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Lindh E, Meller A, Raekallio M. Effects of vatinoxan in rats sedated with a combination of medetomidine, midazolam and fentanyl. Acta Vet Scand 2024; 66:23. [PMID: 38822394 PMCID: PMC11141047 DOI: 10.1186/s13028-024-00744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/22/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Alpha2-adrenoceptor agonists (α2-agonists) are widely used in animals as sedatives and for pre-anaesthetic medication. Medetomidine has often been given subcutaneously (SC) to rats, although its absorption rate is slow and the individual variation in serum drug concentrations is high via this route. In addition, α2-agonists have various effects on metabolic and endocrine functions such as hypoinsulinaemia, hyperglycaemia and diuresis. Vatinoxan is a peripherally acting α2-adrenoceptor antagonist that, as a hydrophilic molecule, does not cross the blood-brain barrier in significant quantities and thus alleviates peripheral cardiovascular effects and adverse metabolic effects of α2-agonists. Aim of this study was to evaluate the effects of vatinoxan on sedation, blood glucose concentration, voiding and heart and respiratory rates and arterial oxygen saturation in rats sedated with subcutaneous medetomidine, midazolam and fentanyl. RESULTS Onset of sedation and loss of righting reflex occurred significantly faster with vatinoxan [5.35 ± 1.08 (mean ± SD) versus 12.97 ± 6.18 min and 6.53 ± 2.18 versus 14.47 ± 7.28 min, respectively]. No significant differences were detected in heart and respiratory rates and arterial oxygen saturation between treatments. Blood glucose concentration (18.3 ± 3.6 versus 11.8 ± 1.2 mmol/L) and spontaneous urinary voiding [35.9 (15.1-41.6), range (median) versus 0.9 (0-8.0) mL /kg/min] were significantly higher without vatinoxan. CONCLUSIONS Acceleration of induction of sedation, alleviation of hyperglycaemia and prevention of profuse diuresis by vatinoxan may be beneficial when sedating rats for clinical and experimental purposes with subcutaneous medetomidine, midazolam and fentanyl.
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Affiliation(s)
- Emily Lindh
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Koetilantie 4, P.O.Box 57, Helsinki, FI-00014, Finland
| | - Anna Meller
- Laboratory Animal Center, Mustialankatu 1 G, P.O.Box 29, Helsinki, FI-00014, Finland
| | - Marja Raekallio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Koetilantie 4, P.O.Box 57, Helsinki, FI-00014, Finland.
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Debiage RR, Más FED, Thomas LD, Wolfran L, Silva MM, Fukushima FB. DEXMEDETOMIDINE AND XYLAZINE IN SHEEP: A STUDY OF CARDIOPULMONARY, HEMATOLOGICAL, AND GASTROINTESTINAL EFFECTS. Small Rumin Res 2022. [DOI: 10.1016/j.smallrumres.2022.106863] [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]
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Concentrations of vatinoxan and xylazine in plasma, cerebrospinal fluid and brain tissue following intravenous administration in sheep. Vet Anaesth Analg 2021; 48:900-905. [PMID: 34561183 DOI: 10.1016/j.vaa.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate the extent of vatinoxan distribution into sheep brain, and whether vatinoxan influences brain concentrations of xylazine; and to examine the utility of cerebrospinal fluid (CSF) as a surrogate of brain tissue concentrations for vatinoxan and xylazine. STUDY DESIGN Randomised, blinded, experimental study. ANIMALS A total of 14 adult female sheep. METHODS Sheep were randomly allocated into two equal groups and premedicated with either intravenous (IV) vatinoxan (750 μg kg-1, VX) or saline (SX) administered 10 minutes before IV xylazine (500 μg kg-1). Sedation was subjectively assessed at selected intervals before and after treatments. At 10 minutes after xylazine administration, a venous blood sample was collected and the sheep were immediately euthanised with IV pentobarbital (100 mg kg-1). Plasma, CSF and brain tissues were harvested, and concentrations of vatinoxan and xylazine were quantified using liquid chromatography-tandem mass spectrometry. Drug ratios were then calculated and the data were analysed as appropriate. RESULTS The brain-to-plasma and CSF-to-plasma ratios of vatinoxan were 0.06 ± 0.013 and 0.05 ± 0.01 (mean ± standard deviation), respectively. Xylazine brain concentrations were not significantly different (835 ± 262 versus 1029 ± 297 ng g-1 in groups VX and SX, respectively) and were approximately 15-fold higher than those in plasma. The CSF-to-brain ratio of vatinoxan was 0.8 ± 0.2, whereas xylazine concentrations in the brain were approximately 17-fold greater than those in CSF, with and without vatinoxan. CONCLUSIONS AND CLINICAL RELEVANCE Vatinoxan did not significantly affect sedation with xylazine or the concentrations of xylazine in the brain. CSF is not a good predictor of xylazine concentrations in the brain, whereas vatinoxan concentrations were concordant between the brain and CSF, using the dosages in this study.
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Adam M, Lindén J, Raekallio M, Meller A, Mannerström B, Abu-Shahba A, Seppänen-Kaijansinkko R, Salla K. Effects of vatinoxan on xylazine-induced pulmonary alterations in sheep. J Vet Pharmacol Ther 2021; 45:117-125. [PMID: 34478172 DOI: 10.1111/jvp.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/20/2021] [Accepted: 08/24/2021] [Indexed: 11/30/2022]
Abstract
It was hypothesized that premedication with vatinoxan, a peripheral α2 -adrenoceptor antagonist, would mitigate xylazine-induced pulmonary alterations in sheep. Fourteen adult sheep were allotted into two equal groups and premedicated with either vatinoxan (750 µg/kg IV) or saline and sedated 10 min later with xylazine (500 µg/kg IV). Arterial oxygen saturation (SpO2 ) was measured and respiratory rate (RR) counted at intervals. The sheep were euthanized with IV pentobarbital 10 min after xylazine administration. The severity of pulmonary parenchymal alterations was assessed and graded grossly and histologically and correlations of the morphological changes with SpO2 evaluated. Following xylazine injection, SpO2 was significantly higher and RR significantly lower with vatinoxan than with saline and the sheep administered vatinoxan exhibited significantly smaller quantities of tracheal foam than those receiving saline. No significant differences in macroscopic oedema scores were detected between treatments. In contrast, the vatinoxan-treated animals exhibited significantly graver microscopic interstitial alveolar oedema and haemorrhage than saline-treated animals. The histological severity scores did not correlate with changes in SpO2 . In conclusion, xylazine induced a marked reduction in SpO2 which was abolished by the prior administration of vatinoxan. The histologically detected alterations after pentobarbital euthanasia with vatinoxan premedication need to be studied further.
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Affiliation(s)
- Magdy Adam
- Department of Equine and Small Animal Medicine, Faculty of veterinary Medicine, University of Helsinki, Helsinki, Finland.,Pharmacology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Jere Lindén
- Department of Veterinary Bioscience, Faculty of veterinary Medicine, University of Helsinki, Helsinki, Finland.,Finnish Centre for Laboratory Animal Pathology, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Marja Raekallio
- Department of Equine and Small Animal Medicine, Faculty of veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anna Meller
- Laboratory Animal Centre, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Bettina Mannerström
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ahmed Abu-Shahba
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Riitta Seppänen-Kaijansinkko
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kati Salla
- Department of Equine and Small Animal Medicine, Faculty of veterinary Medicine, University of Helsinki, Helsinki, Finland
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Einwaller J, Meyer LCR, Auer U, Raekallio M, Nowack J, Haw A, Vetter S, Painer J, Stalder G. Cardiovascular effects of intravenous vatinoxan in wild boars (Sus scrofa) anaesthetised with intramuscular medetomidine-tiletamine-zolazepam. Vet Rec 2021; 190:e835. [PMID: 34472117 DOI: 10.1002/vetr.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/18/2021] [Accepted: 07/29/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND The potent sedative medetomidine is a commonly used adjunct for the immobilisation of non-domestic mammals. However, its use is associated with pronounced cardiovascular side effects, such as bradycardia, vasoconstriction and decreased cardiac output. We investigated the effects of the peripherally-acting alpha-2-adrenoceptor antagonist vatinoxan on cardiovascular properties in medetomidine-tiletamine-zolazepam anaesthetised wild boar (Sus scrofa). METHODS Twelve wild boars, anaesthetised twice with medetomidine (0.1 mg/kg) and tiletamine/zolazepam (2.5 mg/kg) IM in a randomised, crossover study, were administered (0.1 mg/kg) vatinoxan or an equivalent volume of saline IV (control). Cardiovascular variables, including heart rate (HR), mean arterial blood pressure (MAP), pulmonary artery pressure (PAP), pulmonary artery occlusion pressure (PAOP) and cardiac output (CO), were assessed 5 min prior to vatinoxan/saline administration until the end of anaesthesia 30 min later. RESULTS MAP (p < 0.0001), MPAP (p < 0.001) and MPAOP (p < 0.0001) significantly decreased from baseline after vatinoxan until the end of anaesthesia. HR increased significantly (p < 0.0001) from baseline after vatinoxan administration. However, the effect on HR subsided 3 min after vatinoxan. All variables remained constant after saline injection. There was no significant effect of vatinoxan or saline on CO. CONCLUSION Vatinoxan significantly reduced systemic and pulmonary artery hypertension, induced by medetomidine in wild boar.
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Affiliation(s)
- Joy Einwaller
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Leith C R Meyer
- Department of Paraclinical Sciences and Centre for Veterinary Wildlife Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Ulrike Auer
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Marja Raekallio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Julia Nowack
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria.,School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Anna Haw
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Sebastian Vetter
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Johanna Painer
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Gabrielle Stalder
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
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Abouelfetouh MM, Salah E, Ding M, Ding Y. Application of α 2 -adrenergic agonists combined with anesthetics and their implication in pulmonary intravascular macrophages-insulted pulmonary edema and hypoxemia in ruminants. J Vet Pharmacol Ther 2021; 44:478-502. [PMID: 33709435 DOI: 10.1111/jvp.12960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
Alpha2 -adrenergic agonists have been implicated in the development of pulmonary edema (PE) and sustained hypoxemia that lead to life-threatening pulmonary distress in ruminants, especially with sensitive and compromised animals. Recently, there is limited understanding of exact mechanism underlying pulmonary alterations associated with α2 -adrenergic agonist administration. Ruminants have a rich population of pulmonary intravascular macrophages (PIMs) in the pulmonary circulation, which may be involved in the development of pulmonary alveolo-capillary barrier damage. Hence, the central thesis of this review is overviewing the literatures regarding the systemic use of α2 -adrenergic agonists in domestic ruminants, focusing on their pulmonary side effects, especially on the influence of PIMs on the lung. At this moment, further studies are needed to provide a clear emphasis and better understanding of the potential role of PIMs in the lung pathophysiology associated with α2 -adrenergic agonists. These preliminary studies would be potentially to develop future medications and intervention targets that may be helpful to alleviate or prevent the critical striking pulmonary effects, and thereby improving the safety of α2 -agonist application in ruminants.
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Affiliation(s)
- Mahmoud M Abouelfetouh
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China.,Department of Surgery, Radiology and Anaesthesiology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Egypt
| | - Eman Salah
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei, China.,Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Egypt
| | - Mingxing Ding
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Yi Ding
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
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Evaluation of intramuscular sodium nitroprusside injection to improve oxygenation in white-tailed deer (Odocoileus virginianus) anesthetized with medetomidine-alfaxalone-azaperone. Vet Anaesth Analg 2020; 48:65-73. [PMID: 33279394 DOI: 10.1016/j.vaa.2020.10.006] [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: 07/29/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE In ungulates, α2-adrenergic agonists can decrease oxygenation possibly through alteration of pulmonary perfusion. Sodium nitroprusside can decrease pulmonary vascular resistance (PVR) and increase cardiac output (Q˙t) through vasodilation. The objective was to determine if sodium nitroprusside would improve pulmonary perfusion and attenuate the increased alveolar-arterial (a-a) gradient resulting from medetomidine-azaperone-alfaxalone (MAA) administration. STUDY DESIGN Prospective, randomized, crossover study with a 2 week rest period. ANIMALS A group of eight adult female captive white-tailed deer (Odocoileus virginianus). METHODS Deer were administered MAA intramuscularly (IM), and auricular artery and pulmonary artery balloon catheters were placed. Deer spontaneously breathed air. Saline or sodium nitroprusside (0.07 mg kg-1) were administered IM 40 minutes after MAA injection. Heart rate (HR), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), pulmonary artery occlusion pressure (PAOP), right atrial pressure (RAP), Q˙t, arterial pH, PaCO2 and PaO2 were obtained immediately before nitroprusside injection (baseline) and 5, 10 and 15 minutes afterwards. Mixed venous blood samples were obtained at baseline and at 5 minutes. Systemic vascular resistance (SVR), PVR, intrapulmonary shunt fraction (Q˙s/Q˙t), a-a gradient, oxygen delivery (D˙O2) and oxygen extraction ratio (O2ER) were calculated. Statistical analysis was performed with repeated measures analysis of variance with correction factors. A p value < 0.05 was considered significant. RESULTS With nitroprusside, MAP, MPAP, PAOP, RAP, SVR and O2ER significantly decreased and HR, Q˙t and D˙O2 increased compared with baseline and between treatments. There was a significant decrease in PVR and a-a gradient and increase in PaO2 compared with baseline and saline treatment. Changes were not sustained. CONCLUSIONS AND CLINICAL RELEVANCE Nitroprusside temporarily changed hemodynamic variables, increased PaO2 and decreased a-a gradient. Nitroprusside possibly led to better pulmonary perfusion of ventilated alveoli. However, IM nitroprusside at this dose is not recommended because of severe systemic hypotension and short action.
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Rossi H, Raekallio M, Määttä M, Tapio H, Hanifeh M, Junnila J, Rajamäki MM, Mykkänen A. Effects of general anaesthesia in dorsal recumbency with and without vatinoxan on bronchoalveolar lavage cytology of healthy horses. Vet J 2019; 251:105352. [PMID: 31492391 DOI: 10.1016/j.tvjl.2019.105352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/05/2019] [Accepted: 08/02/2019] [Indexed: 11/29/2022]
Abstract
Pneumonia is one of the potential complications of general anaesthesia in horses. Anaesthesia is known to increase neutrophils in bronchoalveolar lavage fluid (BALF) of horses after lateral recumbency, but studies after dorsal recumbency are lacking. Our primary aim was to determine when lung inflammation reaches its maximum and how rapidly BALF cytology returns to baseline after anaesthesia in dorsal recumbency. A secondary aim was to investigate the possible effect of vatinoxan, a novel drug, on the BALF cytology results. Six healthy experimental horses were enrolled in this observational crossover study. The horses were subject to repeated BALF and blood sampling for 7 days after general anaesthesia with two treatment protocols, and without anaesthesia (control). During the two treatments, the horses received either medetomidine-vatinoxan or medetomidine-placebo as premedication, and anaesthesia was induced with ketamine-midazolam and maintained with isoflurane for 1h in dorsal recumbency. The differences in BALF and blood variables between the two anaesthesia protocols and control were analysed with repeated measures analysis of variance models. In this study, anaesthesia in dorsal recumbency resulted in no clinically relevant changes in airway cytology that could be differentiated from the effect of repeated BALF sampling. No differences in BALF matrix metalloproteinase gelatinolytic activity could be detected between the two treatments or the control series. Marked increase in serum amyloid A was detected in some animals. Vatinoxan as premedication did not consistently affect lung cytology or blood inflammatory markers after anaesthesia.
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Affiliation(s)
- H Rossi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland.
| | - M Raekallio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland
| | - M Määttä
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland
| | - H Tapio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland
| | - M Hanifeh
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland
| | - J Junnila
- Oy 4Pharma Ltd., Arkadiankatu 7, Helsinki, Finland
| | - M M Rajamäki
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland
| | - A Mykkänen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, Finland
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