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Xylazine: A Drug Adulterant of Clinical Concern. Curr Pain Headache Rep 2024; 28:417-426. [PMID: 38507135 PMCID: PMC11126434 DOI: 10.1007/s11916-024-01211-z] [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] [Accepted: 01/08/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE OF REVIEW The opioid epidemic has been responsible for significant morbidity and mortality in the USA and worldwide. As a result, it is essential to recognize the threat these potent drugs can cause when illicitly used. Specifically, introducing fentanyl as a drug adulterant has been shown to impact overdose rates drastically. In this regard, the Drug Enforcement Agency recently released a public safety alert announcing the new threat of a new adulterant called xylazine. Xylazine is a powerful animal sedative with a different mechanism of action when compared to illicit opioids such as heroin and fentanyl. Xylazine is typically injected intravenously via a syringe, often in combination with multiple other drugs. One of the most common drugs, xylazine, is taken in combination with fentanyl, with users of this drug combination describing xylazine as prolonging the euphoric sensation produced by fentanyl. RECENT FINDINGS Xylazine may cause adverse effects such as bradycardia, brief hypertension followed by hypotension, premature ventricular contractions, ataxia, slurred speech, sedation, and respiratory depression. Much of the recent literature on xylazine use in humans comes from case reports and review articles. Related to widespread use in veterinary medicine and increasing circulation in illicit drug markets, there is a critical need for public awareness and additional clinical-based studies to further increase understanding of mediated or modulated pharmacological effects of xylazine in humans. Further research is urgently needed to more clearly understand the implications of unregulated xylazine in the illicit drug market, to formulate public health interventions, and to implement harm reduction strategies.
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Xylazine Poisoning in Clinical and Forensic Practice: Analysis Method, Characteristics, Mechanism and Future Challenges. TOXICS 2023; 11:1012. [PMID: 38133413 PMCID: PMC10748319 DOI: 10.3390/toxics11121012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Xylazine abuse is emerging globally, while the identification of xylazine lethal cases poses a great challenge in clinical and forensic practice. The non-specific symptoms delay the diagnosis and treatment of xylazine poisoning, the pathological changes and lethal concentration of xylazine in body fluid and organs of fatal xylazine poisoning cases are seldom reported and the other toxins detected in such cases complicate the role of xylazine in the cause of death. Therefore, we carefully reviewed related updated information on xylazine, summarized the knowledge from clinical and forensic perspectives and can thus provide a reference in such cases and throw light on further study in the field of xylazine poisoning.
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Abstract
Xylazine is an animal sedative, approved by the U.S. Food and Drug Administration, that is commonly used in veterinary medicine and is not approved for human use. Since 2016, xylazine has consistently appeared in the illicitly manufactured fentanyl supply and has significantly increased in prevalence, likely due to its low cost, easy availability, and presumed synergistic psychoactive effect. Clinical experience along with the available pertinent research were used to review xylazine adulteration of the drug supply and provide guidance on the care of patients exposed to xylazine. This review discusses xylazine pharmacology, animal and human clinical effects, and what is known to date about care of patients experiencing acute overdose, xylazine-fentanyl withdrawal, and xylazine-associated wounds.
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Effect of Xylazine on Pharmacokinetics and Physiological Efficacy of Intravenous Carprofen in Castrated Goats Kids. Animals (Basel) 2023; 13:2700. [PMID: 37684964 PMCID: PMC10486870 DOI: 10.3390/ani13172700] [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: 06/29/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Carprofen can be used in the castration process of male goats due to its low side effects, long elimination half-life, and long-term effect. However, no studies were found on the pharmacokinetics and physiological efficacy of carprofen when employed for castration in male goats. The aim of this study was to determine the effect of xylazine (0.05 mg/kg, intramuscular) on the pharmacokinetics and physiological efficacy following intravenous administration of carprofen (4 mg/kg, intravenous) in male goat kids castrated using the burdizzo method. Thirty male Kilis goat kids (5-6 months and 18-30 kg of body weight) were randomly assigned to five groups (n = 6) as follows: healthy control (HC), castration control (CAST), castration+carprofen (CAST+CRP), castration+xylazine (CAST+XYL), and castration+xylazine+carprofen (CAST+XYL+CRP). Plasma concentrations of carprofen were analyzed via a non-compartmental method. Physiological parameters including serum cortisol, scrotal temperature, rectal temperature, and scrotal circumference were determined. Xylazine caused a decrease in the volume of distribution and clearance and an increase in the area under the curve of carprofen in CAST+XYL+CRP group (p < 0.05). The mean cortisol concentrations in CAST+CRP and CAST+XYL remained lower compared to CAST (p < 0.05). The mean cortisol concentrations in CAST+XYL+CRP were lower than in CAST+CRP and CAST+XYL (p < 0.05). In addition, the effect of carprofen administration alone on reducing the initial cortisol response to castration was observed from 6 to 48 h, while in combination with xylazine, it was observed immediately up to 48 h. No treatment differences were observed in rectal temperature, scrotal temperature, and scrotal circumference (p > 0.05). Xylazine caused an increase in plasma concentration and a decrease in clearance of carprofen after co-administration. However, when the effect of the combined administration of carprofen with xylazine on cortisol is evaluated, their combined use in castration process may be beneficial.
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Self-reported Xylazine Experiences: A Mixed Methods Study of Reddit Subscribers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.13.23287215. [PMID: 36993695 PMCID: PMC10055471 DOI: 10.1101/2023.03.13.23287215] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Objectives Xylazine is an alpha-2 agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from People Who Use Drugs (PWUDs). Specifically, we sought to answer the following: 1) what are the demographics of Reddit subscribers reporting exposure to xylazine? 2) is xylazine a desired additive? and 3) what adverse effects of xylazine are PWUDs experiencing? Methods Natural Language Processing (NLP) was used to identify mentions of "xylazine" from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022. Results 76 posts mentioning xylazine were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. 61 participants completed the survey. Of those that disclosed their location, 25/50 (50%) participants reported locations in the Northeastern United States. The most common eoute of xylazine use was intranasal use (57%). 31/59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%). Conclusions Among respondents on these Reddit forums, xylazine appears to be an unwanted adulterant. PWUDs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This appeared to be more common in the Northeast.
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Xylazine Complicating Opioid Ingestions in Young Children. Pediatrics 2023; 151:190352. [PMID: 36550066 DOI: 10.1542/peds.2022-058684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 12/24/2022] Open
Abstract
The authors of this report present 3 cases of synthetic opioid intoxication complicated by the concomitant presence of the additive xylazine, a nonopioid sedative analgesic and muscle relaxant used in veterinary medicine that potentiates respiratory depression associated with the opioid toxidrome. Three exposed children presented with severe signs and symptoms, 2 of whom experienced cardiac arrest, a need for continuous naloxone infusion or multiple naloxone doses, or mechanical ventilation to treat respiratory failure after their exposures. Additives were detected in urine studies only through the performance of specialized toxicology testing. Detection of xylazine among adult overdose deaths has recently increased sharply, particularly across the northeastern United States. Adulteration by xylazine is an emerging public health threat nationally. Our report reveals that pediatricians should be aware of sentinel drug trends among adults, including the emerging types of illicit, synthetic, or counterfeit formulations of recreational substances, because children may be harmed because of accidental or intentional exposure. Children exposed to dangerous substances also need child protection services that may entail safe relocation outside of the home and the referral of affected caregivers to necessary substance use treatment services. Given epidemic drug use among adults, pediatricians should be competent to recognize common toxidromes and be aware that signs and symptoms may be potentiated by synergistic novel additives or polysubstance exposures. Importantly, standard urine drug screens may not detect synthetic opioid derivatives or contributing additives, so that diagnosis will require specialized toxicology testing.
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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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Intratracheal oxygen administration increases FIO2 and PaO2 compared with intranasal administration in healthy, standing horses. Am J Vet Res 2022; 83:450-454. [PMID: 35263280 DOI: 10.2460/ajvr.21.09.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy of 2 different oxygen delivery strategies-intranasal and tracheal insufflation-on the inspired fraction of oxygen (FIO2) in standing horses and to determine the time needed for arterial oxygen partial pressure (PaO2) equilibration. ANIMALS 6 healthy adult horses. PROCEDURES In this blinded, randomized crossover design study, horses were randomly assigned to receive oxygen via nasal cannula (group N) or transcutaneous tracheal catheter (group T). After placement of venous and arterial catheters, FIO2 was measured through a catheter placed into the distal portion of the trachea. After baseline measurements were obtained, horses received oxygen at up to 25 mL/kg/min for 1 hour via either intranasal or intratracheal catheter. The FIO2 and PaO2 were recorded at 5, 10, 15, 20, 25, 30, 45, and 60 minutes during and 5, 10, 15, 20, and 30 minutes after oxygen insufflation. Data were analyzed by use of a 2-way repeated measures ANOVA with Tukey-Kramer post hoc testing for pairwise comparisons (P < 0.05). RESULTS During oxygen administration, FIO2 and PaO2 increased significantly when compared with baseline, resulting in significantly higher values for group T (37.7 ± 2.4%; 214.6 ± 18 mm Hg) than for group N (34.3 ± 3.9%; 184.1 ± 11 mm Hg). The equilibration time was less than 10 minutes. CLINICAL RELEVANCE Intratracheal oxygen administration resulted in better oxygenation than nasal insufflation and should therefore be considered in standing horses that are experiencing severe respiratory compromise. The equilibration between FIO2 and PaO2 is rapid in adult horses.
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A comparison of sedative effects of xylazine alone or combined with levomethadone or ketamine in calves prior to disbudding. Vet Anaesth Analg 2021; 48:906-913. [PMID: 34602358 DOI: 10.1016/j.vaa.2021.08.004] [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: 04/09/2021] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the sedative effects of intramuscular xylazine alone or combined with levomethadone or ketamine in calves before cautery disbudding. STUDY DESIGN Randomized, blinded, clinical trial. ANIMALS A total of 28 dairy calves, aged 21 ± 5 days and weighing 61.0 ± 9.3 kg (mean ± standard deviation). METHODS Calves were randomly allocated to three groups: xylazine (0.1 mg kg-1) and levomethadone (0.05 mg kg-1; group XL), xylazine (0.1 mg kg-1) and ketamine (1 mg kg-1; group XK) and xylazine alone (0.2 mg kg-1; group X). Local anaesthesia (procaine hydrochloride) and meloxicam were administered subcutaneously 15 minutes after sedation and 15 minutes before disbudding. The calves' responses to the administration of local anaesthesia and disbudding were recorded. Sedation was assessed at baseline and at intervals up to 240 minutes postsedation. Times of recumbency, first head lift and first standing were recorded. Drug plasma concentrations were measured. RESULTS Data were obtained from 27 animals. All protocols resulted in sedation sufficient to administer local anaesthesia and to perform disbudding. Sedation scores significantly correlated with drug plasma concentrations (p ≤ 0.002). Times to recumbency did not differ among protocols (2.8 ± 0.3, 3.1 ± 1.1 and 2.1 ± 0.8 minutes for groups XL, XK and X, respectively), whereas interval from drug(s) administration until first head lift was significantly shorter in group XK than X (47.3 ± 14.1, 34.4 ± 5.3 and 62.6 ± 31.9 minutes for groups XL, XK and X, respectively). The area under the time-sedation curve was significantly greater in group X than XK or XL (754 ± 215, 665 ± 118 and 1005 ± 258 minutes for groups XL, XK and X, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Levomethadone or ketamine with a low dose of xylazine produced short but sufficient sedation for local anaesthesia and disbudding with minimum resistance.
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Toxicokinetics of U-47700, tramadol, and their main metabolites in pigs following intravenous administration: is a multiple species allometric scaling approach useful for the extrapolation of toxicokinetic parameters to humans? Arch Toxicol 2021; 95:3681-3693. [PMID: 34604914 PMCID: PMC8536616 DOI: 10.1007/s00204-021-03169-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022]
Abstract
New synthetic opioids (NSOs) pose a public health concern since their emergence on the illicit drug market and are gaining increasing importance in forensic toxicology. Like many other new psychoactive substances, NSOs are consumed without any preclinical safety data or any knowledge on toxicokinetic (TK) data. Due to ethical reasons, controlled human TK studies cannot be performed for the assessment of these relevant data. As an alternative animal experimental approach, six pigs per drug received a single intravenous dose of 100 µg/kg body weight (BW) of U-47700 or 1000 µg/kg BW of tramadol to evaluate whether this species is suitable to assess the TK of NSOs. The drugs were determined in serum and whole blood using a fully validated method based on solid-phase extraction and LC–MS/MS. The concentration–time profiles and a population (pop) TK analysis revealed that a three-compartment model best described the TK data of both opioids. Central volumes of distribution were 0.94 L/kg for U-47700 and 1.25 L/kg for tramadol and central (metabolic) clearances were estimated at 1.57 L/h/kg and 1.85 L/h/kg for U-47700 and tramadol, respectively. The final popTK model parameters for pigs were upscaled via allometric scaling techniques. In comparison to published human data, concentration–time profiles for tramadol could successfully be predicted with single species allometric scaling. Furthermore, possible profiles for U-47700 in humans were simulated. The findings of this study indicate that unlike a multiple species scaling approach, pigs in conjunction with TK modeling are a suitable tool for the assessment of TK data of NSOs and the prediction of human TK data.
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Clinical Randomized Comparison of Medetomidine and Xylazine for Isoflurane Balanced Anesthesia in Horses. Front Vet Sci 2021; 8:603695. [PMID: 33959647 PMCID: PMC8093396 DOI: 10.3389/fvets.2021.603695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/22/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: To assess drug plasma levels, preanesthetic sedation, cardiopulmonary effects during anesthesia and recovery in horses anesthetized with isoflurane combined with medetomidine or xylazine. Study design: Prospective blinded randomized clinical study. Animals: Sixty horses undergoing elective surgery. Methods: Thirty minutes after administration of antibiotics, flunixine meglumine or phenylbutazone and acepromazine horses received medetomidine 7 μg kg−1 (group MED) or xylazine 1.1 mg kg−1 (group XYL) slowly intravenously (IV) and sedation was assessed 3 min later. Anesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and medetomidine 3.5 μg kg−1 h−1 or xylazine 0.69 mg kg−1 h−1. Ringer's acetate 10 mL kg−1 h−1 and dobutamine were administered to maintain normotension. All horses were mechanically ventilated to maintain end-tidal carbon dioxide pressures at 45 ± 5 mmHg (5.3–6.7 kPa). Heart rate (HR), invasive arterial blood pressures, inspired and expired gas compositions, pH, arterial blood gases, electrolytes, lactate and glucose were measured. For recovery all horses received intramuscular morphine 0.1 mg kg−1 and medetomidine 2 μg kg−1 or xylazine 0.3 mg kg−1 IV. Recovery was timed and scored using three different scoring systems. Plasma samples to measure medetomidine and xylazine concentrations were collected at predetermined timepoints. Repeatedly measured parameters were analyzed using a two-way repeated-measures analysis of variance for differences between groups and over time; p < 0.05 was considered statistically significant. Results: Mean arterial blood pressures (MAP) stayed within normal ranges but were higher (p = 0.011) in group XYL despite significant lower dobutamine doses (p = 0.0003). Other measured parameters were within clinically acceptable ranges. Plasma levels were at steady state during anesthesia (MED 2.194 ± 0.073; XYL 708 ± 18.791 ng mL−1). During recovery lateral recumbency (MED 42.7 ± 2.51; XYL 34.3 ± 2.63 min; p = 0.027) and time to standing (MED 62.0 ± 2.86; XYL 48.8 ± 3.01 min; p = 0.002) were significantly shorter in group XYL compared to group MED. Recovery scores did not differ significantly between groups. Conclusion and Clinical Relevance: In horses anesthetized with isoflurane and medetomidine or xylazine, xylazine maintained higher MAP, reduced the dobutamine consumption and recovery time, whilst overall recovery quality was unaffected.
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Doping detection in animals: A review of analytical methodologies published from 1990 to 2019. Drug Test Anal 2021; 13:474-504. [PMID: 33440053 DOI: 10.1002/dta.2999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/10/2020] [Accepted: 01/08/2021] [Indexed: 01/09/2023]
Abstract
Despite the impressive innate physical abilities of horses, camels, greyhounds, or pigeons, doping agents might be administered to these animals to improve their performance. To control these illegal practices, anti-doping analytical methodologies have been developed. This review compiles the analytical methods that have been published for the detection of prohibited substances administered to animals involved in sports over 30 years. Relevant papers meeting the search criteria that discussed analytical methods aiming to detect and/or quantify doping substances in animal biological matrices published from 1990 to 2019 were considered. A total of 317 studies were included, of which 298 were related to horses, demonstrating significant advances toward the development of doping detection methods for equine sports. However, analytical methods for the detection of doping agents in sports involving other species are lacking. Due to enhanced accuracy and specificity, chromatographic analysis coupled to mass spectrometry detection is preferred over immunoassays. Regarding biological matrices, blood and urine remain the first choice, although alternative biological matrices, such as hair and feces, have been considered. With the increasing number and type of drugs used as doping agents, the analytes addressed in the published papers are diverse. It is very important to continue to detect and quantify these drugs, recognizing those that are most frequently used, in order to punish the abusers, protect animals' health, and ensure a healthier and genuine competition.
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First Report on Molecular Characterization of Taenia multiceps Isolates From Sheep and Goats in Faisalabad, Pakistan. Front Vet Sci 2020; 7:594599. [PMID: 33240964 PMCID: PMC7683608 DOI: 10.3389/fvets.2020.594599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/19/2020] [Indexed: 11/21/2022] Open
Abstract
Coenurus cerebralis is the larval stage of Taenia multiceps commonly found in the brain (cerebral form), intramuscular and subcutaneous tissues (non-cerebral form) of ungulates. Globally, few reports exist on the molecular characterization and genetic diversity of C. cerebralis with none available for Pakistan. The current study molecularly characterized 12 C. cerebralis isolates surgically recovered from sheep (n = 4) and goats (n = 8) from a total of 3,040 small ruminants using a portion of the cytochrome c oxidase subunit 1 (cox1) mitochondrial (mt) gene. NCBI BLAST search confirmed the identity of each isolate. A high haplotype and a low nucleotide diversity with three haplotypes from the 12 isolates were observed. The findings suggest the existence of unique haplotypes of C. cerebralis in Pakistan. The negative value of Tajima's D and the positive value of Fu's Fs were inconsistent with population expansion, however, the sample size was small. Bayesian phylogeny revealed that all Pakistani isolates alongside the Chinese sequences (obtained from GenBank) constituted a cluster while sequences from other regions constituted another cluster. This is the first molecular study to determine the genetic diversity of C. cerebralis in Pakistan and serves as a foundation for prospective studies on the prevalence and population structure of C. cerebralis in the country. Furthermore, in this study, we amplified only a partial segment of the cox1 gene from a limited sample size. This could have implications on the interpretation of the actual population structure in reality. Thus, we recommend future studies to consider a larger sample size in a massive epidemiological survey for further insights.
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Association Between Disease Severity, Heart Rate Variability (HRV) and Serum Cortisol Concentrations in Horses with Acute Abdominal Pain. Animals (Basel) 2020; 10:ani10091563. [PMID: 32887514 PMCID: PMC7552187 DOI: 10.3390/ani10091563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Acute abdominal pain is a major cause for emergency treatment in horses and associated with a high stress level leading to an increased serum cortisol concentration. Stress can also be assessed by analyzing the heart rate variability (HRV). We investigated whether the stress level was different between horses with different causes of abdominal pain and, therefore, demanding a different treatment strategy. Heart rate, its variability in the time domain analyses, and cortisol level indicated a decrease in the stress level the day after admission and the day of discharge from the hospital in comparison to admission for both conservatively and surgically treated patients. However, such changes, over time, were not seen in horses that were euthanized during the hospitalization. Furthermore, the difference in the parameters measured between horses that were eventually euthanized and those that survived was best visible the day after admission. Therefore, we concluded that HRV can give further important information on the stress level in horses with colic and might be helpful in assessing possible outcome. However, further studies are required to assess the validity of HRV analyses in horses with colic. Abstract Heart rate variability (HRV) is a noninvasive technique to detect changes in the autonomous nervous system. It has rarely been investigated in horses with colic. Therefore, the objective was to assess the evolution of HRV parameters and cortisol concentrations in horses with colic. The 43 horses included in this study were categorized into three groups according to the treatment (1, surgical; 2, conservative; 3, euthanized). The HRV and laboratory variables were measured at admission (T1), the day after admission (T2), and at discharge (T3) and compared between groups and over time with an ANOVA with Bonferroni correction. Relationships between the HRV parameters themselves and the laboratory variables was assessed by Pearson correlation coefficients. Evolution of the heart rate (HR) over time, mean normal to normal R intervals (meanNN) and cortisol concentrations indicate a decreased sympathetic stimulation over time in group 1 and 2, in contrast to group 3. For group 3, the meanNN and HR differed significantly to group 2 at T1 and to group 1 and 2 at T2. Treatment induced a change in the HRV and cortisol response in horses managed conservatively or surgically but not in horses that required euthanasia. However, further studies are required to assess the validity of HRV analyses in horses with colic.
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Xylazine Identified in the Unregulated Drug Supply in British Columbia, Canada. CANADIAN JOURNAL OF ADDICTION 2020. [DOI: 10.1097/cxa.0000000000000089] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of imidazoline and nonimidazoline α-adrenoceptor agonists and antagonists, including xylazine, medetomidine, dexmedetomidine, yohimbine, and atipamezole, on aggregation of feline platelets. Am J Vet Res 2020; 81:159-171. [PMID: 31985287 DOI: 10.2460/ajvr.81.2.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine the effects of imidazoline and nonimidazoline α-adrenergic agents on aggregation of feline platelets. SAMPLE Blood samples from 12 healthy adult cats. PROCEDURES In 7 experiments, the effects of 23 imidazoline and nonimidazoline α-adrenoceptor agonists or antagonists on aggregation and antiaggregation of feline platelets were determined via a turbidimetric method. Collagen and ADP were used to initiate aggregation. RESULTS Platelet aggregation was not induced by α-adrenoceptor agonists alone. Adrenaline and noradrenaline induced a dose-dependent potentiation of ADP- or collagen-induced aggregation. Oxymetazoline and xylometazoline also induced a small potentiation of ADP-stimulated aggregation, but other α-adrenoceptor agonists did not induce potentiation. The α2-adrenoceptor antagonists and certain imidazoline α-adrenergic agents including phentolamine, yohimbine, atipamezole, clonidine, medetomidine, and dexmedetomidine inhibited adrenaline-potentiated aggregation induced by ADP or collagen in a dose-dependent manner. The imidazoline compound antazoline inhibited adrenaline-potentiated aggregation in a dose-dependent manner. Conversely, α1-adrenoceptor antagonists and nonimidazoline α-adrenergic agents including xylazine and prazosin were ineffective or less effective for inhibiting adrenaline-potentiated aggregation. Moxonidine also was ineffective for inhibiting adrenaline-potentiated aggregation induced by collagen. Medetomidine and xylazine did not reverse the inhibitory effect of atipamezole and yohimbine on adrenaline-potentiated aggregation. CONCLUSIONS AND CLINICAL RELEVANCE Adrenaline-potentiated aggregation of feline platelets may be mediated by α2-adrenoceptors, whereas imidazoline agents may inhibit in vitro platelet aggregation via imidazoline receptors. Imidazoline α-adrenergic agents may have clinical use for conditions in which there is platelet reactivity to adrenaline. Xylazine, medetomidine, and dexmedetomidine may be used clinically in cats with minimal concerns for adverse effects on platelet function.
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Pharmacokinetics of xylazine after 2-, 4-, and 6-hr durations of continuous rate infusions in horses. J Vet Pharmacol Ther 2020; 43:557-564. [PMID: 32424949 DOI: 10.1111/jvp.12873] [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: 07/27/2019] [Revised: 03/27/2020] [Accepted: 04/27/2020] [Indexed: 11/27/2022]
Abstract
Intravenous (i.v.) bolus administration of xylazine (XYL) (0.5 mg/kg) immediately followed by a continuous rate infusion (CRI) of 1 mg kg-1 hr-1 for 2, 4, and 6 hr produced immediate sedation, which lasted throughout the duration of the CRI. Heart rate decreased and blood pressure increased significantly (p > .05) in all horses during the first 15 min of infusion, both returned to and then remained at baseline during the duration of the infusion. Compartmental models were used to investigate the pharmacokinetics of XYL administration. Plasma concentration-time curves following bolus and CRI were best described by a one-compartment model. No differences were found between pharmacokinetic estimates of the CRIs for the fractional elimination rate constant (Ke ), half-life (t1/2e ), volume of distribution (Vd ), and clearance (Cl). Median and range were 0.42 (0.15-0.97)/hr, 1.68 (0.87-4.52) hr, 5.85 (2.10-19.34) L/kg, and 28.7 (19.6-39.5) ml min-1 kg-1 , respectively. Significant differences were seen for area under the curve ( AUC 0 ∞ ) (p < .0002) and maximum concentration (Cmax ) (p < .04). This indicates that with increasing duration of infusion, XYL may not accumulate in a clinically relevant way and hence no adjustments are required in a longer XYL CRI to maintain a constant level of sedation and a rapid recovery.
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Effect of castration procedure on the pharmacokinetics of meloxicam in goat kids. J Vet Pharmacol Ther 2020; 43:429-434. [PMID: 32420638 DOI: 10.1111/jvp.12872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/13/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022]
Abstract
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 (t1/2 ʎz ), area under the concentration-time curve (AUC0-∞ ), total body clearance (ClT ), and volume of distribution at steady-state (Vdss ) 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 t1/2 ʎz of meloxicam prolonged, AUC0-∞ increased, and ClT and Vdss decreased. In conclusion, the excretion of meloxicam from the body slowed and the t1/2 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.
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Towards a fully automated surveillance of well-being status in laboratory mice using deep learning: Starting with facial expression analysis. PLoS One 2020; 15:e0228059. [PMID: 32294094 PMCID: PMC7159220 DOI: 10.1371/journal.pone.0228059] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/06/2020] [Indexed: 01/09/2023] Open
Abstract
Assessing the well-being of an animal is hindered by the limitations of efficient communication between humans and animals. Instead of direct communication, a variety of parameters are employed to evaluate the well-being of an animal. Especially in the field of biomedical research, scientifically sound tools to assess pain, suffering, and distress for experimental animals are highly demanded due to ethical and legal reasons. For mice, the most commonly used laboratory animals, a valuable tool is the Mouse Grimace Scale (MGS), a coding system for facial expressions of pain in mice. We aim to develop a fully automated system for the surveillance of post-surgical and post-anesthetic effects in mice. Our work introduces a semi-automated pipeline as a first step towards this goal. A new data set of images of black-furred laboratory mice that were moving freely is used and provided. Images were obtained after anesthesia (with isoflurane or ketamine/xylazine combination) and surgery (castration). We deploy two pre-trained state of the art deep convolutional neural network (CNN) architectures (ResNet50 and InceptionV3) and compare to a third CNN architecture without pre-training. Depending on the particular treatment, we achieve an accuracy of up to 99% for the recognition of the absence or presence of post-surgical and/or post-anesthetic effects on the facial expression.
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Pharmacokinetics and clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. J Vet Pharmacol Ther 2020; 43:369-376. [PMID: 32166760 DOI: 10.1111/jvp.12855] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/29/2020] [Accepted: 02/23/2020] [Indexed: 12/01/2022]
Abstract
This study determined the pharmacokinetics and compared the clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. Six healthy horses aged 8.5 ± 3 years and weighing 462 ± 50 kg were anesthetized with isoflurane for 2 hr under standard conditions on two occasions one-week apart. In recovery, horses received 200 μg/kg xylazine or 0.875 μg/kg dexmedetomidine intravenously and were allowed to recover without assistance. These doses were selected because they have been used for postanesthetic sedation in clinical and research studies. Serial venous blood samples were collected for quantification of xylazine and dexmedetomidine, and the pharmacokinetic parameters were calculated. Two individuals blinded to treatment identity evaluated recovery quality with a visual analog scale. Times to stand were recorded. Results (mean ± SD) were compared using paired t tests or Wilcoxon signed-ranked test with p < .05 considered significant. Elimination half-lives (62.7 ± 21.8 and 30.1 ± 8 min for xylazine and dexmedetomidine, respectively) and steady-state volumes of distribution (215 ± 123 and 744 ± 403 ml/kg) were significantly different between xylazine and dexmedetomidine, whereas clearances (21.1 ± 17.3 and 48.6 ± 28.1 ml/minute/kg), times to stand (47 ± 24 and 53 ± 12 min) and recovery quality (51 ± 24 and 61 ± 22 mm VAS) were not significantly different. When used for postanesthetic sedation following isoflurane anesthesia in healthy horses, dexmedetomidine displays faster plasma kinetics but is not associated with faster recoveries compared to xylazine.
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Season's Effects on Some Clinical, Hematological Parameters and Blood Cortisol Level in Sedated Arabian Horses With Xylazine. J Equine Vet Sci 2019; 84:102835. [PMID: 31864466 DOI: 10.1016/j.jevs.2019.102835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/26/2019] [Accepted: 11/05/2019] [Indexed: 11/23/2022]
Abstract
Influence of heat or cold stress in sedated animals is unclear and requires further investigations. The present study aimed to evaluate the season's effects on some clinical, hematological parameters and blood cortisol level in sedated Arabian horses with xylazine. Therefore, seven Arabian horses were used to investigate heart and respiratory rates, and capillary refill time and serum cortisol level were recorded before (0) and at 5, 15, 60, and 180 minutes postsedation. Heparinized venous samples were collected before (0) and 3 hours postsedation for analysis of hematological analysis. Arterial blood samples were collected before and 1 hour postsedation for arterial blood gases and electrolytes analysis. Repeated analysis of variance was performed (P < .05). Significant decreases have been observed in heart and respiratory rates at 5, 15, and 60 minutes postsedation in summer and only at 5 minutes postsedation in winter. Arterial oxygen pressure and arterial carbon dioxide pressure showed a significant decrease and increase, respectively at 1 hour postsedation in summer and winter. The serum cortisol levels were significantly higher in summer than in winter at 5, 15, and 60 minutes postsedation. In summer, the postsedation concentrations of cortisol did not change significantly than its values before sedation. However, in winter, the cortisol concentration decreased significantly at 5, 15, and 60 minutes postsedation compared with their value before sedation. The present study suggests that these season's effects on the sedated Arabian horses could take into consideration in xylazine-sedated Arabian horses.
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The Effects of Xylazine Administration on Peripheral Leukocyte Values in Thoroughbred Horses. J Equine Vet Sci 2019; 81:102738. [DOI: 10.1016/j.jevs.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/26/2019] [Accepted: 05/01/2019] [Indexed: 10/26/2022]
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Effects of a topically applied anaesthetic on the behaviour, pain sensitivity and weight gain of dairy calves following thermocautery disbudding with a local anaesthetic. N Z Vet J 2019; 67:295-305. [PMID: 31272290 DOI: 10.1080/00480169.2019.1640651] [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] [Indexed: 10/26/2022]
Abstract
Aims: To compare the effect of a topically applied anaesthetic to no pain relief or meloxicam on the behavioural responses, pain sensitivity and weight gain of calves following disbudding with or without sedation. Methods: A total of 364, 2-6 week-old calves from three commercial farms were systematically allocated to one of six treatment groups. All calves received a cornual nerve block prior to disbudding, with half restrained in a crate and half sedated with xylazine. Within these groups one third received no further treatment (control), one third were treated with meloxicam >10 minutes prior to disbudding and one third received a topical anaesthetic applied to the horn bud wounds following disbudding. The frequency of ear flicks, head shakes, head scratches and pain sensitivity of the wound were recorded on up to eight occasions over 24 hours after disbudding. Calves were weighed before, and 7 and 28 days after, disbudding to determine average daily weight gain (ADG). Results: Compared to calves in the crate-control group, all other groups had reduced ear flicks at all times following disbudding (p < 0.01). Treatment with meloxicam and topical anaesthesia in addition to sedation reduced head scratches compared to calves in the crate-control group (p ≤ 0.013). At 22 hours after disbudding head shakes were reduced in sedated calves treated with topical anaesthetic compared to calves in the crate-control group (p < 0.001). Pain sensitivity was lower in all sedated calves than unsedated calves (p < 0.001). The ADG between Days 0-7 was 0.14 (95% CI = 0.015-0.274) kg/day greater in sedated calves treated with meloxicam than calves in the crate-control group (p = 0.03), and the ADG between Days 0-28 tended to be 0.06 (95% CI=-0.01-0.13) kg/day greater in sedated calves treated with topical anaesthetic than calves in the crate-control group (p = 0.09). Conclusion and clinical relevance: Sedation of calves for disbudding reduced the pain experienced in the following 24 hours. There was a benefit to providing calves with topical anaesthetic following disbudding on behavioural responses and pain sensitivity, which was similar to that of treating calves with meloxicam.
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Considerations in selecting postoperative analgesia for pregnant sheep following fetal instrumentation surgery. Anim Front 2019; 9:60-67. [PMID: 32002263 PMCID: PMC6952008 DOI: 10.1093/af/vfz019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Efficacy of xylazine in neonatal calves via different routes of administration. Vet J 2019; 247:57-60. [PMID: 30971352 DOI: 10.1016/j.tvjl.2019.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/21/2022]
Abstract
Intramuscular (IM) injections may be more aversive than subcutaneous (SC) and intra-nasal (IN) routes. Xylazine is commonly used as a sedative for cattle, but little is known about efficacy via these routes. The first aim of this study was to compare efficacy using these different routes of administration. The second aim was to determine whether a simple behavioural assessment was associated with physiological responses. Using a within-subject design, the effects of xylazine (0.2mg/kg) were assessed in 12 Holstein calves (6.2±2.8days old) administered via IM, SC, IN drip tube (IN) and IN spray (INs). Sedation was assessed on a scale based on recumbency and eyeball rotation. Heart rate (HR), respiratory rate (RR) and rectal temperature (RT) were recorded for 2h after treatment. Intramuscular and SC routes produced an equivalent mean±standard deviation (SD) onset of sedation (IM: 4.8±2.0min vs. SC: 6.8±2.2min) and duration of sedation (IM: 60.3±25.5min vs. SC: 61.9±23.3min). IN treatments produced less consistent and longer onset times (IN: 33.0±26.9min, and INs: 31.0±15.1min) and a shorter duration of sedation (IN: 42.0±31.5min, and INs: 26.7±21.8min). Behaviour scores were moderately correlated with changes in HR (r=-0.52; CI -0.60, -0.43) and changes in RR (r=-0.42; CI -0.51, -0.32), but not with changes in RT (r=-0.09, CI -0.20, 0.02). We conclude that SC is a viable alternative to the more aversive IM route, and that a simple clinical scale can be useful for assessing xylazine sedation.
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Pharmacokinetic profile and partitioning in red blood cells of romifidine after single intravenous administration in the horse. Vet Med Sci 2017; 3:187-197. [PMID: 29152313 PMCID: PMC5677780 DOI: 10.1002/vms3.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aims of this study were to assess the plasma concentrations of romifidine in horses after intravenous injection, to evaluate the red blood cell (RBC) partitioning of the anaesthetic drug, and to improve knowledge regarding its sedative effect in horses describing the pharmacokinetic model. Eight adult Standardbred horses received a single bolus of romifidine at a dosage of 100 μg/kg. Blood samples (5 mL) were collected immediately before romifidine administration (t0), and at 2, 5, 10, 15, 20, 25, 30, 40, 50, 60, 75, 90, 105, 120, 150 and 180 min after injection. A sedation score was recorded at the same time. The romifidine concentrations in plasma and red blood cells were determined by high performance liquid chromatography (HPLC). The plasma and red blood cell concentrations were correlated with the sedation at each time point. Romifidine produced a satisfactory level of sedation in all animals. The sedation was detectable in all horses for up to 105 min. All the animals returned to normal without any behavioural changes at 180 min. The romifidine concentrations in the red blood cells were significantly higher (P < 0.01) at all time points than those in the plasma. The T1/2β was 148.67 ± 61.59 min and body clearance was 22.55 ± 6.67 mL/kg per min. The results showed that after a single bolus administration of romifidine, a partitioning in the RBCs was detected.
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Hyaluronidase administered with xylazine-tiletamine-zolazepam into adipose tissue shortens recovery from anesthesia in pigs. Vet Anaesth Analg 2017; 44:594-599. [PMID: 28533108 DOI: 10.1016/j.vaa.2016.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the effect of hyaluronidase on uptake, duration and speed of elimination of xylazine-tiletamine-zolazepam administered in the subcutaneous fat over the dorsal lumbar region of swine. STUDY DESIGN Blinded, randomized, crossover study. ANIMALS Six healthy Landrace/Large White pigs weighing 132±24 kg (mean±standard deviation). METHODS Animals were administered xylazine (1 mg kg-1) and tiletamine-zolazepam (8 mg kg-1) (control treatment, CON), or xylazine-tiletamine-zolazepam at the same doses with hyaluronidase (400 IU) (treatment HYA). The treatments were administered into the dorsal lumbar adipose tissue, 2.5-3.0 cm laterally from the spinous process of the second lumbar vertebra. The latency, anesthesia and recovery periods were measured. Heart rate, noninvasive systolic, diastolic, and mean arterial pressures, respiratory rate, hemoglobin oxygen saturation and rectal temperature were recorded every 10 minutes for up to 50 minutes. RESULTS One animal in CON and one animal in HYA were responsive to stimulation and did not allow safe handling. No significant difference was found between treatments for latency (CON 11.3±5.9 minutes, HYA 7.4±5.1 minutes) and anesthesia (CON 53±53 minutes, HYA 49±38 minutes) periods. Recovery period was shorter in HYA (9±6 minutes) than in CON (32±16 minutes) (p < 0.05). Physiological variables were not significantly changed over time and were within accepted normal clinical limits for the species in both treatments. CONCLUSION AND CLINICAL RELEVANCE Hyaluronidase (400 IU) administered into adipose tissue in pigs did not reduce the latency and duration of dissociative anesthesia, but was associated with faster recovery.
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The effect of detomidine on clinical signs, serum electrolytes, electrocardiographic indices, and cardiac arrhythmias in Camelus dromedarius. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s00580-017-2441-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Comparison between the effects of postanesthetic xylazine and dexmedetomidine on characteristics of recovery from sevoflurane anesthesia in horses. Vet Anaesth Analg 2017; 44:273-280. [PMID: 28258815 DOI: 10.1016/j.vaa.2016.04.002] [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] [Received: 01/08/2016] [Revised: 03/31/2016] [Accepted: 04/11/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare postanesthetic xylazine and dexmedetomidine on recovery characteristics from sevoflurane anesthesia in horses. STUDY DESIGN Randomized, crossover study. ANIMALS Six geldings, mean±standard deviation (SD) (range), 17±4 (11-24) years and 527±80 (420-660) kg. METHODS Horses were anesthetized with sevoflurane for 60 minutes under standardized conditions for a regional limb perfusion study. In recovery, horses were administered either xylazine (200 μg kg-1) or dexmedetomidine (0.875 μg kg-1) intravenously. Recoveries were unassisted and were video-recorded for later evaluation of recovery events and quality by two individuals unaware of treatment allocation. Recovery quality was assessed using a 100 mm visual analog scale (VAS) (0=poor recovery, 100=excellent recovery), the Edinburgh Scoring System (ESS) (0-100; 100=excellent recovery) and the mean attempt interval (MAI) (longer=better). Data are mean±SD. RESULTS All recovery quality assessments (xylazine and dexmedetomidine, respectively: VAS: 71±21 mm, 84±13 mm; ESS: 65±22, 67±30; MAI: 52±24 minutes, 60±32 minutes) and events (first limb movement: 37±8 minutes, 42±10 minutes; first attempt to lift head: 44±12 minutes, 48±9 minutes; first attempt to sternal posture: 57±28 minutes, 50±7 minutes; number of head bangs: 2.0±3.0, 0.5±0.5; time to first attempt to stand: 72±6 minutes, 78±13 minutes; time to standing: 79±14 minutes, 84±13 minutes) did not differ significantly between treatments (p>0.05). CONCLUSIONS AND CLINICAL RELEVANCE Recovery characteristics did not differ significantly between postanesthetic xylazine and dexmedetomidine following 1 hour of sevoflurane anesthesia in horses in this study. Further evaluations in more horses and in younger horses are required to confirm these results.
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Differences in Motor Evoked Potentials Induced in Rats by Transcranial Magnetic Stimulation under Two Separate Anesthetics: Implications for Plasticity Studies. Front Neural Circuits 2016; 10:80. [PMID: 27766073 PMCID: PMC5052269 DOI: 10.3389/fncir.2016.00080] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/26/2016] [Indexed: 11/25/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is primarily used in humans to change the state of corticospinal excitability. To assess the efficacy of different rTMS stimulation protocols, motor evoked potentials (MEPs) are used as a readout due to their non-invasive nature. Stimulation of the motor cortex produces a response in a targeted muscle, and the amplitude of this twitch provides an indirect measure of the current state of the cortex. When applied to the motor cortex, rTMS can alter MEP amplitude, however, results are variable between participants and across studies. In addition, the mechanisms underlying any change and its locus are poorly understood. In order to better understand these effects, MEPs have been investigated in vivo in animal models, primarily in rats. One major difference in protocols between rats and humans is the use of general anesthesia in animal experiments. Anesthetics are known to affect plasticity-like mechanisms and so may contaminate the effects of an rTMS protocol. In the present study, we explored the effect of anesthetic on MEP amplitude, recorded before and after intermittent theta burst stimulation (iTBS), a patterned rTMS protocol with reported facilitatory effects. MEPs were assessed in the brachioradialis muscle of the upper forelimb under two anesthetics: a xylazine/zoletil combination and urethane. We found MEPs could be induced under both anesthetics, with no differences in the resting motor threshold or the average baseline amplitudes. However, MEPs were highly variable between animals under both anesthetics, with the xylazine/zoletil combination showing higher variability and most prominently a rise in amplitude across the baseline recording period. Interestingly, application of iTBS did not facilitate MEP amplitude under either anesthetic condition. Although it is important to underpin human application of TMS with mechanistic examination of effects in animals, caution must be taken when selecting an anesthetic and in interpreting results during prolonged TMS recording.
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Pharmacokinetic and pharmacodynamics of xylazine administered to exercised thoroughbred horses. Drug Test Anal 2016; 9:713-720. [DOI: 10.1002/dta.2047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/14/2016] [Accepted: 08/01/2016] [Indexed: 11/06/2022]
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Xylazine Dependence and Detoxification: A Case Report. PSYCHOSOMATICS 2016; 57:529-33. [DOI: 10.1016/j.psym.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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Influence of commonly used pharmaceutical agents on equine bone marrow-derived mesenchymal stem cell viability. Equine Vet J 2016; 49:352-357. [PMID: 27160051 DOI: 10.1111/evj.12590] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 05/01/2016] [Indexed: 12/27/2022]
Abstract
REASON FOR PERFORMING STUDY To provide evidence to support recommendations regarding the co-administration of drugs with mesenchymal stem cell (MSC) therapy. OBJECTIVES To determine the influence of sedatives, local anaesthetic and corticosteroids on MSC viability and proliferation, in comparison to somatic cells derived from tendon (TDCs). STUDY DESIGN In vitro cell culture. MATERIALS AND METHODS MSCs (n = 3) and TDCs (n = 2) were cultured in media containing a clinically relevant dose range of xylazine, romifidine, detomidine and butorphanol, mepivacaine, methylprednisolone, or triamcinolone acetonide. Cell viability in suspension culture was assessed at intervals up to 4 h using the trypan blue dye assay. MSCs in monolayer culture were exposed to the highest concentrations of drug and proliferation was measured using the alamarBlue fluorescence assay. RESULTS Exposure to romifidine or mepivacaine did not significantly affect viability or proliferation rate of MSCs or TDCs at any of the dosages tested. At the highest concentration of detomidine and butorphanol, MSC viability was significantly reduced compared to controls. Although xylazine exposure caused a significant (P < 0.001), dose-dependent reduction in MSC viability compared to controls, overall population viability remained good. Conversely, both methylprednisolone and triamcinolone resulted in the rapid death of significant numbers of MSCs (P < 0.001). CONCLUSIONS Clinicians can sedate horses and administer nerve blocks to assist in intratendinous or intrathecal injection of MSCs with confidence that these drugs will not impact the viability of implanted cells. However, the concomitant use of corticosteroids is likely to have a severely detrimental effect on cell viability and should not be performed. Similarly, steroid administration into the sheath of a damaged tendon is not recommended.
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Effect of Mesenchymal Stem Cell Application on the Distracted Bone Microstructure: An Experimental Study. J Oral Maxillofac Surg 2016; 74:1463.e1-1463.e11. [PMID: 27109711 DOI: 10.1016/j.joms.2016.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/18/2016] [Accepted: 03/18/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE Distraction osteogenesis (DO) is a surgical technique used to regenerate bone. The aim of this study was to improve bone quality and quantity during DO by the addition of mesenchymal stem cells (MSCs). MATERIALS AND METHODS The study was conducted on 12 goats assigned to a study group or a control group. In the study group, DO was aided with MSCs. Bone quality was assessed using energy dispersive x-ray (EDX), a scanning electron microscope (SEM), and histology. The histologic assessment was performed by measuring trabecular bone (TB) thickness in sections stained with hematoxylin and eosin (H&E) and by measuring osteoid bone percentage in sections stained with Masson trichrome (MT). RESULTS EDX showed an increase in calcification in the study group (mean Ca(2+), 17.58%; standard deviation [SD], 4.9%) compared with the control group (mean Ca(2+), 14.17%; SD, 6.7%). However, the increase was not statistically significant (P = .3354). Histomorphometric analysis of the H&E samples showed an increase in TB size in the study group (mean TB, 174.7 μm; SD, 33.5 μm) compared with the control group (mean TB, 115.4 μm; SD, 19.6 μm), and the increase was highly statistically significant (P = .0039). Analysis of the MT samples showed a decrease in osteoid percentage (mean osteoid percentage, 13.4%; SD, 2%) in the study group compared with the control group (mean osteoid percentage, 27.3%; SD, 3.5%). The decrease in osteoid percentage was statistically significant (P = .0001), indicating more rapid healing in the study group compared with the control group. CONCLUSION MSCs improved the bone quality of distracted bone and increased the crystal density in SEM images of the study group compared with that of the control group. MSCs showed promising results in improving the quality and quantity of distracted bone.
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Sedative and cardiopulmonary effects of xylazine alone or in combination with methadone, morphine or tramadol in sheep. Vet Anaesth Analg 2016; 43:179-88. [DOI: 10.1111/vaa.12296] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 05/12/2015] [Indexed: 11/26/2022]
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Quantification of horse plasma proteins altered by xylazine using the fluorogenic derivatization-liquid chromatography-tandem mass spectrometry. J Equine Sci 2016; 26:141-6. [PMID: 26858580 PMCID: PMC4739145 DOI: 10.1294/jes.26.141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 11/09/2015] [Indexed: 01/10/2023] Open
Abstract
In the doping tests currently used in horse racing, prohibited substances or their metabolites are usually
directly detected in urine or blood samples. However, despite their lasting pharmaceutical effects, some
prohibited substances are rapidly eliminated from horse urine and blood, making them difficult to detect.
Therefore, new indirect biomarkers for doping, such as plasma proteins that are increased by the prohibited
substances, have recently attracted much attention. Here, a fluorogenic derivatization-liquid
chromatography-tandem mass spectrometry (FD-LC-MS/MS) method was adopted for horse plasma proteomics analysis,
in order to identify plasma proteins whose concentrations were altered in response to xylazine in Thoroughbred
horses. Xylazine, which is rapidly absorbed and eliminated and has possibility of the change in the levels of
plasma proteins, was selected as a model drug. Of the ten plasma proteins identified, four proteins, including
three acute phase proteins (haptoglobin, ceruloplasmin, and α-2-macroglobulin-like), were significantly
increased after xylazine administration. Therefore, our present approach might be useful in identifying
indirect biomarkers of drug administration.
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Phospholipid Adsorption Polymeric Materials for Detection of Xylazine and Metabolite in Blood and Urine. INT J POLYM SCI 2016. [DOI: 10.1155/2016/3682167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Polymers have been used in different areas. Recently, polymeric material is favored in analytical area due to its high performance and high consistency, which was used in sample pretreatment in this study. Xylazine poisoning is often seen in body fluid samples obtained from various accidents or suicides. However, the content of xylazine is difficult to detect precisely due to matrix effect in testing practices. In this paper, a method application for phospholipid adsorption polymeric materials to determine xylazine in blood and urine samples was proposed, developed, and validated. Compared with existing method, this method using polymeric pretreatment has a wider linear range of 2.0–2000.0 ng/mL for xylazine and its metabolite 2,6-dimethylaniline in both blood and urine and lower detection limits of 0.3 ng/mL for 2,6-dimethylaniline and xylazine in blood and 0.2 ng/mL for 2,6-dimethylaniline and xylazine in urine. Therefore, this method is suggested to be applied in testing practices by academic groups and commercial organizations.
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Effect of sedation on fore- and hindlimb lameness evaluation using body-mounted inertial sensors. Equine Vet J 2015; 48:603-7. [DOI: 10.1111/evj.12463] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 05/18/2015] [Indexed: 12/01/2022]
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Quantitation of the anaesthetic xylazine in ovine plasma by LC–MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 997:81-4. [DOI: 10.1016/j.jchromb.2015.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 05/23/2015] [Accepted: 06/04/2015] [Indexed: 11/26/2022]
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Endoscopic-Assisted Resection of a Pedunculated Uterine Leiomyoma With Maximal Tissue Preservation in a Cow and a Mare. Vet Surg 2014; 44:200-5. [DOI: 10.1111/j.1532-950x.2014.12257.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 11/01/2012] [Indexed: 11/30/2022]
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Pharmacokinetics and pharmacodynamics of xylazine administered by the intravenous or intra-osseous route in adult horses. J Vet Pharmacol Ther 2014; 37:565-70. [DOI: 10.1111/jvp.12136] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 05/02/2014] [Indexed: 11/29/2022]
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Cardiopulmonary effects of dexmedetomidine and ketamine infusions with either propofol infusion or isoflurane for anesthesia in horses. Vet Anaesth Analg 2014; 42:39-49. [PMID: 24984762 DOI: 10.1111/vaa.12194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 03/17/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the cardiopulmonary effects of two anesthetic protocols for dorsally recumbent horses undergoing carpal arthroscopy. STUDY DESIGN Prospective, randomized, crossover study. ANIMALS Six horses weighing 488.3 ± 29.1 kg. METHODS Horses were sedated with intravenous (IV) xylazine and pulmonary artery balloon and right atrial catheters inserted. More xylazine was administered prior to anesthetic induction with ketamine and propofol IV. Anesthesia was maintained for 60 minutes (or until surgery was complete) using either propofol IV infusion or isoflurane to effect. All horses were administered dexmedetomidine and ketamine infusions IV, and IV butorphanol. The endotracheal tube was attached to a large animal circle system and the lungs were ventilated with oxygen to maintain end-tidal CO2 40 ± 5 mmHg. Measurements of cardiac output, heart rate, pulmonary arterial and right atrial pressures, and body temperature were made under xylazine sedation. These, arterial and venous blood gas analyses were repeated 10, 30 and 60 minutes after induction. Systemic arterial blood pressures, expired and inspired gas concentrations were measured at 10, 20, 30, 40, 50 and 60 minutes after induction. Horses were recovered from anesthesia with IV romifidine. Times to extubation, sternal recumbency and standing were recorded. Data were analyzed using one and two-way anovas for repeated measures and paired t-tests. Significance was taken at p ≤ 0.05. RESULTS Pulmonary arterial and right atrial pressures, and body temperature decreased from pre-induction values in both groups. PaO2 and arterial pH were lower in propofol-anesthetized horses compared to isoflurane-anesthetized horses. The lowest PaO2 values (70-80 mmHg) occurred 10 minutes after induction in two propofol-anesthetized horses. Cardiac output decreased in isoflurane-anesthetized horses 10 minutes after induction. End-tidal isoflurane concentration ranged 0.5%-1.3%. CONCLUSION AND CLINICAL RELEVANCE Both anesthetic protocols were suitable for arthroscopy. Administration of oxygen and ability to ventilate lungs is necessary for propofol-based anesthesia.
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Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: A comprehensive review of the literature. Forensic Sci Int 2014; 240:1-8. [PMID: 24769343 DOI: 10.1016/j.forsciint.2014.03.015] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 02/28/2014] [Accepted: 03/12/2014] [Indexed: 10/25/2022]
Abstract
Xylazine is not a controlled substance; it is marketed as a veterinary drug and used as a sedative, analgesic and muscle relaxant. In humans, it could cause central nervous system depression, respiratory depression, bradycardia, hypotension, and even death. There have been publications of 43 cases of xylazine intoxication in humans, in which 21 (49%) were non-fatal scenarios and 22 (51%) resulted in fatalities. Most of the non-fatal cases required medical intervention. Over recent years xylazine has emerged as an adulterant in recreational drugs, such as heroin or speedball (a cocaine and heroin mixture). From the 43 reported cases, 17 (40%) were associated with the use of xylazine as an adulterant of drugs of abuse. Its chronic use is reported to be associated with physical deterioration and skin ulceration. Literature shows some similar pharmacologic effects between xylazine and heroin in humans. These similar pharmacologic effects may create synergistic toxic effects in humans. Therefore, fatalities among drug users may increase due to the use of xylazine as an adulterant. Xylazine alone has proven harmful to humans and even more when it is combined with drugs of abuse. A comprehensive review of the literature of non-fatal and fatal xylazine intoxication cases including those in which the substance was used as adulterant is presented, in order to increase the awareness in the forensic community, law enforcement, and public health agencies.
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A pharmacokinetic/clinical approach to postulate a local action of intra-articular xylazine administration in the horse: a preliminary study. J Vet Pharmacol Ther 2014; 37:464-71. [DOI: 10.1111/jvp.12110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 01/12/2014] [Indexed: 11/26/2022]
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Sedative and clinical effects of the pharmacopuncture with xylazine in dogs. Acta Cir Bras 2014; 29:47-52. [DOI: 10.1590/s0102-86502014000100007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/20/2013] [Indexed: 11/22/2022] Open
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Abstract
Euthanasia of stranded large whales poses logistic, safety, pharmaceutical, delivery, public relations, and disposal challenges. Reasonable arguments may be made for allowing a stranded whale to expire naturally. However, slow cardiovascular collapse from gravitational effects outside of neutral buoyancy, often combined with severely debilitating conditions, motivate humane efforts to end the animal's suffering. The size of the animal and prevailing environmental conditions often pose safety concerns for stranding personnel, which take priority over other considerations. When considering chemical euthanasia, the size of the animal also necessitates large quantities of euthanasia agents. Drug residues are a concern for relay toxicity to scavengers, particularly for pentobarbital-containing euthanasia solutions. Pentobarbital is also an environmental concern because of its stability and long persistence in aquatic environments. We describe a euthanasia technique for stranded mysticetes using readily available, relatively inexpensive, preanesthetic and anesthetic drugs (midazolam, acepromazine, xylazine) followed by saturated KCl delivered via custom-made needles and a low-cost, basic, pressurized canister. This method provides effective euthanasia while moderating personnel exposure to hazardous situations and minimizing drug residues of concern for relay toxicity.
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Effects of dexmedetomidine and xylazine on cardiovascular function during total intravenous anaesthesia with midazolam and ketamine and recovery quality and duration in horses. Vet Anaesth Analg 2013; 41:25-35. [PMID: 24127757 DOI: 10.1111/vaa.12095] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 02/20/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To compare cardiovascular effects and recovery quality and duration of total intravenous anaesthesia (TIVA) with xylazine-ketamine-midazolam or dexmedetomidine-ketamine-midazolam. STUDY DESIGN Prospective, randomized experimental cross-over trial. ANIMALS Eight adult warmblood horses. METHODS After sedation with acepromazine and either xylazine [0.5 mg kg(-1) , intravenously (IV)] or dexmedetomidine (3.5 μg kg(-1) IV) anaesthesia was induced with ketamine and midazolam and maintained with a constant rate infusion (CRI) of xylazine (1 mg kg(-1) hour(-1) ) [XKM] or dexmedetomidine (7 μg kg(-1) hour(-1) ) [DKM] in combination with midazolam (0.1 mg kg(-1) hour(-1) ), and ketamine infusion (initially 3 mg kg(-1) hour(-1) ) for 120 minutes. Ketamine infusion rate was increased in response to positive reactions to electrical nociceptive stimulation performed every 30 minutes. Heart rate (HR), mean arterial blood pressure (MAP) and cardiac output (Q˙t) were measured before treatment (baseline), after sedation (not Q˙t), and during anaesthesia. Xylazine, dexmedetomidine, midazolam and ketamine kinetics were calculated, from plasma drug concentrations. Twenty minutes after end of TIVA, flumazenil (0.01 mg kg(-1) IV) was administered. Recovery quality and duration were assessed. Two-way analysis of variance with repeated measurements or Wilcoxon signed rank test as relevant were used to analyse data with an alpha of 5%. RESULTS Compared to baseline, MAP did not change, while similar, but limited, decreases in HR and Q˙t were observed in both TIVA's. Mean ketamine doses of 3.7 mg kg(-1) hour(-1) were required with both treatments. Plasma concentrations of dexmedetomidine and xylazine showed high intra- and inter-individual changes with elimination half-lifes of 46 ± 7 minutes and 64 ± 13 minutes, respectively. Recovery quality was good to excellent with mean duration of 37 ± 16 and 46 ± 21 minutes after stopping TIVA with XKM and DKM, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Both drug combinations are suitable to maintain anaesthesia for two hours, with good cardiovascular and good to excellent recovery conditions.
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In vivo and in vitro effects of neostigmine on gastrointestinal tract motility of horses. Am J Vet Res 2013; 74:579-88. [PMID: 23531066 DOI: 10.2460/ajvr.74.4.579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the response to neostigmine of the contractile activity of the jejunum and pelvic flexure and the effects of a continuous rate infusion (CRI) of neostigmine in horses. ANIMALS 7 adult horses and tissue from 12 adult horses. PROCEDURES A CRI of neostigmine (0.008 mg/kg/h) or placebo was administered to 6 horses in a crossover study design. Gastric emptying was evaluated by the acetaminophen test. The frequency of defecation and urination and the consistency and weight of feces were recorded throughout the experiment. The effect of neostigmine on smooth muscle contractile activity was evaluated in tissues from the jejunum and pelvic flexure. The effect of neostigmine and acetylcholine after incubation with muscarinic receptor antagonists (atropine and DAU 5884) and an acetylcholinesterase inhibitor (edrophonium) was also investigated in vitro. RESULTS No difference was observed between neostigmine and placebo for time to reach peak plasma acetaminophen concentration and absorption rate constant. A CRI of neostigmine increased fecal production and frequency of urination. Neostigmine induced a dose-dependent increase of contractile amplitude in jejunum and pelvic flexure muscle strips. Incubation of muscle strips with atropine and DAU 5884 inhibited the response to acetylcholine and neostigmine. Incubation of smooth muscle strips from the jejunum with edrophonium increased the response to acetylcholine and had no effect on the response to neostigmine in vitro. CONCLUSIONS AND CLINICAL RELEVANCE A CRI of neostigmine increased fecal production and urination frequency in horses. A CRI of neostigmine did not decrease gastric emptying. Neostigmine stimulated contractile activity of jejunum and pelvic flexure smooth muscle strips in vitro.
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