Pharmacokinetics and bioavailability of meloxicam in Pekin ducks following intravenous, intramuscular and oral administration

OBJECTIVE

To determine the pharmacokinetics and bioavailability of meloxicam following intravenous (IV), intramuscular (IM), and oral administrations at a dose of 1.0 mg kg-1 in Pekin ducks.

STUDY DESIGN

Randomized experimental trial.

ANIMALS

A total of 18 clinically healthy male Pekin ducks.

METHODS

Pekin ducks were randomly assigned to three groups of six ducks: IV, IM and oral. Meloxicam (1.0 mg kg-1) was administered to each Pekin duck. A non-compartmental analysis was used to evaluate pharmacokinetic parameters.

RESULTS

No local or systemic adverse effects were observed in any bird. Meloxicam was detected in the plasma up to 120 hours following IV, IM or oral administration. The elimination half-life of the IV route was slightly shorter than that of the IM and oral routes (p < 0.05). Following IV administration, volume of distribution at steady state and total clearance were 133.17 mL kg-1 and 6.68 mL kg-1 hour-1, respectively. The mean absorption time was 2.29 hours for IM and 1.13 hours for oral route. There were significant differences between IM and oral administration for the peak plasma concentration (Cmax), time to reach Cmax and bioavailability (p < 0.05).

CONCLUSIONS AND CLINICAL RELEVANCE

Meloxicam showed long elimination half-life and high bioavailability following IM and oral administration. Meloxicam in Pekin ducks provided the effective therapeutic concentration indicated in other species for up to 48 hours. However, there is a need to determine the clinical efficacy of meloxicam in Pekin ducks.

Modulating disease phenotype in a songbird: A role for inflammation in disease tolerance?

Individual animals vary greatly in their responses to infection, either killing off the invading pathogen (resistance) or minimizing the per-pathogen costs of infection on host fitness (tolerance). Though we understand little about the physiological drivers of tolerance in wild animals, phenotypically, it manifests as milder clinical signs of disease. Here, we use a well-described disease system, finch mycoplasmosis, to evaluate the role of inflammation in disease tolerance. House finches (Haemorhous mexicanus) infected with the bacterial pathogen Mycoplasma gallisepticum (MG) develop conjunctival pathology that satisfies the cardinal signs of inflammation. We report on a captive trial performed in 2016 and replicated in 2018 that tested whether chemotherapeutics, specifically nonsteroidal anti-inflammatory drugs (NSAIDs), can reduce lesion severity, thus pushing individuals toward more tolerant phenotypes. Though birds treated with NSAIDs in the first trial developed milder pathology per unit pathogen load, we found no effect of treatment in the second trial, perhaps due to natural variation in baseline tolerance within the source population across years. Second-trial control birds developed markedly milder pathology than first-year controls, suggesting that the effect of trial swamped the effect of treatment in this study. Moving forward, using birds from a population in which the disease is absent or only recently emerged-and so tolerance has not yet been selected for-may better elucidate the role of pro-inflammatory mediators in disease tolerance.

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.

Pharmacokinetics of intravenous meloxicam, ketoprofen and tolfenamic acid in chukar partridge (Alectoris chukar)

1. The aim of this study was to determine the pharmacokinetics of meloxicam (MLX, 1 mg/kg body weight (BW)), ketoprofen (KETO, 2 mg/kg BW), and tolfenamic acid (TA, 2 mg/kg BW) in chukar partridge (Alectoris chukar) following intravenous (IV) administration.2. Twenty-four healthy chukar partridges were randomly divided into three equal groups (n = 8) as MLX, KETO and TA. Plasma concentrations of MLX, KETO and TA were measured using high-performance liquid chromatography-ultraviolet detection and analysed using non-compartmental analysis.3. No adverse effects were determined in chukar partridges after IV administration of MLX, KETO and TA. MLX, KETO and TA were detected in plasma up to 10, 12 and 12 h, respectively. The terminal elimination half-life of MLX, KETO and TA was 1.22, 1.77 and 1.95 h, respectively. MLX, KETO and TA exhibited volumes of distribution at a steady-state of 0.03, 0.23 and 0.41 l/kg BW, respectively. The total plasma clearance of MLX, KETO and TA was 0.02, 0.11 and 0.15 l/h/kg, respectively. The extraction ratios for MLX, KETO and TA were calculated as 0.002, 0.011 and 0.016, respectively.4. MLX, KETO and TA offer treatment in chukar partridges for various conditions with an absence of adverse reactions and properties such as short elimination half-life and low volume of distribution. However, there is a need to establish the safety and adverse effects of repeated administration, pharmacokinetics of other administration routes and pharmacological efficacy of MLX, KETO and TA in chukar partridges.

Pharmacokinetics of a Single Dose of Oral Meloxicam in Rehabilitated Wild Brown Pelicans (Pelecanus occidentalis)

Because of concerns regarding potential adverse effects of meloxicam in pelicans reported by several zoos and wildlife rehabilitation facilities, this study was undertaken to determine the pharmacokinetics of a single oral dose of meloxicam in brown pelicans (Pelecanus occidentalis). A pilot study was performed with 6 apparently healthy wild adult brown pelicans of unknown sex during rehabilitation, administered a single oral dose of meloxicam at 0.2 mg/kg. Plasma drug concentrations were monitored for 24 hours but failed to capture the elimination phase of the drug. Consequently, a principal study monitored plasma concentrations for 120 hours. Six additional adult wild brown pelicans, 3 males and 3 females, approaching releasable condition in rehabilitation were split into 3 groups and each orally administered 0.2 mg/kg meloxicam. Blood samples were collected at baseline and at 4 additional time points that differed between groups. Plasma concentrations were measured with liquid chromatography-mass spectrometry. The mean maximum plasma concentration was 1.22 µg/mL and was achieved at 24 hours after drug administration. The elimination half-life was 36.3 hours, the longest reported to date for any avian species. Further studies are needed to determine the pharmacokinetics of multiple doses of meloxicam and other routes of administration, as well as the pharmacodynamics and safety profile of meloxicam in brown pelicans. On the basis of the results of these investigations, caution is advised when dosing brown pelicans with meloxicam until more studies are completed. By extrapolation, close taxonomic relatives in the order Pelecaniformes may also warrant additional studies.

Pharmacokinetics of meloxicam, carprofen, and tolfenamic acid after intramuscular and oral administration in Japanese quails (Coturnix coturnix japonica)

The aim of this study was to determine the pharmacokinetics of meloxicam (MLX), carprofen (CRP), and tolfenamic acid (TA) in Japanese quails (Coturnix coturnix japonica) following intramuscular (IM) and oral administration at doses of 1, 10, and 2 mg/kg, respectively. A total of 72 quails were randomly divided into 3 equal groups as MLX, CRP, and TA. Each group was separated into two sub-groups that received IM and oral administration of each drug. Plasma concentrations of MLX, CRP, and TA were determined using HPLC-UV and analyzed by non-compartmental method. The t_1/2ʎz and MRT of MLX, CRP, and TA after oral administration were similar to those after IM administration. The V_darea /F of MLX, CRP, and TA after IM administration was 0.28, 2.05, and 0.20 L/kg. The Cl/F of MLX, CRP, and TA after IM administration was 0.12, 0.19, and 0.09 L/h/kg. MLX, CRP, and TA after oral administration showed significantly lower C_max and longer T_max compared with IM administration. The relative bioavailability of MLX, CRP, and TA following oral administration in quails was 76.13%, 61.46%, and 57.32%, respectively. The IM and oral route of MLX, CRP, and TA can be used for the treatment of various conditions in quails. However, further research is necessary to determine the pharmacodynamics and safety of MLX, CRP, and TA before use in quails.

Gerontology of Psittacines

With recent improvements in the husbandry, nutrition, and veterinary care of captive psittacines, the avian clinician must be familiar with common medical condition seen in geriatric parrots. A review of the theory of evolution and avian senescence is provided. Five clinically relevant medical conditions are described: organ failure, atherosclerosis, neoplasia, cataracts, and osteoarthritis.

Development of an in Vivo Lipopolysaccharide Inflammation Model to Study the Pharmacodynamics of COX-2 Inhibitors Celecoxib, Mavacoxib, and Meloxicam in Cockatiels (Nymphicus hollandicus)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used frequently in avian medicine for their antipyretic, analgesic, and anti-inflammatory properties during surgery and for diseases that cause tissue damage and inflammation. NSAIDs inhibit cyclooxygenase (COX) enzymes, which are responsible for the induction of pyresis, pain, and inflammation. In our study, a lipopolysaccharide-induced (LPS) pyresis model was optimized using cockatiels (Nymphicus hollandicus) as subject birds (four males/three females) and validated in two females and one male, characterized by an intravenous bolus injection of LPS (7.5 mg/kg) administered at T₀ and T₂₄ (24 hours following the first LPS injection). To demonstrate the feasibility of the model to assess pharmacodynamic (PD) parameters of different NSAIDs, mavacoxib 4 mg/kg (four males/four females), celecoxib 10 mg/kg (four males/four females) and meloxicam 1 mg/kg (four males/four females) were evaluated in the model at dosages used frequently in practice. The PD parameters (body temperature, mentation, posture, preference of location in the cage, and prostaglandin E₂ [PGE₂] plasma concentrations) were determined for 10 hours following the second LPS injection. At the doses evaluated, mavacoxib and celecoxib significantly reduced LPS-induced hypothermia, but had no clear effects on other clinical signs of illness. In contrast, no effect on hypothermia or clinical appearance was observed in the LPS-challenged cockatiels treated with meloxicam. All three NSAIDs were able to inhibit the increase in LPS-induced PGE2 plasma concentrations, yet the effect was most pronounced in the birds treated with meloxicam. Consequently, the presented model opens perspectives for future dose-effect PD studies to optimize analgesic protocols in cockatiels.

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.

Treatment With Nonsteroidal Anti-Inflammatory Drugs Fails To Ameliorate Pathology In Cockatiels Experimentally Infected With Parrot Bornavirus-2

Purpose

Parrot bornavirus is the etiological agent of Parrot bornavirus syndrome, also referred to and comprising proventricular dilatation disease or PDD, macaw wasting disease, enteric ganglioneuritis and encephalitis, and avian ganglioneuritis. It has been suggested that nonsteroidal anti-inflammatory drugs may be able to ameliorate this disease. Therefore, this study investigated the effects of two commonly used nonsteroidal anti-inflammatory drugs, celecoxib and meloxicam, on cockatiels experimentally inoculated with Parrot bornavirus-2 (PaBV-2).

Materials and methods

Twenty-seven cockatiels were randomized into 3 groups of 9 birds, matched with respect to historical PaBV shedding, weight, and sex. The cockatiels were inoculated with cell culture-derived PaBV-2 by the intranasal and intramuscular routes. Beginning at 23 days post-inoculation, birds in each group received oral treatment once daily with placebo, meloxicam (1.0 mg/kg), or celecoxib (10.0 mg/kg).

Results

Within 33–79 days post-inoculation, 2 birds died and 6 birds were euthanized based on neurological or gastrointestinal signs consistent with Parrot bornavirus syndrome: 2 birds were euthanized in the placebo group, 1 bird died and 1 bird was euthanized in the meloxicam-treated group, and 1 bird died and 3 birds were euthanized in the celecoxib-treated group. Of these 8 birds, black intestinal contents were found upon necropsy in 2 birds of the meloxicam-treated group and 2 birds of the celecoxib-treated group. At day 173 (±2) post-inoculation, the remaining 19 birds were euthanized. Necropsy and histopathology showed lesions characteristic of Parrot bornavirus syndrome in 23 cockatiels. Histopathologic lesions were present in birds of all 3 groups. There was no statistical difference between the groups nor was there a statistical difference among the 3 treatment groups in the detection of PaBV RNA and PaBV nucleoprotein using RT-PCR and immunohistochemistry, respectively.

Conclusion

Meloxicam and celecoxib treatments do not appear to alter the clinical presentation, viral shedding, gross lesions, histopathology, or viral distribution. Treatment with NSAIDs may cause gastrointestinal toxicity in cockatiels experimentally inoculated with PaBV-2.

Advances in Exotic Animal Clinical Pathology

Over the last 10 years, exotic animal clinical pathology has been evolving, improving health assessment in avian, mammal, fish, reptile, and amphibian patients. These advances are reviewed in this article. Species-specific reference intervals for blood parameters are becoming more available (eg, for ionized calcium, endocrine panels, and vitamin D plasmatic concentrations). In addition, new technologies are being developed to facilitate targeted metabolite detection and result acquisition by veterinarians. Novel techniques, biomarkers, and clinical changes related to disease have been described in avian, mammal, fish, reptile and amphibian species. The use of mobile applications may also be helpful.

PHARMACOKINETICS OF A SUSTAINED-RELEASE FORMULATION OF MELOXICAM AFTER SUBCUTANEOUS ADMINISTRATION TO AMERICAN FLAMINGOS ( PHOENICOPTERUS RUBER)

Meloxicam is commonly used in avian medicine to relieve pain and inflammation, but the recommended dosing frequency can be multiple times per day, which can contribute to stress during convalescence. In this study, the pharmacokinetics of a sustained-release formulation of meloxicam were determined after subcutaneous administration of a single 3-mg/kg dose to eight healthy adult American flamingos ( Phoenicopterus ruber). Blood samples were collected before (time 0) and at 0.5, 1, 4, 8, 12, 24, 48, 96, and 120 hr after drug administration. Analysis of meloxicam in plasma samples was conducted with the use of reversed-phase high-performance liquid chromatography, and pharmacokinetic parameters were calculated by noncompartmental analysis. Plasma concentrations reached a mean maximum (±standard deviation) of 7.65 (±2.39) μg/ml at 0.56 (±0.18) hr with a terminal half-life of 1.76 (±1.41) hr. Based on these findings, this sustained-release formulation of meloxicam does not extend the interval between treatments as compared to the regular formulation, so it is not recommended in American flamingos at this time.

Pharmacokinetics of a Sustained-release Formulation of Meloxicam After Subcutaneous Administration to Hispaniolan Amazon Parrots (Amazona ventralis)

Meloxicam has been shown to have a safe and favorable pharmacodynamic profile with individual variability in Hispaniolan Amazon parrots (Amazona ventralis). In the current study, we determined the pharmacokinetics of a sustained-release formulation of meloxicam after subcutaneous administration to Hispaniolan Amazon parrots. Twelve healthy adult parrots, 6 males and 6 females, were used in the study. Blood samples were collected before (time 0) and at 0.5, 1, 2, 6, 12, 24, 48, 72, 96, and 120 hours after a single dose of the sustained-release meloxicam formulation (3 mg/kg SC). Plasma meloxicam concentrations were measured by high-pressure liquid chromatography. Pharmacokinetic parameters were determined by noncompartmental analysis. Plasma concentrations reached a mean C_max of 23.4 μg/mL (range, 14.7-46.0 μg/mL) at 1.8 hours (range, 0.5-6 hours), with a terminal half-life of 7.4 hours (range, 1.4-40.9 hours). Individual variation was noticeable, such that some parrots (4 of 12 birds) had very low plasma meloxicam concentrations, similar to the high variability reported in a previous pharmacokinetic study of the standard meloxicam formulation in the same group of birds. Two birds developed small self-resolving scabs at the injection site. On the basis of these results, the sustained-release meloxicam formulation could be administered every 12 to 96 hours in Hispaniolan Amazon parrots to manage pain. Because of these highly variable results, the use of this formulation in this species cannot be recommended until further pharmacokinetic, safety, and pharmacogenomic evaluations are performed to establish accurate dosing recommendations and to understand the high pharmacokinetic variability.

Dynamic viscoelastic coagulometry of blood obtained from healthy chickens

OBJECTIVE

To assess feasibility of the use of a dynamic viscoelastic coagulometer on chicken blood and compare coagulation variables for fresh whole blood and sodium citrate-preserved whole blood as well as effects of 3 coagulation activators on blood from chickens.

SAMPLE

Blood samples from 30 hens.

PROCEDURES

Chickens were allowed to rest undisturbed for 1 hour. A blood sample was collected from an ulnar vein; 1.4 mL was analyzed immediately, and 1.8 mL was mixed with sodium citrate and subsequently recalcified and analyzed. A separate coagulation activator (glass beads, kaolin clay, or tissue factor) was in each of the 2 channels of the analyzer. Chickens were allowed a 1-hour rest period, and another blood sample was collected from the contralateral ulnar vein; it was processed in the same manner as for the first sample, except both channels of the analyzer contained the same coagulation activator.

RESULTS

Compared with fresh samples, citrated samples had higher values for activated clotting time and platelet function and lower clotting rates. Intra-assay coefficients of variation of coagulation profiles for citrated samples were markedly greater than the limit of 10%, whereas values for fresh samples were close to or < 10%.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that use of a dynamic viscoelastic coagulometer on chicken blood was feasible and that analysis of fresh whole blood from healthy chickens provided results with less variability than did analysis of citrated blood. Samples preserved with sodium citrate were associated with significant relative hypocoagulability, compared with results for fresh blood.

Pharmacokinetics of meloxicam during multiple oral or intramuscular dose administration to African grey parrots (Psittacus erithacus)

OBJECTIVE To determine the pharmacokinetics of meloxicam in African grey parrots (Psittacus erithacus) during administration of multiple doses. ANIMALS 6 healthy African grey parrots. PROCEDURES Meloxicam was administered at each of 3 dosages (1 mg/kg, IM, q 24 h, for 7 days; 1 mg/kg, PO, q 24 h, for 12 days; and 1.6 mg/kg, PO, q 24 h, for 7 days) with an 8-week washout period between treatments. Blood samples were collected 12 and 24 hours after each drug administration (times of presumptive peak and trough drug concentrations) for pharmacokinetic analysis. Birds were visually assessed during all experiments and monitored for changes in selected plasma and urine biochemical variables after administration of the drug at 1.6 mg/kg. RESULTS Mean trough plasma concentrations at steady state were 10.7 and 9.16 μg/mL after meloxicam administration at 1 mg/kg, IM, and 1 mg/kg, PO, respectively. Plasma drug accumulation was evident (accumulation ratios of 2.04 ± 0.30 [IM treatment] and 2.45 ± 0.26 [PO treatment]). Plasma and urine N-acetyl-β-d-glucosaminidase activities were significantly increased at the end of meloxicam treatment at 1.6 mg/kg. CONCLUSIONS AND CLINICAL RELEVANCE Plasma concentrations of meloxicam were maintained at values greater than effective analgesic concentrations described for other avian species. Although administration of meloxicam at a dosage of 1 mg/kg IM and PO daily for 1 week and 12 days, respectively, was not associated with adverse clinical effects in this population, further studies are needed to assess the efficacy and safety of the drug during prolonged treatment and the clinical relevance of its accumulation.

Intertarsal Joint Stabilization in a Bateleur Eagle (Terathopius ecaudatus) Using a Novel Application of a Braided Suture and Titanium Button System

A 32-year-old adult captive male bateleur eagle (Terathopius ecaudatus) with a history of laxity, degenerative joint disease, and varus deviation of the distal left hindlimb for several years was presented for evaluation of left hindlimb lameness and was diagnosed with chronic subluxation of the left intertarsal joint. After failing to improve with conservative management and pain medication, surgical stabilization of the joint was performed using a novel application of a braided suture and titanium button system. Unsatisfactory clinical improvement and postsurgical reevaluation indicated that the initial surgical stabilization was unsuccessful. The surgery was repeated, and the animal showed postsurgical improvement in intertarsal joint stability, weight-bearing, and lameness for a period of several years with use and adjustment of chronic pain medications. The novel surgical technique described in this case report represents an additional treatment option for management of avian intertarsal joint subluxations. Presurgical planning should consider the unique anatomic features and variability of the avian tarsometatarsus to avoid surgical complications.

Population pharmacokinetics of a single dose of meloxicam after oral and intramuscular administration to captive lesser flamingos (Phoeniconaias minor)

OBJECTIVE To determine the pharmacokinetics of a single dose of meloxicam after IM and oral administration to healthy lesser flamingos (Phoeniconaias minor) by use of a population approach. ANIMALS 16 healthy captive lesser flamingos between 1 and 4 years of age. PROCEDURES A single dose of meloxicam (0.5 mg/kg) was administered IM to each bird, and blood samples were collected from birds at 3 (n = 13 birds), 2 (2), or 1 (1) selected point between 0 and 13 hours after administration, with samples collected from birds at each point. After a 15-day washout period, the same dose of meloxicam was administered PO via a red rubber tube and blood samples were collected as described for IM administration. Pharmacokinetic values were determined from plasma concentrations measured by high-performance liquid chromatography. RESULTS Plasma drug concentrations after IM administration of meloxicam reached a mean ± SD maximum value of 6.01 ± 3.38 μg/mL. Mean area under the concentration-versus-time curve was 17.78 ± 2.79 μg•h/mL, and mean elimination half-life was 1.93 ± 0.32 hours. Plasma concentrations after oral administration reached a mean maximum value of 1.79 ± 0.33 μg/mL. Mean area under the curve was 22.16 ± 7.17 μg•h/mL, and mean elimination half-life was 6.05 ± 3.53 hours. CONCLUSIONS AND CLINICAL RELEVANCE In lesser flamingos, oral administration of meloxicam resulted in higher bioavailability and a longer elimination half-life than did IM administration, but the maximum plasma concentration was low and may be insufficient to provide analgesia in flamingos. Conversely, IM administration achieved the desired plasma concentration but would require more frequent administration.