Effects of vatinoxan on cardiorespiratory function, fecal output and plasma drug concentrations in horses anesthetized with isoflurane and infusion of medetomidine

A constant rate infusion (CRI) of medetomidine is used to balance equine inhalation anesthesia, but its cardiovascular side effects are a concern. This experimental crossover study aimed to evaluate the effects of vatinoxan (a peripheral α2-adrenoceptor antagonist) on cardiorespiratory and gastrointestinal function in anesthetized healthy horses. Six horses received medetomidine hydrochloride 7 μg/kg IV alone (MED) or with vatinoxan hydrochloride 140 μg/kg IV (MED + V). Anesthesia was induced with midazolam and ketamine and maintained with isoflurane and medetomidine CRI for 60 min. Heart rate, carotid and pulmonary arterial pressures, central venous pressure, cardiac output and arterial and mixed venous blood gases were measured. Selected cardiopulmonary parameters were calculated. Plasma drug concentrations were determined. Fecal output was measured over 24 h. For statistical comparisons, repeated measures analysis of covariance and paired t-tests were applied.Heart rate decreased slightly from baseline in the MED group. Arterial blood pressures decreased with both treatments, but significantly more dobutamine was needed to maintain normotension with MED + V (P = 0.018). Cardiac index (CI) and oxygen delivery index (DO2I) decreased significantly more with MED, with the largest difference observed at 20 min: CI was 39 ± 2 and 73 ± 18 (P = 0.009) and DO2I 7.4 ± 1.2 and 15.3 ± 4.8 (P = 0.014) mL/min/kg with MED and MED + V, respectively. Fecal output or plasma concentrations of dexmedetomidine did not differ between the treatments. In conclusion, premedication with vatinoxan induced hypotension, thus its use in anesthetized horses warrants further studies. Even though heart rate and arterial blood pressures remained clinically acceptable with MED, cardiac performance and oxygen delivery were lower than with MED + V.</p

Investigation of the treatment of sand accumulations in the equine large colon with psyllium and magnesium sulphate

Enteropathy associated with sand accumulation in the large colon of horses has been reported worldwide. Intestinal sand accumulations are commonly treated medically, but randomised controlled clinical trials on horses are scarce. This prospective study evaluated the efficacy of an enterally administered combination of psyllium and magnesium sulphate (MgSO4) for the removal of large colonic sand accumulations in horses without clinical signs of acute colic. The two groups comprised 20 untreated control horses and 20 horses treated with 1g/kg bodyweight (bwt) of psyllium and 1g/kg bwt of MgSO4 administered by nasogastric intubation once daily for 4 days. Both groups had no access to soil during the study period. The amounts of accumulated sand were evaluated radiographically before and after treatment. Significantly more treated horses cleared their sand accumulations than horses in the control group. This clearance was determined by observing the estimated quantity by area of sand remaining in the large colon (PPeer reviewe

Promoting veterinary medication safety – Exploring the competencies of community pharmacy professionals in veterinary pharmacotherapy

The science of veterinary medicine is currently lacking studies on medication safety, although its importance in protecting animals from medication errors is central. Pharmacy professionals have an important role in ensuring medication safety of both prescription and over-the-counter medications of animals. However, this requires adequate competencies of pharmacy professionals in veterinary pharmacotherapy. The present study aimed to explore the competencies of pharmaceutical staff in community pharmacies in veterinary pharmacotherapy, which factors influence these competencies and what kind of information sources they typically use on veterinary pharmacotherapy.The study was conducted as a cross-sectional online survey targeted to pharmacy professionals in the Finnish community pharmacies, providing 596 responses. Less than half of the respondents (41%, n = 246) are considered to possess good competencies in veterinary pharmacotherapy. A third of the respondents (35%, n = 211) would dispense an anti-inflammatory drug for an animal off-label, whereas 24% (n = 145) would not interview the pet owner to discover the need for internal parasite medication before dispensing the drug. A small proportion (<1%, n = 5) would have dispensed a broad-spectrum internal parasite medication. Approximately a quarter of the respondents (27%, n = 159) stated that they acquired information on pharmacotherapy only from the material produced by the manufacturers of veterinary drugs.The competencies of pharmacy professionals in veterinary pharmacotherapy need to be strengthened in many areas to better promote veterinary medication safety. It should also be ensured that pharmacy professionals can access and use independent, high-quality information on veterinary pharmacotherapy

Clinical effects and pharmacokinetic variables of romifidine and the peripheral α2‐adrenoceptor antagonist MK‐467 in horses

Objectives: To investigate the effects of MK‐467 on sedation quality, and cardiopulmonary and pharmacokinetic variables in horses sedated intravenously (IV) with romifidine. Study design: Experimental, randomized, crossover design. Animals: Seven healthy mares. Methods: Romifidine (80 μg kg−1; R) and MK‐467 (200 μg kg−1; MK) were administered IV alone and in combination (R + MK). Levels of sedation and borborygmi were scored. Heart rate (HR), direct arterial blood pressure (ABP) and respiratory rate (fR) were recorded. Arterial and venous blood gas analyses were performed and venous plasma drug concentrations were measured. Pharmacokinetic parameters were calculated. Linear mixed modelling for repeated measures, contrasts of least square means by Bonferroni correction tests, one‐way ANOVA for repeated measures with Bonferroni multiple comparison tests and paired Student's t‐tests were used to compare results within and between treatments as appropriate. Significance was set at p < 0.05. Results: After R, ABP increased and HR and fR decreased significantly. After R + MK, HR, fR, systolic and mean ABP decreased. MK alone increased both HR and fR. After R, ABP was significantly higher than after R + MK. HR and fR were significantly higher after MK than after R and R + MK. Areas under the curve for sedation time were similar after R and R + MK. Intestinal activity decreased markedly after R and less after R + MK. Volume of distribution and clearance of romifidine were significantly higher and area under the concentration time curve extrapolated to infinity significantly lower after R + MK than after R. Conclusions: Combined romifidine and MK‐467 prevented the cardiovascular changes commonly seen with romifidine but did not affect sedation quality. Clinical relevance: Combined IV romifidine and MK‐467 can be used to attenuate the cardiovascular effects of romifidine, such as in horses with colic or undergoing general anaesthesia. © 2016 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesi