Equine, Large + Production Animal Therapeutics Flashcards
Adrenaline
- Inc duration of action of local anaesthetic
- AE: neuro injury
Procaine (+ adrenaline) = adrenacaine
- Local anaesthetic
- Onset = 15 - 20 min
- Duration = 1 - 1.5 h
- Max dose = 2 mg/kg
- Cattle + horses, ruminants, camelids
Lidocaine
- Onset = 5 - 10 min
- Duration = 1 h
- Max dose = 4 - 6 mg/kg
- Not licensed in ruminants
- Allowed list for FPAs - HORSES
Lidocaine (+ adrenaline)
- Onset = 5 - 10 min
- Duration = 2 h
- Max dose = 4 - 6 mg/kg
- Licensed for horses
- Allowed list for FPAs
Mepivacaine
- Onset = 10 - 15 min
- Duration = 2 h
- Max dose = 4 - 6 mg/kg
- Licensed for horses
Bupivacaine
- Onset = 15 - 20 min
- Duration = 6 -8 h
- Max dose = 2 mg/kg
- Not licensed
Xylazine, Detomidine
- Alpha 2 agonist -> sedation
- Some analgesic + muscle relaxant properties
- Cattle, horses, cats, dogs
- Handling fractious animals, medical examination, pre-med - local/regional anaesthesia
- Atipamezole = antagonist (Banned use in FPA)
- Pigs (1 - 3 mg/kg) - not great sed, provide some calming, duration 30 min
- Risk of abortion - cause smooth muscle relaxation
Morphine
- Epidural
- Intra-articular
- Horses only
- AE: urinary retention
Flunixin (flunixin meglumine)
- NSAID - systemic
- Analgesia
- Pig, horse, ruminants
- Endotoxaemia - blocks inflam pathway, COX pathways that cause systemic inflam = toxin-binding, LDA
- Toxic mastitis in cattle; puerperal (toxic) metritis; clinical metritis; manual reduction of twin pregnancy in mare; uterine laceration; uterine prolapse
- E.g. Post-op care - GI disorders - pain/colic/visceral pain
Ketoprofen (Ketofen)
- NSAID
- Analgesia
- Pig
- Ruminants
- 0 d milk withdrawal
- Multiple doses
Meloxicam (Metacam)
- NSAID
- Analgesia
- Pig = IM + oral licensed
- Most readily available, one dose
- Ruminants
- Can provide 48 h of analgesia
- Not licensed in goats
Butorphanol
- Opioid
- Analgesia
- Only licensed in horses
- Not licensed - pigs, ruminants
- In addition to xylazine - ruminants
Procaine +/- xylazine
- Local anaesthesia
- Pig, ruminants - only LA licensed in farm animals
Isoflurane
- Inhalation anaesthesia
- Licensed in FPA - horses
- Pigs - cascade
- AEs: malignant hyperthermia in Landracs, Pietrain + Duroc pig breeds, muscle rigidity
Azaperone
- Pigs
- Light-mod sedation/calming
- Pigs (0.5 - 2 mg/kg deep IM)
- Low dose in boars intended for breeding (max 1 mg/kg), risk of penis extrusion + damage
- Neuroleptic sedative - Tx of aggression, stress, obstetric conditions, pre-med in local + GA
- Highest dose may result in lying down + reduced movement
- Overall reduction in aggressiveness
- Pre-med
- Duration = 1 - 2 h
- Onset sed = 15 min (quick)
- AEs - vasodilation -> enlargement of penis (high dose)
Ketamine
- Induction injectable anaesthesia - in combo w/ xylazine (horse, cattle, dog, cat) - licensed
- Induction injectable anaesthesia - in combo w/ azaperone (pig)
- Restraint + minor Sx (cat)
- AEs: high dose -> muscle rigidity -> muscle fasciculations, inc salivation (can regurg/aspirate)
- Gastric protectant - become more in control to swallow food
- Not licensed when used for sedation - lower doses
- Licensed @ 15 - 20 mg/kg = pain relief
Buscopan
- Antimuscarinic
- Urolithiasis - if no rupture/blocked urethra, unlicensed in ruminants
- Camelids
- Colic (horses)
Tetanus antitoxin
- Given pre-op in horses to prevent tetanus infection from wounds
Trimethoprim/sulfamethoxazole (TMPS)
- Systemic AB
- Potentiated sulphonamide
- Horse
- Ruminant - non-contaminated abdominal Sx
- Ruminant - suspected/known beta-lactamase resistance Sx
- DOES NOT WORK WALL IN PRESENCE OF PUS
Azaperone + Ketamine
- Pigs
- 2 mg/kg azaperone + 15 - 20 mg/kg ketamine
- Anaesthesia for minor Sx
- Duration = 30 min
- Onset sed = 30 min (long)
Ketamine + Xylazine + Butorphanol
- Anaesthesia in pigs
- 5 mg/kg ketamine, 1 - 3 mg/kg xylazine, 0.1 - 0.2 mg/kg butorphanol
- Can top up w/ ketamine q 20 min
- Duration 40 - 60 min
Oxytocin
- Encourages uterine involution
- Post uterine prolapse
Carprofen (Rymadyl)
- NSAID
- Ruminants
- 0 d milk withdrawal
Metaclopramide
- Prokinetic
- 5-HT receptor agonist + dopaminergic antagonist
- Narrow therapeutic window
- Dose-dependant - if give too much -> neuro signs
- Post-op ileus (horse)
Lidocaine
- Weak evidence for prokinetic activity (horse, post-op ileus)
- Anti-inflam - help gut to recover + normal gut motility
- Post-op analgesic, dec hospitalisation time
- Short half-life, neuro signs resolve if infusion stopped
- Loading dose: 1.3 mg/kg - admin over 10 min IV
- CRI: 0.05 mg/kg/min
Phenylbutazone
- NSAID - analgesia
- Prostaglandin inhibitor -> anti-inflam
- Orthopaedic pain
- Post-anaesthesia/Sx analagesia - IV at time of Sx, PO for 5 d
- Horse
Phenylephrine
- Alpha-1 adrenergic agonist - peripheral vasoconstriction -> inc diastolic + inc systolic BP =
- Phenothiazine-induced hypotension
- Nephrosplenic entrapment - This causes the spleen to contract, which helps to dislodge the colon from the nephrosplenic space
- Anaesthetic-induced hypotension - horse
Clenbuterol
- Beta agonist
- HR + contractility increase, blood flow increases to the muscles and is reduced to splanchnic organs (abdo/GIT), glycogenolysis and lipolysis increase
- Inc abdo contraction
- Hypotension anaesthesia - horse
- C-section
Dobutamine
- Vasodilator
- Ionotropic - increases contractility, leading to decreased end-systolic volume and, therefore, increased stroke volume, increases blood pressure
- Horse
Glyceryl Guaicolate Ether (GGE) / Guaifenesin
- Central muscle relaxant
- Horse - induction + ketamine
- IV to effect
- Variable rate infusion (triple drip) 10% 500 mL
- Causes ataxia, dec dose w/ midazolam
- Horse
Prilocaine
- EMLA cream
- Local anaesthetic
- Horse
Acepromazine (horse)
- Sedation - onset = 30 min
- 0.04 - 0.05 mg/kg IM - 20 mg standard horse; 10 mg standard pony
- Phenothiazine
- Desirable effects - mild sed, improves recovery quality, anti-arrhythmic, vasodilation
- Caution in entire males - causes protrusion of penis, persistent erection may occur - don’t use in breeding stallion
Xylazine (horse)
- Alpha-2 agonist
- Pre-med - 0.5 - 1 mg/kg
- Intermittent IV bolus - 1/2 pre-med dose w/ every top up
- Variable rate infusion (triple drip) - 100 mg/mL 5 mL / 20 mg/mL 25 mL
Detomidine (horse)
- Alpha-2 agonist
- Pre-med - 10 - 20 µg/kg
- Intermittent IV bolus - 1/2 pre-med dose every other top up
- Variable rate infusion (triple drip) - 10 mg/mL 1 mL
Romifidine (horse)
- Alpha-2 agonist
- Pre-med - 80 - 100 µg/kg
Butorphanol (horse)
- Opioid
- Pre-med - 0.2 mg/kg, onset 2 - 5 min, duration 30 - 60, IV
Buprenorphine (horse)
- Opioid
- Pre-med - 10µg/kg, onset 30 - 45 min, duration 12 - 24 h, IV
Pethidine (horse)
- Opioid
- Pre-med - 5 mg/kg, onset 2 - 5 min, duration 1 - 2 h, IM only
- Large amount given
Morphine (horse)
- Opioid
- Pre-med - 0.12 mg/kg, onset 10 - 20 min, 4 - 6 h, IM or slow IV
- Unlicensed
Ketamine (horse)
- Dissociative anaesthetic
- Induction - 2.2. mg/kg IV
- Central muscle relaxant
- Gives 10 min of Sx anaesthesia
- Short procedures - give intermittent bolus doses
- Long procedures - variable rate infusion (triple drip)
- Maintenance/intermittent IV bolus - 1/3 induction dose q 8 min, 2 min onset
- Variable rate infusion (triple drip) 100 mg/mL 10 mL
Midazolam / Diazepam (horse)
- Benzdiazepine
- Induction - 0.05 mg/kg IV
- Ketamine
- Midazolam is licensed
Thiopental
- Barbiturate, AKA thiopentone, injectable anaesthetic
- Not licensed for use in any species in the UK anymore, only used in certain situations.
- Only administered IV - if extravasation -> skin sloughing, presented as aq solution, pH 10, comes as dry powder + add water for injection, once made up, quite stable, store for month w/o bacterial growth.
- Eliminated by hepatic + renal metabolism, really slow in any case.
- Very rapid onset time of 20 to 40 seconds after IV injection
- Given in intermittent IV bolus of anaesthesia in horses, 1 - 2 mg/kg, when patient moves
- Not licensed, accum may affect recovery
- Horse
Colic - monitor
- Ausc GI motility - caecal flush in RD quadrant
- Water intake/faecal output
- Further investigation if in doubt - rectal examination
Colic impactions
- Fluids - enteric (nasogastric tube) isotonic fluids (5 - 8L) given q 2 - 4 hours to 500kg horse +/- Magnesium sulphate (osmotic laxative) or liquid paraffin (soften food in GIT)
- IVFT if horse dehydrated
- Analgesic - if showing colic signs, need to take entire clinical picture into account when choosing an NSAID and dose
- Management - stop feed, and-walking – if clinical condition allows
- Continue to monitor closely
Dimethyl sulfoxide
- Topical anti-inflam
- Thrombophlebitis
- Horse
Compagel
- Topical anti-inflam - acute inflam
- Thrombophlebitis - horse
Aspirin
- Anti-thrombotic
- Thrombophlebitis
- Horse
Ampicillin
- Aminopenicillin AB
- Ruminant - non-contaminated abdominal Sx
Amoxicillin
- Aminopenicllin AB
- Ruminant - non-contaminated abdominal Sx
- Ruminant - anaerobic contamination/infection established Sx
- Ruminant - suspected/known beta-lactamase resistance Sx (+ Clavulanic acid)
Penicllin
- Penicillin AB
- Anerobic efficacy
- Distributes well in into purulent material + necrotic tissue
- Ruminant - non-contaminated abdominal Sx
Streptomycin
- Aminoglycoside AB
- Ruminant - non-contaminated abdominal Sx
Cephalexin
- First gen cephalosporin AB
- Ruminant - non-contaminated abdominal Sx
- Ruminant - anaerobic contamination/infection established Sx
Oxytetracycline
- Tetracycline AB
- Ruminant - non-contaminated abdominal Sx
- Ruminant - suspected/known beta-lactamase resistance Sx
- DOES NOT WORK WALL IN PRESENCE OF PUS
Ceftiofur
- Third gen cephalosporin AB
- Ruminant - suspected/known beta-lactamase resistance Sx
Doxpram
- Dopram TM NSAID
- Postnatal asphyxia - stimulates respiration in neonates
- Calves, lambs
- No longer available
Prostaglandin (PGF2-alpha Dinoprost) (Lutalyse; Zoetius)
- Regression of luteal ovarian cysts but takes longer than P4, causes luteolysis (doesn’t work on follicular cysts as no CL present)
- Possible medical management for pyometra
- Endometritis - induces natural oestrus, delivery of WBCs to uterus, against T. pyogenes/E. coli
- Induction of parturition - what would be produced from placenta in parturition, can be used in combo w/ corticosteroids (150 - 270 days)
- Causes uterine contractions
- Interrupts CL + stops P4 production
- Canine CL not as responsive as other species
- Brachycephalic breeds susceptible to bronchospasm
- Need to ensure not pregnant + cervix is open
- Dog
- Cattle - 5 - 100 days (+/- 100 - 150 days)
Penethamate hydriodide
- Systemic AB used for mastitis, only systemic AB that can cross blood-udder mem + high conc in udder
- When more than one quarter is affected
- Cattle
Penicillins, lincosamides, 1st + 2nd gen cephalosporins
- Lactating cow tubes (LCT), intramammary AB - G+ bacteria for mastitis infections
- Pus
- Time-dependant + bactericidal
- Cattle
Aminoglycosides, 3rd + 4th gen cephalosprins
- Lactating cow tubes (LCT), intramammary AB - G- bacteria for mastitis infections
- Pus
- Time-dependant + bactericidal
- Cattle
Intramammary cloxacillin
- Only AB licensed in sheep for mastitis
Amoxicillin / doxytetracycline
- Systemic AB
- Calving injury - trauma to birth canal / neighbouring structures; uterine prolapse; metritis: puerperal (toxic) metritis, clinical metritis
Oxytocin
- After parturition (large animals)
- Contracts uterus + occludes small blood vv
- Post-partum haemorrhage - promotes uterine involution; persistent mating-induced endometritis (PMIE); metritis; hypogalactia/agalactia
- Uterine prolapse once replaced -> inc uterine tone / dystocia - post-calving for uterus involution
- Retained foetal membranes (low dose IM hourly)
- Milk letdown
- Toxic mastitis - cleans udder, milk let-down
- Maternal bonding
Metricure
- Intrauterine cefapirin - baceteriogical cure AB
- Chronic endometritis
- Only intrauterine AB licensed in cattle
- Esp when no CL present in ovary
Clenbuterol
- AKA Planipart
- Beta-2 receptor agonist = smooth muscle relaxant
- Dystocia - relaxes uterus for prepping birth canal in heifers + opens up uterus, aid to obstetrical manoeuvres; caesarean section (can find incision made); replacement of prolapsed uterus; uterine torsion
Oxytocin / calcium
- Uterotonics -> uterine contraction
- Dystocia
- Following Clenbuterol use - reverses effects
- Control of post-partum haemorrhage
- Management of uterine prolapse (after replacement)
Cloprostenol
- AKA Estrumate
- Synthetic analogue of PGF2-alpha
- Induces luteolysis
- Tx of pyometra; synchronisation of oestrous cycle
- Oestrus in 2-5 d depending on follicle size, serve to natural heat
- 2nd dose 10-11d later for fixed timed AI, ensures CL large enough
- Cattle, horses, dogs
- AE - can cause colic in mares due to smooth muscle contraction, don’t inject women -> abortion
Oestrous cycle synchronisation therapeutics summary in cattle
- CL = PG
- Follicle = GnRH
- Want to synchronise/don’t have anything = P4
GnRH
- When follicle/follicular cyst present
- Induces LH surge, gets rid of cyst
Calcium
- Hypocalcaemia when dec muscle contractions, weak contractions
- Dystocia
CIDR bolus
- P4 implants in comb w/ PMSG
- Equivalent of prid/exogenous jab -> endo P4
- Exogenous P4
- If starting cycle earlier
- Sheep
P4 + PMSG (pregnant mare serum gonadotropin)
- Induction and synchronisation of oestrus and ovulation
- Anoestrus
- Tighten lambing period
IV calcium borogluconate
- Calcium
- Hypocalcaemia
Butylscopolamine
- Anti-spasmodic
- LDA/RDA/RVA
Metamizole and hyoscine butylbromide (Spasmium)
- Analgesia, anti-spasmodic
- LDA/RDA/RVA
- Urolithiasis
Mg(OH)2 / Al(OH)3 / NaHCO3
- Intra-ruminal buffers
- Peri-op in rumenotomy
Tylosin
- Macrolide AB
- Aerobic efficacy
- But distribute well in purulent material necrotic tissue - pH trap into acidic solutions