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Wun MK, Leister E, King T, Korman R, Malik R. Acute kidney injury in 18 cats after subcutaneous meloxicam and an update on non-steroidal anti-inflammatory drug usage in feline patients in Australia. Aust Vet J 2023; 101:90-98. [PMID: 36470590 DOI: 10.1111/avj.13222] [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: 07/06/2022] [Revised: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Acute kidney injury (AKI) is a well-known but poorly documented adverse effect of non-steroidal anti-inflammatory drugs (NSAIDs) in cats. We aimed to describe instances of NSAID-associated AKI in cats and survey Australian veterinarians on NSAID use in acute settings. METHODS Medical records of cats that developed an AKI subsequent to the administration of meloxicam were obtained by searching the databases of seven practices in Queensland, as well as by contemporaneously contacting select veterinary colleagues of the authors in both general and specialist small animal practice. An online questionnaire was created for the survey, and the URL distributed to Australian practitioners. RESULTS A total of 18 cases were retrieved, all of which received injectable meloxicam. The indication(s) for its use and the dosage prescribed were within the manufacturer's recommendations for Australian veterinarians. The majority of cases (13/18 cats) received the label dose of 0.3 mg/kg subcutaneously (SC) on the day of the procedure. In 12/18 cats, the injection was given in association with general anaesthesia or sedation. Fourteen cats survived to hospital discharge. Of 187 survey respondees, 89% routinely administered NSAIDs for surgery-related analgesia, with 98% prescribing meloxicam and 84% of these giving it SC. Ninety percent of respondees routinely administered NSAIDs for non-surgical-related analgesia, with 99% prescribing meloxicam and 35% of those giving it SC. CONCLUSIONS AND RELEVANCE We strongly recommend that practitioners avoid prescribing meloxicam SC in cats. This recommendation is emphatic in situations where concurrent dehydration and/or hypotension are possible.
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Affiliation(s)
- M K Wun
- Veterinary Specialist Services, Underwood, Australia
- Animal Referral Hospital Brisbane, Sinnamon Park, Australia
| | - E Leister
- Pet Intensive Care Unit, Underwood, Australia
| | - T King
- Veterinary Specialist Services, Underwood, Australia
| | - R Korman
- Veterinary Specialist Services, Underwood, Australia
| | - R Malik
- Centre for Veterinary Education, B22, The University of Sydney, Camperdown, Australia
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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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Quesada N, Pelligand L, Doig M, Sanchis‐Mora S. Suspected local anaesthetic systemic toxicity (LAST) after several bupivacaine injections through an epidural catheter in a cat. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nuria Quesada
- Clinical Science and Services Royal Veterinary College London UK
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Gittel C, Schulz-Kornas E, Sandbaumhüter FA, Theurillat R, Vervuert I, Larenza Menzies MP, Thormann W, Braun C. Pharmacokinetics and pharmacodynamics of l-methadone in isoflurane-anaesthetized and mechanically ventilated ponies. Vet Anaesth Analg 2020; 48:213-222. [PMID: 33423953 DOI: 10.1016/j.vaa.2020.04.018] [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: 04/28/2019] [Revised: 04/05/2020] [Accepted: 04/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the pharmacokinetics and selected pharmacodynamic effects of a commercially available l-methadone/fenpipramide combination administered to isoflurane anaesthetized ponies. STUDY DESIGN Prospective single-group interventional study. ANIMALS A group of six healthy adult research ponies (four mares, two geldings). METHODS Ponies were sedated with intravenous (IV) detomidine (0.02 mg kg-1) and butorphanol (0.01 mg kg-1) for an unrelated study. Additional IV detomidine (0.004 mg kg-1) was administered 85 minutes later, followed by induction of anaesthesia using IV diazepam (0.05 mg kg-1) and ketamine (2.2 mg kg-1). Anaesthesia was maintained with isoflurane in oxygen. Baseline readings were taken after 15 minutes of stable isoflurane anaesthesia. l-Methadone (0.25 mg kg-1) with fenpipramide (0.0125 mg kg-1) was then administered IV. Selected cardiorespiratory variables were recorded every 10 minutes and compared to baseline using the Wilcoxon signed-rank test. Adverse events were recorded. Arterial plasma samples for analysis of plasma concentrations and pharmacokinetics of l-methadone were collected throughout anaesthesia at predetermined time points. Data are shown as mean ± standard deviation or median and interquartile range (p < 0.05). RESULTS Plasma concentrations of l-methadone showed a rapid initial distribution phase followed by a slower elimination phase which is best described with a two-compartment model. The terminal half-life was 44.3 ± 18.0 minutes, volume of distribution 0.43 ± 0.12 L kg-1 and plasma clearance 7.77 ± 1.98 mL minute-1 kg-1. Mean arterial blood pressure increased from 85 (±16) at baseline to 100 (±26) 10 minutes after l-methadone/fenpipramide administration (p = 0.031). Heart rate remained constant. In two ponies fasciculations occurred at different time points after l-methadone administration. CONCLUSIONS AND CLINICAL RELEVANCE Administration of a l-methadone/fenpipramide combination to isoflurane anaesthetized ponies led to a transient increase in blood pressure without concurrent increases in heart rate. Pharmacokinetics of l-methadone were similar to those reported for conscious horses administered racemic methadone.
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Affiliation(s)
- Claudia Gittel
- Department for Horses, University of Leipzig, Leipzig, Germany; Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.
| | - Ellen Schulz-Kornas
- Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Friederike A Sandbaumhüter
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Regula Theurillat
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Ingrid Vervuert
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, University of Leipzig, Leipzig, Germany
| | - M Paula Larenza Menzies
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria
| | - Wolfgang Thormann
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Christina Braun
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria
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Oral Transmucosal or Intramuscular Administration of Dexmedetomidine-Methadone Combination in Dogs: Sedative and Physiological Effects. Animals (Basel) 2020; 10:ani10112057. [PMID: 33172163 PMCID: PMC7694765 DOI: 10.3390/ani10112057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/01/2020] [Accepted: 11/03/2020] [Indexed: 11/29/2022] Open
Abstract
Simple Summary During the last decade, new alternative non-invasive administration routes for drug delivery have gained interest in veterinary medicine. The administration of drugs via the oral transmucosal route is non-invasive, painless, easy to perform, and generally well tolerated. Furthermore, it avoids gastric acid degradation typical of oral administration. All these characteristics contribute to make this administration route very attractive, especially for veterinary patients who are difficult to inject, fearful, or anxious. In contrast, intramuscular injection is associated with pain and requires more invasive restraint, potentially incrementing patients’ discomfort. The aim of this study was to assess and compare the sedative and clinical effects of a dexmedetomidine–methadone combination following either oral transmucosal and intramuscular administration in healthy dogs and to record any possible adverse effects following each administration route. The present study suggests that oral transmucosal administration of dexmedetomidine and methadone combination provided a satisfactory level of sedation, allowing safe handling of the patients with less pronounced cardiorespiratory effects. Indeed, thanks to the lesser impact on the cardiac function, it could be considered as a useful option for those patients difficult to restrain in which cardiovascular stability should be preserved. Abstract The aim of this study was to compare the sedative and physiological effects following either oral transmucosal (OTM) or intramuscular administration of dexmedetomidine–methadone combination in healthy dogs. Thirty dogs were randomly assigned to receive a dexmedetomidine–methadone combination either by the OTM (n = 15) or intramuscular (n = 15) route. Sedation was scored 10, 20, and 30 min after drugs administration. Heart rate (HR), non-invasive blood pressure (NIBP), respiratory rate (fR), and body rectal temperature were recorded before drugs administration and then every 10 min for 30 min. Propofol dose required for orotracheal intubation was recorded. Sedation scores increased over time within both groups with higher values in intramuscular group (p < 0.05). Within each group, HR decreased significantly compared with baseline (p < 0.001) and was significantly lower in intramuscular group compared with the OTM group (p < 0.001). In both groups, NIBP increased significantly compared with baseline (p < 0.05). In the intramuscular group, fR was lower compared with the OTM group at all the observational time points (p < 0.001). Propofol dose was lower in the intramuscular group (p < 0.05). Compared to intramuscular dexmedetomidine–methadone, OTM combination produced lower but effective sedation in healthy dogs.
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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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Nejamkin P, Cavilla V, Clausse M, Landivar F, Lorenzutti AM, Martínez S, Del Sole MJ, Martín-Flores M. Sedative and physiologic effects of tiletamine-zolazepam following buccal administration in cats. J Feline Med Surg 2020; 22:108-113. [PMID: 30744474 PMCID: PMC10814565 DOI: 10.1177/1098612x19827116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The aim of this study was to describe the sedative and some physiological effects of tiletamine-zolazepam following buccal administration (BA) in cats. METHODS Seven healthy spayed European shorthair cats (three males, four females) were studied twice in this randomized, blinded, crossover study. Each cat received two doses of tiletamine-zolazepam by BA: the low-dose (LD) group consisted of 5 mg/kg of each drug, and the high-dose (HD) group consisted of 7.5 mg/kg of each. Baseline systolic blood pressure (SAP), heart rate (HR), respiratory rate (RR) and a sedation score were recorded prior to administration of each treatment. The same variables plus the percentage of hemoglobin saturated with oxygen as measured by pulse oximetry (SpO2) were recorded at predefined intervals for the next 2 h. RESULTS All cats completed the study. No retching or vomiting were observed. Hypersalivation was observed in 0/7 and 3/7 for LD and HD groups, respectively (P = 0.2). There were significant changes in scores over time for posture, response to clippers and response to manual restraint for both groups, without differences between groups. RR, HR and SAP changed significantly over time. SAP and RR were significantly lower for the HD than for the LD group. No values for hemoglobin saturation <95% were observed. CONCLUSIONS AND RELEVANCE BA of tiletamine-zolazepam at the doses studied here is a simple and effective method for chemical restraint in cats, where the LD group had a lower impact on SAP and RR than the HD group.
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Affiliation(s)
- Pablo Nejamkin
- Hospital for Small Animals, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
- Hospital for Large Animals, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
| | - Verónica Cavilla
- Small Animal Medicine and Surgery, Clinical Department, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
| | - María Clausse
- General Clinical Surgery Department, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
- Veterinary Research Center of Tandil (CIVETAN, CONICET-CICPBA), Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
| | - Florencia Landivar
- Hospital for Large Animals, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
| | - Augusto M Lorenzutti
- Pharmacology and Toxicology, Faculty of Agricultural Sciences, Catholic University of Córdoba, Córdoba, Argentina
| | - Sofía Martínez
- Small Animal Medicine and Surgery, Clinical Department, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
| | - María J Del Sole
- Hospital for Large Animals, Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
- Veterinary Research Center of Tandil (CIVETAN, CONICET-CICPBA), Faculty of Veterinary Sciences, National Central University of the Province of Buenos Aires, University Campus, Tandil, Argentina
| | - Manuel Martín-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Di Cesare F, Gioeni D, Ravasio G, Pellegrini A, Lucatello L, Bisutti V, Villa R, Cagnardi P. Clinical pharmacokinetics of a dexmedetomidine-methadone combination in dogs undergoing routine anaesthesia after buccal or intramuscular administration. J Vet Pharmacol Ther 2019; 42:392-400. [PMID: 31197847 DOI: 10.1111/jvp.12771] [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: 11/05/2018] [Revised: 03/11/2019] [Accepted: 04/03/2019] [Indexed: 01/09/2023]
Abstract
This study aimed to define the pharmacokinetic profiles of dexmedetomidine and methadone administered simultaneously in dogs by either an oral transmucosal route or intramuscular route and to determine the bioavailability of the oral transmucosal administration relative to the intramuscular one of both drugs, so as the applicability of this administration route in dogs. Twelve client-owned dogs, scheduled for diagnostic procedures, were treated with a combination of dexmedetomidine hydrochloride (10 μg/kg) and methadone hydrochloride (0.4 mg/kg) through an oral transmucosal route or intramuscularly. Oral transmucosal administration caused ptyalism in most subjects, and intramuscular administration caused transient peripheral vasoconstriction. The results showed reduced and delayed absorption of both dexmedetomidine and methadone when administered through an oral transmucosal route, with median (range) Cmax values of 0.82 (0.42-1.49) ng/ml and 13.22 (2.80-52.30) ng/ml, respectively. The relative bioavailability was low: 16.34% (dexmedetomidine) and 15.5% (methadone). Intramuscular administration resulted in a more efficient absorption profile, with AUC and Cmax values for both drugs approximately 10 times higher. Dexmedetomidine and methadone administered simultaneously by an oral transmucosal route using injectable formulations were not well absorbed through the oral mucosa. Nevertheless, additional studies on these drugs combination using alternative administration routes are recommended.
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Affiliation(s)
- Federica Di Cesare
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Milan, Italy
| | - Daniela Gioeni
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Giuliano Ravasio
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | | | - Lorena Lucatello
- Dipartimento di Biomedicina Comparata ed Alimentazione, Università degli Studi di Padova, Legnaro (PD), Italy
| | - Vittoria Bisutti
- Dipartimento di Biomedicina Comparata ed Alimentazione, Università degli Studi di Padova, Legnaro (PD), Italy
| | - Roberto Villa
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Milan, Italy
| | - Petra Cagnardi
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Milan, Italy
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Mathews KA. Emergency and Critical Care Medicine: An Essential Component of All Specialties and Practices. Front Vet Sci 2017; 4:165. [PMID: 29075634 PMCID: PMC5642140 DOI: 10.3389/fvets.2017.00165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/21/2017] [Indexed: 01/30/2023] Open
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Dooley SB, Aarnes TK, Lakritz J, Lerche P, Bednarski RM, Hubbell JAE. Pharmacokinetics and pharmacodynamics of buprenorphine and sustained-release buprenorphine after administration to adult alpacas. Am J Vet Res 2017; 78:321-329. [PMID: 28240955 DOI: 10.2460/ajvr.78.3.321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine pharmacokinetics and pharmacodynamics of buprenorphine after IV and SC administration and of sustained-release (SR) buprenorphine after SC administration to adult alpacas. ANIMALS 6 alpacas. PROCEDURES Buprenorphine (0.02 mg/kg, IV and SC) and SR buprenorphine (0.12 mg/kg, SC) were administered to each alpaca, with a 14-day washout period between administrations. Twenty-one venous blood samples were collected over 96 hours and used to determine plasma concentrations of buprenorphine. Pharmacokinetic parameters were calculated by use of noncompartmental analysis. Pharmacodynamic parameters were assessed via sedation, heart and respiratory rates, and thermal and mechanical antinociception indices. RESULTS Mean ± SD maximum concentration after IV and SC administration of buprenorphine were 11.60 ± 4.50 ng/mL and 1.95 ± 0.80 ng/mL, respectively. Mean clearance was 3.00 ± 0.33 L/h/kg, and steady-state volume of distribution after IV administration was 3.8 ± l.0 L/kg. Terminal elimination half-life was 1.0 ± 0.2 hours and 2.7 ± 2.8 hours after IV and SC administration, respectively. Mean residence time was 1.3 ± 0.3 hours and 3.6 ± 3.7 hours after IV and SC administration, respectively. Bioavailability was 64 ± 28%. Plasma concentrations after SC administration of SR buprenorphine were below the LLOQ in samples from 4 alpacas. There were no significant changes in pharmacodynamic parameters after buprenorphine administration. Alpacas exhibited mild behavioral changes after all treatments. CONCLUSIONS AND CLINICAL RELEVANCE Buprenorphine administration to healthy alpacas resulted in moderate bioavailability, rapid clearance, and a short half-life. Plasma concentrations were detectable in only 2 alpacas after SC administration of SR buprenorphine.
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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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Crosignani N, Luna SP, Dalla Costa T, Pimenta EL, Detoni CB, Guterres SS, Puoli Filho JN, Pantoja JC, Pigatto MC. Pharmacokinetics and pharmacodynamics of the injectable formulation of methadone hydrochloride and methadone in lipid nanocarriers administered orally to horses. J Vet Pharmacol Ther 2017; 40:398-405. [DOI: 10.1111/jvp.12393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/10/2016] [Indexed: 12/18/2022]
Affiliation(s)
- N. Crosignani
- Department of Anesthesiology; Faculty of Medicine; UNESP - Universidade Estadual Paulista; Sao Paulo Brazil
| | - S. P. Luna
- Department of Veterinary Surgery and Anesthesiology; Faculty of Veterinary Medicine and Animal Science; UNESP - Universidade Estadual Paulista; Sao Paulo Brazil
| | - T. Dalla Costa
- Faculty of Pharmacy; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - E. L. Pimenta
- Faculty of Veterinary Medicine; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - C. B. Detoni
- Faculty of Pharmacy; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - S. S. Guterres
- Faculty of Pharmacy; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - J. N. Puoli Filho
- Department of Animal Production; Faculty of Veterinary Medicine and Animal Science; UNESP - Universidade Estadual Paulista; São Paulo Brazil
| | - J. C. Pantoja
- Department of Veterinary Hygiene and Public Health; Faculty of Veterinary Medicine and Animal Science; UNESP - Universidade Estadual Paulista; Sao Paulo Brazil
| | - M. C. Pigatto
- Faculty of Pharmacy; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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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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Pypendop BH, Shilo‐Benjamini Y, Ilkiw JE. Effect of morphine, methadone, hydromorphone or oxymorphone on the thermal threshold, following intravenous or buccal administration to cats. Vet Anaesth Analg 2016; 43:635-642. [DOI: 10.1111/vaa.12356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 12/05/2015] [Indexed: 11/27/2022]
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15
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Slingsby LS, Sear JW, Taylor PM, Murrell JC. Effect of intramuscular methadone on pharmacokinetic data and thermal and mechanical nociceptive thresholds in the cat. J Feline Med Surg 2016; 18:875-881. [PMID: 26404026 PMCID: PMC11132222 DOI: 10.1177/1098612x15605164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The aim of the study was to assess simultaneous pharmacokinetics and thermal and mechanical antinociception after intramuscular methadone (0.6 mg/kg) in 10 cats. Methods Thermal and mechanical threshold (TT and MT, respectively) testing and blood collection were conducted at baseline and up to 24 h after administration. Methadone plasma concentrations were determined by liquid chromatography-tandem mass spectrometry and pharmacokinetic parameters were estimated by a non-compartmental method. TT and MT were analysed using ANOVA ( P <0.05). Time of maximum plasma concentration (Tmax), time of onset of antinociception and time of reaching cut-out threshold (TT 55°C; MT 30 Newtons [N]) were determined. Results TT and MT increased above baseline from 20-240 mins and 5-40 mins, respectively, after intramuscular (IM) administration ( P <0.005). Mean maximum delta T (measured as TT minus baseline threshold) was 7.9°C (95% confidence interval [CI] 4.3-11.6) at 60 mins and mean maximum delta F (measured as MT minus baseline threshold) was 4.2 (95% CI 1.6-6.7) N at 45 mins. IM methadone concentration-time data decreased curvilinearly, and gave a clearance estimate of mean 9.1 ml/kg/min (range 5.2-15.7) with median Tmax at 20 mins (range 5-360 mins). Conclusions and relevance IM data followed classical disposition and elimination in all cats. Plasma concentrations after IM administration were associated with an antinociceptive effect, including negative hysteresis. These data can be used for devising dosing schedules for methadone in clinical feline practice.
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Affiliation(s)
| | - John W Sear
- John Radcliffe Hospital, University of Oxford, Oxford, UK
| | | | - Joanna C Murrell
- School of Veterinary Science, University of Bristol, Bristol, UK
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16
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Abstract
OBJECTIVES The objectives were to review systematically the range of assessment tools used in cats to detect the behavioural expression of pain and the evidence of their quality; and to examine behavioural metrics (considering both the sensory and affective domains) used to assess pain. METHODS A search of PubMed and ScienceDirect, alongside articles known to the authors, from 2000 onwards, for papers in English was performed. This was followed by a manual search of the references within the primary data sources. Only peer-reviewed publications that provided information on the assessment tool used to evaluate the behavioural expression of pain in cats, in conscious animals (not anaesthetised cats), were included. RESULTS No previous systematic reviews were identified. One hundred papers were included in the final assessment. Studies were primarily related to the assessment of pain in relation to surgical procedures, and no clear distinction was made concerning the onset of acute and chronic pain. Ten broad types of instrument to assess pain were identified, and generally the quality of evidence to support the use of the various instruments was poor. Only one specific instrument (UNESP-Botucatu scale) had published evidence of validity, reliability and sensitivity at the level of a randomised control trial, but with a positive rather than placebo control, and limited to its use in the ovariohysterectomy situation. The metrics used within the tools appeared to focus primarily on the sensory aspect of pain, with no study clearly discriminating between the sensory and affective components of pain. CONCLUSIONS AND RELEVANCE Further studies are required to provide a higher quality of evidence for methods used to assess pain in cats. Furthermore, a consistent definition for acute and chronic pain is needed. Tools need to be validated that can detect pain in a range of conditions and by different evaluators (veterinary surgeons and owners), which consider both the sensory and emotional aspects of pain.
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Affiliation(s)
| | - Daniel S Mills
- School of Life Sciences, University of Lincoln, Lincoln, UK
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17
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Slingsby LS, Bortolami E, Murrell JC. Methadone in combination with medetomidine as premedication prior to ovariohysterectomy and castration in the cat. J Feline Med Surg 2015; 17:864-72. [PMID: 25406177 PMCID: PMC11112194 DOI: 10.1177/1098612x14558893] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OBJECTIVES The aim of the study was to evaluate the tolerability, sedative and analgesic effects of methadone in combination with medetomidine for premedication prior to neutering in healthy cats. METHODS This was an assessor-blinded, randomised, clinical research study. Forty-five cats were recruited and divided into three treatment groups of 15. Following premedication with medetomidine (20 µg/kg) and one of the three test drugs - methadone 0.5 mg/kg, buprenorphine 20 µg/kg or butorphanol 0.4 mg/kg intramuscularly - anaesthesia was induced with propofol and maintained with isoflurane, and neutering was carried out. Sedation and physiological parameters were assessed before premedication, after premedication before induction of anaesthesia, and at 90 mins and 2, 3, 4, 6, 7, 8 and 24 h after premedication. Pain and mechanical nociceptive threshold were assessed at similar time points. RESULTS There were no differences between groups with respect to age, sex, duration of anaesthesia or surgery. Most cats had low pain scores in the postoperative period, with small differences in pain scores between groups at individual time points only. Five, two and no cats required additional rescue analgesia in the postoperative period in the butorphanol, methadone and buprenorphine groups, respectively, representing no significant difference between groups. CONCLUSIONS AND RELEVANCE Medetomidine combined with methadone for premedication prior to neutering in healthy cats provided adequate analgesia for the first 6 h after administration with no adverse effects; effects overall were comparable with medetomidine combined with buprenorphine or butorphanol. Administration of further analgesia with methadone at 6 h and a non-steroidal anti-inflammatory drug at 8 h provided adequate analgesia for the first 24 h after surgery.
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Affiliation(s)
| | - Elisa Bortolami
- School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Joanna C Murrell
- School of Veterinary Sciences, University of Bristol, Langford, UK
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18
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Bortolami E, Love EJ. Practical use of opioids in cats: a state-of-the-art, evidence-based review. J Feline Med Surg 2015; 17:283-311. [PMID: 25832586 PMCID: PMC11104155 DOI: 10.1177/1098612x15572970] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
RATIONALE Recent recognition of the need to improve pain management in cats has led to the investigation of the pharmacokinetics and efficacy of opioid analgesic drugs in this species. The results of these studies may be difficult to interpret because the effect of these drugs varies with dose, route of administration and the method used to assess them. As equipotency of different opioids is not known, it is hard to compare their effects. Animals do not verbalise the pain they feel and, in cats, it may be more difficult to recognise signs of pain in comparison with other species such as dogs. AIM This article reviews the use of opioid analgesics in cats. It must be remembered that not all drugs are licensed for use in cats, and that marketing authorisations vary between different countries.
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Affiliation(s)
- Elisa Bortolami
- Department of Animal Medicine, Production and Health, University of Padua, Italy
| | - Emma J Love
- School of Veterinary Sciences, University of Bristol, Langford, UK
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19
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Hedges AR, Pypendop BH, Shilo Y, Stanley SD, Ilkiw JE. Impact of the blood sampling site on time-concentration drug profiles following intravenous or buccal drug administration. J Vet Pharmacol Ther 2014; 37:145-50. [PMID: 24745064 DOI: 10.1111/jvp.12075] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to examine the effect of the sampling site on the drug concentration-time profile, following intravenous or buccal (often called 'oral transmucosal') drug administration. Buprenorphine (20 μg/kg) was administered IV or buccally to six cats. Blood samples were collected from the carotid artery and the jugular and medial saphenous veins for 24 h following buprenorphine administration. Buprenorphine concentration-time data were examined using noncompartmental analysis. Pharmacokinetic parameters were compared using the Wilcoxon signed rank test, applying the Bonferroni correction. Significance was set at P < 0.05. Following IV administration, no difference among the sampling sites was found. Following buccal administration, maximum concentration [jugular: 6.3 (2.9-9.8), carotid: 3.4 (1.9-4.9), medial saphenous: 2.5 (1.7-4.1) ng/mL], area under the curve [jugular: 395 (335-747), carotid: 278 (214-693), medial saphenous: 255 (188-608) ng·min/mL], and bioavailability [jugular: 47 (34-67), carotid: 32 (20-52), medial saphenous: 23 (16-55)%] were higher in the jugular vein than in the carotid artery and medial saphenous vein. Jugular venous blood sampling is not an acceptable substitute for arterial blood sampling following buccal drug administration.
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20
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Scala C, Marsot A, Limoges MJ, Locatelli Y, Simon N, Alvarez JC. Population pharmacokinetics of methadone hydrochloride after a single intramuscular administration in adult Japanese sika deer (Cervus nippon nippon). Vet Anaesth Analg 2014; 42:165-72. [PMID: 24962270 DOI: 10.1111/vaa.12186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 12/07/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the population pharmacokinetics of methadone in deer. STUDY DESIGN Prospective non-randomized experimental trial. ANIMALS Twelve healthy adult sika deer (nine males and three females). METHODS Deer received intramuscular administration of racemic methadone hydrochloride at 0.5 mg kg(-1) or 1 mg kg(-1) . Plasma methadone and its metabolite 2-Ethylidene-1,5-Dimethyl-3,3-Diphenyl-Pyrolidine (EDDP) concentrations were determined by validated liquid chromatography coupled to tandem mass spectrometry methods, at times 0, 30 minutes, 1, 2, 3, 4, 5, 6, 8, 12 and 24 hours. Population pharmacokinetics analysis was undertaken using a non-linear mixed effects modelling (NONMEM). RESULTS A two-compartment linear disposition model best described observed time-concentration profiles of methadone and EDDP. Population parameter estimates of methadone were elimination clearance (17.3 L hour(-1) ), metabolic clearance (34.6 L hour(-1) ), volume of distribution of compartment 1 (216.0 L) and volume of distribution of compartment 2 (384.0 L). Population parameter estimates of EDDP were elimination clearance (121.0 L hour(-1) ), volume of distribution of compartment 3 (1.08 L) and volume of distribution of compartment 4 (499.5 L). The total clearance and total volume of distribution of methadone and EDDP were 51.9 L hour(-1) , 121.0 L hour (-1) , 600.0 L and 500.6 L, respectively. The methadone terminal elimination half-life was 8.19 hours. No adverse effects were observed after methadone administration. CONCLUSIONS AND CLINICAL RELEVANCE Following intramuscular injection, methadone was characterized by a large total volume of distribution, high systemic clearance and intermediate terminal half-life in sika deer.
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Affiliation(s)
- Christopher Scala
- Réserve de la Haute-Touche, Muséum National d'Histoire Naturelle, Obterre, France
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21
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Pypendop BH, Ilkiw JE, Shilo-Benjamini Y. Bioavailability of morphine, methadone, hydromorphone, and oxymorphone following buccal administration in cats. J Vet Pharmacol Ther 2013; 37:295-300. [DOI: 10.1111/jvp.12090] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- B. H. Pypendop
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - J. E. Ilkiw
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Y. Shilo-Benjamini
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
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22
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Warne LN, Beths T, Holm M, Bauquier SH. Comparison of perioperative analgesic efficacy between methadone and butorphanol in cats. J Am Vet Med Assoc 2013; 243:844-50. [DOI: 10.2460/javma.243.6.844] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Methadone in healthy goats – Pharmacokinetics, behaviour and blood pressure. Res Vet Sci 2013; 95:231-7. [DOI: 10.1016/j.rvsc.2013.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 01/29/2013] [Accepted: 02/22/2013] [Indexed: 11/24/2022]
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24
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Bortolami E, Murrell JC, Slingsby LS. Methadone in combination with acepromazine as premedication prior to neutering in the cat. Vet Anaesth Analg 2013; 40:181-93. [DOI: 10.1111/j.1467-2995.2012.00736.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Gurney MA. Pharmacological options for intra-operative and early postoperative analgesia: an update. J Small Anim Pract 2012; 53:377-86. [DOI: 10.1111/j.1748-5827.2012.01243.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. A. Gurney
- Department of Anaesthesia; Northwest Surgeons; Cheshire; WA7 3FW
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