Tramadol et AINS - Cannabis et propriétaires de chiens - Dexmédétomidine et méthadone



1/ Safety and efficacy of reduced dosage ketoprofen with or without tramadol for long-term treatment of osteoarthritis in dogs: a randomized clinical trial

Beatriz P. Monteiro, Cedric Lambert, Elena Bianchi, Jean Pierre Genevois, Giulio Soldani and Eric Troncy BMC Veterinary Research, 2019, 15:213, Published: 25 June 2019

Résumé : 
This study aimed to evaluate the safety and efficacy of reduced-dosage ketoprofen with or without tramadol in dogs. Five healthy dogs receiving standard-dosage ketoprofen (2 mg/kg SC, then 1 mg/kg PO daily) comprised Group A. Twenty dogs with osteoarthritis were randomized to receive reduced-dosage ketoprofen (0.5 mg/kg SC once; 0.25 mg/kg PO daily) alone (Group B) or in combination with tramadol (5 mg/kg/day PO) (Group C). Treatments were administered for 28 days. Platelet aggregation time (PAT), gastrointestinal (GI) endoscopy and glomerular filtration rate (GFR) were performed up to 60 days after treatment initiation. Pain was scored using a validated clinical metrology instrument up to D120. Data were analyzed with general linear mixed model for repeated measures (α = 0.05).
Results:PAT was not different between groups but was increased with time for all groups. GI lesion scores were higher in Group A than Groups B and C (day 28; P = 0.005) and were increased with time for Group A (P = 0.005). GFR was lower in Group A than Groups B and C (day 28; P < 0.01) and were decreased with time for group A (P < 0.001). Standard-dosage ketoprofen administration resulted in clinically relevant adverse effects. Pain score decreased in both treated groups (B and C) from D0 to D28. Need of rescue analgesia from D29 to D120 was higher in Group B than in Group C (P = 0.039).
Conclusions: The long-term safety profile of reduced-dosage ketoprofen is similar whether the drug is administered alone or in combination with tramadol to dogs with osteoarthritis. Analgesic efficacy of the combination looks attractive.

2/ Canadian dog owners’ use and perceptions of cannabis products

Lori R. Kogan, Peter W. Hellyer, Sarah Silcox, Regina Schoenfeld-Tacher Can. Vet. J., 2019, vol. 60, n° 7, p. 749

Résumé : Usage du cannabis et perceptions à l’égard de ce produit parmi les propriétaires canadiens de chiens. Le marché légal pour le cannabis récréatif et médicinal pour la consommation humaine affiche une croissance à l’échelle mondiale. La commercialisation des produits de cannabis pour utilisation chez les animaux de compagnie connaît une croissance. Pourtant, peu de travaux de recherche ont exploré les effets de l’usage du cannabis en médecine vétérinaire. Cette étude a mené un sondage en ligne anonyme pour évaluer les raisons des propriétaires canadiens d’animaux de compagnie d’acheter des produits de cannabis pour leurs chiens et leurs perceptions concernant l’efficacité de ces traitements. Les propriétaires ont acheté des produits de cannabis pour le traitement de la douleur, de l’inflammation et de l’anxiété chez les chiens et ils percevaient ces préparations comme étant tout autant ou plus efficaces que les médicaments conventionnels. La plupart des propriétaires ont signalé des effets secondaires minimaux chez leurs chiens. Malgré avoir indiqué de l’aise pour la discussion de l’administration de cannabis à leur chien avec leur vétérinaire, la plupart des propriétaires se fiaient à des sites Web commerciaux pour obtenir de l’information sur les produits. Les principales raisons pour le choix de produits de cannabis étaient la capacité de l’utiliser comme adjuvant pour les autres thérapies et la perception que c’était une substance naturelle. Compte tenu de ces renseignements, il incombe aux vétérinaires de bien conseiller leurs clients et aussi de préconiser des études factuelles pour évaluer l’efficacité de l’usage du cannabis chez des espèces non humaines.(Traduit par Isabelle Vallières).

3/ Clinical pharmacokinetics of a dexmedetomidine–methadone combination in dogs undergoing routine anaesthesia after buccal or intramuscular administration

Federica Di Cesare, Daniela Gioeni, Giuliano Ravasio, Alberto Pellegrini, Lorena Lucatello, Vittoria Bisutti, Roberto Villa, Petra Cagnardi J. Vet. Pharmacol. Therap., Version of Record online:14 June 2019

Résumé : This study aimed to define the pharmacokinetic profiles of dexmedetomidine and methadone administered simultaneously in dogs by either an oral transmucosal route or intramuscular route and to determine the bioavailability of the oral transmucosal administration relative to the intramuscular one of both drugs, so as the applicability of this administration route in dogs. Twelve client‐owned dogs, scheduled for diagnostic procedures, were treated with a combination of dexmedetomidine hydrochloride (10 μg/kg) and methadone hydrochloride (0.4 mg/kg) through an oral transmucosal route or intramuscularly. Oral transmucosal administration caused ptyalism in most subjects, and intramuscular administration caused transient peripheral vasoconstriction.
The results showed reduced and delayed absorption of both dexmedetomidine and methadone when administered through an oral transmucosal route, with median (range) Cmax values of 0.82 (0.42–1.49) ng/ml and 13.22 (2.80–52.30) ng/ml, respectively. The relative bioavailability was low: 16.34% (dexmedetomidine) and 15.5% (methadone). Intramuscular administration resulted in a more efficient absorption profile, with AUC and Cmax values for both drugs approximately 10 times higher.
In conclusion, the results of this study suggest that DEX (10 μg/ kg) and MET (0.4 mg/kg) administered simultaneously using the OTM route with injectable formulations are not readily absorbed through the oral mucosa in dogs. The increase in salivation (ptyalism) and the possible consequent swallowing of the drugs may have played a major role in this process. The blood concentrations of DEX and MET following OTM co‐administration compared with those administered via the IM route are not sufficient to allow rec‐ ommendation of this administration in the normal routine of surgical preanaesthesia. This type of sedative protocol requires more extensive studies, that is, with different formulations or larger groups of animals, before it can be suggested to be a viable clinical option. Despite these limitations, OTM administration of DEX and MET may be considered a useful tool in noncooperative canine patients that excessively react to intramuscular administration or that can be safely approached only by their owners to perform complete clinical visits. Dexmedetomidine and methadone administered simultaneously by an oral transmucosal route using injectable formulations were not well absorbed through the oral mucosa. Nevertheless, additional studies on these drugs combination using alternative administration routes are recommended.