Pharmacokinetics of tramadol and its primary metabolite O-desmethyltramadol in African penguins (Spheniscus demersus)

Treatment of Pain in Birds

This article provides an overview of the current understanding of evidence-based clinical analgesic use in birds. The field of avian analgesia has dramatically expanded during the last 20 years, affording more options for alleviating both acute and chronic pain. These options include opioids, nonsteroidal anti-inflammatory drugs, local anesthetics, and/or other drugs like gabapentin, amantadine, and cannabinoids, acting at different points in the nociceptive system thereby helping to provide greater pain relief while reducing the risk of adverse effects when combined.

RETROSPECTIVE STUDY OF MORBIDITY AND MORTALITY OF AFRICAN PENGUINS (SPHENISCUS DEMERSUS) UNDER MANAGED CARE IN NORTH AMERICA: 2007-2018

Currently, more than 20% (51/240) of zoos and aquariums accredited by the Association of Zoos and Aquariums house African penguins (Spheniscus demersus) in their collections. The African penguin Species Survival Plan (SSP) veterinary advisors regularly collect information from those facilities to characterize morbidity and mortality for this species and to collate preventative medicine and treatment regimens. These efforts resulted in more than 10 yr of collection of management data across the SSP, representing the care and management of more than a thousand birds. The most common morbidities reported included those of dermatologic (27%, 125/452 institutions) and musculoskeletal or neurologic (18%, 82/452 institutions) disease, while the most common causes of mortality were respiratory diseases (20%, 65/323 deaths) and systemic or multifactorial conditions (19%, 62/323 deaths). Aspergillosis cases accounted for 69% (45/65 deaths) of respiratory-related mortality and avian malaria cases comprised 31% (19/62 deaths) of mortality related to systemic diseases. Mortality was most commonly reported in geriatric birds, or those older than 15 yr of age (34%, 111/323 deaths). Reproductive related mortality was only defined in female birds, while other causes of death were more evenly distributed between sexes. Utilizing the SSP data to determine morbidity and mortality trends within this population provides important information to veterinary and animal care teams, allowing them to provide enhanced levels of care to the penguins housed at their institutions. By recognizing the most important diseases and causes of death in this species, management and healthcare resources can target conditions with the highest impact on the population.

A Critical Review of the Pharmacokinetics and Pharmacodynamics of Opioid Medications Used in Avian Patients

Opioid drugs are used to manage moderate to severe pain in mammals and avian species. In dosing opioids for a particular species, it is optimal to use dosing regimens based on pharmacokinetics or pharmacodynamics studies conducted in the same species as variability in the physiology among different species may result in differences in drug pharmacokinetics and pharmacodynamics. Unfortunately, dosing regimens are typically extrapolated from closely related avian species or even mammals, which is unideal. Therefore, this critical review aims to collate and evaluate the dosing regimens of selected opioids: tramadol, hydromorphone, buprenorphine, butorphanol, and fentanyl, in avian species and its related safety, efficacy and pharmacokinetic data. Our review found specific dosing regimens not described in the Exotic Animal Formulary for tramadol used in Indian Peafowl (Pavo cristatus), Muscovy Duck (Cairina moschata) and Hispaniolan Parrot (Amazona ventralis); hydromorphone used in Orange-winged Parrot (Amazona amazonica); buprenorphine used in Cockatiel (Nymphicus hollandicus), American Kestrel (Falco sparverius) and Grey Parrot (Psittacus erithacus); and butorphanol used in Hispaniolan Parrot (Amazona ventralis), Broiler Chicken and Indian Peafowl (Pavo cristatus). Cockatiel appeared to not experience analgesic effects for hydromorphone and buprenorphine, and American Kestrel exhibited sex-dependent responses to opioids. The selected opioids were observed to be generally safe, with adverse effects being dose-dependent.

Pilot Study of a Single Dose of Orally Administered Tapentadol Suspension in Hispaniolan Amazon Parrots (Amazona ventralis)

Tapentadol is an analgesic agent that acts as both a µ-opioid receptor agonist and a norepinephrine reuptake inhibitor. It is a common therapeutic agent in human medicine for management of acute and chronic pain, and it is currently being investigated for use in veterinary medicine. Tapentadol was evaluated in Hispaniolan Amazon parrots (Amazona ventralis) because there is only 1 other oral opioid-like analgesic agent, tramadol, which has been evaluated in an avian species. The effectiveness of tramadol after administration to a patient involves a complex physiologic metabolism and has been found to have variable pharmacokinetics between species. Because of the lack of active metabolites from tapentadol, less interspecific variation was expected. Seven Hispaniolan Amazon parrots were used to evaluate the pharmacokinetics of tapentadol after a single 30 mg/kg PO administration of a compounded 5 mg/mL tapentadol suspension. Blood samples were collected before (time 0) and 0.25, 0.5, 0.75, 1, 1.5, 3, and 6 hours after administration, following a balanced, incomplete-block design. Plasma tapentadol concentrations were measured by high-pressure liquid chromatography with mass spectrometry. Results revealed detectable plasma concentrations in only 2 of 7 birds (29%), and the bird with the highest plasma levels had a peak concentration (C_max) of 143 ng/mL and a half-life (T _1/2) of 24.8 minutes. The variable plasma concentrations and short half-life of this drug in Hispaniolan Amazon parrots suggests that this drug would be of limited clinical use in this species; however, it is possible that this drug will be more bioavailable in other avian species.

Analgesic Efficacy of Tramadol Compared With Meloxicam in Ducks (Cairina moschata domestica) Evaluated by Ground-Reactive Forces

The purpose of this study was to determine the efficacy of tramadol and meloxicam in an induced, temporary arthritis model in ducks as assessed by ground-reactive forces measured by a pressure-sensitive walkway (PSW) system. Twelve ducks (Cairina moschata domestica) were randomly separated into 3 equal groups of 4 birds each: water control, tramadol treatment, and meloxicam treatment. Baseline measurements were collected by having all ducks walk along a 3-m-long PSW in a custom-built corral before anesthesia and induction of arthritis. Arthritis was induced in all groups through injection, under anesthesia, of a 3% monosodium urate (MSU) solution into the intertarsal joint. One hour after MSU injection, birds were orally gavage fed 1 mL of tap water (control), tramadol (30 mg/kg), or meloxicam (1 mg/kg). After treatments, all ducks were reevaluated on the PSW at 1, 2, 3, 4, 8, and 24 hours post-MSU injection. The difference in maximum force was significantly greater in the control group than in both the tramadol- (P = .006) and meloxicam-treated (P = .03) individuals. Post hoc comparisons revealed differences between control and treated birds occurred only at the 3- and 4-hour time points after administration. No differences were found in the absolute difference in maximum force between tramadol- and meloxicam-treated birds at any time point (P > .05). Results of this study support the hypothesis that tramadol (30 mg/kg PO) and meloxicam (1 mg/kg PO) improve certain objective variables in an induced arthritis model in ducks. Our findings also support studies in other avian species that determined that both tramadol and meloxicam are effective analgesic drugs in some birds.

Pharmacokinetics of orally administered tramadol in Muscovy ducks (Cairina moschata domestica)

This study documents the pharmacokinetics of oral tramadol in Muscovy ducks. Six ducks received a single 30 mg/kg dose of tramadol, orally by stomach tube, with blood collection prior to and up to 24 hr after tramadol administration. Plasma tramadol, and metabolites O-desmethyltramadol (M1), and N,O-didesmethyltramadol (M5) concentrations were determined by high-pressure liquid chromatography (HPLC) with fluorescence (FL) detection. Pharmacokinetic parameters were calculated using a one-compartment model with first-order input. No adverse effects were noted after oral administration. All ducks achieved plasma concentrations of tramadol above 0.10 μg/ml and maintained those concentrations for at least 12 hr. Elimination half-life was 3.95 hr for tramadol in ducks, which is similar to other avian species. All ducks in this study produced the M1 metabolite and maintained plasma concentrations above 0.1 μg/ml for at least 24 hr.