable in experimental settings and has been used in pharmacodynamics studies assessing feline antinociception. Although mechanical stimulation is currently less used in cats, in the future it might play a role in the evaluation of clinical feline pain. However, the low response reliability after stimulus repetition within a narrow time interval represents a major limitation for the clinical use of mechanical thresholds in this species. Challenges remain when thermal thresholds are used to investigate analgesics that have the potential to affect skin temperature, such as opioids and α2-adrenergic agonists, and when a model of inflammatory pain is reproduced in experimental cats with the purpose of evaluating non-steroidal anti-inflammatory drugs as analgesics.
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16
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Watanabe R, Marcoux J, Evangelista MC, Dumais Y, Steagall PV. The analgesic effects of buprenorphine (Vetergesic or Simbadol) in cats undergoing dental extractions: A randomized, blinded, clinical trial. PLoS One 2020; 15:e0230079. [PMID: 32142538 PMCID: PMC7059904 DOI: 10.1371/journal.pone.0230079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/20/2020] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the analgesic efficacy of two dosage regimens using two different concentrations of buprenorphine in cats undergoing dental extractions. Twenty-three cats with oral disease (8.2 ± 2.2 years old; 4.9 ± 0.9 kg) were included in a prospective, blinded, randomized clinical trial. Cats randomly received either Simbadol (1.8 mg/mL; 0.24 mg/kg, subcutaneously, every 24h: SG, n = 11) or Vetergesic (0.3 mg/mL; 0.02 mg/kg, intramuscularly, every 8h: VG, n = 12) throughout the study. They were admitted at day 0, underwent oral examination/radiographs/treatment under general anesthesia (buprenorphine-propofol-isoflurane-meloxicam-local anesthetic blocks) at day 1 and discharged at day 4. Sedation and pain were scored using the dynamic interactive visual analog scale (day 1) and the Glasgow Composite Measure Pain Scale-Feline (CMPS-F; up to postoperative 8 hours at day 1, 8 am, 4 pm and midnight at days 2 and 3, and 8 am at day 4), respectively. Rescue analgesia was administered with hydromorphone (0.05 mg/kg intravenously on day 1 or 0.1 mg/kg intramuscularly after day 2) when CMPS-F ≥ 5. Resentment defined as any type of escape behavior associated with aversion to drug administration was recorded. Sedation and pain scores, the prevalence of rescue analgesia and resentment during drug administration were analyzed using linear mixed models and Fisher’s exact test, respectively (p < 0.05). Pain and sedation scores were not significantly different between groups. Sedation scores were significantly higher up to postoperative 2 hours in both groups. Pain scores in SG and VG were significantly higher up to postoperative 8 hours and 8 am of day 2, respectively, than baseline. Prevalence of rescue analgesia and resentment were not significantly different between groups (SG: 27.3%, VG: 33.3% and SG: 0%, VG: 25%, respectively). Simbadol produced similar analgesic effects to Vetergesic without resentment during drug administration.
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Affiliation(s)
- Ryota Watanabe
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
| | - Josée Marcoux
- Centre Hospitalier Universitaire Vétérinaire (CHUV), Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
| | - Marina C. Evangelista
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
| | - Yvan Dumais
- Centre Hospitalier Universitaire Vétérinaire (CHUV), Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
| | - Paulo V. Steagall
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
- * E-mail:
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17
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Leedham R, White KL, Yates D, Brown L. Comparison of two high doses of subcutaneous buprenorphine in cats undergoing ovariohysterectomy. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/coan.2019.0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objectives: The aim of the study was to evaluate the analgesia and recovery effects of two doses (0.12 mg/kg and 0.24 mg/kg) of subcutaneous buprenorphine in cats undergoing ovariohysterectomy. Methods: This was an assessor-blinded, randomised, clinical study. A total of 83 cats were recruited and randomly allocated to receive 0.12 mg/kg buprenorphine or 0.24 mg/kg buprenorphine subcutaneously, followed 30 minutes later by 40 μg/kg medetomidine intramuscularly. Anaesthesia was induced with intravenous alfaxalone to effect and maintained with isoflurane in oxygen. All cats received meloxicam before surgery. Temperament score, quality of sedation, induction of anaesthesia, dose of alfaxalone and recovery were scored using simple descriptive scales. Atipamazole was administered following surgery. Physiological variables during anaesthesia were recorded. Cats were assessed postoperatively by the same blinded observer at 2, 4 and 24 hours using a modified Colorado Feline Acute Pain scale. The presence or absence of mydriasis was noted. Results: No significant differences were identified between groups. Three cats in the 0.12 mg/kg group and four in the 0.24 mg/kg group required rescue analgesia. Mydriasis persisting for at least 24 hours was evident in 75 cats. Conclusions and relevance: No differences in analgesia were detected between groups with these protocols; mydriasis was common in both groups.
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Affiliation(s)
- Rosa Leedham
- RSPCA Greater Manchester Animal Hospital, 411 Eccles New Rd, Salford M5 5NN, UK
| | - Kate L White
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough UK
| | - David Yates
- RSPCA Greater Manchester Animal Hospital, 411 Eccles New Rd, Salford M5 5NN, UK
| | - Lauren Brown
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough UK
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18
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Schroers M, Meyer-Lindenberg A, Reese S, Dobenecker B, Pieper K. Pharmacokinetics of low-dose and high-dose buprenorphine in cats after rectal administration of different formulations. J Feline Med Surg 2019; 21:938-943. [PMID: 30427272 PMCID: PMC11132234 DOI: 10.1177/1098612x18810933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES A prospective experimental study was performed in nine young healthy cats to investigate a pharmacokinetic profile and the clinical relevance of rectally administered buprenorphine. Rectal pH value was measured in all nine cats. METHODS Blood was collected 15, 30, 60, 90, 120, 240 and 480 mins and 24 h after the rectal administration of a suppository and a gel at doses between 0.02 mg/kg and 0.1 mg/kg buprenorphine to determine the plasma concentration of buprenorphine. Rectal pH was measured with pH paper. RESULTS Upon pharmacokinetic non-compartment analysis of high-dose buprenorphine (0.1 mg/kg), average maximal plasma concentration was found to be 1.13 ng/ml, time to maximal plasma concentration was 45 mins and area under the plasma concentration-time curve was 94.19 ng*min/ml, representing low but potential bioavailability. Mean residual time was 152.2 mins and the half-life was 92.6 mins. A wide range of plasma concentrations within the cohort was measured and two of the cats had to be excluded from statistical analysis owing to incomplete uptake. Vital parameters of all cats were considered to be normal but three of the cats showed mydriasis up to 8 h after application. After the administration of a low-dose suppository or a rectal gel (0.02 mg/kg) within pilot studies, no buprenorphine was detected in cat plasma. Rectal pH in all cats was between 7.7 and 8. CONCLUSIONS AND RELEVANCE The rectal application of buprenorphine at a dose of 0.1 mg/kg revealed a potential but weak uptake in cats. Regarding effective concentrations in previous pharmacokinetic investigations, rectal administration is currently not recommended for good provision of opioid analgesia in cats. Pharmacological investigations of formulation and galenics in order to improve the rectal bioavailability of buprenorphine remain to be clarified before further dose-finding and pharmacokinetic/pharmacodynamic studies are performed.
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Affiliation(s)
- Maike Schroers
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Ludwig Maximilians University Munich, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Ludwig Maximilians University Munich, Munich, Germany
| | - Sven Reese
- Department of Veterinary Science, Faculty of Veterinary Medicine, Ludwig Maximilians University Munich, Munich, Germany
| | - Britta Dobenecker
- Department of Veterinary Science, Faculty of Veterinary Medicine, Ludwig Maximilians University Munich, Munich, Germany
| | - Korbinian Pieper
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Ludwig Maximilians University Munich, Munich, Germany
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19
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Mackiewicz AL, Salyards GW, Knych HK, Hill AE, Christe KL. Pharmacokinetics of a Long-lasting, Highly Concentrated Buprenorphine Solution after Subcutaneous Administration in Rhesus Macaques ( Macaca mulatta). JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2019; 58:501-509. [PMID: 31227029 PMCID: PMC6643088 DOI: 10.30802/aalas-jaalas-18-000115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/05/2018] [Accepted: 12/13/2018] [Indexed: 11/05/2022]
Abstract
Opioids are essential for use in rhesus macaques (Macaca mulatta) that require multimodal analgesia or those unable to receive NSAID as part of their pain management plan. The current opioid epidemic has universally limited the availability of these vital analgesics, compelling clinicians to investigate other options including novel opioid formulations. A commercially available injectable, long-lasting, highly concentrated buprenorphine solution (HCBS) provides therapeutic plasma concentrations lasting 24 h after a single dose in cats ( Felis catus). We hypothesized that this same HCBS would achieve therapeutic concentrations (≥0.1 ng/mL) for at least 24 h in rhesus macaques. In the current study, 6 healthy, adult rhesus macaques were included in a randomized, 2-period, 2-treatment crossover study. The low dose (0.24 mg/kg SC) achieved a peak plasma concentration of 19.1 ± 5.68 ng/mL at 0.308 ± 0.077 h, with an AUC of 236.4 ± 22.5 h/ng/mL and terminal elimination half-life of 19.6 ± 4.02 h; for the high dose (0.72 mg/kg SC), these parameters were 65.2 ± 14.7 ng/mL, 0.034 ± 0.004 h, 641.3 ± 79.4 h/ng/mL, and 20.6 ± 2.30 h, respectively. The mean plasma concentrations for the low and high doses in rhesus macaques significantly exceeded the therapeutic threshold for 48 and 72 h, respectively. One macaque showed mild somnolence at both doses, and another showed mild pruritus at both doses. These findings show that subcutaneous administration of HCBS provides prolonged and long-lasting therapeutic plasma levels for 48 to 72 h dosing without problematic adverse effects and thus represents a potential new analgesic alternative.
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Affiliation(s)
- Alexis L Mackiewicz
- Department of Primate Medicine, California National Primate Research Center, University of California, Davis, Davis, California;,
| | - Gregory W Salyards
- Department of Primate Medicine, California National Primate Research Center, University of California, Davis, Davis, California
| | - Heather K Knych
- KL Maddy Equine Analytical Chemistry Laboratory, University of California, Davis, Davis, California
| | - Ashley E Hill
- California Animal Health and Food Safety Laboratory, University of California, Davis, Davis, California; Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Kari L Christe
- Department of Primate Medicine, California National Primate Research Center, University of California, Davis, Davis, California; Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California
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20
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Watanabe R, Monteiro BP, Evangelista MC, Castonguay A, Edge D, Steagall PV. The analgesic effects of buprenorphine (Vetergesic or Simbadol) in combination with carprofen in dogs undergoing ovariohysterectomy: a randomized, blinded, clinical trial. BMC Vet Res 2018; 14:304. [PMID: 30290820 PMCID: PMC6173890 DOI: 10.1186/s12917-018-1628-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/25/2018] [Indexed: 11/17/2022] Open
Abstract
Background Buprenorphine is a potent lipophilic opioid analgesic that is largely used in the multimodal treatment of acute pain. Simbadol (buprenorphine hydrochloride) is the first and only FDA-approved high-concentration formulation of buprenorphine for use in cats. The aim of this study was to evaluate the analgesic efficacy of carprofen in combination with one of two commercial formulations of buprenorphine (Simbadol and Vetergesic, 1.8 mg/mL and 0.3 mg/mL, respectively) in dogs undergoing ovariohysterectomy. Twenty-four dogs were included in a randomized, prospective, controlled, clinical trial. Patients were randomly divided into 2 groups as follows. Dogs were premedicated with acepromazine (0.02 mg/kg) and either 0.02 mg/kg of Vetergesic or Simbadol intramuscularly (Vetergesic group – VG; Simbadol group – SG, respectively; n = 12/group). General anesthesia was induced with propofol and maintained with isoflurane in 100% oxygen. Carprofen (4.4 mg/kg SC) was administered after induction of anesthesia. Heart rate, respiratory rate, blood pressure, pulse oximetry, pain scores using the Glasgow Composite Pain Scale Short Form (CMPS-SF), sedation scores using a dynamic interactive visual analogue scale and adverse events were evaluated before and after ovariohysterectomy by an observer who was unaware of treatment administration. If CMPS-SF scores were ≥ 5/20, dogs were administered rescue analgesia (morphine 0.5 mg/kg IM). Statistical analysis was performed using linear mixed models and Fisher’s exact test (p < 0.05). Results Pain and sedation scores and physiological parameters were not significantly different between treatments. Three dogs in VG (25%) and none in SG (0%) required rescue analgesia (p = 0.109). Adverse effects (i.e. vomiting and melena) were observed in two dogs in SG and were thought to be related to stress and/or nonsteroidal anti-inflammatory drug toxicity. Conclusions The administration of buprenorphine with carprofen preoperatively provided adequate postoperative analgesia for the majority of dogs undergoing OVH without serious adverse events. Prevalence of rescue analgesia was not significantly different between groups; however, it could be clinically relevant and explained by a type II error (i.e. small sample size). Future studies are necessary to determine if analgesic efficacy after Simbadol and Vetergesic is related to individual variability or pharmacokinetic differences.
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Affiliation(s)
- Ryota Watanabe
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Beatriz P Monteiro
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Marina C Evangelista
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Amélie Castonguay
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | | | - Paulo V Steagall
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada.
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21
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Thermal antinociception after buccal administration of a high-concentration formulation of buprenorphine (Simbadol) at 0.24 mg kg−1 in conscious cats. Vet Anaesth Analg 2018; 45:714-716. [DOI: 10.1016/j.vaa.2018.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 11/22/2022]
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22
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Doodnaught GM, Monteiro BP, Benito J, Edge D, Beaudry F, Pelligand L, Steagall P. Pharmacokinetic and pharmacodynamic modelling after subcutaneous, intravenous and buccal administration of a high-concentration formulation of buprenorphine in conscious cats. PLoS One 2017; 12:e0176443. [PMID: 28445495 PMCID: PMC5405979 DOI: 10.1371/journal.pone.0176443] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/10/2017] [Indexed: 12/05/2022] Open
Abstract
Background The aim of this study was to describe the joint pharmacokinetic-pharmacodynamic model and evaluate thermal antinociception of a high-concentration formulation of buprenorphine (Simbadol™) in cats. Methods Six healthy cats (4.9 ± 0.7 kg) were included in a prospective, randomized, blinded, crossover study. Simbadol™ (1.8 mg mL-1) was administered by the subcutaneous (SC; 0.24 mg kg-1), intravenous (IV; 0.12 mg kg-1) or buccal (OTM; 0.12 mg kg-1) route of administration and thermal thresholds (TT) were compared with a saline group (SAL). Thermal threshold testing and blood sampling were performed at predetermined time points up to 72 hours including a placebo group. Plasma buprenorphine and norbuprenorphine concentrations were measured using liquid chromatography mass spectrometry. A bespoke bicompartmental pharmacokinetic model simultaneously fitted data from two analytes/three routes of administration. Temporal changes in TT were analyzed using one-way ANOVA followed by Dunnett’s test and treatment comparisons using two-way ANOVA with Bonferroni’s correction (P < 0.05). Results Thermal thresholds were significantly increased after SC, IV and OTM from 1–24 hours (except 2 hours), 0.5–8 hours (except 6 hours), and 1–8 hours (except 6 hours), respectively, when compared with baseline. Thermal thresholds were significantly increased after SC (1–30 hours), IV (1–8 hours) and OTM (1–12 hours) when compared with SAL, but not different among buprenorphine-treated cats. The absolute buprenorphine clearance was 0.98 L kg-1 hour-1, volume of distribution at steady state was 7.9 L kg-1 and the elimination-half-life was 12.3 hours. Bioavailability for SC and OTM was 94% and 24%, respectively. Subcutaneous absorption was biphasic. An initial peak (0.08 hours) was followed by a slow (half-life 11.2 hours) and progressive (peak acceleration at 2.8 hours) uptake. Conclusion The SC administration of Simbadol™ was characterized by prolonged absorption half-life and sustained plasma concentrations yielding long-lasting antinociception (≥ 24 hours) when compared with the IV and OTM routes.
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Affiliation(s)
- Graeme M. Doodnaught
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Beatriz P. Monteiro
- Groupe de Recherche en Pharmacologie Animal du Québec (GREPAQ), Département de Biomédecine Vétérinaire, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Québec, Canada
| | - Javier Benito
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Daniel Edge
- Zoetis Inc., Florham Park, New Jersey, United States of America
| | - Francis Beaudry
- Groupe de Recherche en Pharmacologie Animal du Québec (GREPAQ), Département de Biomédecine Vétérinaire, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Québec, Canada
| | - Ludovic Pelligand
- Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Hertfordshire, United Kingdom
| | - Paulo Steagall
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de Recherche en Pharmacologie Animal du Québec (GREPAQ), Département de Biomédecine Vétérinaire, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Québec, Canada
- * E-mail:
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23
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Evangelista MC, Doodnaught GM, Fantoni DT, Steagall PVM. Sciatic and femoral nerve blockade using bupivacaine alone, or in combination with dexmedetomidine or buprenorphine in cats. Vet Rec 2017; 180:592. [PMID: 28341722 DOI: 10.1136/vr.104152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2017] [Indexed: 11/04/2022]
Abstract
The aim of this study was to determine the onset and offset of antinociception after sciatic (ScN) and femoral (FN) nerve blocks. Six healthy adult cats (4.8±1.3years; 4.3±0.4 kg) were included in a randomised, crossover, blinded and controlled study. Following sedation with dexmedetomidine (25 µg/kg, intramuscular), each ScN and FN injection was performed using 0.1 ml/kg of saline (CONTROL), bupivacaine (0.46 per cent, 0.46 mg/kg; BUPI), bupivacaine and dexmedetomidine (1 µg/kg; BUPI-DEX) or bupivacaine and buprenorphine (2.5 µg/kg; BUPI-BUPRE). Atipamezole (250 µg/kg) was administered after injections. Paw withdrawal thresholds (PWT) and motor blockade were evaluated before sedation and up to 24 hours. The PWT were significantly increased at half an hour in CONTROL, from two to four hours in BUPI and BUPI-DEX when compared with baseline. Motor blockade was observed between one and three hours in treatments using bupivacaine. Ability to walk was significantly impaired in BUPI at half an hour to two hours, BUPI-DEX at one to two hours and BUPI-BUPRE at two hours. Antinociception was observed in BUPI between one and eight hours, and in BUPI-DEX and BUPI-BUPRE between one and four hours. This study could not demonstrate a benefit of administering bupivacaine with dexmedetomidine or buprenorphine in cats. Results in BUPI-DEX may have been biased by the administration of atipamezole.
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Affiliation(s)
- M C Evangelista
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - G M Doodnaught
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - D T Fantoni
- Department of Surgery, Faculty of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - P V M Steagall
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
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24
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Doodnaught GM, Evangelista MC, Steagall PV. Thermal antinociception following oral administration of tapentadol in conscious cats. Vet Anaesth Analg 2017; 44:364-369. [DOI: 10.1016/j.vaa.2016.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/30/2016] [Accepted: 05/11/2016] [Indexed: 11/28/2022]
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25
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Simon BT, Steagall PV. The present and future of opioid analgesics in small animal practice. J Vet Pharmacol Ther 2016; 40:315-326. [DOI: 10.1111/jvp.12377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 09/25/2016] [Indexed: 11/30/2022]
Affiliation(s)
- B. T. Simon
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX USA
| | - P. V. Steagall
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Université de Montréal; Saint-Hyacinthe QC Canada
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26
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Johnson RJ, Kerr CL, Enouri SS, Modi P, Lascelles BDX, del Castillo JRE. Pharmacokinetics of liposomal encapsulated buprenorphine suspension following subcutaneous administration to cats. J Vet Pharmacol Ther 2016; 40:256-269. [DOI: 10.1111/jvp.12357] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- R. J. Johnson
- Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - C. L. Kerr
- Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - S. S. Enouri
- Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - P. Modi
- Transdermal Corp; Birmingham MI USA
| | - B. D. X. Lascelles
- College of Veterinary Medicine; North Caroline State University; Raleigh NC USA
| | - J. R. E. del Castillo
- GREPAQ - Département de Biomédecine Vétérinaire; Université de Montréal; Saint-Hyacinthe QC Canada
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