High-concentration buprenorphine exceeds target plasma concentrations for extended periods following subcutaneous administration in American flamingos (Phoenicopterus ruber).

OBJECTIVE: To determine the pharmacokinetic parameters of a high-concentration buprenorphine formulation after a single SC dose in American flamingos (Phoenicopterus ruber). ANIMALS: 6 healthy adult American flamingos (3 males and 3 females). METHODS: A single dose of high-concentration buprenorphine (1.8 mg/kg) was administered SC to all birds. Blood samples were collected at 0.25, 0.5, 1, 2, 4, 8, 12, 24, 48, 72, and 96 hours after drug administration between October 14 and October 18, 2022. Plasma buprenorphine concentrations were determined by liquid chromatography-tandem mass spectrometry and a noncompartmental analysis was used to determine pharmacokinetic parameters. RESULTS: Mean ± SD peak plasma drug concentration (Cmax) was 195.1 ± 187.4 ng/mL, the mean time to peak plasma concentration (Tmax) was 0.32 ± 0.31 hours, the mean area under the concentration-vs-time curve from time 0 to the last measured concentration (AUC0-last) was 881.4 ± 205.4 ng/mL, and mean terminal half-life (t1/2) was 12.6 ± 3.86 hours. Mean plasma buprenorphine concentrations were >1 ng/mL for at least 48 hours after drug administration. No clinically significant adverse effects were observed. CLINICAL RELEVANCE: High-concentration buprenorphine dosed at 1.8 mg/kg SC in American flamingos rapidly exceeded plasma drug concentrations reported to have analgesic effects in other avian species and maintained these levels for extended periods. Sedative effects were similar to those reported for other species. Additional studies are needed to evaluate the clinical efficacy of high-concentration buprenorphine at this dose in American flamingos.

Keratinized Odontogenic Cysts in a Malayan Tiger (Panthera tigris jacksoni).

A 14-year-old male intact Malayan tiger (Panthera tigris jacksoni) was presented for a routine annual wellness exam and comprehensive oral health assessment and treatment, during which an odontogenic cyst was incidentally diagnosed from radiographs. Prior to a second immobilization for computed tomography (CT) and surgical removal of the cyst, the tiger developed anorexia, lethargy, and reluctance to train, which were clinical signs suspected to be reflective of pain secondary to the odontogenic cyst. A CT scan of the skull revealed 2 odontogenic cyst lesions associated with teeth 204-207 and 208-209, and associated tooth root resorption, focal lysis of the maxilla, communication with the left nasal passage, thinning of the ventral margin of the left orbit and maxillary foramen, and left mandibular lymphadenopathy. Complete enucleation of each cyst wall and surgical extraction of associated teeth were performed. Histopathologic findings were consistent with an odontogenic cyst containing keratinized stratified squamous epithelium, keratin debris within the cyst lumen, and a lymphoplasmacytic inflammatory infiltrate. Postoperatively, the tiger recovered uneventfully, clinical signs resolved within 2 weeks and have not recurred at the time of publication of this article. Similar keratinized odontogenic cysts are described in dogs, and there is only one other case report in a felid. This is the first known report of an odontogenic cyst in a tiger and of a keratinized odontogenic cyst in a nondomestic species.

Examination of the pharmacokinetics and differential inhibition of cyclooxygenase isoenzymes in New Zealand white rabbits (Oryctolagus cuniculus) by the Non-Steroidal anti-inflammatory Robenacoxib.

Effective rabbit analgesia is challenging, and there are few studies available on the newer COX-2 selective NSAIDs, such as robenacoxib. This study aimed to establish the pharmacokinetics of oral and subcutaneous robenacoxib, describe its inhibitory actions on COX enzymes, and develop dosing, using six healthy New Zealand white rabbits. Pharmacokinetics were determined from plasma concentrations after oral administration of robenacoxib (0.83-0.96 mg/kg) and also after subcutaneous administration (2 mg/kg). The inhibitory actions of robenacoxib were evaluated by measuring plasma concentrations of thromboxane B2 (TBX2 ) and prostaglandin E2 (PGE2 ) as surrogate markers of cyclooxygenase enzyme isoform inhibition. The mean maximum concentration for oral and subcutaneous administration was 0.23 µg/ml and 5.82 µg/ml, respectively. Oral robenacoxib administration did not demonstrate a significant difference between any time point for PGE2 or TBX2 , though subcutaneous administration did for both. There was no significant difference in PGE2 or TBX2 concentrations at any time point when comparing subcutaneous versus oral routes. Although the results support that plasma robenacoxib exceeds the therapeutic levels compared to dogs and cats, there was little significance in the difference in the changes associated with COX-1 and COX-2 inhibition. Further studies are warranted to determine appropriate dosing, safety, and efficacy in rabbits.

Evaluation of a primary care-based collaborative care model (PARTNERS2) for people with diagnoses of schizophrenia, bipolar, or other psychoses: study protocol for a cluster randomised controlled trial.

BACKGROUND: Current NHS policy encourages an integrated approach to provision of mental and physical care for individuals with long term mental health problems. The 'PARTNERS2' complex intervention is designed to support individuals with psychosis in a primary care setting. AIM: The trial will evaluate the clinical and cost-effectiveness of the PARTNERS2 intervention. DESIGN & SETTING: This is a cluster randomised controlled superiority trial comparing collaborative care (PARTNERS2) with usual care, with an internal pilot to assess feasibility. The setting will be primary care within four trial recruitment areas: Birmingham & Solihull, Cornwall, Plymouth, and Somerset. GP practices are randomised 1:1 to either (a) the PARTNERS2 intervention plus modified standard care ('intervention'); or (b) standard care only ('control'). METHOD: PARTNERS2 is a flexible, general practice-based, person-centred, coaching-based intervention aimed at addressing mental health, physical health, and social care needs. Two hundred eligible individuals from 39 GP practices are taking part. They were recruited through identification from secondary and primary care databases. The primary hypothesis is quality of life (QOL). Secondary outcomes include: mental wellbeing, time use, recovery, and process of physical care. A process evaluation will assess fidelity of intervention delivery, test hypothesised mechanisms of action, and look for unintended consequences. An economic evaluation will estimate its cost-effectiveness. Intervention delivery and follow-up have been modified during the COVID-19 pandemic. CONCLUSION: The overarching aim is to establish the clinical and cost-effectiveness of the model for adults with a diagnosis of schizophrenia, bipolar, or other types of psychoses.

NONINVASIVE SAMPLING FOR DETECTION OF ELEPHANT ENDOTHELIOTROPIC HERPESVIRUS AND GENOMIC DNA IN ASIAN (ELEPHAS MAXIMUS) AND AFRICAN (LOXODONTA AFRICANA) ELEPHANTS.

Elephant endotheliotropic herpesvirus (EEHV) hemorrhagic disease (EEHV-HD) threatens Asian elephant (Elephas maximus) population sustainability in North America. Clusters of cases have also been reported in African elephants (Loxodonta africana). Risk to range country elephant populations is unknown. Currently, EEHV detection depends upon sampling elephants trained for invasive blood and trunk wash collection. To evaluate noninvasive sample collection options, paired invasively collected (blood, trunk wash and oral swabs), and noninvasively collected (chewed plant and fecal) samples were compared over 6 wk from 9 Asian elephants and 12 African elephants. EEHV shedding was detected simultaneously in a paired trunk wash and fecal sample from one African elephant. Elephant γ herpesvirus-1 shedding was identified in six chewed plant samples collected from four Asian elephants. Noninvasively collected samples can be used to detect elephant herpesvirus shedding. Longer sampling periods are needed to evaluate the clinical usefulness of noninvasive sampling for EEHV detection.