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ANESTHESIA - 2 > 34 – Exotic Pet Analgesia > Flashcards

34 – Exotic Pet Analgesia Flashcards

1
Q

Overall what is important about small animals metabolic rates?

A
  • FASTER metabolic rate
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2
Q

Prey species: pain recognition

A
  • Most HIDE signs of sickness or pain
  • May pretend to eat/groom in stressful situations
  • *Difficult to assess pain
  • Observer bias can make studies different
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3
Q

Recognizing pain in small mammals

A
  • Mostly prey species
  • Body position/posture
  • Activity and attitude changes
  • Unkempt hair coat
  • Appetite and fecal production
  • Facial expression: grimace scale
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4
Q

Rat grimace scale: components

A
  • Orbital tightening
  • Nose/cheek flattening: absence of crease b/w cheek and whisker pads
  • Ear changes=pointed shape
    o Some rats have ears naturally to the sides (genetic selection)
  • Whisker change: move forward away from face
    o Ferrets: if go back=pain (DIFFERENCE!)
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5
Q

‘blood’ stain around the eyes

A
  • NOT BLOOD
  • Pigment released from lacrimal gland (goes in urine of rabbits)
  • *NON-SPECIFIC: stress, overcrowding, illness, just not doing well
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6
Q

Rabbits analgesia: info

A
  • Many drugs tested on them, but info difficult to find
  • Studies on young, healthy animals
  • Shorter time frames
  • Small number of animals
  • Studies NOT usually looking at analgesia (often looking at toxic effects, PK)
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7
Q

Ferrets and opioids

A
  • LOWER dosages compared to other small mammals (similar to cats: ‘little cat’)
  • Buprenorphine: SQ not great (like cats)
    o IM or IV
  • Predator
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8
Q

Guinea pigs and chinchillas: opioids

A
  • Dosages for analgesia are 10x those of a cat!
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9
Q

Opioids: variety of routes available

A
  • IM, SC for sedation
  • IV, IM, SC for hospitalized patients
  • Oral transmucosal (OTM): limited absorption, but can be administered more often
    o Herbivore: more keratinized mucosa=don’t go through as well, so give higher dosages (10x the dose, some going orally, but wont do anything)
    o Difficult for most people to do AT HOME
    o *expensive (buprenorphine)
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10
Q

Tramadol studies (opioids)

A
  • Not analgesic in chinchillas and can get neurological signs
  • Rabbits maybe at higher doses but not reliable
  • *limited at home use
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11
Q

Hydromorphone in chinchilla

A
  • Analgesia at a minimum (2mg/kg) and slows GI transit
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12
Q

NSAID: analgesia

A
  • *Meloxicam is most commonly used
  • Ferrets more similar to small animals patients (dogs and cats)
  • Lacking studies
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13
Q

*NSAIDs in rabbits

A
  • Tolerated well (can’t vomit)
    o Tastes good=take it well
  • No drug accumulation or toxicosis in liver, urinary bladder, GIT, kidneys
  • *limited: only young, healthy rabbits
  • *give 1mg/kg (5x higher) and give twice daily!
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14
Q

Lidocaine analgesia

A
  • Can be administrated CRI, alone or with other agents
  • CRI demonstrated to provide better analgesia than buprenorphine
  • *good for VISCERAL PAIN
  • Lidocaine and bupivacaine used for local blocks and epidural
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15
Q

Analgesia protocol:

A
  • Choose opioid base on estimated intensity of pain
    o Buprenorphine has plateau effect: MODERATE
    o Hydromorphone, morphine or fentanyl: INTENSE
  • *opioid + NSAID
  • *opioid + lidocaine CRI in rabbits
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16
Q

Avian ‘differences’

A
  • KIDNEYS
  • *Fast metabolism (especially psittacine): high body temperature
    o Need higher doses
  • Mostly done on poultry: does NOT work to compare to parrots
17
Q

Pain recognition in birds

A
  • *Squinty eyes: ‘I am unwell’
  • Laying low, hunched
  • Fluffed feathers (puffier): unless a baby bird
18
Q

Avian analgesia: opioid receptors?

A
  • DIFFERENCES between avian orders!
  • Most psittacine evaluated: Hispaniolan Amazon Parrot (HAP)
  • *thought that they had more kappa receptors: use butorphanol
    o NOT true across the board!
19
Q

Opioids in psittacine (parrots, buggies, etc.)

A
  • Butorphonal: opioid of choice
  • Tramadole
    o If give lots=can produce analgesia, give every 8 hrs (oral administration)
20
Q

Butorphanol in psittacines

A
  • More Kappa receptors
  • Short half-life, need to re-dose often!
    o Challenge
  • Can do CRI
  • Liposome encapsulated formulation in but not commercially available
21
Q

Opioids in raptors

A
  • Mu receptors more represented
  • Majority of research on kestrels (falcons)
    o May be different for other raptor species
  • *hydromorphone (buprenorphine doesn’t work great)
    o Effective at range of dosages
    o Significant sedation at high disease
    o Dose every 3-6 hours
  • Butorphanol=considered ineffective
22
Q

Buprenorphine in raptors

A
  • Similar to hydromorphone
  • Does not sedate as much
  • Sex differences
23
Q

Tramadol in raptors

A
  • Small raptors: higher PK=higher doses
24
Q

NSAIDs in psittacines

A
  • High metabolism=higher dosages
  • *meloxicam
    o Twice daily
    o Well tolerated (not many hepatic or renal effects)
  • Flunixin-meglumine: does not work well
25
Q

NSAIDs in raptors

A
  • No PK or PD studies
  • Diclofenac=TOXIC
  • Carprofen, flunixin, phenylbutazone=toxic, but not as lethal
  • *restrict it to meloxicam=safe
26
Q

Reptiles metabolism

A
  • Slow metabolism
    o Lower dosages
    o Longer duration
    o Slower absorption
  • *depends on environment
27
Q

Reptiles pain or no pain?

A
  • YES, just don’t show you
    o *not dramatic
  • *if you think painful to human=probably painful in reptile
28
Q

Evidence for pain perception in reptiles

A
  • Behavioural response to painful stimuli
  • ID of pain pathways
  • Demonstration of effective analgesia
29
Q

Signs of pain in reptiles

A
  • May not be observed
  • Aggression in predators species
  • Chelonians: stretch neck, close eyes, bite
  • Snakes: restless (MORE ACTIVE), easily startled, agitated, less coiled, tuck away painful area
  • Lizards: postural changes, flicking at area
30
Q

Reptiles: opioids

A
  • Some mu and some kappa (difficult to extrapolate)
  • Hard to assess sedative effect
  • Varying absorption when drug administered in pelvic limbs
31
Q

Chelonians and opioids

A
  • Mu agonists provide the best analgesia
  • Morphine: higher dose than mammals
    o Monitor side effects
  • Hydromorphone superior to buprenorphine in red-eared sliders
  • Tramadol provides analgesia with minimal respiratory depression
32
Q

Lizards and opioids

A
  • Pure mu-agonists
  • Butorphanol not great
  • Morphine can work
33
Q

Snakes and opioids

A
  • Differ from lizards and chelonians
  • Corn snakes: butorphanol superior to morphine
  • Fentanyl patches tested: high plasma concentration, but no change in thermal nociception
34
Q

Reptiles: NSAIDs

A
  • *meloxicam
  • Low dosages and frequencies due to slower metabolism
  • Limited PK and PD studies

ANESTHESIA - 2 (15 decks)

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