Disposition kinetics of meloxicam in green sea turtles (Chelonia mydas) after intravenous and intramuscular administrations

The pharmacokinetics were described of meloxicam (MLX) in green sea turtles (Chelonia mydas), following a single intravenous (i.v.) and intramuscular (i.m.) administrations at one of two dosages of 0.1 or 0.2 mg/kg body weight (b.w.). The sample of 20 green sea turtles was divided into four groups (n = 5) using a randomization procedure according to a parallel study design. Blood samples were collected at pre-assigned times up to 168 h. MLX in the plasma was cleaned-up and quantified using a validated high-performance liquid chromatography method with UV detection. The concentration of MLX in the experimental green sea turtles with respect to time was pharmacokinetically analyzed using a non-compartment model. MLX plasma concentrations were quantifiable for up to 72 and 120 h after i.v. at dosages of 0.1 and 0.2 mg/kg b.w., respectively, whereas it was measurable for up to 168 h after i.m. administration at both dosages. The long elimination half-life value of MLX (28 h) obtained in green sea turtles after i.v. administration was consistent with the quite slow clearance rate for both dosages. The average maximum concentration (Cmax ) values of MLX were 1.05 μg/mL and 4.26 μg/mL at dosages of 0.1 and 0.2 mg/kg b.w., respectively, with their elimination half-life values being 37.26 h and 30.64 h, respectively, after i.m. administrations. The absolute i.m. bioavailability was approximately 110%. These results suggested that i.m. administration of MLX at a dosage of 0.2 mg/kg b.w. was likely to be effective for clinical use in green sea turtles (Chelonia mydas). However, further studies are needed to determine the pharmacodynamic properties and clinical efficacy of MLX for the treatment of inflammatory disease after single and multiple dosages.

Surgical removal of an atypical histiocytic cell proliferation in a bearded dragon (Pogona vitticeps)

A 4-year-old female bearded dragon (Pogona vitticeps) was referred to the Clinic for Small Mammals, Reptiles and Birds of the University of Veterinary Medicine, Hannover, Germany for diagnostics and treatment of a growing mass in the right cervical region. The owner reported that the mass had grown over the past 4 weeks with only little alteration in the lizard´s behavior when the animal started rubbing its neck against the cage equipment. Physical examination as well as ultrasonographic and computed tomographic diagnostics revealed a highly vascularized mass, which allowed for the hypothesis of an aneurysm or a neoplasia. Complete surgical resection of the mass could be performed uneventfully. The bearded dragon recovered well from anesthesia and the surgical procedure. The microbiological sample of the excised mass revealed Group F-67 Salmonella. Histopathological examination of the excised mass revealed a histiocytic cell proliferation with centrally located blood filled cavities, hemorrhages and granulation tissue resembling features of a pseudoaneurysm. This report describes the diagnosis of an atypical growing mass in a bearded dragon and its successful removal.

PHARMACOKINETICS OF MELOXICAM AFTER SINGLE ORAL AND INTRAMUSCULAR ADMINISTRATION IN CHINA ROCKFISH (SEBASTES NEBULOSUS)

Fish species are important for various purposes including aquaculture stock and display animals, but there are significant gaps in the medical knowledge regarding pharmacological parameters and effective pain management. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that has been studied in few teleost species and with several administration routes. However, these species were typically freshwater or euryhaline fish, and evaluation in marine species is lacking. The pharmacokinetic properties of meloxicam were determined in nine adult China rockfish (Sebastes nebulosus), presumed healthy based on physical examination and benign medical histories. Based on a pilot study, China rockfish were given 1 mg/kg meloxicam via IM injection in the epaxial musculature, and, after a 48-h washout period, 1 mg/kg meloxicam was given by PO gavage. Blood samples were collected from the caudal vein at baseline and at nine time intervals over a 48-h time period following administration of meloxicam. Plasma meloxicam concentrations were determined by reverse phase high-performance liquid chromatography, and noncompartmental analysis was performed. The mean peak plasma concentration after IM injection was 4.9 µg/ml, and the mean terminal half-life was 5.0 h. The mean peak plasma concentration after PO administration was 0.07 µg/ml. Based on these findings, IM injected meloxicam reaches plasma levels consistent with therapeutic concentrations in select mammals, and peak levels were maintained for ≤12 h. Single-dose PO administration failed to achieve similar concentrations, and clinical practicality is unknown. Further studies evaluating NSAID multidose regimes and their pharmacodynamic effects may provide additional dosing information.

Treatment of Pain in Reptiles

This chapter provides an overview of our current understanding of clinical analgesic use in reptiles. Currently, μ-opioid agonist drugs are the standard of care for analgesia in reptiles. Reptile pain is no longer considered a necessary part of recovery to keep the reptile from becoming active too early. Rather, treating pain allows for the reptile to begin normalizing their behavior. This recognition of pain and analgesia certainly benefits our reptile patients and greatly improves reptile welfare, but it also benefits our students and house officers, who will carry the torch and continue to demand excellence in reptile medicine.

A Critical Review on the Pharmacodynamics and Pharmacokinetics of Non-steroidal Anti-inflammatory Drugs and Opioid Drugs Used in Reptiles

Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are analgesics used for moderate to severe pain in many animals, including reptiles. However, reptilian dosing regimens are often extrapolated from other animal species. This is not ideal as inter- and intra-species variability in physiology may result in varied drug disposition. Therefore, this critical review aims to collate data from pharmacological studies of selected NSAIDs and opioids performed in reptile and provide an analysis and discussion on the existing pharmacodynamic knowledge and pharmacokinetic data of NSAIDs and opioids use in reptiles. Additionally, key pharmacokinetic trends that may aid dosing of NSAIDs and opioids in reptiles will also be highlighted. Most of the existing reports of NSAID used in reptiles did not observe any adverse effects directly associated to the respective NSAID used, with meloxicam being the most well-studied. Despite the current absence of analgesic efficacy studies for NSAIDs in reptiles, most reports observed behavioural improvements in reptiles after NSAID treatment. Fentanyl and morphine were studied in the greatest number of reptile species with analgesic effects observed with the doses used, while adverse effects such as sedation were observed most with butorphanol use. While pharmacokinetic trends were drug- and species-specific, it was observed that clearance (CL) of drugs tended to be higher in squamates compared to chelonians. The half-life (t_1/2) of meloxicam also appeared to be longer when dosed orally compared to other routes of drug administration. This could have been due to absorption-rate limited disposition. Although current data provided beneficial information, there is an urgent need for future research on NSAID and opioid pharmacology to ensure the safe and effective use of opioids in reptiles.

Pain and Pain Management in Sea Turtle and Herpetological Medicine: State of the Art

Simple Summary

Rescue and rehabilitative medicine of sea turtles must deal with several circumstances that would be certainly considered painful in other species (trauma, situations that require surgery); thus, it would be natural to consider the use of analgesic drugs to manage the pain and avoid its deleterious systemic effects to guarantee a rapid recovery and release. However, in these animals (as well as in reptiles in general), many obstacles stand in the way of the application of safe and effective therapeutic protocols. It has been demonstrated that, anatomically and physiologically, turtles and reptiles in general must be considered able to experience pain in its definition of an “unpleasant sensory and emotional experience”. Unfortunately, specific studies concerning sea turtles and reptiles on pain assessment, safety, and clinical efficacy of analgesic drugs currently in use (mostly opioids and non-steroidal anti-inflammatory drugs—NSAIDs) are scarce and fragmentary and suffer from some basic gaps or methodological bias that prevent a correct interpretation of the results. At present, the general understanding of the physiology of reptiles’ pain and the possibility of its reasonable treatment is still in its infancy, considering the enormous amount of information still needed, and the use of analgesic drugs is still anecdotal or dangerously inferred from other species.

Abstract

In sea turtle rescue and rehabilitative medicine, many of the casualties suffer from occurrences that would be considered painful in other species; therefore, the use of analgesic drugs should be ethically mandatory to manage the pain and avoid its deleterious systemic effects to guarantee a rapid recovery and release. Nonetheless, pain assessment and management are particularly challenging in reptilians and chelonians. The available scientific literature demonstrates that, anatomically, biochemically, and physiologically, the central nervous system of reptiles and chelonians is to be considered functionally comparable to that of mammals albeit less sophisticated; therefore, reptiles can experience not only nociception but also “pain” in its definition of an unpleasant sensory and emotional experience. Hence, despite the necessity of appropriate pain management plans, the available literature on pain assessment and clinical efficacy of analgesic drugs currently in use (prevalently opioids and NSAIDs) is fragmented and suffers from some basic gaps or methodological bias that prevent a correct interpretation of the results. At present, the general understanding of the physiology of reptiles’ pain and the possibility of its reasonable treatment is still in its infancy, considering the enormous amount of information still needed, and the use of analgesic drugs is still anecdotal or dangerously inferred from other species.

Pharmacokinetics and bioavailability of meloxicam in rainbow trout (Oncorhynchus mykiss) broodstock following intravascular, intramuscular, and oral administrations

The pharmacokinetics and bioavailability of meloxicam were investigated after single intravascular (IV), intramuscular (IM), and oral dose of 1 mg/kg in rainbow trout broodstock at 11 ± 1.2°C. A total of 36 healthy rainbow trout (Oncorhynchus mykiss) broodstock weighing 1.40 ± 0.26 kg was used for the investigation. Plasma concentrations of meloxicam were measured with high-performance liquid chromatography-ultraviolet detection, and pharmacokinetic parameters were calculated by non-compartmental analysis. The elimination half-life for IV, IM, and oral routes was 3.63, 4.55, and 2.95 h, respectively. The IV route for meloxicam showed the total clearance of 0.05 L/h/kg and volume of distribution at a steady state of 0.20 L/kg. The peak plasma concentration was 2.97 μg/ml for the IM route and 0.84 μg/ml for the oral route. The bioavailability was 78.45% for the IM route and 21.48% for the oral route. Meloxicam following IM and oral administration displayed short t_1/2ʎz . The short t_1/2ʎz could be an advantage for the short-term use in acute conditions. The IM route with the good bioavailability can be preferred for the treatment of various conditions. However, developing new oral formulations with the good bioavailability for meloxicam is necessary to minimize stress and trauma through minimal handling in rainbow trout broodstock.

Effect of castration procedure on the pharmacokinetics of meloxicam in goat kids

The aim of this study was to determine the changes in the pharmacokinetics of meloxicam in goat kids who were castrated following the administration of xylazine. Six goat kids were used for the study. The study was performed in two periods according to a longitudinal study, with a 15-day washout period between periods. In the first period (Control group), 1 mg/kg meloxicam was administered by i.v. route to kids. In the second period (Castration group), the kids were sedated with 0.3 mg/kg xylazine and castration was performed following meloxicam administration. Plasma meloxicam concentration was analyzed using HPLC-UV, and pharmacokinetic parameters were calculated by noncompartmental model. In the control group following the administration of meloxicam, mean elimination half-life (t_{1/2 ʎz} ), area under the concentration-time curve (AUC_0-∞ ), total body clearance (Cl_T ), and volume of distribution at steady-state (V_dss ) were 13.50 ± 0.62 hr, 41.10 ± 2.86 hr µg/ml, 24.43 ± 1.75 ml hr^-1  kg^-1 , and 0.45 ± 0.03 L/kg, respectively. In the castration group, the t_{1/2 ʎz} of meloxicam prolonged, AUC_0-∞ increased, and Cl_T and V_dss decreased. In conclusion, the excretion of meloxicam from the body slowed and the t_{1/2 ʎz} was prolonged in the castrated goat kids following xylazine administration. However, there is a need to determine the pharmacodynamics of meloxicam in castrated goat kids.

Pharmacokinetics of tolfenamic acid in red-eared slider turtles (Trachemys scripta elegans)

OBJECTIVE

To determine the pharmacokinetics of tolfenamic acid (TA) after different routes of administration [intravenous (IV) and intramuscular (IM), 2 mg kg^-1] and doses (IV, 2 and 4 mg kg^-1) in red-eared slider turtles (Trachemys scripta elegans).

STUDY DESIGN

Randomized experimental trial.

ANIMALS

Sixteen healthy red-eared slider turtles.

METHODS

Turtles were randomly assigned to two groups (n = 8 each). Group 1 received TA at a dose of 2 mg kg^-1 IV and then IM, after a washout period of 30 days. Group 2 received 4 mg kg^-1 TA IV. A noncompartmental analysis was used to calculate pharmacokinetic variables.

RESULTS

No local and/or systemic adverse drug effects were observed in any turtle. Elimination half-life and mean residence time following IM administration at 2 mg kg^-1 were significantly longer than those following IV administration. The bioavailability following IM administration was complete. The area under the plasma concentration-time curve, elimination half-life, mean residence time and total clearance were significantly different between the dose groups.

CONCLUSIONS AND CLINICAL RELEVANCE

The absence of adverse reactions in the turtles of the study of TA along with the favourable pharmacokinetic properties (the long half-life and the complete bioavailability) of TA administered at the single doses of 2 and 4 mg kg^-1 suggest the possibility of its effective use in turtles. However, further studies are required to establish a multiple dosage regimen of TA and to evaluate the clinical efficacy of administering TA.

The Educated Guess: Determining Drug Doses in Exotic Animals Using Evidence-Based Medicine

Lack of species-specific pharmacokinetic and pharmacodynamic data is a challenge for pharmaceutical and dose selection. If available, dose extrapolation can be accomplished via basic equations. If unavailable, several methods have been described. Linear scaling uses an established milligrams per kilograms dose based on weight. This does not allow for differences in species drug metabolism, sometimes resulting in toxicity. Allometric scaling correlates body weight and metabolic rate but fails for drugs with significant hepatic metabolism and cannot be extrapolated to avians or reptiles. Evidence-based veterinary medicine for dose design based on species similarity is discussed, considering physiologic differences between classes.

Pain and Its Control in Reptiles

Reptiles have the anatomic and physiologic structures needed to detect and perceive pain. Reptiles are capable of demonstrating painful behaviors. Most of the available literature indicates pure μ-opioid receptor agonists are best to provide analgesia in reptiles. Multimodal analgesia should be practiced with every reptile patient when pain is anticipated. Further research is needed using different pain models to evaluate analgesic efficacy across reptile orders.

Advancements in Evidence-Based Analgesia in Exotic Animals

The importance of appropriate recognition, assessment, and treatment of pain in all veterinary species, including exotic animals, cannot be overstated. Although the assessment of pain perception in nondomestic species is still in its infancy, this does not preclude appropriate analgesic management in these species. Although analgesic drug selection is often based on data extrapolated from similar species, as the pharmacokinetics and pharmacodynamics of many drugs can vary greatly between species, an evidence-based approach to analgesic therapy should be used whenever possible. This article provides an overview of recent advances in evidence-based analgesic management in companion exotic animals.

Radio Transmitter Implantation and Movement in the Wild Timber Rattlesnake ( Crotalus horridus )

Radiotelemetry transmitters have become critical to studies of wildlife ecology. However, little is known about how transmitter implantation surgery affects the mobility of some species, including the timber rattlesnake, Crotalus horridus . Tracking snake movement can provide insights into the effects of transmitter implantation. During 2007-11, 71 radio transmitters were surgically implanted intracoelomically in 47 timber rattlesnakes. Over 20 of these snakes underwent surgery at least twice in 5 yr to replace old transmitters. Surgeries were performed under general anesthesia with a local nerve block at the site of implantation, 20 cm cranial to the cloaca. Snakes were also administered postsurgical meloxicam and enrofloxacin every 24 h for three doses. Two to five days after surgery, snakes were released at their original locations and radiotracked regularly during the active seasons (April-October 2007-11). Average daily movement data (distance traveled) were compiled for each snake. Snakes undergoing transmitter surgery in a given year did not differ significantly in distance traveled compared to snakes that had transmitters but did not have surgery in that year. Distance traveled for each snake did not differ before or after surgery or between weeks 1 and 2 postsurgery, indicating that the transmitter implantation did not alter snake movement.